November 12, 2014
A Warm-Up To Improve Performance
Author: Ed Harrold
What does every athlete or fitness enthusiast want the key to? We all yearn for that space where exercise feels effortless physically and meditative mentally. In Western athletics, we call this “the zone.”
As an athlete in my mid-30’s, my body was breaking down from all the years of training and competing. Fifteen years ago, a female friend of mine recommended yoga. I was amazed at what she could do with her body. The competitor in me had to take this on.
While I loved the practice of asana, I was most intrigued by yoga breathing; pranayama. You see, without the breath, it’s not yoga. It’s exercise. The pranayama (or conscious breathing) is what “yokes” the body/mind. So, if the breathing was having such a profound effect in the movement of yoga, why wouldn’t it within cardiovascular and strength-training exercise?
October 27, 2014
Author: Dr. Christina Miller
With so many infectious diseases on our minds right now, this may be a good time to think about how to strengthen our own immunity.
Do you ever wonder why some people get sick more frequently? Or why the infection becomes more severe in some, and others just get a cold? Is it luck? Genetics? Or is there something we can actually do about it?
As it turns out, while genetics (and luck) do play a role, we can also alter how our body responds
October 20, 2014
Author: Dawn Shepard
You come to the Aspen Club regularly. You are active and you love hiking, skiing, and cycling. You believe that you are a healthy eater, but you are just not where you want to be with your weight. You think that losing five to ten pounds would make you feel better, look better, and you want to be lighter to improve your time up Aspen Mountain for the upcoming Summit for Life. Here are my top ten suggestions to help get you where you want to be.
1. Get real about what you are eating. If you are exercising regularly, and your weight is not where you want it to be, it is because of what, and how much you are eating. Get a notebook and start writing down EVERYTHING you are eating and drinking, and then calculate how many calories you have eaten at the end of the day. The alternative is using an app like “My Fitness Pal.” This app is great and will do all of the calculations for you and it is free. Logging will make you think twice about ordering that scone with your afternoon coffee and it will reveal where you can make changes. Clients who have done this report that it is a hassle at first, but if done consistently, logging what you eat makes a huge difference. This may be the only thing you need to do.
2. Eat out less. When you eat out, you will eat at least 200 calories more per meal than you would if you prepared your own food. Restaurants give big portions, and they are usually too liberal with oils, sugar, and salt.
3. If you drink alcohol, consider stopping or sharply reducing. This is a biggie. We Aspenites on the whole are leaner and healthier than average, but we can drink a little too much. Liquid calories are dangerous because we just don’t think that a glass or two of wine really makes a difference, but it does. Calculate 150-200 calories per glass. The other thing you may have noticed is that it is hard to eat healthy when you are a little buzzed. Limit yourself to one drink, and ideally only on special occasions. Over time, you may find that making this one change will get you to your target weight.
4. Add some intensity. If you are not doing any interval training, you are losing out. Adding two days of interval training will burn more calories during and after your exercise session. Intense exercise tends to use the fat around your middle for fuel. We all should know that spot reducing is a myth, but in this case, there is some truth to it. We are not sure why our bodies use more abdominal fat during vigorous exercise but we are glad it does! Abdominal fat promotes inflammation and is therefore disease promoting.
5. Get the crap out of your house, office, car and any other place you hang out. If it isn’t there you won’t eat it. The excuse I hear most is “I keep these cookies, candies, and chips in the house for the kids, or when company stops by.” Do yourself and your kids a favor and keep healthy snacks around instead, or if you feel strongly about having that stuff around for your kids or company, put it in a place where you can’t see it. Do the same in your work place. Keep the candy and other crappy snacks in a place that is not visible, like on a high shelf. You know that stash of M&Ms in your drawer? How about changing it out for unbuttered popcorn instead.
6. Some supplements can really pack on the pounds. If you are drinking Gatorade or some other sports beverage straight out of the container, know that you are consuming an enormous amount of sugar and calories. If you are exercising for a couple of hours you will need to replace electrolytes and salt you are losing, and adding a little salt can help your body absorb fluid better. You can make your own sports drink pretty easily with a little diluted fruit juice, salt and bit of coconut water. Don’t get sucked into those “sports nutrition systems.” The other supplements that pack on the pounds are protein drinks and bars. Even very active people can easily get their protein needs met through food. Getting lots of extra protein through protein drinks and bars will not build muscle. It will however build your fat stores.
7. Stop thinking that there is a quick and easy way to lose weight and keep it off, because there just isn’t. You can lose weight fairly quickly by doing a cleanse, or the fad diet du jour, but you have less than a 5% chance of keeping it off. Repeated restrictive dieting also messes with your metabolism, and it makes losing weight in the future much harder. The best diets have the following characteristics.
· They are high in unprocessed vegetables and fruits. Fruits and vegetables should make up at least 50% of your plate.
· Lean protein such as poultry, fish, tofu, and legumes should make up 25% of your plate. Processed meats and red meat are high in fat and calories and have a strong link to diseases such as cancer and heart disease. I know bacon is a very trendy thing to eat right now, but it is full of saturated fat, and along with adding lots of calories, it is very, very bad for your health.
· Whole grains should make up the other 25% of your plate. Notice I said whole grains. Stay away from processed grains such as bagels, white bread and pasta, especially if you want to lose weight.
Injury to the anterior cruciate ligament (ACL) is one of the most common knee injuries sustained in sports. The anterior cruciate ligament attaches from the femur to the tibia and is one of the four primary ligaments that stabilizes the knee joint. The ACL prevents the tibia from translating forward excessively on the femur and also gives rotational stability to the knee joint.
An increase in participation of youth in sports has led to a rise in ACL injuries in young athletes. Female athletes have a significantly greater risk of ACL injury than their male counterparts due to multiple anatomical and neuromuscular factors. A majority of ACL injuries occur during non-contact situations such as during landing and decelerating, cutting or pivoting. Specifically, these injuries are most likely to occur when the knee is in a valgus position (inwards) or when the knee is straight or hyperextended upon landing. Recent evidence shows that targeted preventative programs can be effective in reducing risk of non-contact anterior cruciate ligament injury in young athletes.
There are multiple factors that contribute to an increased risk of ACL injury. Poor movement patterns during landing, cutting, and pivoting can cause excess stress to the knee. Other factors that may predispose an athlete to injury include muscle weakness or poor muscle balance, decreased joint range of motion, as well as decreased flexibility. ACL injury prevention programs should be unique to each athlete however will generally focus on strengthening the core, gluteal and hamstring muscles as well as optimizing muscle flexibility for that individual. Training athletes how to move effectively and safely through agility and plyometric training can decrease their risk of injury when placed in a competitive, dynamic situation.
An effective ACL prevention program typically consists of training a minimum of 2 times per week for 6-8 weeks prior to the competitive season. Ideally, exercises can be integrated into warm up and cool down by coaches during the sports season. Proper performance of exercises should continually be monitored.
All athletes, young and old, can benefit from targeted neuromuscular and strength training to reduce their risk of knee, and specifically ACL injury in the future. By teaching movement strategies and proper biomechanics as well as targeted muscle strengthening, prevention programs can contribute to decreased risk of ACL injury.
Before we get into what exactly Self Myofascial Release (SMR) is, we need an EXTREMELY simple overview of how the musculoskeletal system works as one unit. The entire body is made of hundreds of muscles that are not isolated entities with clearly defined borders and individualized functions. Our musculoskeletal system is connected from head to toe, linked together by a web of connective tissue called fascia. After intense exercise, fascial tissues can become knotted up just like a rope and won’t allow for the tissues to glide smoothly forming adhesions. These adhesions can negatively affect performance and/or recovery. Adhesions often develop around the site of previous injury and in areas that receive repeated loading such as the upper back, quads, rotator cuff, glutes, and calves.
Self myofascial release, or SMR, is a popular form of self-massage used to increase range of motion in a joint, reduce soft-tissue stiffness, aid post-workout recovery, and maintain normal muscle function. In the past, this kind of therapy has been reserved for extremely specialized practitioners. However, with the use of some simple mobility tools such as foam rollers, lacrosse balls, and mobility sticks all of which are readily available at the Aspen Club, you can help break up those adhesions. Research completed at The School of Human Kinetics and Recreation at Memorial University of Newfoundland supports the use of Self Myofascial Release. In the study, researchers analyzed the effectiveness of foam rolling the quadriceps for two minutes and found that after rolling just one time their quadriceps increased the available range of motion an average of 8-10% in a group of male athletes1.
Application of these mobility tools is simple, yet the use of any of them requires a brief overview. To properly use the foam roller, lacrosse ball, or mobility stick follow this simple sequence: (1) It’s best to begin rolling muscles at their proximal (closest to the body) attachments, then work distally (away from the center), (2) roll up and down on the desired tissues relatively slow 5 -10 times to get a feel for areas of increased tightness or soreness, (3) maintain constant pressure over the desired tight area or roll over the mobility tool slowly for 30 seconds to 2 minutes, depending on the comfort level. During your SMR session’s avoid bony prominences and focus on muscle and/or fascia. If at any time pain increases stop rolling and rest the muscle for 1 minute to allow for the muscles to relax.
The benefits of SMR will be seen with increased range of motion (both pre- and post- activity), decreased recovery time, and decreased soreness post-activity. So before or after that long hard Hi2T, TRX, Body Pump or Booty Barre class grab one of these simple mobility tools and get to work!
1. MacDonald GZ, Penney MD, & at el. An acute bout of self-myofascial release increases range of motion without a subsequent decrease in muscle activation or force. J Strength Cond Res. 2013; 3: 812-821.
2. Vogel A. Beginner's Guide to Self Myofascial Release. Available at: http://www.pureperformancetraining.com/blog/a-beginner039s-guide-to-selfmyofascial-release. Accessed August 5, 2014.
What makes me a candidate for a partial knee replacement as compared to a full replacement?
An individual is a candidate for a partial knee replacement if they have arthritis in 1or 2 knee compartments (medial/lateral side of the joint only or medial/lateral side of the joint along with the undersurface of the patella), have good range of motion of the knee, good stability of the knee, normal alignment, and are not obese (Body Mass Index (BMI) > 35, calculated by a formula that uses weight and height to measure body fat).
How does robotic technology improve the outcome for my partial knee replacement? Does this have a long term benefit?
Robotic technology can be used with partial knee replacements and helps the surgeon obtain normal alignment of the knee during surgery. It takes away the subjectivity in measurements for the prosthetic joint that can lead to error. It thereby allows optimal post-operative knee alignment, an important factor in longevity of the prosthesis.
Why would you suggest I consider a "patient specific" prosthetic as compared to a traditional prosthetic?
As with robotic partial knee replacement, the patient specific instrumentation (PSI) approach is an approach to Total Knee Replacement that assures proper postoperative alignment of the replaced knee. This again helps with longevity and long term outcomes.
Will there be any activities that I am not going to be able to do anymore long term after my replacement?
After a partial or total knee replacement patients are able to resume almost all of their previous activities. The only activities not recommend are running and exercises that involve repetitive jumping, as the repetitive stress from these activities can lead to early loosening of the prosthesis and early failure of the prosthetic component.
How long before I'm back to my activities of biking, hiking, skiing, golf? Does this depend on the type of replacement I have?
After a partial and total replacement and the necessary post- operative physical therapy that follows it, most patients are back to full activity by 34 months after their surgery However, everyone heals and progresses with their physical therapy differently some patients can be skiing at 6 weeks and others at 6 months.
What role does physical therapy play in the outcome of my surgery?
Physical therapy is important before and after surgery. If a patient goes into surgery with good motion and strength, post operative rehabilitation will be accelerated. Physical therapy visits prior to surgery can help with this. Postoperative physical therapy rehabilitation is essential to help decrease postoperative knee swelling and to optimize range of motion, strength, allowing a full return to function and activities.
Do I have any alternatives to having a knee replacement surgery?
We offer knee replacement only when all nonoperative management strategies, including medications (NonSteroidal Anti-Inflammatory medications such as Ibuprofin, analgesic medications such as Tylenol), physical therapy, bracing, weight loss, injections (steroids, hyluronic acid, platelets, stem cells) have failed. If, after trying these more conservative approaches, the patient still has pain, the option of joint replacement is discussed.
I am very active, and my active young friend tells me that her knees feel great after having had them replaced. She says that she can hear the "clunking" of the prosthesis in her knee at times, though it doesn't bother her. Will an outcome like this cause me problems?
"Clunking", if not associated with pain and swelling, is of no major concern. This is often noticed within the first three months after joint replacement surgery when muscle support is still weak and the metal and plastic of the prosthetic knee components can sometimes be felt.
With time and improved strength this predictably goes away. What types of knee replacements do you specialize in?
I specialize in partial knee replacement using the Makoplasty robotic system and in total knee replacement. I am an advocate of the patient specific prosthetic knee for total knee replacement, as this gives more predictable alignment which will affect long term outcome.
But I’m skeptical. First, let’s take a look at history. When vitamins were first discovered and marketed from 1912 – 1940’s, it was thought that they would dramatically lower the risk of some of the major diseases, such as heart disease and cancer.2,3 Yet, the opposite happened. From the 1930’s to the present, cancer rates have continued to increase, and autoimmune illnesses and heart disease have skyrocketed. The supplements did not seem to make us healthier. It wasn’t until about 20 years ago that nutritional scientists first realized that vitamins and minerals weren’t the only micronutrients in natural foods. Phytochemicals also play a crucial role.
As it turns out, it’s not just the phytochemicals. They’re working in combination with the thousands of other nutrients and chemicals in whole foods and have synergistic effects. Can isolated nutrients and phytochemicals do that?
According to T. Colin Campbell, PhD, author of Whole, “Although touted as “natural”, there’s nothing natural about consuming these nutrients in isolation. Oftentimes, the combination of nutrients is more or less than the sum of its parts, and the body plays a crucial role in determining how many nutrients from the foods we consume are actually used.”4
One recent study compared broccoli sprouts, noted to have some of the highest concentrations of ITC’s (Isothiacianates, which are potent phytochemicals being studied for their anticancer and stem cell effects) to broccoli supplements, made up of isolated ITC’s.5, The product advertises, ½ head of broccoli in each pill, and recommends 6 pills/day. In the study, they measured amounts of ITC’s absorbed and excreted in the urine. The results showed a significantly smaller spike in phytochemicals (almost negligible) in those that consumed the supplements when compared to the broccoli sprouts. Certainly not worth the extra money and all those pills.
In a separate but related study done on rats, researches showed that when tomatoes and broccoli combined was compared to either using tomatoes or broccoli alone, vs the powders made from extracts from either tomatoes or broccoli, the combination of tomatoes and broccoli was dramatically more effective at shrinking prostate tumors (52% shrinkage). 6,7 This demonstrates the power of using combination foods over isolated nutrients or supplements for cancer prevention and treatment.
So, they may not be as beneficial as they claim. But, could they actually be harmful?
I did a search on ConsumerLab.com, which is an independent agency that looks at whether health and nutritional products really are as they say. I found nearly one third of powdered “greens” or “whole foods” either didn’t live up to their claims, or worse, were contaminated with lead, arsenic, or harmful bacteria. According to Tod Cooperman, MD, president of ConsumerLab.com, “Greens and whole foods powders and pills can provide a range of vitamins and natural antioxidants. But because these products include ingredients like kelp, Spirulina, and many other unusual plants and herbs, contamination is a problem.”8 And remember, the FDA does not regulate supplements, so they aren’t FDA-approved.
My thought is, it’s always best to eat real, whole foods. There’s just no substitute to consuming vegetables and fruit, and history has proven this time and time again. But, if you’re traveling or find yourself in a pinch, search ConsumerLabs.com for a brand you trust, and use them at these times. They may even contribute some added nutrients. Just, don’t replace them for your daily doses of veggies and fruit.
4. Campbell, T.C Whole, 2013, p156
5. http://www.ncbi.nlm.nih.gov/pubmed/21816223. Clarke, JD, Hsu, A, Bioavailability and inter-conversion of sulforaphane and erucin in human subjects consuming broccoli sprouts or broccoli supplement in a cross-over study. Pharmacol Res. 2011 Nov;64(5):456-63. doi: 10.1016/j.phrs.2011.07.005. Epub 2011 Jul
7. http://www.ncbi.nlm.nih.gov/pubmed/17213256, Canene-Adams, K, Lindshield, BL, Combinations of tomato and broccoli enhance antitumor activity in dunning r3327-h prostate adenocarcinomas, Cancer Res. 2007 Jan 15;67(2):836-43. Epub 2007 Jan 9.