The View from Sports Center

If the Shoe Fits, Will it Make You Fit?

There are "innovators", "early adopters", "early majority, "late majority" and "laggards" when it comes to trying or buying new things. It's called the "innovation curve".  I'm on the "innovator" to "early adopter" side of the curve. One of those guys that buys new stuff just to try it out; curiosity more than anything (besides, who wants to be known as a "laggard"?

So, a few years ago, I bought a pair of MBT sandals, Chung Shi shoes, and Spira shoes. Oh, and I bought a pair of Kangoos too.

To be fair to the folks I bought them from, no one told me I would become fitter by wearing these shoes (I think they were just happy to see me drop in every couple of weeks).

That's not what Reebok would like you to think though.

They have come out with a shoe that they claim makes you fitter as you walk.

The EasyTone.

Really?

No. Sorry. The science behind this says otherwise. The shoe alone has no additional benefit other than perhaps convincing you to walk more than you would otherwise because you think that doing so will give you legs and a butt to die for.

Researchers at the University of Wisconsin studied three shoes: MBT, EasyTone, and Sketchers' ShapeUps (you know, the ones Joe Montana wears in the ads). They looked at muscle activation among these shoes and regular running shoes and concluded:

"All three toning shoes tested showed no statistically significant increases in either exercise response or muscle activation during the treadmill trials, when compared to the normal athletic shoes tested.  There was simply no evidence to indicate that the toning shoes offer any enhanced fitness benefits over traditional sneakers, despite studies cited by manufacturers seemingly “proving” the toning shoes’ effectiveness."

Ok, so if the shoes don't make you any fitter, why buy them?

Like I said, I buy a lot of stuff just to try it out; see what works, how I can use it, etc. Here's why I bought some of these shoes:

1. I have multiple joint (ankle, knee, spine) degenerative joint disease; couple of Schmorl's Nodes in my thoracic spine. So, reducing impact load for things like jogging makes sense. Thus, the Spiras and Kangoos.
2. The MBT sandals are just about the most comfortable sandal type shoe I've worn. And again, the reduction in impact is nice on the joints so if I know I'm going to be standing around for quite  a while, I'm apt to wear them.
   
3. The Chung Shi shoes force you to walk into the "fall line". They have a ridge across the bottom of the shoe which tends to rock you forward. This will naturally make you walk faster. And, they're also comfortable.
4. Spira shoes also reduce impact load. Their claim to fame was getting banned by the United States Association of Track and Field because the USATF thought the shoe would provide an unfair advantage due to the springs in the shoe.
   
5. The Kangoos reduce the impact of running by about 50%. So, for me, especially after a meniscus tear that hasn't completely healed, reducing impact load makes a of of sense. Yes, they tend to attract a lot of attention. One guy walked up to me and hollered, "Do those things really work?" I wondered what he meant. Work for what? I just said "Yeah" and kept running.

Bottom line, you get fit by stressing your body and for some people buying one or more of these shoes will do that simply because they'll be more active in the shoe than otherwise. But, the shoes alone aren't as magical as their marketing.

A Heart is not a Heart: Do Women Need a Different Heart Rate Max Formula?

Figuring out your maximum heart rate used to be simple: 220-AGE.

That's what I was taught in school. That's what most people, if you ask, will tell you.

Of course it wasn't exactly right either and there's an interesting history behind maximum heart rate.

The year was 1968.

Bill Haskell, an exercise physiologist at the U.S. Public Health Service had been given an assignment by his boss Sam Fox, MD.  Dr. Fox, a cardiologist, was scheduled to talk at a World Health Organization meeting on exercise and heart disease.  Haskell's job was to collect research on maximum heart rate testing. All the experts agreed that exercise was important following a cardiac event or if you had heart disease.

But, at the time, no one knew how hard a person should exercise following a heart attack. Haskell assembled the information and plotted the results on a graph. He and Fox studied the graph and discovered a pattern. By drawing a line through the data points, Haskell found that the maximum heart rate at the intervals of 20 years, 40 years and 60 years, was 220 minus the age. Haskell and Fox presented their finding at scientific meetings in Tel Aviv and Tuxedo Park, New York. In 1971, they published their formula that was to become the gold standard for exercise.

The problem with their discovery was the studies were done only on men all under the age of sixty who did not exercise regularly. Haskell and Fox did not actually perform any research. They compiled data from existing studies. So, their formula was not valid for all people. For a valid study, the results must be true in other places, with other people and at other times. Since Fox and Haskell's work was only on men under the age of sixty, the formula was then only valid for sedentary men under the age of sixty.

Now, new information from Northwestern University in Chicago, suggests that women need their own formula: 206 minus 88 percent of a woman’s age.

The old formula for a woman age 40 was:

220-40 = 180 beats per minute.

The new formula is:

206-(40*.88) = 171 beats per minute.

The researchers followed over 5400 women for 16 years and discovered a link between abnormal heart activity and risk of heart attack. That's also when they discovered the new formula.

Some women who used the old formula (based on men under the age of 60) found that they could not sustain the heart rate, got frustrated, or exhausted during the exercise. The new formula should correct that making exercise more productive and useful.

But, you may not want to wear a heart rate monitor or stop and take your pulse while jogging or running or cycling. If so, you can read about a different method by clicking here.

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Gulati, M., L. J. Shaw, et al. "Heart rate response to exercise stress testing in asymptomatic women: the st. James women take heart project." Circulation 122(2): 130-7.

Follow my recovery from a meniscus tear here. 

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Here's what one reader had to say about it. "This was great reading. "The Little Book of Sparks" inspired me to live a healthier lifestyle. Each chapter in the book motivates me to do something daily to keep my mind and body healthy and active. This is a book that's entertaining, and filled with simple suggestions that when applied to our daily routines make a positive difference in our health and happiness" - David

What Do I Do for Hip Pain?

I am 61 years old and am most happy when I am hiking, biking, dancing or kayaking.  Degenerative joint disease in my right hip (which an x-ray showed at my last check-up) does not fit into that lifestyle. I have recently been in enough pain to the point that simple walking and even garden work causes pain. I do not want medication.  I want to cure this.

I am going to do your “tailgator” program for my hip.  What other exercises should I do? I have been helped by a physical therapist who gave me exercises to strengthen the muscles in the area…what else should I do? 

I figure that the only aerobic exercise that would be low impact would be swimming, but what about weight bearing exercise for osteopenia?

I am motivated to do anything to fix my problem.

Thanks!

Deborah

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First, thanks for reading Deborah. And, for sending in a question that a lot of people may also have.

To overcome the effects of osteoarthritis, you have to assemble a game plan that includes several things. And the game plan is modified some according to your unique set of problems so this a general strategy to get you started.

• Anti-inflammatory diet. Here's a really good overview of the anti-inflammatory food pyramid. What we eat or drink can greatly influence how our body reacts to physical and emotional stress and can even create inflammation from the nutrients. An anti-inflammatory diet helps you reduce the pro-inflammatory markers produced by these stresses.
• Adequate flexibility of the lumbar spine, hip, and ankle. When joints are sensitive to load, as in OA, inflexibility above and below the joint, can increase force transmitted through the painful joint. Your physical therapist should be able to tell you whether you have enough flexibility and how to improve it. I perform a series of biomechanical tests to help identify movement faults due to weakness or inflexibility but that process is way too detailed to go into in a blog.
• Excellent core muscle endurance. You can test your core endurance with the side plank test. You should be able to hold the position for 20 seconds on each side (see image). If you fail this test,  you have to work on developing the core. You're after endurance not strength. Read anything by Stuart McGill for ideas.
• Low load, high volume motion. I prefer the Total Gym for this. There are other devices that are similar (Body Rail, Vigor), but I haven't used them. You have to find a level of force that is very comfortable to your hip. Usually that will be around the 3rd or 4th rung on the Total Gym. You squat until your knee approaches 90 degrees. It's not a sprint. Slow, comfortable pace. Lots of repetitions. I usually start with 10 minutes, take a break, work on other things, then come back and do another 10 minutes gradually working up to 30 total minutes per day.
• High volume motion with almost no load. Hip swingers is what I use most of the time.
• Muscle strengthening. You know about this, but you have to be careful. The loads produced by the muscle contractions can overload the joint. The muscles to concentrate on are the hip rotators and abductors. 
• Cardiorespiratory exercise. What you do for this depends on how much force your joint can withstand. I will use swimming, ellipticals, walking or exercising in water. In the clinic, we have an anti-gravity treadmill so we can help people walk or even jog without overloading the joint. I shoot for 30 minutes with a 12-13 Rating of Perceived Exertion.
• Supplements. Here's an article I wrote about this. Try to avoid taking NSAIDs as much as you can. Sometimes you have to but I've had clients who turn to NSAIDs at the first sign of pain. Give your body a chance to fight through it. NSAIDs have been shown to weaken the joint cartilage with prolonged use.
• Get real. This is the hard part. You have to accept how much your body can do without injuring your self over and over. While you're working on rebuilding your joint capacity, you'll likely have to let go of doing certain things, and most of these are things you really love to do, until your joint is strong enough to withstand the loads of those activities. If you don't do this, you not only continue to hurt, you'll advance the disease process and simply lose more and more things from your life over time. There's a phrase from Buddhism that I like a lot - "The Middle Way". It means finding the path between too much and too little. Avoid the extremes. 
• Meditate. Meditation calms the sympathetic nervous system - the fight or flight part of your body. It helps you clear your mind of the past and future and just focus on now. I especially like Dale Goldstein's "Awareness Meditation" audio guide.
• Journal. Gratitude for what you have, for what you can do. There are always people worse off the you.

If you start working this list, you should start feeling better. The thing to remember is that your body is amazingly adaptable. Just give it a chance and you can really improve a lot of things in your life. Just because you have changes on x-ray doesn't mean you're doomed to a life of sitting on the sidelines watching everyone else enjoy themselves. But, you must be patient, persistent and disciplined.

I hope this helps you.

Follow my recovery from a rotator cuff tear here. I post new stuff every day or two generally.

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Do you have a copy of my book, "The Little Book of Sparks"? You can read a sample and order it here.

Sirens of Temptation

"It's just SO nice out! I just HAVE to go for a run!"

"My yard was so sad and it was so beautiful outside! I just HAD to work on it!"

The Sirens of Temptation. Injury be damned. I'm not dead yet. And all the other things we say to ourselves to give us permission to do stuff which is actually harmful.

Uh-huh.

I get it. 

In fact, read about my night of bowling with a rotator cuff injury to learn just how much I get it.

What is Strength?

What does it mean to be strong?

Is it the amount of weight you can lift? Bench press? Biceps curl?

Or, how fast you can lift it? An Olympic clean and jerk for example?

Or is it how well you can control the weight you lift at the speed you lift it?

The formal definition of strength is the maximum amount of force a muscle or group of muscles can produce under specific circumstances.

Strength is condition specific.

So, in light of that, check out this video for a stunning display of strength in action.

Wow.

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For the latest on my shoulder recovery, click here.

Post-Prolo: Day 1

You can find my journal of post-prolo recovery and my shoulder rehab here. From the main page of the blog, look on the left hand side below READERSHIP and you'll see a link to "Shoulder Recovery and Rehab". It'll be one page so all of the entries will be together. When I add something, I'll post a link to it.

Onward....

The Mistakes Marathoners and Half-Marathoners Make

Running season is gearing up. For those of you into the long runs, here's a good article on the common training mistakes runners make for a marathon or half-marathon.

Barefoot Running

Several questions recently about barefoot running so here's an interesting article on the subtle shift in load by changing from a heel strike to mid-foot running style and here's a site that digs into the differences between a conventional running style and barefoot.

And yes, I dig my Vibram Five Fingers. But, you have to work your way up to a sustained amount of running since your calf, Achilles tendon, and buttock muscles are not used to doing so much work. Or at least mine weren't :-)

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Do you have a copy of my book, "The Little Book of Sparks"? You can read a sample and order it here.

Bring It

I still think about Cirque from time to time. He was such a great dog, companion, buddy. One of the things I used to love to do was watch him wait. He would spot a squirrel and turn to stone. Crouched, poised, still. He could wait forever. Just letting the power inside him build and when he sensed it was time to go, he would explode after the squirrel. Full force. Nothing half-way.

I never saw him catch one but the failure never changed his attitude. Every time, Cirque would bring it.

Thinking about Cirque and his ability to bring it, made me think of how sometimes, we need to be more like him.

Don't underestimate what it takes. Cirque knew that to catch his prey, he needed all of his energy so he prepped for it. He removed all other distractions. He wouldn't even look at food or a treat. He was all business; just getting ready. Sometimes I've failed to realize just how much effort or energy something is going to take and I approach it with 50% or 70% thinking that it will be enough. It never is. Even simple things, like making the time to re-train my shoulder, take more time and energy than I realize and, as a result, it can be frustrating. You'll be better off if you overestimate the energy or time involved and prep your self.

Give the effort your full attention and energy. I use a phrase, "Give your intention your attention" when I teach drills to clients or help someone carve out a path to a goal. What's the intention? For Cirque, it was to catch the squirrel. Simple. And, every drill, every action, every plan has an intention. Find it, drill it down to a simple sentence and hold it on your mind. Give it all of your attention.

Hold nothing back. When you finally do take action, do it. Give it all of your effort. If I see a client performing a drill haphazardly, I know either we've not conveyed the intention well or the client has lost focus and is holding back. Don't waste your time with a half-hearted effort. When Cirque made the decision to go after a squirrel, he didn't trot or skip along gently wagging his tail hoping the squirrel would look at him and think, "Oh, what a nice dog! Let's play!". He moved like he had been shot out of a cannon. Bam! It's not the speed that's important. It's the effort. Even when you do something like meditate, you give the task all of your effort even if your effort is to let go.

Let failure motivate you; not deter you. Cirque would just gear up and go again. Never hung his head, moped around the yard, whined. Nope. He just was sure he could catch the next one. It's so easy to let the negative energy of a setback seep into your mind and contaminate your thoughts, words, and actions. Learn what you can from what didn't work and rise another day and gear up.

Try applying to your life what came naturally to Cirque and see if it doesn't help you. I'm betting it will.  

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P.S. - We're looking for a physical therapist assistant (PTA) to join our team. You should be eager to learn, want to be part of a team, enjoy a fast paced environment, and absolutely love helping people. If this is you, email a one page letter describing why we should hire you along with your resume to [email protected] Also, if you really want to stand out, do what some of our other staff have done and email us a short (60 second) video of your self explaining what's great about you and how you could help our team.

You can comment on any post by clicking "COMMENTS" at the end of the article. Share your opinions and ideas!

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New to the View? Consider subscribing to my RSS feed: Subscribe to this blog's feed. Or sign up to get email updates in the box at the top left hand corner of my blog and then share this blog with your friends.

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Do you have a copy of my book, "The Little Book of Sparks"? You can read a sample and order it here.

Being Active is Not Enough

"...My doctor said my heart and lung function looks normal (whatever that means), but that there were some signs of "de-conditioning".  I asked him what he meant by the term and he said 'You are not in as good shape as you once were.'  Kind of cryptic.  And, how does a CPET show that kind of thing, anyway? Well, needless to say, I was pretty surprised, given the fact that I run 3 miles twice a week and swim for 40 minutes twice a week.  But, I guess I am not placing as much demand on my body as I need to be.  Apparently, I have some degree of muscle atrophy, including heart muscle, due to not having to deal with high demand.  Maybe I am not getting my heart rate up high enough for long enough snaps of time.

I was telling Sandra that it is bothersome to come to the realization that I have probably spent 20-25 years getting exercise solely to avoid GETTING FAT (which I think I have mostly managed to do) and have falsely concluded that if you exercise enough to burn off the calories you are taking in, then you are IN SHAPE.  But, in fact, if you don't constantly place some level of DEMAND on your body, you are going to end up getting OUT OF SHAPE, no matter how many calories you burn.  What an eye-opener.
 
Doing a little research today, I also learned that over time most people lose muscle fiber (natural aging process) but also lose muscle mass due to living sedentary lives.  The loss of mass is largely reversible.  But here is exactly where the problem comes in - being something other than non-sedentary is NOT ENOUGH. 
 
Better late than never, I guess."

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That was from my brother, Josh (and he said it was ok for me to share this with you).

He had a CardioPulmonary Exercise Test (CPET) which is a test that evaluates your heart and lung function and how well your body uses oxygen. Although his test was fine as far his heart and lungs were concerned, his physician dropped the "D" word on him: de-conditioned.

"De-conditioning is adaptation of an organism to less demanding environment, or, alternatively, the decrease of physiological adaptation to normal conditions."

So, what Josh is struggling with is that although he has consistently exercised for years (running and swimming), he is not as fit as he needs or wants to be (but he was certainly fit enough to kick my butt in golf a few weeks ago).

How is this possible? How could be unfit or de-conditioned?

Fitness is being suitably adapted to the environmental demands - physical, mental, and emotional. It is the adaptation of an organism to the demands of the environment, or alternatively, an increase of physiological adaptation to normal conditions (that's my definition by the way).

So, one of the problems is that your body will adapt to the demands you place on it and unless you deliberately and periodically raise the demand, you will become less fit over time.

If you use running to stay "fit", you have to work on running faster or using speed intervals to increase the demand. The same would be true for swimming.

But, it still may not be enough.

The human body has been designed to work through multiple planes of motion and withstand demands across several domains (think of power, stamina, strength, flexibility, balance and coordination, aerobic capacity).

If you're not training to achieve fitness across those domains, you lose "fitness" and the only way you'll know you're not fit (unless you have a special test like a CPET), is when you need to call on one of those domains and it's not there.

Your training should be persistent while consistently varied to achieve maximal adaptation across fitness domains.

Bottom line, as my brother pointed out, just being active is not enough to be fit. You have to embrace the demand.