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July 29, 2007

Why Count?

Istock_000003197973xsmall Most people understand that to have stronger muscles you have to exercise, but did you know that you also have to count?  I've run into a few folks who lift weights or use some type of exercise machine until they feel tired.  Their argument is that as long as each time you exercise you feel tired, well, who cares how many repetitions you do?  What matters is that your muscles are tired.  Right?

Not quite.  Yes, exercising until you're tired is better than not exercising at all but why not get the most out of your time every time?  Why waste it?  Counting the number of repetitions is important for a few reasons and I'll cover one of them today: fatigue.

What is fatigue?  "The inability to continue functioning at a prescribed work rate in the presence of an increased perception of effort."  The key word in this definition is perception. Fatigue is not just a physical phenomenon resulting from insufficient energy.  It also occurs when you think you're tired or you feel tired or you feel disinterested.  It's your perception of the effort that determines the degree of fatigue.  Have you ever tried to exercise when you're in a foul mood or bored?  What normally is an invigorating thirty minutes on the elliptical or jogging trail turns into a dreary, drawn out, will-this-ever-end session.  You feel or you perceive that you're more fatigued than you actually are.  If, however, I start yelling at you, "Get your butt in gear! Come on! You got more than that!" (just imagine me doing that - it will bring a wide grin to your face), you will suddenly be much less fatigued.  Your perception has changed.  This is why counting repetitions (or having other objective measures like revolutions per minute) is so important to getting the most out of your exercise session (even if you work with someone who yells at you).  Keeping track of repetitions forces you to produce consistent levels of effort and yields the best results. 

For those of you who have been to Sports Center, you know all about fatigue.  We rate fatigue on a 0 to 10 scale where 0 is no fatigue and 10 is extreme.  When you're training your muscles, you want a fatigue level between 6 and 8 on a scale of 10 that occurs between 15 and 30 repetitions.  Training at this intensity will give you increased strength and endurance which most of us need in everyday activities (getting bigger muscles is a completely different training regimen).

If you exercise without keeping track of your repetitions and fatigue level, one day you might perform 20 repetitions and another day 10, or 30, or 6 because you quit when you feel tired instead of pushing yourself to reach at least the level of performance you achieved in a prior session. Inconsistent training yields inconsistent results.  Each session you should push yourself for one more repetition, at least.  Write it down along with your fatigue level.  Week by week, your repetitions will go up.  Then, one day, you'll discover that you can perform 30 repetitions of a drill with a fatigue level of 4.  This tells you that you're ready to increase the resistance or weight. When you do, your repetition level will drop closer to 15 or 20 repetitions.  That's okay.  You're in the right zone; the right combo of reps and resistance or weight.

So, who's counting?

July 22, 2007

Is Back Pain Evolutionary?

Evolution_4 Should we blame our back pain on the evolution of the human form? Do we have back pain because we were really designed to walk on all fours (or at least use all of our limbs like apes) and some tweak in the evolutionary cycle converted us to upright beings thereby squishing our discs? A doctor from Cedars Sinai Medical Center in Los Angeles, California seems to think so.

Dr. Aaron Filler, a spine specialist, has come to the conclusion that a shift in the structure of the spine, based on fossil evidence of a ape-like creature called Morotopithecus, allowed humans to walk and carry objects. This then created the perfect environment for back pain.

Great. So, now we can blame our aching backs on evolution. It's not our fault that we sit on our butts most of the day, lead exceptionally stressful lives, skip breakfast, rarely workout, and pop pain erasers as soon as we feel anything uncomfortable. Nah...it's the way we evolved. That's why we hurt.

Well, someone needs to let Nigerian and Filipino farmers know because they have four times less back pain than the citizens of wealthier countries And the reason?  Well, most farmers are active, don't sit around, use their bones, muscles, discs, and work out their stress.

If you want your back to hurt less, move. You may need helpfiguring out how to move, how much to move, how often to move, but the answer for most back pain will not be found in the fossilized remains of a questionable evolutionary link. The answer is to move.

July 15, 2007

What's Fun?

Istock_000003203867xsmall The young man, about 22 years old, smiled as I approached the paint counter in Lowe's store. "Hey brotha', what can I do for ya?" he asked. 

"I need this primer tinted to match a certain color. Can you do it?"

"Hmm...not sure. Let me look."

As he opened the paint can, he asked, "So, whaddya paintin' ?"

"The outside of my house, well, at least part of it."

He stopped what he was doing, put both hands on the counter, and looked up. He said, "Man, I can't wait 'til I have a house to paint someday. That must be awesome." He turned and looked right at me and asked, "Are you havin' fun? I just think that would be so awesome to paint your own house."

"Fun? Well, I like painting okay. I'm not sure sure about fun though."

"Well, I gotta plan. I got me a real small apartment - cheap but clean - and I'm saving as much as I can every month. I got about two years to go and I can get me a small house. Just a two bedroom - that's fine by me. I just want a house and I can't wait to take care of it," he said dripping with sincerity.

When I went into the store, painting was about the last thing I considered fun. In fact, I may have been grumbling ever so slightly as I entered the store. His question made me think about the whole notion of what's fun and what's not.

When you want something badly enough, even the most tedious things can seem fun.

I think this is what helps some people overcome significant injuries or surgeries. They find the fun, somehow, in the process of recovery. What's fun about learning how to perform a quad set or how to stretch your shoulder, or how to move your knee cap around? What's fun about having to elevate your leg every hour for ten minutes, or lie down on the floor and prop up your legs on a big rubber ball or roll it back and forth? I don't know but I do know people who have found the fun buried inside these seemingly mindless tasks.

When you want something badly enough, you make a plan to get it and get excited by the plan.

My buddy at Lowe's wants a house and put together a plan to get a house. He doesn't seem to mind that it will take him three years to get there. He's not intimidated by the size of the task. He didn't say, "Man, I'll never get a house. I don't make enough money, houses are too expensive. Life sucks." If you want to beat an injury, you had better be like my buddy at Lowe's. Do the same thing. Figure out what you really want (run, hike, play with the kids, workout, etc.) and begin chipping away at the stack of boulders in front of you. Day after day after day. And, keep your eye on the prize not on the size of the boulders.

So, three things to think about this week: what do you really want, what are you willing to do to get it and can you have fun doing it?

Ciao.

July 08, 2007

Volleyball Anyone?

Sportscenter_volleyball "Hey - you wanna play?"

"Uhh..volleyball? I don't know...I'm.."

"We could use you. You're tall. Come on. It'll be fun."

I decided against playing and then spent the next hour and a half watching, wishing I had said yes. I wanted to play but feared the outcome. I hadn't played volleyball, beach volleyball, in a long time. I wondered if my spine, knees, ankles could hold up to the pounding. Things like, "What if I fall? What if I twist the wrong way? Maybe my spine will break again? Maybe my knees will swell? Maybe...what if..." and on and on swung through my mind like monkeys through the jungle.  I didn't want to spend the remaining time I had in Cozumel with a cranky back and a pair of whining knees. I had worked too long, too hard, and given up too much to let it all slide away over a volleyball game.

So, I played the next day.

I was lounging under a palapa and another person asked me to play. I looked at the net, then my wife. I had an odd combination of feelings like looking over the edge of a cliff into the deep ocean below and wanting to jump but wondering if the water was deep enough. She said, "You should try it. You might like it." Ellen is usually right - about a lot of things.

I told my sister-in-law that I hadn't played in about ten years. A not so subtle way of saying, "Don't expect much. I'm not very good." My team mates all wanted me on the front line. So, there I was front and center playing beach volleyball in Cozumel, Mexico.

The first few volleys were harmless. The ball sailed way over my head into the second and third rows but then the ball came up in my territory. It was slightly out of reach but I jumped up, reached with my right hand and tapped it into the second row of the other team. The ball came back quickly. I wasn't set but somehow, and I have no clue where this motor pattern is in my head, I jumped up, turned from the left to the right in the air, extended my left arm up and smashed the ball down to the sand with my left hand. My team mates yelled and clapped. I checked to make sure everything was still working. I looked up sort of stunned and shook my head. "Oh, I haven't played in ten years! I'm not really very good!" shouted my sister-in-law with plenty of good natured sarcasm. A lot of people laughed.

I played two games that day and three the next. No problems emerged other than calf and foot muscles complaining about working too hard in the sand. No back pain. No swelling of the knees. Zip.

Fear is an equal opportunity employer. It doesn't care how much you know, how much money you make, how skilled you might be. I was limiting myself because I was afraid of what might happen. I allowed the past to dictate my future. The facts, had I taken the time to list them, were overwhelmingly in my favor of a positive outcome in volleyball. They were:

  • I could squat on one leg with my bodyweight plus 20 lbs with good form and no symptoms.
  • I could run for 600 yard intervals and up to 10 intervals at a time.
  • I could lift 50 lbs. repeatedly without symptoms.
  • I could exercise 6 days a week including cardiovascular training and weight training consistently without symptoms and had for over one year.

Ok, so, the bottom line is this; being afraid of something when you are unprepared or incapable is one thing. If your knee hurts walking around the neighborhood or your back hurts when you are reading a book, yes, I would agree that you should wait on beach volleyball.  But when you're afraid because of what has happened before and that it might happen again even though you are capable and you know you are, you're just missing out on your life.

I want to be a player in my life not a spectator of my life. How about you?

July 01, 2007

You're Just Not That Into You

Istock_000003169860xsmall_2 "I don't do cardio. I just lift weights. You can't see any benefit from cardio - right? I mean really, weight lifting, is worth the hassle. My pants fit better, I look better, you know, I'm fit. I work out for results. Cardio is a waste of my time."

"So, you know that cardio is important for your health though, right?" I asked.

"Yeah, yeah. I know. But, it's boring and really, I can't tell that it helps me any."

And, how do you feel when you're done with your workout?" I asked.

"Feel? Tired I guess. My back hurts usually but it's not too bad. Just sort of stiff and tight. It's just annoying is all. I figure it's ok as long as I stay fit, right?" he replied.

Maybe his genes will protect him as he ages. Maybe his heart and lungs will continue to function optimally even though he demands less from them day after day. Maybe he won't have a heart attack, or wake up one morning and discover he can't move an arm because he had a stroke in the middle of the night. Maybe over two decades of research is just wrong.

Maybe.

Bottom line, this guy doesn't really care enough about himself to take care of himself. He just wants to look good - whatever that means. He exercises - sort of - but is willing to roll the dice on his health for a marginally toned body.

And, he hurts.

When you hurt during or after exercise and you keep doing it, you're just not that into you. You care more about what you look like, how others perceive you, than how well your mind and body work. You would rather have toned, taut hips or big biceps than a spine that feels good and works even better. You're chasing an image of your self that is not based on a healthy self.

Exercise to get healthy and stay healthy and your appearance will reflect that choice. Take care of your heart and lungs (cardio exercise), your muscles (weight lifting), your brain (balance and coordination exercise), and your mind (meditation, Yoga, Pilates) and you'll look as good as you feel.

Get into you.

Doug Kelsey

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    I am not your therapist and cannot give you specific advice. Please call your board-certified physical therapist (you can get a list of therapists from http://www.apta.org). Client stories are based on true events and, unless I have permission to use names, I have changed any personal identifying information. Resemblance to any person alive or dead is purely coincidental. Believe me, it's not all about you. However, if you are my friends or family members, you'll likely show up in my stories. I express my opinions, freely. They may not match yours - that's ok.

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