Category — Health and Wellness

In my last blog entry on stress, Carson Boddicker asked about some ways to quantify stress without getting to extreme.  I offered a few “low-tech” methods which work very well and at the end of the article mentioned some of the more ”high-tech” methods that people can use when sufficient funds allow.

In the comments section of the blog article, track coach Carl Valle mentioned an app available for the iPhone or iPad to evaluate HRV called ithlete.  I heard that they may be making one compatible with the Droid, however nothing for the Blackberry at this moment (which is unfortunate for me).  This seems to be a reasonably priced product and cheaper than some of the Polar watches which can be used to measure HRV.

What is HRV and how can it be used?

Heart Rate Variability (HRV) is one method being used to evaluate the stress of the athlete and determine if they are in a more sympathetic or parasympathetic state, which would then guide the training program for that day. 

HRV assess the interval of time between heart beats by measuring the time between R’s in a QRS wave.  Having a high HRV corresponds with a high Vo2max, while having a low HRV can be an indicator of increased mortality and possible cardiac events.  Additionally, when R-R intervals are plotted the frequency at which the length of time between them is measured – very low frequency power (VLFP), low frequency power (LFP), high frequency power (HFP) and finally a ratio of LFP to HFP.  Different frequencies have different influences on both the parasympathetic and sympathetic nervous system.

In a nutshell, when HRV is high, this can be taken as an indicator of a parasympathetic state and being well rested.  When HRV is low it suggest sympathetic domminance, high stress, and a potentially overtrained state.  Additionally, it should be noted that parasympathetic activity is a major contributor to HFP, while LFP is often accepted as a marketer of sympathetic modulation (however, LFP has been debated in the literature with some suggesting that LFP is a paramater of both sympathetic and parasympathetic influences).  Finally, when the ratio of LFP to HFP is high, this reflects sympathetic dominance.

If HRV is low, back off that day, lower the intensity and volume, or take an off-day and recover.  If HRV is high, then training today is business as usual.  Another interesting thing to evaluate is how well the athlete recovers following a high stress situation like competition.  Athletes who are better conditioned will return to a parasympathetic state faster than those with poor conditioning.  This information can be used to plan training the day after competition for individual athletes.

Trained athletes have higher HRV, HFP, and increased R-R interval times compared to untraied individuals.  Additionally, as noted above, athletes who are in better condition are often able to recover at a faster rate following intense bouts of training and competition.

One thing that I would like to investigate in future articles is the influence that soft tissue therapy and manual therapy can have on HRV and promoting a more sympathetic state, as this has important implications to both recovery from training/competition and rehabilitation from injury.

Patrick
patrick@optimumsportsperformance.com

In response to Monday’s blog post, Stress!!, the following question was asked

Getting into some of our conversation from yesterday, is there any way we can quantify this stuff without extreme ends? Have you used anything like the Profile of Mood States?

Regards,

Carson Boddicker

Carson, great question.  Quantifying whether or not the athlete is under high amounts of stress and ready for intense/high quality work that day can be done several ways.

First, on my general intake form there is a question regarding the clients own subjective stress levels.  This is something that I further enquire about when talking with the individual, as I want to try and determine where they are at before I start adding more stress.  I’ll ask them about their sleep, their overall daily mood, and times when they feel the most stress.

Having a stress profile as you suggested can be helpful.  Having the individual jot down and/or rate how well they slept the night before, how they feel today, are they sore, how hard would they rate the last workout, etc, can provide you with valuable information to plan training on a specific day.  Additionally, resting heart rate and blood pressure can be taken and compared to previous tests to determine if they are at or around their general norm.

If you don’t want to have the athletes fill out paper work every time, you can also just talk to them and observe them during the warm up.  Being a good observer is an important aspect of being a good coach.  Notice how the athlete(s) look when walking into the gym.  Are they looking sluggish?  Do they look down?  What is their overall posture like (this can tell a lot about a persons general mood)?  From there, during the warm up, you may notice the athlete(s) moving in a slower or uncharacteristic manner.  When I see things like this, I immediately start asking more questions.  If I feel that the athlete is not prepared for intense/high quality training that day, based on what I see and the feedback I am getting, then we go ahead and do a back off day or we just do some soft tissue work and mobility exercises.  I have also sent people home on certain occasions when I felt that taking a full day of rest would be the best thing for them.  Additionally, knowing when stressful periods of the year are coming up can help you plan training.  For example, you work with several collegiate athletes.  Midterms and finals time would be a good time to turn down the training stress as the athletes are usually staying up late to study or write papers, and under high amounts of stress from taking tests all week.

Finally, performance measures can be used if you have a base to measure them against.  A vertical jump or a broad jump (following a good warm up of course) can help to determine if the athlete is ready for strength or power work on a given day.  I believe in Fleck and Kraemer’s Optimizing Strength Training, they recommend taking the average of three jumps.  That number should be roughly 90% or greater than their normal vertical or broad jump if you are going to train power or strength that day.  If it is below 90%, then the athlete is not prepared for high quality work that day and should take a back off day to allow for more recovery to ensure they are ready for the next intense workout.

Those are a few “low-tech” ways of evaluating the athlete, others may have additional ideas, so hopefully they leave the in the comments section.  Of course you can also try and go more “high-tech” with things like the Omega Wave (which I confess I don’t know much about at this time) or even a Polar watch/heart rate monitor that can take your heart rate variability (HRV).

Patrick
patrick@optimumsportsperformance.com

Stress plays an important part in what we do as strength coaches/trainers, as well as in other areas such as physical therapy, chiropractic, and even massage therapy.

Basically, we apply a stressful stimulus to our athletes/clients - either in the form of a training intervention or in the form of a therapeutic modality (soft tissue therapy, manipulation, stretch, etc) and we ask their bodies to respond.  When stress resistance is low, the response is not favorable as the athlete cannot recover properly and their body will not respond the way it needs to.  When stress resistance is high, we can push the envelope a bit more and train at a higher level, knowing that the individual is able to sustain this level of stress, recover from it, and come back for more.

With a sound training and recovery program we can help to enhance stress resistance.  Obviously this is also dependant on what else the athlete has going on in their lives, as this too can play a factor in how they respond to the stresses of training and treatment. 

Unfortuntely, stress resistance is not infinite.  We can’t increase our resistance to stress forever.  Rather, stress resistance tends to modulate depending on what we have going on.

• Your girl friend breaks up with you and you may be feeling depressed, which brings you down and lowers your stress resistance.  Alternatively, perhaps breaking up with your girlfriend is a huge relief and a large amount of stress has now been lifted off your shoulders….stress resistance goes up!!

 

• You start working another shift at work and your stress resistance may decrease because you are now cutting into some of your recovery time and adding more hours in an environment that can be taxing (both physically and psychologically).

 

• You get sick for a few days and stress resistance is impaired.

As coaches and therapists it is important to understand stress and take into account all the factors of your athletes/clients lives.  If you push an athlete with low stress resistance to hard, you may run into a rather large set back in training.

A favorite book of mine was written by stress researcher and Standford professor, Dr. Robert Sapolsky.  Why Zebras Don’t Get Ulcers does an excellent job of explaining stress and its affects on the body in a rather easy (and often times humorus)  manner.  I can’t recommend this book enough.

Additionally, National Geographic did a great piece on stress featuring Dr. Sapolsky called Stress: Portrait of a Killer.  Below, posted in six parts (about an hour), is the entire episode. 

I hope you enjoy them!

Patrick
patrick@optimumsportsperformance.com

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The popular debate that surfaced this past year was between the role of exercise in fat loss.

It basically started with Time Magazine running an article titled Why Exercise Wont Make You Thin.

Right when the article came out, it began an internet firestorm from health professionals blogging about how horrible Time Magazine was for publishing this article – talk about going viral!

I read the article a few days after it came out and to tell you the truth, it wasn’t that bad!  In reality, all it was saying was what we basically already know, “you can’t out work a poor diet.”

I am not going to dispute that diet is an important component to losing fat.  In fact, it is the most important component as far as I am concerned.  We have all seen those people in the gym who kill themselves 2 hours a day/7 days a week, yet see minimal to no results because they are constantly over-eating.

While diet is important for losing fat, exercise is essential for achieving higher levels of health.  Together, an appropriate calorie-restricted diet and a sound exercise program are essential not only for improving body composition, but also improving the overall function of the body’s systems.

Researchers at the Pennigton Biomedical Research Center at Louisiana State University recently evaluated the results of caloric restriction with or without exercise.

Thirty-six overweight participants (16 males/20 females) were randomly assigned to one of three groups for the 6-month study:

1. A control group who ate a weight-maintenance healthy diet
2. A caloric restriction group who restricted energy intake by eating at a daily caloric deficit of 25%
3. A caloric restriction plus exercise group who created a daily caloric deficit of 25% by reducing energy intake by 12.5% and increasing energy expenditure by 12.5%

The researchers posed the following question:

“Does caloric restriction with or without exercise result in different improvements in cardiometabolic risk factors which could ultimately improve longevity?  The purpose of this analysis was to determine whether a deficit by energy restriction or energy restriction plus aerobic exercise that produces equal change in fatness leads to greater cardiometabolic benefits when exercise is included.”

The Diet

The diets used in the study where based on the America Heart Association’s Step 1 recommendations.

During the first 12 weeks of the study food was provided for all groups based on their dietary needs.  In weeks 13-22 the subjects self-selected their own diet based on their individual caloric target, and in weeks 22-24 (the final two weeks of the study) the subjects returned to the in-feeding protocol, which they used in the fist 12 weeks.

The Exercise

Both the control group and the caloric restriction only group where not allowed to alter their current level of physical activity for the 6-month study.

The caloric restriction plus exercise group was required to increase their energy expenditure by 12.5% above their baseline requirements.  They did so by partaking in a structured aerobic exercise program (IE, walking, running or stationary cycling) for 5 days a week.

Adherence

Adherence is a common problem in studies like this, and subjects are notorious for under-reporting their caloric intake and over-reporting their caloric-expenditure.

The subjects in this study attended weekly group meetings and were contacted once per week via telephone to ensure there were no adherence problems to the program.

Tests

The subjects were tested for changes in fat mass, visceral fat, Vo2 peak (using a graded treadmill test), muscular strength (isokinetic knee extension/flexion), blood lipids, blood pressure, and insulin sensitivity/secretion.

Aerobic Fitness and Muscle Strength Results

The exercise group was the only group that saw improvements in Vo2 peak, which is to be expected since they were the only group stressing their aerobic fitness.

There were no changes in muscle strength between the groups.  This would be expected considering this study did not have a resistance training component to it.

Body Composition Results

Body fat was significantly reduced in both the caloric restriction and caloric restriction plus exercise groups, as were total body fat mass and visceral abdominal fat.

People may look at those results and think that those results aren’t very promising for the exercise group; however, I look at those results and see what I would expect to see given that both groups had created an equal caloric deficit (25%).

Cardiometabolic Risk Factors

This is where, in my opinion, things get important.

HDL (the “good” cholesterol) was significantly increased in all treatment groups, including the control group. This is possibly because their diet was set up for them based on the American Heart Association guidelines. And even though they were not eating in a caloric deficit – rather eating at a weight-maintenance level – the diet was probably healthier than the normal junk they would eat on a daily basis.

Fasting serum triglyceride concentration increased significantly in the control group, but decreased significantly in both the caloric restriction and the caloric restriction plus exercise groups.

While systolic blood pressure was not changed in any of the groups, diastolic blood pressure, total cholesterol, LDL (the “bad” cholesterol), and insulin sensitivity were significantly improved ONLY in the caloric restriction plus exercise group!

Summary

- Adding exercise to your calorie-restricted fat-loss diet has greater improvements on cardiometabolic health, which are greater than caloric restriction alone.

- The addition of aerobic exercise to a calorie-restricted diet enhances overall aerobic fitness which is helpful for improving health and wellness.

- Calorie restriction is essential for fat loss and body composition changes; however, when combined with exercise, the amount of caloric restriction needed to illicit the same results in body composition is decreased (12.5% caloric restriction with exercise intervention vs. 25% caloric restriction with no exercise).

- Aerobic exercise has been shown to improve insulin sensitivity, which is important in the health of overweight/obese individuals who may be at greater risk for diabetes and/or other metabolic disorders.

Conclusion

Calorie restriction is king when it comes to fat loss.  A proper diet will help you achieve this goal, but exercise can be effective in not only helping you reach this goal (without having to rely as heavily on reducing calories, which typically leads to a miserable experience and lack of adherence) but also, in helping improve your overall cardiovascular and metabolic health.

Patrick

patrick@optimumsportsperformance.com

Reference

Larson-Meyer DE, Redman L, Heilbronn LK, Martin CK, Ravussin E. Caloric restriction with or without exercise: The fitness versus fatness debate. Med Sci Sports Exerc 2010;42(1):152-159.

Stop reading and take in a breath of air.

Go ahead.  I give you permission. 

Get a nice big breath of air and see how that feels.

We seem to take breathing for granted.  We don’t really think about it, we just sort of “do it”. 

Certainly evaluating proper breathing patterns is nothing new; however, it has recently gained popularity in the strength and conditioning world.  I don’t think most strength coaches, trainers, therapists, etc, really thought about the importance of this task with regard to their client/athletes performance, pain or function.  I can tell you that as a strength coach/trainer I didn’t think about it that seriously until I started studying massage, where people are more inclined to talk about the importance of proper breathing.

While many are now looking at breathing and its potential effects on shoulder position/function and neck pain/tension, the impact that faulty breathing may have on the entire system does not stop there.

Over the next few blog articles, I am going to discuss breathing and hopefully give you all something to think about with regard to this critical life task.

Breathing Gone Bad

When I told you to breathe a minute ago, how was it? 

Did you take in a deep breath through your nose, fill up your belly, hold it for a second and slowly breathe out? 

Or, did you take a shallow breath, or maybe what you thought was a big breath because you raised your chest up high and didn’t properly allow the diaphragm to move downward.  Did you breathe through your mouth?  Were you rushed in your breathing – after all, who has time to take a big breath? 

Chances are, more people were in the later group than the former.  Unless of course, you have been trained to breath properly. 

Trained to breath properly? 

I know it sounds weird because we have been doing it since birth, but there is a good chance that your breathing has changed since then.  If you observe a baby breathing, you will see that no one had to tell them to be “belly breathers”.  They just sort did it.  They lie there and comfortably breathe through their nose and let their belly rise and fall in a nice relaxed state. 

However, as we go through life, stress begins to pile up and we go through states of anxiety and depression as our challenging lives unravel before us.  In addition, we put mileage on our bodies with all the injuries, aches and pains that we accumulate through the years (some traumatic and some just built up over the years from overuse and/or disuse). 

Breathing, and the way we breathe, plays a critical role in our physical state.  When breathing is rapid and rushed (IE, hyperventilation) we are more sympathetic than when we are relaxed and breathing slowly (parasympathetic).  Below are just a few things (and there are many more) that can happen to our bodies on a global scale when breathing patterns are faulty:

• Reduced availability to oxygen
• Excessive amounts of exhaled Carbon Dioxide lead to respiratory alkalosis, producing a sense of anxiety
• Possible dizziness
• Sympathetic dominance potentially leading to dilated pupils, dry mouth (which can be further enhanced by being a mouth breather), and sweaty palms
• Headaches
• Overall tension through the body
• Inability to relax and be comfortable
• Potentially a heightened pain perception
• General fatigue

Now, lets look at some of the things that can potentially happen to our muscles when breathing patterns are poor (after all, that is what most people reading this blog are probably interested in):

• The upper ribs elevate to a greater degree, creating sensitivity in the costal cartilage and innercostal muscles
• Thoracic spine movement is disturbed due to improper rib mechanics during breathing
• Accessory breathing muscles become overactive/hypertonic and are more prone to trigger points and ischemia – scalenes, upper trapezius, SCM, serratus posterior superior, subclavius
• The cervical spine is more prone to developing rigidity as muscles develop stiffness to compensate for the new upper chest breathing pattern
• Altered shoulder function and scapular position/mechanics
• Psoas and QL share a fascial connection to the diaphragm at the lumbar vertebrae, making them vulnerable to disuse, weakness, and myofascial trigger points when diaphragmatic breathing is not observed
• Pelvic floor muscles can be prone to potential weakness and an imbalance in tone between the abdominal muscles and over-active erector spinae muscles may be noted

With the above issues in mind, over the next few blog articles, I hope to attack the topic of breathing and give you some practical information that you can apply to your clients (or yourself) as a way to evaluate and re-teach breathing patterns.

Patrick
patrick@optimumsportsperformance.com