Tuesday, December 5, 2017

Achilles Tendon Rupture: Pre Surgery Day 1-3

When it comes to injuries, hindsight is 20/20.  It's easy to look back in time and create the why.  It's also easy to chalk up injuries to bad luck.   As a Strength coach and Chiropractor/therapist I want to know the why's.  I don't believe in bad luck.  There are reasons.  I don't know all of them, but we do our best to learn and move on.  We also have to be careful to not just create reasons because it fits with our need to have answers.

Sunday morning I had a complete rupture of my left achillies tendon.  I somehow saved my bike from a slide out, I must have used my leg as a kickstand and I felt someone run into or kick my calf.  I looked behind me to see who was there, and in that matrix like moment, time slowed, I saw no one, dropped an f bomb and knew.  I knew instantly when I didn't see anyone behind me.  In the seconds that processed through my brain I thought, here comes the next year of my life.

I've had on and off pain in this achillies tendon for over 10 years.  So chances are there are some decent amount of degeneration in the fibers before the rupture.  From a mechanics stand put, this ankle has lacked as much dorsiflexion in it since a pretty bad ankle sprain that limited life for about 6 months as a freshman in college, jumping over a wall and landing on a parking berm.

Take Care of Your Joints.

It would come and go the inflammation around the achillies.  One thing I've neglected is dynamic loading when I was feeling good.  We know you need to use the qualities you want to keep.  Healthy tendons need load, eccentric strength and must go through stretch shortening cycle.  This had started to fade over the years.

Variable Loads Are Needed.

I normally take my HRV every morning, but I had just finished getting over a weird cold that seemed to last 18 days and had gotten out of the habit.  It had left me with good power in terms of strength, but anything over 160 heart rate I was wiped out.  Part of me thinks I was still fighting something, had extra inflammation in my system when this all when caput.

When I got home from the ER, that Sunday reached out to a bunch of friends and got some surgeons names that were recommended.  I was able to see my Doc Monday morning and he stated it was a bit higher then normal.  I said, great more blood flow!  He said yes, but less tendon to work with.  (here's hoping I'm right)

A good friend sent me to the website of Dr. Amol Saxena, one of the leading foot/calf guys in the world.  He performs lots of achillies surgeries on athletes who's livelihood depends on it.  He lays out a great rehab protocol.  Week by week.  Post Op Rehab Achillies

Nutritionally I'm going to do a very high protein, high fat, low carb diet for at least a month.  Essentially eat no junk and try to limit inflammation.  Bought a bunch of high quality bone broth to drink multiple times a day to see if I can maximize connective tissue health.

Have a Plan

ALTIS just posted a nice recap of their Coaching program and one thing that stuck out was this from Matt Jordan.  1.  Know what matters.  2.  Measure what matters.  3.  Change what matters.  Dr. Saxena has seen hundreds through to the return to running and 3 things matter.  1.  Perform 5x25 single leg raises with 15 seconds rest between sets.  2.  Have a post operative limb within 5mm of the good leg.  This is tricky as mine was already 1.5-2 cm smaller from when I had a back injury to the left.  My goal will be to get as close to the size pre surgery.  3.  Have ankle dorsiflexion and plantarflexion of 5 degrees of the good limb.  If access to an AlterG run 85% bodyweight for 10 minutes.

Be Abel to Measure Your Plan

Surgery is in the morning.  Then the fight begins.  It's been humbling to feel and hear all kinds of support from family and friends.  My wife has been amazing.  Funny, after my first thought of oh shit I tore my achillies, my 2nd thought was, Kelly is going to kill me!  lol

Instagram @drjasonross

Wednesday, November 29, 2017

Developing a Template and Momentum for 2018

When you watch a lot of sports you get a sense of the power of momentum.  It's a very weird thing to witness.  One team seemingly has control, but one play later and things can change.  That one play leads to another.  Everyone can feel it.  Players that weren't making plays, start making spectacular plays.  The ball starts bouncing their way.   Momentum is powerful.

"Momentum solves 80% of your problems. "  John Maxwell

This is about building some momentum going into the new year 2018.  People want to think that a new year is a new you.  There hoping that some extra magic happens because they watched a glittery ball drop.  

Instead of starting from scratch, prepare, get it going.  Preparation is the key to getting where you want to go.  Most peoples new year resolutions revolve around being more healthy.  That is hard to define.  So take the time to define it.  Perhaps it means losing 15 pounds.  Getting your blood pressure low enough to get off medications.  Complete a 100 mile bike race.  Do your first 5k.  Walk a 12 minute mile.  Eat 3 servings of vegetables a day.  The list is endless. 

Step 1.  Define in very specific details what you want to accomplish.  
This needs to be written down.  Research has shown that what gets written by hand is a much more powerful way of doing things.  Buy a journal/writing pad that can be used daily for a year.  Get a pen with blue ink.  Research says we remember blue ink better then black ink.  (It can't hurt!)

Now, one can have more then one goal, but it's hard to have 3 or 4 specific and different goals.  But, some goals become very similar when you break them down.  I'll have several people tell me they want to get to the gym more, eat better, lose some weight.  At the end of the day, they are all kind of the same goal.  Write a book, lose weight, attend all my kids games, make more money.  These are all very different goals.  So choose wisely.  

Step 2.  Figure out what you are going to give up.  This is the power of negativity.  Example is giving up smoking.  Your not doing anything extra, but your stopping doing something that isn't healthy.  Perhaps it's giving up your happy hour with friends or one night out a week.  Giving up TV, cable.  Giving up buying a treat with your coffee.  Make some time for what your trying to do.  At the very least, by examining your week/day hour by hour, you will be much more conscious on how you are spending your time.  

"How we spend our days, if of course how we spend our lives.  What we do with this hour and that one is what we are doing."  Annie Dillard 

Step 3.  Make a list of all the Micro things it takes to accomplish your goal.  
Take the Micro and make it Macro for awhile.  I call this the consistency beats intensity.  We all know the person that is gung ho for a few weeks and then fades like a shooting star 3 weeks in.  They stuff every possible new habit into the day.  Wake up early, eat a crazy smoothie, hit the gym, run, cook every meal, do yoga, no TV, go to bed early, read that book.  3 weeks later, they are stressed out and burned out.  

Take what you envision to be your ideal day and mold that day into a week.  Instead of cooking every day, pick one dinner out of 7 and cook that one.  Get that one meal down.  What to buy for it, what to keep in your fridge to make it.  Did you cook that one meal one time in the week.  That is a check mark in your journal.  

Instead of hitting the gym everyday.  Get to the gym one time. (Gym is just a word for lifting weights)  Work out for 45 min doing something you enjoy.  Did you do that one time this week.  Check it off in your journal.

Did you floss your teeth one time this week?  Did you elevate your heart rate for 30 min one time this week (aerobic stuff).  Check those boxes off.  Wake up early one day, go to bed early one day.  Check those boxes. 

The idea is to make a checklist of what your vision of a perfect day is.  Then expand your day to a week.  So it's not about burning out day to day, it's about building slow growth over the course of that week.  Get momentum, (there's that word again).  Create consistency with smaller commitments that will most likely bleed into bigger ones.  Also check those boxes, for real.  Are brains are wired to achieve pleasure in marking off things done.  They are victories after all.  

Step 4.  Remove Restraints
Listening to Freakanomics Podcast on Behavior Change and they interviewed Daniel Kahneman.  He had a great idea that he credited to Kurt Lewin, that peoples behavior is driven by two main forces.  Restraining and Driving and our behavior is the equilibrium between these two.  There are two ways of going about influencing behavior.  Get rid of the restraining forces or increase the driving forces.  Increasing the driving forces is a poor choice, getting rid of the restraining forces is the key.  

Instead of trying to figure out how you can eat more vegetables, figure out why you aren't doing it in the first place.  This goes for everything.  At the end of the day, we all have more then enough information.  We need more application.  One by one address the answers that pop up with the question why not.  Remove the restraints to make moving forward easier.

I never have vegetable in my fridge when I get home from work.  (Every Sunday I'll buy vegetables)
I go to make them and they have gone bad.  (Ask the groceries or Google what are the best vegetables that last a full week or how to store vegetables.  
They taste bad.  (two recipes on google with spices that create an enjoyable eating experience)
Clean up is annoying and tiring (aluminum foil on a cookie sheet)

Step 5.  Create Discipline
Look at your week and write down when you are going to do what.  Obviously make sure that it's a real time commitment.  Can't hit the gym at 530 if you routinely get out of work at 545.  No matter what, commit to what you put in writing no matter what you "feel."

Feelings at the end of the day are irrelevant.  I don't feel great, so I'm going to skip the gym today.  I feel tired, so I'm not going to cook tonight.  We have all said that and done that.  How many of us have said I'm still tired I'm going to lay in bed and not show up to work?  My kid is really bothering me today, I don't think I'll take the time and get dinner for him.  Can you see how silly that sounds.  We can keep commitments when they are obvious.  Just eliminate feelings as a choice. This is how discipline is created.  Doing what you said you would do.

"Discipline Equals Freedom"  Jocko Willinck

Get started now, create momentum to hit the ground running in 2018.  Don't wait for the glittery ball to drop.  

Wednesday, November 8, 2017

Patience in 2.5 Unit Increments

There are a lot of quotes on patience.  A quick google search will brings hundreds of memes that extol patience.  We all know we need it, very few of us want to use it, even fewer of us want to be in situations that require it.  I speak from experience.

 We all know it's useful but unless there are concrete actionable steps to take, be patient becomes just another saying.  Want to be successful, early bird gets the worm.  Cool.  Wake up early and then what?  See what I mean, memes and saying look nice on a quote board, but unless a plan is in place, sayings are just poems.

I came across an article about a man learning to use the 2.5 minute rule with his kids.  Every task, partition an extra 2.5 minutes because kids are slow, less dexterous, and some things aren't memorized motor tasks.  Ask them to put their shoes on, extra 2.5 minutes.  We can slip our shoes on literally in a few seconds.  Not so much for young kids.  Tasks like this.  Give yourself and your kids this leeway.

I learned early on that you need to partition extra time when you are taking your kids somewhere.  I learned it so well almost 6 years in with kids, that I'm only late like 3 out of 5 times.  Of those 3 times, I'm sure I was a bit stressed and I'm sure I stressed them as well.

There was no plan.  If you don't have a plan, you ultimately don't succeed often, when you do, it's probably by luck.  Give your self "extra" time is just arbitrary.  2.5 minutes is concrete.

When I first started lifting weights.  The only principle I understood was that if I put more weight on the bar then the last weeks effort, I was getting stronger.  If I kept doing this, I'd get to where I wanted to go.  So I used those small 2.5 pound weights every single time for my last set.  If I beat my last weeks effort, I'd go up 2.5 pounds on each side the following week.  If I didn't I stayed there.

Those 2.5 pound weights got me where I wanted to go.  They also taught patience.  You don't go from squatting 135 pounds to 405 pounds in big increments.  Your body needs time to build up connective tissue, motor unit recruitment, cross sectional muscle development, vascular networks and loads of other physiological adaptations.

One of the things I've noticed with myself is the lack of patience with some of my bigger lifts in the last few years.  I've also noticed lack of progress.  Part of it, is just being content at staying at a certain weight.  Part of it, was just lack of patience.  Wanting to just get
in get a lift in, but not having the patience to commit to slow progress.

With winter coming, patience in 2.5 unit increments is becoming a concrete goal.

"The two most powerful warriors are Patience and Time."  Leo Tolstoy

Monday, October 2, 2017

The MOBI Is A LifeStyle Tool for Better Movement and Recovery

We know that information doesn't lead to change.  Facts are not enough to convince us to do something or change a habit.  Would anyone still smoke if facts were enough?  We all know some very basic health facts, that not all of us do.  Do we all floss?  Do we all eat 3-5 servings of vegetables a day?  Do we all wear a seatbelt?

So if facts don't change our habits, what does?

Charles Duhiggs book the Power of Habit is one of my all time favorites.  In it he outlines a habit loop that consists of 3 parts.  Cue, Routine and Reward.  

1.  Cue.  Some call it the trigger or reminder.  This is usually visual.  I see it, so I'm reminded to do it.
2.  Routine.  Because of the cue, you proceed to do what has been determined to be correct action.
3.  Reward.  Because of the action taken, we usually have a burst of dopamine that reinforces good behavior.  For example, floss tonight and you will feel accomplished.  I took positive steps towards my goal.  

We created the MOBI to be a musculoskeletal tool for your connective tissue.  Part recovery tool, part mobility tool, but 100% lifestyle tool.  What does that mean?

Our goal was to create a visually appealing, aesthetically sound device that feels natural to have around.  It feels good to hold in your hands.  It doesn't look weird to be laying flat on your desk at work.  It travels well regardless if its a backpack, computer bag, yoga mat or gym bag.  

We wanted something that was around.  Visual cues.  I'm an out of sight out of mind type of person.  If I see, I do.  I keep post it's on my computer of things I have to do.  If I see the book I'm reading on the couch, I pick it up and read it.  If my kids knock it under the couch, I tend to almost forget about that book.  The biggest benefit to MOBI in my eye is the greatest asset any athlete can possess,  availability.  If an athlete is not available, they are not helpful to their team.  If something can help you, but you don't have it with you, in the end it's not helpful.   MOBI is designed to be "available."

If your foot has pain with walking, of course you will be reminded about trying to do something for your foot.  But, why wait for pain.  We have been taught at a young age to brush our teeth morning and night, not because they hurt, but because they keep our teeth healthy.  

What did your parents, coaches or health practitioner teach you about the rest of your body.  Do you have a physical practice or routine that helps the muscles, fascia and joints to move and feel better?  

Do you do something daily that helps with how your body recovers or moves?  

I want MOBI to be that tool that becomes your cue.  We have created videos that show routines to help create small 60 second actionable steps to form your own personal movement and recovery routines.  It doesn't matter if you are sitting at your desk, finished a bike ride, starting a session at the gym, or hanging in your living room.  If there is something in your hands, you will use it.  You will have a routine to help areas move and feel better.

It's the small stuff that adds up over a lifetime.  One minute, 10 times a day is 10 minutes a day of being better.  It wouldn't help to brush your teeth once a week for 10 min.  But, one minute, 2x a day can be the difference between healthy teeth and dental nightmares.  The body responds the same way.  Frequency trumps intensity.  

Every time you use your MOBI your brain will elicit the reward to do it again.  Not because the MOBI is magic, (it's just a tool) but because you took a positive action towards better health, recovery and movement.   We know that if we do that daily, over months we will have created a positive habit.  I think spending 5-10 minutes a day working on moving and recovering the musculoskeletal system can be an amazing health habit, that everyone needs.  

We are few weeks out from our Kickstarter goal.  Check out the video of the MOBI in action.  If you know of someone that you think this may help, please share.  MOBI on KICKSTARTER.

DRJASONROSS on Instagram for some MOBI videos, pictures of coffee, kids, bikes, occasional workout ideas, craft beer and more coffee.

Monday, September 18, 2017

Becoming A Performance Therapist

Performance therapy is a term that has become more mainstream in the last decade.  When I was in school, the term Sports Chiropractor was probably more common.  I can only give this article the viewpoint from the lens of a chiropractor as I have not walked the road of other professions even though I interact with them frequently.

I've been an athlete my whole life and because I was a fairly good, I was able to make a National Team in the sport of bobsled.  I had just graduated chiropractic school, so the first people I worked on were high level powerful folks.  In my world, this was the norm.  It took me almost a full year to get used to a more passive mindset in clients when I left to work in the private sector.

I've had the good fortune of working an Olympic Games, traveling the world with some really fast guys and taking part in big meets and events.  I've been able to work with lots of different sports and teams and had some amazing memories from them.

This article isn't about getting to do that.  Some of it was luck and some of it was knowing the right people, and some was the classic right place at the right time.  Sure, if the door opened and you aren't that good, you don't get asked back.  This article is about being good enough to get asked back.

Performance therapy by my definition, is therapy that perpetuates better performance.  It can be on a spectrum.  Hurt on the left.  Increased performance on the right.  Someone will present somewhere between those two points.  While performance therapy can be used to overcome injury, it is by definition treating someone not injured and looking to make that session or that race optimal.  I think the best work is done in a heavy training block and therapy is used to help recover and allow more training volume and better training sessions to happen.  I stress that not injured doesn't mean optimal.  Think of someone that is running well, but the lower back get sore after every sprint session.  Perhaps the big toe doesn't have enough motion to allow full ROM on push off at high speeds so the athlete arches their back to compensate.  Still training well, but not as fast as they could progress and are getting increased lumbar soreness.  

First a few points to remember.  This is my opinion.  Ask someone else and they may disagree on everything I'm about to tell you.  Don't ever get into the mindset that because someone works for someone or some team that they are amazing.  Just like someone driving an expensive car doesn't mean they are rich.  The outline I'm going to talk about is also not the path I took.  Many of the courses and people I've met along the way, weren't around when I was in school or on my graduation.  So in a way, even though I've taken these courses it wasn't my path.  This should tell you there are many paths, but the following path is what I tell kids when they email me asking advice on how to become a performance therapist.

Get a huge base.  You need a big base if your ever going to build a big pyramid.  Your base is what your going to spend most of your time with and it will take up most of your treatment.  All other things become less effective if you don't master the basics.  How many times have we been told, master the basics,  build a solid base, don't skip ahead.  The best course hands down for building this base is the Functional Range Release (FR).  You get very good at finding anatomy and feeling anatomy.  Locating tension and then addressing tension and tone, also differentiating mechanical tension from neural.  (This was one of my biggest mistakes on leaving school) If you develop this base well, you will be able to help a lot of people even if you never went any further with your training.  I plan on taking one every year or so, until I feel like I'm not getting anything out of it.  I'll bleed this one dry.  Get good at knowing what structure you are feeling and if what you are feeling is normal.

Get good at loading the tissue. 
Things get better when we load them.  Things get worse when we load them wrong.  Things don't improve very much or as quick if we don't load them at all.  Become a master of understanding load.  The best course is Functional Range Conditioning.  You may think I'm biased, but it probably worked out this way for a reason.  The FR originators understood that to get great results required load and the conditioning course was born.  This course goes deep into that understanding.  I mean deep.  It made me go back and read histology and cell physiology and truly enjoy it.  I will retake this course in the future.

Get good at Being Part of a Team.
A performance therapist should know about physical training.   Understand strength and conditioning.  You probably won't be the primary coach for that person or athlete, but to understand what exactly is happening during training is extremely important.  The body adapts to training, understand how your therapy can be synergistic to that.  Being able to have a competent conversation with the athlete and coach is so undervalued it's criminal.  If you end up working in a team setting, this may be the difference in being asked back.  Are you competent in being part of the triangle of performance, athlete, coach and therapist.  The best course is being offered by ALTIS, another hands down.  It's the only thing really like it that I know of.  You get to experience the triangle in action.  You can ask a therapist why they pulled an athlete after watching them in their warm up to treat X.  Then see how that treatment changed the movement or drill.  You can watch and learn as treatment, coaching and athletes response feed of each other and determine the daily dose of training.

Get good at Regression and Lateralization.
This is a term I learned from Charlie Weingroff.  Regression is taking an exercise and making it available to that athlete that can't quite do it as prescribed.  They lack hip mobility so you take a deadlift from the floor to a deadlift off blocks, this is an example of a regression.   Lateralization is a side step.  If you don't have dorsiflexion to get into a great squat position, substitute the squat for a trap bar.  Still being able to train a heavy load with out putting the athlete at risk while working on getting them dorsiflexion.  Charlies Training=Rehab series of DVD's are a tremendous resource.

Get good at Energy Systems.
Not understanding the impact that the physiology of the energy systems plays, is one of the biggest mistakes in therapy.  Getting in great aerobic shape can help the healing response and position the athlete to have better tissue quality, less prone to colds and allow more training volume.  Blood flow brings healing, build more ways for that blood to flow!  I'm currently taking Joel Jamieson's Bioforce Conditioning Coach course.  It's very good.  His book is also a tremendous resource.

Get good at Nerve Flossing.
How to address neural tension or nerves that are causing the major course of dysfunction.  Michael Shacklocks Neurodynamics course is amazing.  4 days of of insane amount of information.  Great anatomy tie ins and superb blend of teaching and hands on.  I will retake this course in the future.

Get good at Knowing What You Don't Know.
This category exists to understand when you need help.  For me, this category is stuff I want to get better at, but am currently inefficient in to give guidance at an elite level.  For example, the everyday person, I can give blood work advice on some basic stuff.  Throw in an autoimmune problem, or fluctuating patterns that I'm not confident with, I'm not going to risk their health.  Some of the systemic monitoring like HRV and omega wave and using technology like EMS are one of the pools I'm learning to swim in, but again, I don't feel confident in giving advice.

Get good at Waking Up.
I think this is a small percentage, and to be honest I'm still figuring out where it belongs in the big scheme of things. But I do think it belongs somewhere.  I put the courses fascial manipulation and Reflex Performance Reset in these.  I give RPR the nod, as it's like 1500 dollars cheaper.  I think there is an appropriate time to "wake up" tissue, like post surgery or when body awareness is low.  I currently am using it mostly in the untrained individual.  I'm finding they  have a hard time "feeling" a muscle work/contract.  Even if it is!  The body awareness is so poor that when you do exercises with them, they start biasing into what they can feel.  RPR has allowed them to have better body awareness.

Get good at Competition
I think therapists should compete in something.  I think you should understand what being at a start line, waiting for the whistle to blow, or waiting for the green light is like.  What it feels like to know your ready to compete, to also know what it feels like to know your under prepared.  To fully know the frustration of being hurt.  To know what bonking is.  To know what heat/cold feel like.  To know the highs and lows of training.  To know that most days are just showing up and putting in work and your therapy is a part of that.  Nothing special, just a part of their day.  You don't have to be good, but you have to work at something and put yourself out there.  I think athletes appreciate when they know you may know a little about their world.  It also helps from an esoteric level.  If your at a big meet/event and you can feel the energy and nervousness that is around, it helps you give a more calming, positive presence in your treatment.  If you have never felt the nerves yourself, you may get caught up in the situation and put out nervousness and feed forward that to your athlete.  So join a lifting club, enter a 5k, register for a local cyclocross race and put yourself out there.

Get good at Reading
Every talented therapist I ever met has been a voracious reader.  It's not just therapy books either.  Although you should have some solid anatomy books.  (I like Stecco's stuff)  The bigger the library the more you start to see how things fit together or intertwine and overlap.  I think this helps you start to recognize patterns and process information at a higher rate.  The more that is in your understanding the faster you can start to process information.  In a private clinic that might mean you get to see 3 people in an hour instead of 2.  At the track it may mean you get to solve a potential problem in warm up instead of interrupting the practice.  Figuring stuff out faster is important.  Train your brain to learn and be creative.  Read more and read from a broad spectrum.  Variability is a good thing for joints, heart and your reading.

This is my recommended path when kids email me.  Now I can just send them to this blog post instead of just listing some courses.  Like I said, this was my opinion.  I'm sure others would have other recommendations.  If you are a therapist that works with sports or athletes, what course have you found instrumental in your learning?

Thursday, August 31, 2017

Random Thoughts From Unicorns to Invisible Casts

I was listening to the Joe Rogan Podcast with Andy Galpin and since then a few ideas I had been thinking about, I'm thinking about more.  Heres a few.

The Fallacy of The Unicorn
Unicorns are by definitions, mythical animals that despite my 5 year olds deep desire, don't exist.  Yet many of us in the fitness/health field and a lot of our patients or athletes can fall for the unicorn.  The unicorn is something that is the panacea, the answer.  The One Thing.  When I was in high school, I thought if I found the "perfect" workout plan I'd be sure to get bigger/faster.  I was up for the latest supplement that was sure to put all the muscle on.

Even today, I'll find myself slipping into this train of thinking.  Wow, beet root supplement increased the performance by 6% on the bike.  I MUST HAVE!  But then I calm down and I think it through. Usually it goes something like this, hmm...I didn't even eat any vegetables today, lets hold off on the 50 dollar beets.  

The Unicorns strength is that it can be used to be that one thing you need that is sure to put you over the top.  It can be almost anything.  Oh, If I go Keto, I'm sure to be (insert superlatives)  If I do this magic exercise I'll never strain my muscle again.  This supplement will make me lose all the weight I've ever wanted.  

Just remember, Unicorns don't exist the next time you start getting super geeked for...

Adapting or Optimizing
While the concept isn't new, how I've thought about it has changed since the podcast.  Adapting means your training session for that day is designed to adapt to something.  Perhaps it's learning to do a harder workout with less carbs, less sleep, or even less water.  Optimizing is making things as perfect as possible to create the best environment to perform your best for that particular workout on that particular day.  Now I find myself deliberately doing both.  Adapt to get better, optimize to express your better-ness.  

Sticking with the adapt and optimize theme, Asker Jeukendrup puts out some great information.  This article "Intestinal Absorption," was about getting your body used to using carbs for a race.  You train your stomach/guts to use carbs.  If you go to long without carbs, you are teaching yourself to run on fats, which is great if you don't plan on optimizing race day.  But, if you do, start increasing your carb intake 3 days prior to your race.  It's essentially a solid article pointing us to the concept of Metabolic Flexibility.  

How To Eat
Most people that aren't in a diseased state benefit from metabolic flexibility.  Mike T Nelson is one of the leading authorities on this, if you want to dive deep into this.  Metabolic flexibility is teaching the body to run on carbs and fats.  Training in both environments.  Getting the body capable of thriving in multiple conditions.  One of the points made in the mentioned podcast was that you would never say this is the one way I'm going to train for all my goals for the rest of my life.  How boring.  Why do we do this with nutrition?  

Patient Dialogue 
As a clinician/manual therapists I've had a few incidences when the patient didn't need manual therapy, but a friend that called them out on their misguided notions.  This takes tact, because you run a good chance of losing the patient.  I don't do it often, but every now and then I just feel like I have to.  My record in these instances aren't good.   

My mentor once told me whatever you are, be that, every day.  Be consistent.  If your ornery, be that, if your quite, be that.  If your boisterous, be that.  But, don't be someone new every day.  I've always tried to do that.  He also said, you don't get to have bad days.  People are paying you to help them, not listen to your struggles, or feel your negativity.  Every now and then I've found myself losing my patience, I always feel like I've let him down, when that happens.  Be better.  

Patients that are in the most pain, are also usually the most scared.  I always try to remember that.  The ones that are the most scared are the ones that had been in pain, got better and then for some reason it came back again.  Falls, time, accident, you name it.  One of the reasons, I always try to get my patients to view themselves as athletes, is because everyone knows athletes have highs and lows, but you wake up and try to get better and better isn't usually a straight line.  

Recently a patient of mine got diagnosed with stomach cancer.  It's never a great day when this news hits your ears.  He was being prepped for chemotherapy and was advised to take a protein shake to try to mitigate the muscle loss.  He asked what to take and was given something.  My patient did their own research and realized it was complete garbage and asked if I could recommend something better.  Of course.  You have to control what you get to control.  Don't leave your health to someone else. 

So where do you go for information?  This day and age, we are inundated with so much stuff.  It's hard to filter when you are not trained.   I can tell you the future of research is in supporting people you find doing awesome stuff and supporting them.  Patreon is a way of crowd funding people you want to help out.  I currently support a few people, Dr. Ben House a functional medical doc that consistently writes outstanding information.   Dr Rhonda Patrick that puts on very informational videos and podcast and Bill Lagakos that writes on health topics I have an interest in.  Patreon is a way of basically saying your doing great work keep it up and hopefully enough people support you to keep it going full time.  

This past year I've gained a new found appreciation for the endurance athletes mental game.  To be honest, I've always known the life of an endurance athlete was hard just from the amount of lonely hours practicing their sport.  Endurance often comes down to willing to suffer.  Pushing the brains impulse to let up.  Until recently I've never been "fit enough" to race though.   Recently, I've gained enough of an aerobic base where I can actually worry about racing instead of just riding.  All of a sudden a new found mental game is being played that I never had to worry about before.  Strategy, boredom, watching the competitors, going with racers, letting racers go, hydration, nutrition.  I found myself mentally tired half way into a race.  I found myself coasting instead of racing, even though my legs could go faster.  It was a very interesting realization.  Always be racing...

In this video Kobe talks about losing focus in a game in high school and losing the game and the next day realizing he was letting his mind wander in Geometry class, just like he let his mind wander when he lost that game.  So teaching himself to focus in geometry was actually teaching him to stay focused, which was training him to be a better basketball player. Great lesson from one of the all time greats.

Katie Bowman writes a lot about living in a more natural state and that we are often limited in our health of our human bodies by the "casts" we have built into our lives.  If we don't do things that help off set the casts, then we are slowly becoming less healthy as a human.  Often the casts are so inundated with our life, that we don't even think of them as "blocking," our health.  They are invisible. Shoes are a cast for the feet, go barefoot.  Chairs are casts for the hips, get down on the floor.  Modern stuff (computers, phones, walls) are casts for the eyes, focus far away through out the day.  Cars are casts for the heart.  Walk more.  In a way, casts can be quite a few things, sometimes its beneficial to do things the hard way to wake up our physiology to provide a different stimulus.  

Have a great Labor Day Weekend!

Friday, August 4, 2017

Commitment Can Be That One "Thing"

I'm a big fan of bike riding.  I can't actually remember a time when I couldn't ride my bike.  One of my first memories as a kid is my older brother taking my training wheels off and telling me I didn't need them.  Ever since, biking has been a part of my active lifestyle.  This last year has brought not only more time on my bike, but a little more commitment to training and getting more aerobically fit.

It's probably not coincidental that this was the first Tour de France I had payed attention to since Lance did his thing, then Floyd did his thing and on and on and on.  This years Tour was highly entertaining and by way of watching more I ended up reading a book about cycling by Phil Gaimon called "Pro Cycling on $10 A Day."

It was a really enjoyable read and I learned quite a bit about the subculture, the lack of money, the struggle and sacrifices that pro cyclists deal with daily.  It was far from my notion of signing a pro contract with a healthy salary.  It was more like the namesake.  I highly recommend the read as his sarcasm and literary wit comes through.

There was a page and half of writing that really resonated with me in terms of key principles.  In this one section of the book Phil describes future Cyclocross National Champion Jeremy Powers coming to see where Phil was living.  Jeremy was described as angry that his friend was not living like a pro athlete should.  "What is this?  You don't have any food.  All you eat is deli meat, sandwiches and rice cakes.  You've got to eat real food!  You don't live like an athlete!  

"You can sit here and half ass this thing, and you'll always make $20,000 a year, or you could do it right, invest in yourself, and make 10 times that.  You know you have the talent, so stop being scared!"

Phil goes on to say that it finally made sense to kick in the last 1% of commitment, in his own words..."otherwise, my sacrifices would be for nothing."

"I turned the thermostat up, bought a few bags of organic groceries, and made a weekly massage appointment.  I treated every training ride like a race, timing my breakfast to maximize my energy, with a recovery meal when I finished and as much sleep as I could get. ...If I was going to be a pro athlete, it was time to embrace it."

Those few pages speak volumes to what I think is missing in a lot of athletes lives, but even going further what is missing in a lot of peoples lives.  That 1%.  A lot of time it might be embracing what we don't like or think is that important.  Perhaps it is your cool down, you may have heard of its importance but have never paid much attention to it.  Perhaps it was sleep, one more 30 min late night talkshow won't hurt will it?  My doctor told me to walk, but walking can't really be that beneficial right? Perhaps it is the boring aerobic rowing class that your coach tells you would benefit you.  Being more aerobically fit will help out a lot with your recovery in your sport, but it meets at 6am on a Saturday and that means choosing it over a late Friday night.

Committing to the 1% will always mean different things to different people.  Whatever it is, I hope you learn to embrace it.