Sports Performance Coach and Licensed Massage Therapist

Nutrition plays an essential role in our ability to recover from a hard workout or competition.  With so much information out there on nutritional intake, various diets, and supplements, it can get extremely confusing about what you should be eating, and when you should be eating it. 

Because pre, during, and post workout nutrition are so critical to recovery, I have decided to focus this article on that topic.  However, 24-hour nutrition plays an important role in recovery and athletes should seek to establish healthy routines with regard to food consumption both in quantity and quality.  Hopefully this article will give you some general/practical recommendations regarding nutrition intake and how it can promote better recovery from training. 

Note: Consult your physician before making dietary changes or ingesting over-the-counter supplements.  The information in this article is not meant to be offered as medical advice and should not be followed instead of a proper medical consultation.  For athletes looking to optimize their nutrition program, it would be best to consult with a registered dietician that specializes in sports nutrition.  These professionals can be located through the International Society of Sports Nutrition.

Carbohydrates post exercise

It has been known for sometime now that post workout nutrition plays an important role in jump-starting recovery following intense training.  Thirty to sixty minutes following exercise is often touted as the “window of opportunity” to get nutrients in.  This is due to the fact that exercise induces an increase in insulin sensitivity, as well as greater permeability of the muscle cell membrane to glucose (blood sugar).  Therefore, carbohydrate intake during this period is extremely beneficial for increasing glycogen storage (glycogen is the storage form of carbohydrates), which has been lowered following intense bouts of exercise.  Additionally, forgoing carbohydrate intake during the 30-60 minute window has been shown to lead to lower rates of glycogen storage, which may have a negative impact on ones ability to recover from training and be prepared for the following training day.

Burke, Kiens, and Ivy offer the following recommendations for daily carbohydrate intake:

• Immediately following exercise: Within a 0-4 hour window post-exercise, consume 1-1.2g per kilogram of bodyweight per hour, at frequent intervals.
• Daily recovery from moderate duration/low-intensity training: 5-7g per kilogram of bodyweight per day
• Daily recovery from moderate to heavy endurance training: 7-12g per kilogram of bodyweight per day
• Daily recovery from an extreme exercise program (4-6+ hours of training per day): 10-12+ grams per kilogram of bodyweight per day

Carbohydrate + Protein post exercise

While the effects of carbohydrate supplementation directly following a bout of exercise are encouraging, these effects appear to be enhanced when protein is combined with the carbohydrate.

Nine male cyclists performed a 2-hour cycling program.  The first 90min. of the program consisted 3 rounds of 15min cycling at 60-65% Vo2max, 15min cycling at 70-75% Vo2max.  The last 30min. of the training program consisted of 10min. cycling at 60-65% Vo2max, 10min. cycling at 70-75% Vo2max, 5min. cycling at 50% Vo2max and 5min. cycling at 80-85% Vo2max.  This training protocol, along with a 12 hour fast prior to training, was used to deplete the athletes’ muscle glycogen.  This program was performed three times during the study, each separated by 7-days.  Following the training program, the cyclists were given a different post workout supplement on all three occasions.  The supplement was administered both post workout and repeated again 2-hours later.  Contents of the supplement during each of the three trials was as follows:

1. 112g of carbohydrate
2. 40.7g of protein
3. 112g of carbohydrate + 40.7g of protein

Zawadzki and colleagues found that the carbohydrate only supplement had a significantly greater plasma glucose response than the carbohydrate + protein supplement.  This is because the carbohydrate + protein supplement had a significantly greater plasma insulin response than the carbohydrate supplement, leading to a significantly faster rate of muscle glycogen sythesis (due to insulin’s stimulating effect on muscle glycogen synthesis and glycogen synthase) compared to the carbohydrate supplement (which was faster than the protein supplement).

Similar findings were esstablished by Berardi et al, who found that muscle glycogen resynthesis was enhanced with a carbohydrate-protein (0.8g carbohydrate per kg of BW/0.4g protein per kg of BW) supplement relative to a carbohydrate supplement (1.2g carbohydrate per kg of BW) or placebo.

General recommendations for protein intake immediately following exercise are 0.4-0.6g protein per kg of bodyweight. 

Daily protein intake recommendations have varied depending on the source.  Some resources have established daily protein requirements to be 1.2-1.4g/kg of bodyweight for endurance athletes, and 1.6-1.7g/kg of bodyweight for strength training athletes.  Others have given the broad recommendation of 1.2-2.0g/kg of bodyweight; while the U.S. registered daily allowance (RDA) recommendations are more conservatively set at 0.8g/kg of bodyweight.  However, it should be noted that the RDA recommendation is designed to prevent protein deficiency, not enhance sport or exercise performance. 

Carbohydrate + Protein pre- and during workout

While post workout nutrition has been shown to be beneficial to an athletes’ recovery, more current research has shifted towards what the athletes are consuming both pre- and during training, in an attempt to optimize their nutritional strategy.

Baty and colleagues conducted a study on 34-untrained male subjects consuming either a carbohydrate-protein supplement or placebo before, during and after resistance training.  The subjects underwent a 3-week adaptation phase where they trained 3x’s/week and were instructed and trained on the 7-exercises that were going to be used during the experimental portion of the study.  The testing day occurred in week four, and the subjects, randomly placed in either an experimental/supplement group or a placebo group, underwent the following routine:

• Following a blood draw the subjects consumed 355ml of their liquid supplement - 16 receiving the carbohydrate-protein supplement and 18 receiving a placebo - and then rest quietly for 30min.  This was a double-blind experiment, so the subjects or the individual overseeing the experiment that day had no idea who was receiving the actual supplement and who was receiving a placebo.
• After their 30min. rest, the subjects received a second blood draw and then consumed another 177ml of the supplement or placebo.
• The subjects then performed the first 4-exercises in their routine.  After those exercises were complete, a third blood draw was conducted, and the subjects again consumed 177ml of their assigned liquid.  The subjects then completed the final three exercises in their routine
• Immediately following the last exercise, the fourth blood draw was conducted, and the subjects consumed another 355ml of their liquid drink.
• The subjects rested in the weight room, until a fifth blood drawn was then taken.
• Finally subjects were allowed to leave the weight room, however they had to return five hours later for the sixth blood draw (the subjects were asked not to consume food until after the sixth blood draw, when they could then eat freely).
• The seventh and final blood draw was conducted 24-hours post exercise.

What the researchers found was that markers of muscle damage (plasma myoglobin and creatine kinase) as well as cortisol levels were significantly elevated in the placebo group compared to the carbohydrate-protein group.  Additionally, those in the carbohydrate-protein group reported less muscular soreness 24-hours after training compared with the placebo group.  While the researchers did not find any significant differences between the two groups with regard to exercise performance, the noted results would certainly suggest that supplementation with a carbohydrate and protein beverage before, during and after training would be beneficial to the athletes recovery.  The findings of this study led the researchers to conclude; “These results suggest the use of a carbohydrate-protein supplement during resistance training to reduce muscle damage and soreness.”

Saunders et al, also sought to evaluate the potential benefits of a carbohydrate beverage on performance and muscle damage.  Fifteen male cyclists performed two rides 12-15 hours apart.  The first ride consisted of the subjects riding at a pace of 75% Vo2max to volitional exhaustion, while the second ride was performed at 85% Vo2max, again to volitional exhaustion.  The subjects consumed either 1.8ml per kilogram of bodyweight of either a carbohydrate only or a carbohydrate-protein beverage (randomly assigned) every 15min. of exercise, and 10ml per kilogram of bodyweight of the same beverage immediately following the ride.  The subjects were blinded to which beverage they consumed and were asked to then repeat the same training protocol 14-days later, when they were then given the opposite supplement that they consumed in the first trial.

Unlike the results from Baty and colleagues, the subjects in the carbohydrate-placebo group in this study saw performance improvements when compared to the carbohydrate only group.  During the first ride (75% Vo2max), those in the carbohydrate-protein group were able to ride 29% longer, while during the second ride (85% Vo2max), they were able to ride 40% longer.  Post exercise muscle damage, assessed by plasma creatine phosphokinase (CPK) levels, were 83% lower in the carbohydrate-protein group compared to the carbohydrate only group.  With these findings, it would appear that the co-ingestion of carbohydrate and protein has the potential to enhance exercise performance and decrease muscle damage.

In order to optimize training results and enhance recovery via better nutrition, athletes should seek to ingest carbohydrate-protein around the workout (before, during and after), as this is a critical time period to get nutrients into the body, and enhance the rebuilding processes following training. 

Taking a carbohydrate-protein supplement at other times of the day may lead to less than desirable results.  Cribb et al., found that when taken before and immediately after training, a supplement consisting of carbohydrate, protein and creatine monohydrate elicited greater results in lean-body mass and 1RM strength, as well as improved muscle creatine and glycogen stores, when compared to a those subjects taking the same supplement in the morning upon waking and in the evening, before bed, on each training day. 

Furthermore, because of it is of high quality, because it is rapidly digested, and because it contains a high level of amino acids, whey protein seems to be the protein of choice for post workout nutrition.  However, when ingested pre-workout, it does not appear to have the same effect on amino acid uptake, while a supplement containing essential amino acids (EAA) plus carbohydrates has been shown to improve muscle protein synthesis when take pre-workout, compared to post-workout intake.  For this reason, athletes may choose to consume an essential amino-acid and carbohydrate supplement prior to training, and a whey protein plus carbohydrate supplement post workout.

 Conclusions

Nutrition plays an important role in recovery from training and competition.  Athletes looking to maximize the results from their training should take their nutrition seriously, and establish a healthy meal plan that is tailored to their needs.  Additionally, nutrition around the work plays a critical role in helping to enhance recovery, improve glyogen resynthesis, and promote greater muscle protein synthesis.  This article contained general recommendations for the amount of protein and carbohydrate intake one should ingest around their workout and during the day.  For the best results, and for individualized recommendations, athletes should seek to consult with a registered dietician or sports nutritionist through the International Society of Sports Nutrition.

Patrick

patrick@optimumsportsperformance.com 

References

Burke LM, Kiens B, Ivy JL. Carbohydrates and Fat for Training and Recovery. J Sports Sciences 22:15-30. 2004.

Zawadzki KM, Yaspelkis BB, Ivy JL. Carbohydrate-protein complex increases the rate of muscle glycogen storage after exercise. J Appl Physiol 72(5):1854-1859. 1992.

Berardi JM, Price TB, Noreen EE, Lemon PW. Postexercise muscle glycogen recovery enhanced with a carbohydrate-protein supplement. Med Sci Sport Exerc 38(6):1106-1113. 2006.

Tipton KD, Witard OC. Protein Requirements and Recommendations for Athletes: Relevance of Ivory Tower Arguments for Practical Recommendations. Clin Sports Med 26:17-36. 2006.

Phillips SM. Moore DR, Tang JE. A critical examination of dietary protein requirements, benefits and excesses in athletes. Int J of Sports Nutr and Exerc Metabolism 17:S58-S76. 2007.

Baty JJ, Hwang H, Ding Z, Bernard JR, Wang B, Kwon B, Ivy J. The effect of a carbohydrate and protein supplement on resistance exercise performance, hormonal response and muscle damage. J Strength Cond Res 21(2):321-29. 2007.

Saunders MJ, Kane MD, Todd MK. Effects of a carbohydrate-protein beverage on cycling endurance and muscle damage. Med Sci Sports Exerc 36(7):1233-1238. 2004.

Saunders MJ. Coingestion of Carbohydrate-Protein During Endurance Exercise: Influences on Performance and Recovery. Int J of Sports Nutr and Exerc Metabolism 17: S87-S103. 2007

Cribb PJ, Hayes A. Effects of Supplement Timing and Resistance Exercise on Skeletal Muscle Hypertrophy. Med Sci Sports Exerc 38(11):1918-1925. 2006.

Tipton KD, Tabatha AE, Cree MG, Aarsland AA, Sanford AP, Wolfe RR. Stimulation of net muscle protein syntehsis by whey protein ingestion before and after exercise. Am J Physiol Endocrinol Metab 292:E71-76. 2007.

Tipton KD, Rasmussen BB, Miller SL, Wolf SE, Owens-Stovall SK, Petrini BE, Wolfe RR. Timing of amino acid-carbohydrate ingestion alters anabolic response of muscle to resistance exercise. Am J Physiol Endocrinol Metab 281:E197-206. 2001.

This week I have a great interview with Sam Leahey.

Sam is currently working towards his degree in exercise science. As well, he is paying his dues by spending time as an intern at some of the top strength and conditioning facilities in the Boston area – Mike Boyle Strength and Conditioning and Cressey Performance.

Through the power of the internet, I got to know Sam via Mike Boyle’s website, www.strengthcoach.com, and we have since become friends/colleagues, exchanging emails and articles on strength and sports performance topics.

Recently Sam wrote a great guest blog for Eric Cressey’s site, regarding the importance of keeping things simple in the weight room. Many of the ideas Sam discusses are similar to things I have written about before regarding program design and the training theme – mainly, focusing on one or two qualities in a workout, rather than trying to do everything.

I decided to have Sam do an interview so that he could elaborate a little more on his ideas from the article, and give us a little insight into what “paying dues” is all about!

Enjoy,

Patrick
patrick@optimumsportsperformance.com

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1. First off, great job on your article for Eric Cressey’s site. Can you tell the readers a little bit about yourself?

The short answer is I’m a college student who is trying to take over the world of Strength & Conditioning :). Alwyn Cosgrove said once you should strive to be the dumbest person in the room. In other words, surround yourself with people you know are better than you in particular areas. If you do this then you will develop much quicker in your pursuit of greatness. The catch is, since doing this I’ve realized I don’t know crap! Purposely putting yourself at the bottom of a knowledge totem pole gives you great perspective in the field and allows you to see how much farther you really have to go. If you’re willing to undergo this humbling process then it will pay huge dividends in the future.

However the longer I do this the more aggravated I find myself getting towards young people like myself who think they “know” something that no one else does. If they were truly being mentored by people way more intelligent and with numerous more years experience they would see how much they really don’t know and would stop acting like they’re the next S&C prodigy. Seriously kids, get over yourselves and find a mentor who will put you in your place. If you really want to be big time, like Patrick Ward, Eric Cressey, Mike Boyle, and Dr. Charlie Weingroff, then put yourself in those humbling situations I alluded to. There are tons of people out there to learn from and theirs no excuse for not finding a “big timer” in your area. At the very least you could join www.strengthcoach.com or www.sportsrehabexpert.com and get “mentored” by the forum they offer. The collective group of brilliance there can really offer you a lot as a young person.

Bottom line - Be humble and always look to those better than you. The moment you think you’re at the top and only have downward to look is the exact moment, which you begin to suck!!!!!!!!!!!!

2. In your article, you said some really important things regarding simplicity and keeping things simple with regard to program design. The thing I particularly enjoyed was how you listed a number of qualities that all need to be trained, and then stated that you are better off just focusing on one or two in a training session, rather than trying to cram it all in there. Which is a similar message that I have tried to convey in some of my previous blog articles on setting up training. I was wondering if you could expand on your comments a little bit. What sort of qualities do you look to train on various days, and how does this shift between different phases of training?

Well if we wanted to get into the specifics you could break it up similar to Brijesh Patel (see Total Program Design Presentation) and have a day of each week that focuses on a particular quality. For example:

Mon - Lower Body Power Day
Tue - Upper Body Strength Day
Thurs - Lower Body Strength Day
Fri - Upper Body Hypertrophy Day

Now in another sense we can talk about someone who moves like crap, has the mobility of a bowling ball and just is flat out weak as heck. A person like would be better served with a program of heavy dose corrective exercise and simple strength work - forget hypertrophy days and power days for now. Some will disagree with that last part but I’m not sure how powerful were getting someone who cant even do a pushup! I remember when Eric Cressey once said, “Many people aren’t even strong enough to worry where they fall on the static-spring continuum.” The particular person I just described is one of them. He needs to learn proper movement patterns (proper motor skills with good mobility and stability) and gain some appreciable strength first before we can start worrying about training his short and long amortization phases.

Shifting gears again, we could talk about other things besides the qualities of strength and power. When do we fit our anaerobic/aerobic conditioning in? Should it be done year round or should we have a “conditioning phase(s)”?

THERE IS NO ONE RIGHT WAY!

Take college football for instance, its very paradoxical. You’re attempting to get a peak in power and anaerobic conditioning just before camp roles around in August. I’ve been part a part of some programs that have you conditioning EVERY DAY AFTER A LIFT! Seriously! Then as the conditioning component of the program increases so does our power development? It seems to me that the football world would be better off peaking strength and power first THEN anaerobic conditioning levels before the start of summer camp. Its easier to maintain one and focus on the other then trying to peak both at the same. Many times if you do it ends up contradicting each other and lowering both qualities.

A few more random ideas are you could work on training movement skills maybe 2-3 times a week instead of doing it everyday. Heck, you can also come in and do a “corrective exercise day” if you were pressed for time previously during the week, similar to Eric’s corrective intervals idea.

All in all, you DON’T have to work on EVERYTHING every single day of your program and in every single phase of training! Take 2 or 3 qualities and milk them for all there worth then move on and maintain that or pick new qualities all together.

3. Being a former athlete, what does your own training look like now? What are your goals, and how does your training differ now, compared to when you played football and had a strength coach writing the program for you?

I didn’t come from a very “updated” strength and conditioning program while playing college football. It was your typical old school mentality. So suffice it to say that it is night and day difference with the only constant being I try to lift heavy stuff frequently. Currently I’m doing Eric Cressey’s Maximum Strength program all while in the midst of coming off of a strained bicep. Its been fun having to learn first hand how to train around injury but admittedly I am embarrassed when I do upper body lifts because I feel so limited :).

4. Thanks for taking the time to answer these questions, Sam. Keep up the great work! Can you let the readers know where they can get in touch with you?

No problem Patrick, anytime. People can reach me at Sam.Leahey@gmail.com. I don’t have a blog but if enough people keep asking me maybe I’ll start one (LOL). My biggest fear in that is I’d be spending time trying to make quality blog posts and no one would read them, HA!

Contrast therapy has been used as a method of recovery in athletics for a significant period of time.

This type of therapy alternates between the application of hot and cold in a repetitive fashion, with the theoretical goal being to enhance recovery, decrease delayed-onset of muscle soreness (DOMS), enhance blood lactate removal, and improve various other markers of inflammation.

Application of Hot and Cold

When using contrast therapy, several factors must be taken into consideration:

• The temperature of the hot and cold plunges
• The duration of time that one spends in the hot and cold plunge
• The number of times one should alternate between hot and cold
• Which intervention - hot or cold - should begin and end the therapy
• Method - some may choose to just place one body part into the hot/cold plunge (IE, lower leg or forearm), while others may choose to do a full body plunge or just a plunge up to their waist.  Additionally, some studies didn’t use a plunge, but rather alternated between hydrocollator (hot packs) and ice packs.

Many coaches and athletes probably have their favorite way of applying contrast therapy; however, the research seems to be up in the air as far as the best way to go about managing hot and cold.

In studies, the duration of time in the hot and cold tended to vary from 1min hot:1min cold all the way up to 10min. hot:1min cold.  The common trend seems to be to have the cold interval shorter than the hot interval, with a majority of the studies using 1min. for the cold plunge. 

One study used 5min hot:5min cold.  The cold intervention, however, was with an ice pack (rather than a cold pool) and the temperature was not noted in the study - this is important to note, as 5min. in an extremely low temperature cold plunge may not be well tolerated by the athletes.

The total duration of time that the athletes spent performing contrast therapy in studies varied.  This would alter the number of times athletes alternate between hot to cold, depending on the duration of time spent in the hot and cold.  Overall, total duration varied from as low as 6-minutes, all the way up to 31-minutes of contrast therapy.

The temperature of hot and cold was different amongst studies as well. 

The temperature during the hot intervention varied from 38° C up to 75° C (100.4° F up to 167° F).  It should be noted that the 75° C was applied via hydrocollator pack with a terry cloth and two layers of towels used to protect the subjects from excessive heat.  The highest temperature used in a study where subjects were submerged up to their waist was 42° C (107.6° F). 

For cold interventions, temperatures ranged from 8° C to 15° C (46.4° F to 59° F).

Starting with hot or cold differed amongst studies, with the majority of the studies electing to begin with heat and end with cold.

Enhancements in Recovery

Studies on contrast therapy have found that this intervention has been shown to change subcutaneous tissue temperature - possibly suggesting enhancements in peripheral circulation and cuteaneous sensation.  However, no studies to date have shown actual changes in intermuscular temperature.

One study showed significant fluctuations in blood flow during a 20min contrast therapy session, where changing from hot to cold showed decreases in blood flow and vice versa when going from cold to heat.  Additionally, when looking at blood marker changes, contrast therapy was shown to reduce creatine kinase (a marker of inflammation) and blood lactate concentration at a similar rate as active recovery, when compared to passive recovery following training.  These findings may suggest that contrast therapy has a potential benefit to athletic recovery.

Finally, following exercise, contrast therapy was shown to decrease girth measurements, increase joint range of motion, and improve perceptions of soreness.

Conclusions

Anecdotally, athletes and coaches have used contrast therapy as a means to enhance recovery following training and competition.

While studies on contrast therapy are limited and their quality has been questioned, the take home points for me are:

• Athletes perceive less soreness following contrast therapy.  The mind is incredibly important, and if this method makes athletes feel less sore and more relaxed/recovered, then its use can be validated in my book.
• Both contrast therapy and active recovery have been shown to improve markers of inflammation following exercise when compared to passive recovery.  This information is potentially beneficial, as active recovery - while helping to get athletes moving and improve recovery - is still dependant on the athletes performing exercise (even if it is low-intensity), which may add more joint stress to an athlete who is slightly overtrained.  Further, for athletes who are in the middle of a long season, the use of contrast therapy may be more appealing (psychologically) than trying to go out and get in another workout/training session (again, even if it is low-intensity).

Hopefully future research will look more closely at this method of recovery to help athletes and coaches come to conclusions about the best ratio, total duration, and application of contrast therapy.

Patrick
patrick@optimumsportsperformance.com

References

Hing WA, White SG, Bouaaphone A, Lee P. Contrast therapy - a systematic review. Physical Thearpy in Sport 2008;9:148-161.

Myrer JW, Measom G, Durrant E, Fellingham GW. Cold and Hot-pack contrast therapy: Subcutaneous and intramuscular change. J Athletic Training 1997;32(3):238-241.

Myrer JW, Draper DO, Durrant E. Contrast therapy and intramuscular temperature in the human leg. J Athletic Training 1994;29(4):318-322.

This week I had the pleasure of interviewing Mark Young.

Aside from being a strength coach, Mark is very much a scientist in the field of exercise and nutrition.  One of the main topics we cover in this interview is the importance of reading research and being skeptical about things you read.

Hope you enjoy it!

Patrick
patrick@optimumsportsperformance.com

—

1.  Mark, thanks for taking the time to do this interview.  Can you briefly tell everyone about your background and what it is you currently do up there, north of the border?
 
No worries Patrick.  I’m proud to be asked.
 
As for my background, I’ve really been blessed with a lot of great opportunities.  I graduated from the kinesiology program at McMaster University in 2000 and stuck around long enough to do some graduate research in exercise physiology under Dr. Stuart Phillips who is one hell of a smart guy.
 
I learned a TON about exercise and nutrition from him and guys like Dr. Martin Gibala, Dr. Mark Tarnopolsky, and Dr. Kevin Tipton (who actually came down to present his research in our lab).  If you look up any of these guys on PubMed.com you’ll see just how fortunate I was.  As much as people tend to think of me as a training guy, our lab was divided pretty evenly between nutrition and training research so we really got the best of both worlds.
 
From a more practical standpoint, I’ve also been helping people to lose fat, gain muscle, and get wicked strong for the last 10 years.  I generally have a pretty wide array of clients ranging from desk jockeys to advanced trainees, but due my obsession with biomechanics, I deal quite often with trainees who’ve busted themselves up due to crappy programming as well. 
 
 2. I have been reading your blog for sometime now, and one thing I greatly appreciate is your interest in science and your healthy dose of skepticism regarding claims in the health and sports performance fields.  Why is being skeptical so important and, what advice can you give to young professionals in this industry regarding reading articles and research.
 
When I was back in grad school our class (which was only about 10 people) were assigned several journal articles to read each week.  Then we’d meet for class every week to discuss what we’d learned from the articles along with the methods and statistics used for each study.
 
One day we were assigned to read a very frequently cited article on pre-workout protein consumption and asked for our conclusions.  After our class unanimously agreed with the conclusions of the study authors that pre-workout protein intake was superior to post-workout intake our profs flew right off the handle.
 
“Did any of you read more than just the damn abstract???”
 
To say that they were pissed would be an understatement.  Of course, being smart enough to know that whoever made eye contact first would be the primary target of the upcoming assault, we all looked down and slowly flipped through our papers as though we were looking for something we missed.
 
After being dragged through the mud for several minutes our professors pointed out the “obvious” fact that the blood flow measures in the pre-workout group were way off and physiologically unlikely.  It was also noted that the method of measuring blood flow in this particular study was known to be subject to such errors and that we should have been aware of the potential limitations of this method.  In fact, this minor detail affected the calculations that determined the whole outcome of the study and we’d all missed it.
 
Had you just read the abstract, read the study, or read someone’s summary of that study you’d probably have come to the same conclusions we had…unless you were skeptical in the first place.  I’m certain that our professors knew we would make this mistake and chose the study to teach us a valuable lesson.
 
I’ve never forgotten that lesson and I’ve remained cautiously optimistic ever since.  I’d suggest that any young professionals in this industry heed the same advice.
 
3. Can you tell us a little bit about your training philosophy, and how you go about assessing clients and the methodology you use to set up programs?
 
Wow…that is a tough one.  To be honest, I’ve never actually written out who whole training philosophy and that would probably take more space than we’ve got, but I can give you some of the gist of it.
 
Generally speaking, I use this layout.
 
Assess -> Set Goals -> Program -> Reassess
 
If the results are moving as expected (based on the milestones determined during goal setting) we continue the program as it is.  Only when results slow or other issues arise (such as boredom) do we need to change the program.  Doing this has provided me with a way of objectively knowing when to change a program instead of using this “muscle confusion” crap people are always talking about.  The same obviously applies to nutrition.
 Assessments - I think these are critical.  As my good friend Brendan Fox likes to say “Your treatment is only as good as your assessment”.  I wholeheartedly agree.
 
Goal Setting - Without this I’d have no idea what my client wants to achieve and would not be able to determine milestones for progress.  This is an underrated step that I think most people don’t spend enough time on.
 
Programming - As boring as this sounds, my programs are all dependent on the goals of that specific client.  Now if Patrick is nice enough to have me back and ask me specifically what I’d do for fat loss, hypertrophy, or strength, I’d be glad to indulge.
 
I ALWAYS include foam rolling, mobility work, muscle activation work, resistance exercise (strength or hypertrophy), core work, metabolic work, and flexibility.  Where and how these fit into the program is subject to the goals of the person and their initial assessment.  In addition, there are always such factors as linear speed, agility, and power that may come into play depending on who I’m working with. 
 
4. Thanks for your time, Mark.  Can you please tell the readers where they can learn more about you, and any future projects you may have coming up?
 
 No problem Patrick.  It was my pleasure.  I’ve got several projects on the go, but my upcoming audio interview series dedicated strictly to the core is set to be released soon. 
 
There are interviews with guys like Dr. Stuart McGill, Thomas Myers, Mike Robertson, and about 9 more industry experts that I plan to release for free so I anticipate this is going to be huge.
 
Your readers can check out my blog at www.markyoungtrainingsystems.com and sign up for my newsletter to stay in the loop.
 
Thanks for the interview!

This past year, I committed myself to embrace the whole “social media” craze.  I started a facebook page for myself, a facebook page for Optimum Sports Peformance, a youtube page, and a Twitter account.

I have to admit, at first I thought it was sort of silly (and sometimes a waste of time); however, I have really enjoyed the process, and it has allowed me to meet other industry professionals and colleagues that I would have otherwise never probably met.

One of those individuals is Dr. Jeff Cubos, a chiropractor north of the border (Canada).  Jeff has been really great about posting excellent information on his twitter page, and sharing articles with me via email, thus helping to contribute to my continuing education.

So, I decided to interview Dr. Cubos this week, and see what he his ideas were on topics like:

-         His well-rounded philosophy on rehabilitation (soft tissue work, ART, manipulation, strength and conditioning/exercise)

-         Continuing education

-         How to find a good chiropractor, and not get roped into long-term deals with lots of strings attached

The interview is a great one, and I hope you enjoy it.

Patrick

patrick@optimumsportsperformance.com

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1) Thank you for taking the time to do this interview, Dr. Cubos.  Since my readers may not be familiar with your background, please tell us a little bit about yourself.

Thanks for having me Patrick. Although I am still surprised to have been asked (Who was scheduled this week but bailed?). Anyway, I am a sports specialist chiropractor with a Masters degree in kinesiology. I’ve also been a strength and conditioning coach for just under 10 years and have spent most of my time working with hockey players (I’m Canadian, so you can’t really expect much else).  On a more personal level, I have recently jumped into the sport of triathlon and along with my wife, have a stuffed dog named “Coobs” (much different than the half shepherd - half pit bull we recently dog-sat for 8 months).

2) From reading your blog, it looks like you are pretty diverse in your approach to therapy, utilizing things like soft tissue work, ART (Active Release Techniques), exercise, and chiropractic manipulations.  Can you please discuss with us your philosophy on patient/athletic rehabilitation?

You hit it bang on. My management approach is truly diverse and I probably wouldn’t say that I have a philosophy just yet. I really don’t want to label myself. However, much of my patient/athletic management approaches do stem from who I have been influenced by. Dating back to my days in University, I was heavily mentored by a sports chiropractor, a sports physician, and a sports massage therapist, all of whom I spent many hours with and looked up to (it also didn’t hurt that they were all part of the Toronto Raptors medical staff at the time). The chiropractor was very ART focused; the physician was as evidence-based as you can be, and the massage therapist took an osteopathic and eastern European approach (he knew about Janda’s work be for Janda did himself!).

From there, I spent a lot of time under the guidance of other sports chiros that took a pain-based approach. These guys were and still are leaders in our profession but it wasn’t until I worked alongside Dr. Thomas Lam of FITS Toronto that I truly appreciated the value of exercise programming in the “health care” setting. There we spent a lot of time developing athletes from the grassroots level all the way to national level athletes. Taking that approach to everyday patients really opened my eyes. I come from an Asian background so let me put it this way: ART, Mulligan Mobs, Thrust Manipulations, Trigger Point/Foam Roller work, SpiderTech tape and all the other treatment modalities I use are great (I don’t just want a toolbox, I want a shed!), but the true staple in my practice (the rice on my plate), is exercise! I make my patients feel better but the progressive exercises I prescribe is what I value most.

So maybe I DO have a philosophy…MOVEMENT!

3) You enjoy reading research and staying current on topics of rehabilitation and general health.  Most clinicians and trainers seem to be very lazy when it comes to increasing their knowledge and skill set.  That being said, what are something’s you are currently reading and is there anything particularly interesting you have learned about or stumbled upon in the past month or two?

Funny you bring this up. I agree 100% that many “professionals” do not spend enough time with continuing education. How many of our colleagues are still practicing EXACTLY the way they did the year they graduated?

I will say, however, that I believe the system needs to be improved. I think the biggest problem is that unless one works in a hospital or university setting, their access to evidence-based resources (journal articles) is limited. Sure there’s organization memberships and Research Review Service, but I don’t think that’s enough. Professionals need to seek out and obtain the literature first hand or else the information can be easily misinterpreted (i.e. barefoot running)

As for what I’m reading, one of my new years resolutions is to go back to my bookshelf and read all the texts I have started (but not finished) in the last 5 years and read them cover to cover. Some of these texts include: Liebenson’s Rehabilitation of the Spine, Lindsay’s Fascia, Brukner and Kahn’s Clinical Sports Medicine, and Reinold’s The Athlete’s Shoulder.

Other texts on my shelf that still have bubble wrap on them include: Gambetta’s Athletic Development, Chaitow’s Muscle Energy Techniques, and Vleeming et al’s Movement Stability and Lumbopelvic Pain. I have always taken an “open-minded” approach to learning and therefore have recently been interested in learning more about Dynamic Neuromuscular Stabilization, Z-health, and anything and everything that has to do with manual therapy.  Oh, and if Athletes Performance is willing to fly me down for their Rehabilitation Specialist mentorship or the NOI group are willing to fly me across the Atlantic, I’d be up for those too!    

4) Like any profession, there are good and bad practitioners.  With so many chiropractors out there, can you please tell us what patients should look for in a chiropractor?  What sort of questions should they ask, and what sort of things should they try and shy away from?

Good question. While I have specific views on my own profession, let me first say that there is someone/something for everyone. Some patients want pain relief and a quick fix, while others want to live with optimal movement. Then you have everyone in between. Having said that, the first thing I suggest when looking for a chiropractor is integrity, integrity, INTEGRITY! That goes with every profession but one of my pet peeves is when health care professionals choose practice management / wealth building seminars over continuing education. I’m all for having more money, I just don’t think the dollar should influence your patient management decisions as a health care practitioner. Can I get an Amen?

The first thing patients should do is perform the “sniff” test. If it smells funny, it probably is! Secondly, that first phone call is key. There should be no surprises, ask about costs (evaluation, treatment, reassessment, etc). Last, but not least, health care is not a contract…you should not be paying for 84 treatments up front, on the first visit. Following an injury, it may take 2 weeks to get you better; it may take 6 months. Who knows? But 3 times per week for the rest of your life smells funny!

Here’s a nice little read to lead athletes in the right direction. “How to select a chiropractor for the management of athletic conditions”.

5) It has been a pleasure, Dr. Cubos.  Can you please tell the readers where they can find out more information about you and your clinic.

My pleasure Patrick! Thanks for having me. Most information can be found on www.jeffcubos.com, but if you want to meet me in person, you’ll have to zip up your parka, grab your steak knife, and meet me in Spruce Grove, Alberta.  Oh, and if you happen to be in Sweden this summer, I’ll be there too!