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Post Concussion Syndrome - Life In A Dirty Pit

Over the last few years, I was able spend some time with Rachel after she received a couple of concussions. She had a few moments of bad luck and knocked her head off some ice and off a dresser. The ice one left her unable to remember key peoples names for about 6 hours, the dresser turned her into a paranoid crazy person for a week or so. It was a challenge to watch because she was suffering, it was evident, and because she wasn’t normally a paranoid person. What was actually frightening about it was that SHE was convinced that she was feeling herself. Her athletic therapist friend Louise called during an argument about me trying to hurt and change her and simply told me that if Rachel wasn’t acting herself, take her to the hospital because there’s a good chance that she’s injured her brain. It took about 4 weeks for her to return to normal and her recovery was an emotional roller coaster of up and down mood, forgetting simple things and struggling to find the right words or thought.

I had the misfortune of sustaining another concussion a few weekends ago. It’s funny looking back at it because I was able to rationalize a lot of craziness that doesn’t make any sense to me now. I was messed up yet I felt like I was fine and everyone else just changed.

The injury was fairly simple, horsing around while white water rafting, and I jumped off the boat spinning and twisting all erratically. I hit the water spinning, tumbling and on the side of my head. There was a stillness when I hit the water, after a massive slam to the side of my head followed by a hissing. I remember floating up to the surface of the water thinking “oh oh, that was stupid.” I was dazed and confused as I swam back to the boat. I couldn’t hear anything from my left ear, had a head ache, was having some trouble figuring out how to get back into the raft and I was beginning to feel sick to my stomach.

We ate a few minutes later, but I had to leave a few times to throw-up. I was beginning to get irritable and a little paranoid, the sickness and headache were building and I was looking around at people wondering who they were and why I’d be in conversations with them. We got back on the boat and things continued to degrade. The head ache and sickness were becoming really bad and I thought about sitting out the next set of rapids, the Coliseum, because I had a feeling the boat was going over. I stayed on and, as expected, the boat threw-out all but one person. My next memories after feeling the boat void its contents into the river were of being underwater, eyes open looking around wondering if I was going to hit the rocks I saw coming at me or if I would be able to float to the surface. Well, I did both.

I didn’t need the second impact to make my day any worse, but I got it. We got out of the water and I puked my face off. My head was killing, my knee was opened-up and I was becoming unhinged. We get off the water about 20 minutes later and I throw-up again. We get back to the camp grounds, I go and change, get sick and start drink water hoping that I’m just dehydrated. But the camp ground isn’t the same as it was when I left. I looks the same, but I don’t belong there. I don’t know any of the people anymore, even the people I’m there with, and I have a growing level of suspicion of everyone. I begin to withdraw into myself because I feel so wrong.

At this point I start to notice that my left ear is leaking. It’s mostly a clear fluid, but there’s a little blood in it. This did not register with me at the time. Simply put, I thought “my ear is leaking. I guess it should be, I hurt it” without so much of a thought about lumping the symptoms together to get a more complete view of what was going on. Head impact leading to  head ache, confusion, irritability, paranoia, nausea, and fluid leaking from the ear. I don’t realize it yet, but for the next week I am going to be this new person, someone who was very much like Rachel after she banged her head on the dresser. A confused shell of a man, small, weak, scared, in a daze, with only flashes of memories from of the time between rafting and, well, right now.

When I visited the doctor they told me my ear drum has a sizable rupture so there must have been some impact. They said it should heal within 6 weeks so my hearing should be fine but that I need to see a specialist to make sure things are normal. They didn’t think much about me not going to the hospital to get checked-out once the fluid started coming from the ear but they weren’t surprised either because if I had a concussion I wasn’t going to be thinking right. Concussions are tough to diagnose, impossible days after the fact, but based on the symptoms and what happened, there’s a good chance I had one, but we’ll never actually know.

All in all, this recovery left me feeling drained, emotionally empty, and completely confused. This was a “in the pits” type recovery that is both extremely erratic and wildly irrational. I’m more than 10 days out and this morning is the first morning since it happened that I have finally gotten a handle on what has been going on.

No Plan B = Full Engagement In Plan A

Had a conversation recently with a guy who was a good pitcher when he was younger. He got hurt at 17 (glenoid labrum tear), missed US scholarships and never fully recovered his throwing. He attended university in Canada, got a degree and started working. He did really well in all his jobs and stated building his resume. This is where he is right now, not 100% content with what he is doing because it isn’t what he dreamed he would be doing when he was younger.

“I didn’t have a plan B. Why would someone have a plan B? That’s like already accepting that you may not and that’s as good as saying you won’t. Why introduce doubt?”

He didn’t consider any other option when he was young and developing as a pitcher. He needed to keep his mind free of negative influence so he could pitch well each game and he knew that, over the long haul, a little bit of doubt each day would eventually move him off the path to the pro league. It was an intense and single minded approach that did get him to the top of his game, scouted and with a number of interested NCAA schools. Unfortunately, his body wasn’t able to keep up to the demands of the training and throwing and it shut down a year before it was needed to be at it’s best to showcase what he could deliver.

He didn’t mention regret for having not considered anything other than professional baseball. There was disappointment for the dream not working out, but he knows that he wouldn’t have gotten as far if he had considered what would happen if he didn’t make it to the top. He did his best when he had the chance to do it and that is enough for him to not regret it. He had been 100% focused on the goal of becoming one of the top pitchers in the country and had not wavered a single step along the way. This allowed him to reach his physical potential, and it very nearly worked out for him the way he had dreamed it. It also created an enormous amount of self-confidence because he knew he had the character to give something everything he was.

It was a great conversation and it left me feeling really uplifted. His passion and intensity had been focused on one extraordinary goal - as opposed to one extraordinary goal and one less noteworthy goal - and it had taken him as far as he was going to go. He knew that by creating a second lesser goal he’d actually be making that his primary goal. No plan B meant full engagement in plan A.

How I Have Not Served My Clients Adequately

Looking back about 3 years on my training, I can now see a few ways that I have not provided my clients with adequate service. Below is a list of 5 things I am now doing differently:

1) Sell small numbers of sessions during the initial few months. Some people will not keep doing this and while it is good for them, getting them to do it actually makes their life worse. It SUCKS to be out of shape and it can be even worse trying to get back into shape. And maybe, just maybe, selling someone a years worth of training when they are feeling excited in January is going to hurt them a lot more than help them. Give them the option to leave early on, and give them plenty of chances. You don’t want to train those who do not want to be trained.

2) Focus on getting them to properly engage their core. Humans need to be able to rotate their upper and lower bodies independently, but they also need to be able to prevent this rotation. If you do not set the ab muscles correctly when you lift, energy is going to be wasted and you will not lift as much weight. Worse still, is that if you ruin your back with relative ease when you lift without properly engaging your core. There has been an enormous increase in the level of satisfaction with most of my female clients now that I stay on them throughout the set to keep their core tight. The initial reduction in load is a small price to pay for the improvement in posture and function that accompanies appropriate core recruitment.

3) Focus on flexibility, joint mobility and function. This is one that annoys me because it was completely selfish. I don’t like stretching much (at all) and while I understood the importance of having adequate flexibility and proper joint range of motion, I didn’t place enough value on this for a long time. Fortunately all of my clients remained injury free so this shortcoming in training didn’t have a major impact on them now that it is being addressed.

4) Focus 70% of the strength training on eccentric phases. The lengthening phase of a working muscle is called the eccentric phase. It’s easiest to build strength and most of the micro trauma that forces muscle recovery occurs during this phase - these mean that if you have a lot to lose by not focusing on eccentric work. At its simplest, when you are lowering a weight you just move at 1/2 to 1/4 the speed that you would when you are lifting the weight. I don’t think you’ll lose fat as quickly if you avoid 4-5 second eccentric phases.

5) Focus on psychology with the people who don’t follow instructions. Athletes listen and do. People who want to change their body composition shut-up and follow the advice that is given. But what do you do when the people say they want something but fail to do what is needed to achieve their objective? You have two choices, the first is to fire them and get a new client, hopefully someone who will follow instructions and work towards their goal. The second choice is to get into their head and try to point out exactly what you are seeing and what it indicates. Doing the second consistently is what separates the good coaches from the great ones - and I’m hoping to be one of the great ones - because you’ll be able to get people to change who could not have achieved it on their own.

I have started to spend more time addressing these areas with my current clients, but I’m sure there will be a new list of shortcomings in the coming months and years, and that’s a good thing! We only improve the process when we admit to that which is not working and seek to change it.

Those Who Do And Everyone Else

Part of what I miss most about working for SST is that most of the athletes who came in to train came in to train their asses off. I don’t see this as much in the commercial gym I am presently working at. I would estimate that about 75% of the members - even those who are training with trainers - have very little desire to achieve much of anything while at the gym.

Don’t get me wrong, I try to beat the living hell out of my clients. Some of them respond by pushing harder than I ask and some work as hard as they are going to regardless of my efforts to interrupt their mediocrity. But those who respond would be working hard for ANYONE - I’m not special, I know more than most trainers but I have yet to be able to figure-out how to make someone work who is unconsciously satisfied with being average.

Now, there are similarities between those who work and those who show-up. Most of those who work hard have jobs that require a lot of independent work - VP’s for large banks / vendors, self-employed, independent or franchise business owners - or are young and working towards something. Those who show-up tend to have jobs that they don’t really like, work for people they don’t particularly like, and present excuses for not doing the things I ask as opposed to simply saying “I made the decision to drink on Saturday night.”

I suppose this is the psychology of fitness and optimal health. At SST I was engaging individuals who were working towards high level competition or with young people who had never enjoyed the slack life that full time employment can offer. At commercial gyms I’m working with those who have tasted the good life - the distractions / indulgences that money can buy - and have found returning to the simple life to be too challenging. It’s sad really, relaxing, eating and slothing away life is easier than grinding away at a mostly pointless activity that leads you to optimal health but moves you further away from passive enjoyment.

I fear for the future of many people on the planet. Most of the people I see and engage are, at least, coming to a gym and of these, 75% of them are not working very hard. I cannot comment for those who do not come to the gym but I’d be willing to guess that 95% of them are doing nothing to make their lives better other than changing their perspective so that those who actually do something are seen as fitness freaks and those who don’t are seen as the norm

Too Much Training Volume

Too many coaches hold the view that more is better when it comes to training volume and this belief is hurting their athletes.

Most of the conversations I have with coaches about a lack of progress focus on the athlete and not the poor program design. I hear things like “the athlete just isn’t getting it” or “they are losing focus” or “the athlete is weak and needs to work harder”. I have yet to hear a coach say “I’ve asked them to do more work than they can recover from” or “I don’t really know what I’m doing so I just get the athlete to do more” or “I train them the way I trained 20 years ago and don’t really feel like advancing my understanding by learning”.

I’m not implying that these coaches do not know how to make their athletes better at their sport because many of them do; they have an eye for the sport and can see things that more people can’t. In fact, many sport coaches are the only people who can coach the skills with their athletes. The issue is, they don’t understand the body well enough to understand that their athletes are failing to make progress because the brain cannot control the muscles to the precise degree needed to make the progress and instead blame the athletes will or focus.

Why are the athletes not progressing? There are two reasons, the muscles are not recovered enough to move as required and the nervous system is not recovered enough to coordinate the muscle fibers to move as required.

In the car racing world a driver can tell his mechanic that the car isn’t responding correctly when he press down the accelerator. The mechanic will then take a look, uncover the problem and fix it. A damaged spark plug for example will limit the amount of power that an engine is able to generate and once it is replaced, the engine goes back to full power. This is like the muscle not being fully recovered. A chef may find that he’s burning all of the items he tries to fry and when he looks at the stove realize that the gas dial goes from off to full with nothing in between. Once the dial is fixed to allow for precise heat adjustments the chef regains the ability to cook foods perfectly. This is like fixing neurological fatigue.

Cooking and car racing have one thing in common that most sports don’t have - a tool that acts as a medium between the individual and performance. This medium can be examined, shown to be malfunctioning and adjusted to function correctly. With most sports, the medium is the athletes body so it’s harder to figure-out the cause of malfunctions and since it’s harder to figure-out or see what is causing them, the first impulse is to blame the athletes will or conscious effort.

This is, when dealing with high level athletes, completely wrong. These individuals work hard, have greater focus than most people and are driven to perform better and better each workout. Their body’s however, cannot perform at a higher level each workout because of muscular and neurological fatigue and without sufficient recovery, their performance decreases. The coaches solution of making them do more reps, more cardio, more anything only serves to decrease their performance further, which will make the coach work them harder.

The good news is that body won’t allow this to continue for every long and the athlete will get sick well before they work themselves to death, which most high level athletes will do because of their work ethic. After about 6-7 weeks of over training, illness takes over and the athlete can’t perform at all. They take a few days off to recover from the illness which allows their body to recover and when they get back to their sport, they perform much better. The coach is happy and feels good knowing that they did a good job because of the improvement. They attribute the illness to a cold or flu and they start the cycle again - performance will begin to decrease after a few weeks as the athlete “loses focus” and the illness will return.

This pattern will continue until the coach smartens up, the athlete switches coaches, the athlete quits their sport or the athlete becomes aware enough to dictate the pace of training and lets the coach know that they are taking a few days off when they need to. Unfortunately, too many young and promising athletes will leave the sport and never actualize their potential because the fun leaves the sport due to this avoidable pattern.

If you are a coach and you notice in your athletes a pattern of decreased performance followed by sickness, a lack of focus following intense training periods, dramatic increases in performance following time off or if your solution for everything is more training, you need to get back to school and learn about neurological and muscular fatigue. If you allow your athletes to continue this cycle YOU are failing them and you may be chasing them out of the sport they love.

You Model What Becomes Normal

This page from kidshealth.org goes over some recent numbers about childhood obesity and the finding that 1 in 3 children is now considered overweight or obese. That’s a lot of young people who are suffering now and will be suffering for most of their lives. Carrying extra body fat makes all activity in life more difficult and there is an innate tendency for people to judge obese people more harshly as a result of their weight. I think some harsh judgement is fitting for someone who has control over the food they buy and eat, it is unfortunate for the younger obese person because up until a certain age, they have almost no control over what they eat.

I have little doubt that there are psychological reasons for many eating behaviours but when it applies to the escalating obesity rate with young people, I believe the obesity preceeds any psychological problems. If the young person’s brain is void of issues then the cause of the obesity is environmental in the form of poor eating behaviors taught by their parents or caregivers. Simply put, fat people breed lean people and then proceed to make them fat.

Fattening up a child is one of the worst things a parent can do because it harms their child but there is something even more insidious about it. Fattening up their children serves to make the obese parent feel more normal because it creates another fat person. Think about it this way, if 2 fat parents have 2 lean children, the ratio of fat to lean people in the family is 1:1. But if 2 fat parents have 1 lean child and 1 fat child, the ration of fat to lean is 3:1. If 75% of the people are obese, obesity can be regarded as the norm. If both children are fat then they have a 100% obesity rate making obesity completely acceptable. Obese parents, by making their children fat, create a life preserving fiction that being fat is normal and nothing to be concerned with or treated.

Fat parents rarely teach their children how they should be eating, what foods to buy and how to prepare these foods to maintain a lean body. They also never model lean as a way to live life. Their food choices are taught to their children, along with the obese lifestyle, as things that are normal. Lacking evidence that says anything different, the children learn that these things are how it is. They do not see a choice until much later in life when the habits are formed and their is a solid foundation of adipose tissue ready to soak-up the extra calories and store fat. By the time they realize that they do have a choice the odds are stacked against them that they will ever be a healthy weight because their body’s have become so good at storing fat.

For the obese parent it is not too late to stop abusing your child but you need to start now. You need to make a big effort to eliminate the behaviors that made you fat in the first place and begin to model the behaviors that will help to maintain leanness. You need to do this even if you will never enjoy a long lean life; just because you were victim to the consequences of poor eating behaviors doesn’t mean that your children need to be. There is more than enough information available that will help you make the right choices that to continue to make the wrong ones amounts to deliberate ignorance. The clock is ticking because your children are watching you and making your behavior the reality. How you act now is how they will act in the very near future. Give them a solid foundation to make their life easier than yours has been.

Long Steady Distance / Low Calorie Diets, Cortisol and Brain Aging

Last summer Tony agreed with me that I was probably killing myself with all the cycling I was doing. Soon there after I wrote Shortening your life by too much exercise to capture what I call the finite beat hypothesis - the heart has the potential for a certain number of beats and once these beat occur the heart stops working. It is a theory that seemed to make sense to me at the time.

In September when I started working at SST it became evident that the volume of cycling that I was doing was slowing my muscle growth because of the high level of cortisol associated with exercising longer than 45 minutes. Once I dropped down to one cardio session per week my lean body mass started to increase. If cortisol can have that dramatic an impact on lean mass creation what impact does it have on other body tissues?

A devastating impact.

Stress hormone may speed up brain aging outlines the findings of a recent study on an elderly population. The goal of the study was to determine if there was a relationship between cortisol levels and hippocampus size and neural density. The hippocampus is a part of the brain that is implicated in memory and spatial awareness functioning. It has long been known that in most individuals, there is a decrease in hippocampus size as they grow older and, as a consequence, ones performance on memory and spatial awareness tasks decreases with age. However, this new study indicates that the degree of deterioration is related to cortisol levels such that those individuals who have higher levels of cortisol show greater impairment and the size of their hippocampus is reduced when compared to those individuals who have lower cortisol levels.

What are the practical implications of this finding?

If you want to keep your brain functioning at a high level for the duration of your life you need to decrease the amount of stress you experience. This doesn’t just mean psychological or mental stress, it also means physiological stress.

Steady state cardio sessions that last more than 45 minutes have been shown to increase cortisol levels as have intense resistance and strength training sessions of the same length. Limit the length of these to less than 45 minutes and if you can’t, make sure you consume some simple sugars during the sessions to mitigate the bodies natural cortisol release in response to a drop in blood sugar level.

Very low calorie diets or eating behaviours that include not eating for more than 4 hours in a row should be avoided as they will cause a release of cortisol.

You should eat within 20 minutes of waking to help lower the level of cortisol in your body - cortisol is very high in the morning because you have not been eating. The sooner it is reduced, the sooner the negative aspects of cortisol will be eliminated.

Remember that cortisol is a wasting hormone that causes your body to consume itself to maintain functioning. When cortisol levels are high very little of your body will grow and we now know that this includes your brain. If you want to maintain a high quality of life into your senior years you need to avoid activities that promote cortisol release when you are younger.

Acidosis - What’s Eating You?

Alkalize or die outlines the negative consequence of acidosis (having too high an acid level) on the body.

Acidosis is the basic foundation of all disease. We need to understand the simple process of alkalizing our body and the important role a properly alkalized body plays in restoring and maintaining our overall health. Our glands and organs function properly in exact proportion to the amount of alkaline and acid levels in our system.

Have you ever been so upset with someone or something that you get an upset stomach? All negative emotions create an acidic environment. Have you ever heard anyone say you are letting your problems “eat away at you” or “get the best of you”?

Fear is the underlining cause of most disease. It will undermine your life and your health. Fear causes anger. Anger causes hate. Hate will consume you with continual suffering. Love and understanding cleanse and heal the body creating an alkaline environment within you.

Worth the read because it explains what happens to most of the main organs when acid levels increase and it offers some solutions on how to lower pH level. Not a big surprise that exercise and eating vegetables are on the list of things that make you more healthy.

Be Careful What You Read - Comment On An Editorial Conclusion

The skinny on fat by The Telegram is an editorial comment that is based on a study released by the American Institute for Cancer Research. The full report is available at http://www.dietandcancerreport.org/?p=ER if you want to read it. It is an average read and confirms a lot of what people have been saying about cancer and environmental influences. It contains a really nice break down on the impact of specific environmental influences on specific cancer rates. It is worth checking out.

I do not believe, however, the author of the Telegram editorial article took the time to read anything OTHER than the summary of the report. It wouldn’t normally be a big deal but they drew a conclusion that I wasn’t able to find in the report:

But whatever mysteries remain, the study stresses there’s no question that fat fuels cancer rates, to the point that the AICR believes poor diet causes as much cancer as smoking.

The study does not stress that there is no question that fat fuels cancer rates. The study doesn’t say much about fat at all. It reports a lot of findings about BEING fat, or over-weight as determined by BMI, as it relates to cancer but it doesn’t make any statements about actual fat. There is a very good reason for that - no one eats a diet of just fat.

The cited report is an epidemiological and meta analysis study that correlates dietary factors to the incident rates of various cancers. It is NOT a experiemental study that controls any dietary variables. These types of studies have a good track record in science but cannot be used to draw any causal conclusions as the author of the editorial has done.

I think this is an important point to make for a number of reasons:

  1. It is irresponsible for an author to attribute their claim to another person or group
  2. It is irresponsible to report feelings as facts
  3. Misinformation is rarely helpful because it moves one away from facts

In a more general sense, unprocessed fat is NOT harmful to an individual when consumed in the right combination with other macro-nutrients. Eating fat with high glycemic index carbohydrates will result in greater fat storage but eating it with protein will not. For example, eating a large steak with a salad will result in less fat storage potential than eating a small muffin with butter. The stake may have more fat calories than the muffin and butter combination, but since it and the salad do not contain any carbohydrates that rapidly increase blood sugar, there is a lower chance that the body will go into fat storage mode.

I don’t blame the author for drawing the conclusion that they do because fat = bad is something that has been said so often that it understood to be a fact. However, to attribute this understanding to the World Cancer Research Fund International and the American Institute for Cancer Research is just wrong. They haven’t made that claim in their report and it is unlikely that they will ever make this claim. Their conclusion is that being OVERLY fat WILL increase your likelihood for developing certain types of cancers.

Shortening Your Life By Too Much Exercise?

I was hanging out with Tony and I mentioned that I figured I was going to die young from a heart attack. Tony agreed so quickly that it kind of scared me. “You think I’m right?” He says “yeah. There’s a cost to all the adaptation that you are forcing your body to go through.” We riff off of that for a while before the conversation returns to something I don’t recall because I was too busy thinking about my rapidly approaching death.

He’s right, there is a cost to adapting to the physical stress I put my body under. Any environmental change forces the body to maintain homeostasis or adjust and create a new stasis, both of these responses require energy. Anytime your body liberates energy from food (digestion and absorption) and anytime it utilizes energy for biological functions, a chemical reaction occurs that gives off pollution in the form of free radicals and other chemicals. We can conclude that anything a person does to increase the amount of energy they use will increase the amount of pollution that is released within the body.

The inverse is also true, anything you do that lowers the amount of energy you utilize will decrease the amount of pollution that is released. The significance of this comes to light when we consider the claims of health practitioners that participating in frequent exercise will increase your health and will increase life expectancy. If their claim is true, exercise must do something to the body that causes it to eventually use less energy as a consequence to having performed the exercise than it uses directly to perform the exercise. Most people experience this benefit as a lowering of the resting heart rate.

Finite Beat Life - I’m not sure about the science behind the belief that the hearts life span is measured in beats vs. age - once it beats that predetermined number of times, it stops working. If this is the case, you should try to lower the amount of work that the heart does. You can either do less work or, you can make the heart stronger so it does more work per beat.

For example, I have a resting heart rate of about 48 beats per minute (BPM). The average resting heart rate is about 72 BPM. At rest, my heart beats 24 fewer times than an average persons - every 2 minutes my heart is saving 1 minute worth of work. My math may be a little off, but that is a saving of about 33%. At rest, I am using 33% less energy because I have trained my heart to work more efficiently. To me, that’s a huge saving of beats; given that most of my day is spent in a resting type state.

It takes a lot of effort to make your heart stronger, but all in all, the amount of beats that are required to lower you resting heart rate to 48 BPM is probably equal to the amount of beats the you save because your heart rate is lower. Lets call it a wash. You are no better off from the finite beat perspective but you do have better overall health due to your more active state. There is a net gain and you are healthier.

However, it requires a lot less to maintain the fitness required to have a resting heart rate of 48 BPM - 3 X 30 minute working segments of working the heart at 150 BPM per week. That works out to be 13500 heart beats (150 X 90). 90 minutes of rest for an average heart = 6480 beats.

When we calculate the daily heart beats for a trained heart and an average heart we get 78300 for trained and 103680 for the untrained. That is a difference of 25380 beats per day. From a finite beats perspective, you are WAY better off having a trained heart because even with the work required to maintain its health, your heart will work about 25% less. This is all good provided your finite beat life is long.

Shortening your life by working out too much - Am I shortening my life by teaching 5 cycling classes and taking two 3 hour bike rides a week? Yes, absolutely. Sure, I’m aging at 2/3rds the rate when I’m at rest, but since I’m exercising 8.5 hours more than I need to maintain a lower rate, I’m created way more internal pollution and excess heart beats than I would if I just worked out at the maintenance level.