Wednesday, August 15, 2007

No One's Going to Save Us

An anonymous poster left a comment about chiropractic this morning, which everyone who wants a little more insight than I can provide on the practice should read in its entirety (click on "comments" after my "Chiro-Skeptic" post below). He wrote about my chiropractor's recent diagnosis that I have forward head syndrome and the chances that chiropractic treatment will successfully fix the problem. One of his points was particularly striking:

...arguably most important is patient compliance. Given the DC has correctly identified what is going on, provides adequate physical medicine, manual manipulation and a correct exercise prescription - chances for success are decent. Chances are much better with patient compliance. There are 168 hours in a week, if you see a DC 3 times a week, 30 min each time, there are still 166.5 hours of time away from the office that the patient is responsible for and thus patient compliance is monumental.

This got me thinking about my own work as a fitness trainer, and about the health care industry in general. Now I'm not a doctor, nor am I a chiropractor. I don't even play one on TV (though I did, once, briefly, many years ago... but that's another story). But people do come to see me regularly for guidance on how to improve their health, and so I do share some of the frustrations of the professionals in that industry, even if I don't share in their six-figure annual income (of course, I didn't share in ten years of schooling, sleeplessness, and crushing debt either).

It's common practice to slam the American health care industry, and with good reason: it's an overpriced, elitist, labyrinthine mess (I haven't seen Michael Moore's latest, pretty much because I live it: as a lifelong asthmatic and a self-employed adult, I'm quite familiar with the nightmare of trying to get good service at a reasonable cost). I harbor just the slightest glimmer of hope that perhaps our next administration will be less concerned with busying giddy minds with foreign quarrels and perhaps a little more attentive to pressing problems at home. But for now, we have to face the fact that American health care is the mess that it is, and you and I have got to figure out a way to work with it.

What I'm making a plea for here is patient accountability. Yes, the system has made it very difficult for many health-care providers to operate at the top of their game, and we patients suffer for it. Yes, there are diseases and conditions that are simply not anyone's fault, and for which the only solution is long-term medication and care.

But let's be honest: there are also a lot of medical conditions -- a whole lot -- that are the result of our own poor choices. Back pain, which, depending on who you ask, is either the number one or number two complaint of the average E.R. visitor, is usually due to some combination of bad posture, a sedentary lifestyle, poor exercise habits, and a bad diet. One could say the same of headaches, of dental problems, diabetes, and even, let's be frank, many, many more severe digestive and cardiorespiratory conditions.

My wife has a friend she's known since high school who has consumed two liters of Pepsi every day of her life for as long as Heidi as known her. She suffers from a host of medical problems: bad teeth, poor body composition, reproductive troubles, digestive problems, bad skin. For long periods she has been so ill that she's barely been able to leave her apartment, much less work a steady job. Now I'm not saying there's a direct causal link, between the two-liter-a-day habit and the host of health problems. But I certainly think that better lifestyle choices could very well have staved off many of her problems and helped her heal more quickly from the rest.

Certainly, it's a doctor's charge to deal with whoever and whatever darkens their office door. And it seems to me that most medical professionals have that down pretty well: they take a history, note the symptoms, they prescribe the standard operating procedure. But if we the patients don't step up and start taking some serious steps to take better care of ourselves -- to eat better, sleep more, exercise harder and more frequently, find ways to take it easy outside our pressure-cooker careers -- how indeed can our hospitals succeed in being much more than a triage unit, desperately slapping Band-Aid treatments on one patient problem after another? Nine times out of ten, the problems that a patient faces go deeper: they're a function of something underlying, some behavior or other that has probably gone on for decades, and needs to change fast.

My chiropractor told me that 95% of physical problems are asymptomatic. A symptom surfaces only when the body's own coping mechanisms can't handle the stresses you're throwing at them, and runs a red flag up the mainmast in the form of pain or sickness to signal you to slow down or just stop hammering away at the body while it figures out a way to heal itself. I don't know if that's an accurate statistic -- I imagine it would be a pretty hard measurement to take -- but it's worth considering that a lot of the time, without knowing it, we may well be functioning at far below optimal levels.

Here's something I know to be true. Say you have asthma, as I do. Your bronchial tubes can be up to 50% blocked before you'll even register that you're having difficulty breathing. So maybe you'll pet the neighbor's cat politely, have a sudden, violent allergic reaction, and wind up in the E.R. When you get home, maybe you'll insist that your neighbor to have their cat euthanized, but in reality your asthma episode was not really kitty's fault, but rather the cumulative result of stress, pollens, pollution, poor diet, limited exercise and whatever other irritants your life requires you to confront on a daily basis. Once you're in the hospital, it's in many ways too late.

I recently saw a simple little diagram that I quite like: it's a continuum showing gradations of health, with "SICKNESS" on the extreme left side, "HEALTH" in the middle, and "FITNESS" on the extreme right. The suggestion is that fitness, practiced correctly, is an extreme form of health. It's as far away from sickness as you can get. So by living a healthy lifestyle we're not only staving off sickness but keeping our insides healthy in ways that are only detectable with the aid of centrifuges and microscopes. We might not feel it, but our bodies will thank us for it anyway.

I do think this is where medicine is headed: towards greater emphasis on prevention and lifestyle and less emphasis on treatment alone.

As one of the doomed passengers on the hijacked airplane says in Paul Greengrass' terrific film UNITED 93, "No one's going to save us. We've got to do this ourselves."

Tuesday, August 14, 2007


Well, as seems to happen on occasion over here at, I'm going to be tucking into a nice slice of humble pie today. Lemmie splain.

About a month ago I was thrashing away in the gym, very excited about the new program I was embarking on by my colleague (in the sense that Pop Warner footballers are 'colleagues' with guys like Tom Brady) Chad Waterbury. Now I was coming off something of a layoff, after several months of work on the bike, in the water, and on the road in pursuit of shaving a few seconds off my sprint-distance triathlon time, and as a result, I should have been careful.

Needless to say, I wasn't. After a too-short warmup, I jumped to near maximum weight on the incline dumbell press, shooting for a set of six reps. Right around rep four, I felt something give and a friendly little stab of pain in the front of my right shoulder. I put the weights down, pretended that it was not a big deal, and limped through the rest of my workout with minuscule weights.

I kept up the pretending for a few weeks, wincing when I had to hand anything over 30 pounds to a client, and hoping I'd wake up one day with the pain miraculously gone.

Didn't happen. A couple of times I leaned on my right arm while lying down and felt like my shoulder had dislocated (which has happened to me, twice. Very painful.) So finally I decided to go see a professional, and I opted for... a chiropractor.

I made that choice for a couple of reasons:

1) This particular D.C. came highly recommended by a very knowledgeable trainer whom I trust and

2) He came cheap, presumably because if he does a good job on me I'll recommend him to my clients, and they'll tell their friends, and they'll tell their friends, and so on, and perhaps, most importantly,

3) Whatever happened, I figured I could blog about it and write about my personal experience with chiropractic, which up to now has been exactly zero.

In part, my chiropractic experience has been limited because I've been a chiro-skeptic. It doesn't really make sense to me that ALL physical ailments can be traced to issues with the spinal column. I don't know much about physiology (or history, or biology, or any of those Sam Cooke topics) compared to some people, but a theme that seems to emerge over and over again is that it's hard to reduce the intricacy of the human body. So many systems, hormones, chemicals, moving parts. Remedies seem very condition-specific. So the idea that you could fix a bad knee by cracking the back seemed counter-intuitive to me.

Another reason I've been wary of chiropractic is that it involves manipulation of the body from the outside, which has always struck me something of an exercise in futility. In my experience, habitual movement patterns will eventually trump whatever external manipulation you impose on the body. Sure, as this video shows, you can grab your biceps tendon and thread it over the end of your clavicle (its optimal position, from which it often slips), but how long will it stay there if you keep repeating the behaviors that pulled it off course in the first place?

Here's a little SAT analogy: stone : river :: body structure : physical movement. That is to say, what you do habitually will eventually imprint itself on your bones, muscles and connective tissues just as surely as rushing water wears away at the rocks in the riverbed. So my strongest resistance to chiropractic medicine has been that whatever the chiropractor does to the body will shortly be undone by your usual physical activities.

Finally, I had the usual fear-of-the-unknown resistance to the idea that all that snapping and popping could really be all that good for you.

In sum I was the Sir Thomas More of chiropractic medicine.

But I was -- and remain -- willing to suspend disbelief in order to come up with a dispassionate assessment of the practice. So that's what this, and probably a few posts in the near future, will be about. Call it a little case-study.

Here's what I've learned so far:

1) My shoulder problem is only part of the equation. The doctor, whose name I won't give here right now because I don't want to slander the guy if my course of treatment is unsuccessful, explained that my habitual neck position was largely responsible for my shoulder problem. This was encouraging, but unsurprising, to hear. I knew going in that chiropractors believe that all problems are ultimately spinal. Some even believe that they're all tracable to L1 or C4 or T2 or some other individual vertebra, which seems like a rather extreme position. But in this case, the doc's assessment makes sense to me. Despite all my efforts to avoid such problems, I have "forward head syndrome," which -- I'll save you the Google search on such a confusing name--means that I crane my head forward habitually. This tendency compresses some nerves in my neck, which itself can cause shoulder pain, but also causes the gears of my clavicle and shoulder joints to grind a bit, like a bicycle with a slipped chain.

2) I need to do all the stuff that I tell my clients to do. This was a weird one. I mean, I figured just telling a few dozen people a week to do some stuff pretty much counted as me actually doing it, but no, apparently I've got to actually be aware of my own posture. Aware, for instance, that when I type away at my computer I shouldn't strain my head forward to see the screen better. And that poking my head out three inches when I'm driving at night probably won't help me see the road signs all that much better. So as I sit here typing away--which, I'm told is one of the root causes of my condition (which means I can blame everyone reading this for my FHS) I'm trying also to be aware of perching my head directly over my shoulders and not jamming it forward like some kind of nearsighted turtle.

3) Chiropractic isn't just about snapping and popping. On the first day, all the chiropractor did was massage the hell out of the front of my right shoulder. To the point of extreme pain, actually, so that my shoulder was sore for a couple of days. I didn't mind, really, and was glad that he didn't just jump to cracking me in half like a pretzel. On my second treatment, he did do some adjusting of my neck and spine (which was weird but actually felt pretty good), but he also handed me a couple of sheets detailing some exercises I could do to help tone up the muscles that keep my head comfortably in retracted-turtle position, and to help rehabilitate my tweaked shoulder. In a way, this was what I was hoping for: some suggestion that retraining behavior was at least as important as manipulating the body from the outside.

I have to admit, though, that after the neck-popping yesterday, my shoulder feels better than it has since my injury, and I don't have the weird radiating pains that I was getting right up until the appointment. Coincidence?

Today's cliffhanger will be, if I do these exercises religiously (and I don't know of any other way to do physical exercises of any kind), will my FHS and shoulder pain really go away?

Watch this space to find out.

Friday, August 10, 2007

Angry Asterisks

A client of mine sent me this story about Mike Murphy, the guy who managed to snag Bonds' historical #756 Tuesday night at San Francisco's AT&T Park and the possible tax penalties Murphy will face if he keeps the ball. Worth a look.

In an effort to keep my readers in the loop, I rigged up a quick time machine and travelled a hundred years into the future to see what would become of our national pastime as a result of Bonds' achievement. Some interesting stuff, let me tell you:

August 14th, 2007: After some intense grabbing and shoving, college student Mike Murphy emerges from the human pig pile at AT&T Park with Barry Bonds' 756th home-run ball. Bonds says he is happy the Murphy had caught the ball, claiming to feel "A certain connection with fans who, like me, have alliterative names." Swallowing hard, Murphy decides to hold onto the ball, reputedly valued at over a half-million dollars, and pays upwards of $200,000.00 in taxes on the ball. The communications major is forced to work overtime in the A/V lab.

June 14th, 2009: MLB's laissez-faire attitude towards drugs in the sport continues, and a team of resentful chemists at Tulane University, sensing an opportunity to make a bid at vicarious athletic glory, refine a host of new performance-enhancing drugs.

April 3, 2010: A suspiciously muscular college student named Allworth Pennwright from New Orleans shatters the college record for home runs in a college career. Negotiations to draft the kid into the big-leagues start at $150 million. Of Pennwright's WWF-proportions, ubiquitous track marks, and frequent dust-ups with old ladies in parking lots whose shopping carts graze his bumper, baseball officials say "That's just Allworth being Allworth."

May 6th, 2018: Six Major Leaguers sail past the 800 homer mark before their 33rd birthdays.

April 18th, 2020: The official definition of a "Home Run" is amended to mean a ball hit not just off the field of play but "out of the ball park." Spectators are theretofore dubbed "Assistant Outfielders."

September 16th, 2021: Four shockingly well-built seventh-graders from Reno reach 800 home runs each over a short three Little League seasons.

June 12th, 2035: Baseball scores routinely begin to resemble basketball scores. Fans leave Fenway Park in droves during a Red Sox-Orioles face-off whose final score is a mere 45-37, played in dense New England fog. "Just not a lot happening in that game, man--what is this, soccer?" said a disappointed fan, polishing off the last bites of his Fenway Frank.

June 28th, 2036: Failing to hit a home run when at bat now defined as an "error." Player regularly fined for failing to hit 100 homers a season.

April 3rd, 2037: Pete Rose expresses incredulity that he's still not in the Hall of Fame.

May 4th, 2040: An angry group of asterisks (*) storm Cooperstown, New York, claiming overwork in annals of baseball history. Scabbing umlauts fill in, claiming, "We have commas to feed, and this is our chance."

August 4th, 2042: A single individual baseball survives a game without having been blasted out of the stadium. An enterprising bat boy swipes the offending ball, which fetches $2.1 million on eBay. Market value of home run balls declines to less than the price of a new ball at SportMart.

June 18th, 2046: Fans lament the passing of the "good old days," when records like Bonds' "really meant something."

June 20th, 2046: Herbert Finkel Von Hofenstein makes a mint selling "Home Run Proof Armor" for spectators and pedestrians in the vicinity of ballparks.

Opening Day, 2075: Fans who were bored with the game in the 80's and returned for the home-run hysteria in the 90's and beyond now bored again with the almost incessant parade of home runs. Baseball stadiums now eerily empty during regular season games, filled only by jackhammer-like sound of near-constant home run hits.

September 20th, 2085: Steroids banned officially from Major League Baseball.

August 6th, 2107: Pete Rose still not in Hall of Fame.

Sunday, August 05, 2007

Smart Advice No One Wants to Hear

I've been taking step lately to rectify my god-awful money management skills lately and, after interviewing a handful of money-management types I realized that, even though I build muscles and they build portfolios, we essentially speak the same language.

As I sat there listening to the third guy I'd seen chatter on about risk tolerance, global funds, 529K's and ROTH IRA's, my mind drifted to a much more pressing question: how is fitness training like managing money? Maybe I signed a couple of documents while I was daydreaming away, and one or two of them might have said something like "I relinquish sole ownership of all funds to the money manager listed below," but who cares? I came up with the following really neat-o list!

1) THINK LONG TERM. Like high-risk hedge funds, short-term diets and super-intense exercise programs may work in the short term, but will eventually crash and burn. You'll fall off your no-carb diet, you'll miss that third aerobic session of the day, you'll injure yourself and have to lay up and gain more weight while you recover, just as sure as the cash you make with a high-roller broker on a hot streak will eventually take a nosedive. Invest prudently in your health and fitness: slow, steady gains, consistent investing, eyes on the big picture.

2) BEWARE OF THAT WHICH APPEARS TOO GOOD TO BE TRUE. Now and then I get emails that promise some amazing tip on some obscure stock and guarantees of huge returns. There's always a moment of "Should I?" followed by a more cautious voice that says, no way. Look, if anyone had the solution -- the real solution -- to either long-term weight control OR consistently trouncing the market, the "Fitness" and "Investment" section of your local Barnes and Noble would consist of exactly one book each. And those two people would be very, very rich, and swimming in Nobel Prizes.

3) DIVERSIFY. If you had every dollar you earned in Enron in the early 90's, you would have been rich one day and then, suddenly... not so much. If two percent of your investment money was in Enron, and the rest in a variety of other securities and funds, you wouldn't have lost all that much. Same with fitness: running will get you fitter for awhile. Then, eventually, your gains will stall, you might even hurt yourself. Stave off injury and stalled progress by adding some stretching, some swimming, some weight training. There's no reason to be a one-trick pony in your fitness pursuits. Even if -- maybe especially if -- you're a competitive athlete, mixing it up is crucial.

4) THE TRUTH IS SIMPLE -- IT'S JUST NOT SEXY. If I wrote a fitness or investment book with the title "hard work, moderation, prudence and patience," I don't even think my mother would buy it -- but that's the key both to getting in shape and growing a nest egg. And we all sort of know that, don't we? But instead of knuckling down and getting to work, we'd rather scour the internet for articles on "Instant Wealth!" and "3% Bodyfat in Seven Seconds a Decade!" My clever little analogy breaks down a little bit here, because I doubt there's a gene for smart investing. But the point is that there are outliers in every field: people who have the good fortune to have hit jackpots either of the low-bodyfat or cash-accumulating varieties. Such people usually write books and articles, and create inspirational DVD's about their experience claiming that what they achieved over a weekend is easily attainable by many, many others! I've got news for you: if you're reading those articles and buying those DVD's, You Aren't One of Them. It's NOT going to be easy for you. All of Cindy Crawford's beauty secrets are sum-up-able in the following words: choose the right parents. For the rest of us, it's a matter of applying those tedious and virtually unmarketable four phrases above.

5) FINALLY, A TIP FOR TRAINERS: PROMISE LESS, DELIVER MORE. A few times early on, I've made the mistake of saying to a new client who has a weight-loss goal something like this: "You'll lose 75 pounds in six months!" This is a mistake because although I like to think I can influence my clients' behavior outside the gym, it's really a crap shoot. They might be ready to address their drinking or eating habits, they might not be. My three hours a week with them might be all they have to give. And that's okay. What's NOT okay is me ASSUMING that they will get with the program 100%, that no job or family issues will distract them one iota from their all-important diet and exercise program, and promising them a given result based on those assumptions. Recently a broker came to me as a new fitness client and asked if he could he get down to 9% body fat in a couple of months. When I told him it depended on his adherence to the diet and exercise program, and that his genetics would play a big role in how easy or hard it would be for him, and that his sleep habits, stress levels, travel plans and other factors would all influence the outcome of his efforts, he laughed and said that I was saying a version of what he told HIS new clients: you can't predict future outcome based on past performance, and you can't control peoples' spending and saving habits.

The money guys I saw this week all carefully talked around my questions about how much I could expect to make and how soon. So I've learned my lesson: my new strategy with clients is that I promise less and try to deliver more. I'll tell a client they can lose a pound every two weeks; then if they lose two pounds in a week it's a miracle and I'm some kind of magician.

So maybe, just maybe, I can apply all these things that I've learned about fitness to the investment world.

Then again, I've been looking to get a squat rack for my garage gym. And I played "Guitar Hero" on my friend's XBox the other day and started thinking how much fun it would be to have one of those...

Thursday, August 02, 2007

New ACSM Exercise Guidelines Rundown

Well, it's here at last folks! What we've all been waiting for. No, I'm not talking about the confounded iPhone! Not the '08 election results! Not the answer to those small-minded questions "Are we alone in the Universe?" or "What happens to our souls after we die?" I'm talking about the new exercise parameters for optimal health offered by the American College of Sports Medicine and the American Heart Association!

This is the kind of thing that fitness writers everywhere love to write about, because it's so easy to take potshots at a group that undertakes an impossible task like prescribing exercise routines for millions of people they've never met. So, without further ado, let the armchair quarterbacking, nitpicking, and utterly uncalled-for snarkiness begin!

For those of you who haven't heard -- and, come on, you've been looking forward to this since the last ones came out in 1995! -- the weekly guidelines are:

20 minutes of vigorous cardio activity, 3 times a week
30 minutes of moderate cardio activity, 5 times a week
2 sessions of 10-12 strength training exercises for 8-12 reps.

So here's what I think. And, just to continue with today's "unoriginal" theme, I'm calling it, 'The Good, the Bad, and the Ugly.' And remember, you heard it here 2,345th:


1) Strength Training. Hurrah! The benefits -- for mobility, strength, posture, joints, bones, and countless other health indicators -- have been so clear for so long that the only question is, why has it taken this long to make strength training a compulsory part of healthy living?

If you fed me a couple of beers, I'd offer the theory that it has something to do with the "muscle for muscle's sake" movement that kicked up in the '60's. People saw these muscular, proto-bodybuilders coming off of Muscle Beach and wondered if all that extra bulk could really be good for you. (Never mind that most of those guys were training with gymnastic-type moves that we'd now classify under the "Functional Training" umbrella -- which itself is a corrective to all the aesthetic training that people were doing in an attempt to emulate... the original Muscle Beach crowd! The sweet irony of it all...) The suspicion stuck, and weight training was relegated to the freaky side of the tracks till pumped-up movie stars and chrome-plated health clubs dragged it kicking and screaming, first into the popular mainstream, and eventually into the good graces of the American Heart Association. Hallelujah.

2) More Activity Overall. Ah, at last, the days of "20 minutes of walking three times a week is all you need for optimum health, weight control, and the vim and vigor of an 19-year-old Pep Squad leader" are behind us. Come on, people: a dog who only walked a total of an hour a week would chew its legs off. These new parameters are more realistic. Plus, an additional caveat that people seeking weight control or reduction will probably need MORE activity is also laudable. This further suggestion also implies -- albeit faintly -- that optimal exercise guidelines may be an individual matter.

3) Vigorous Activity. Earlier guidelines drew almost no distinction between the relative benefits of window-shopping and wind-sprinting up the side of a mountain. Now, at the very least, there's a suggestion that vigorous activity is an important part of the equation, even if it's classified as an option and not an absolute requirement. Half a huzzah for that one.


1) Over-Emphasis on Moderate Exercise. If I hear, read, or get an ESP message from one more trainer warning me that I absolutely must be able to carry on a conversation while I'm exercising lest I give myself hives or pleurosis or Anthrax poisoning, I'm seriously going to explode like the 'wafer-thin mint' guy in 'Monty Python and the Meaning of Life.' This is a vestige of the "training zone" breakdown seen on the control panel of every treadmill in history, which suggests that fat is burned only below a certain effort threshold.

But that, my friends, is nonsense. As my colleague (and consummate b.s. detecting-pro) Alan Aragon once said to a roomful of seminar attendees, "Sitting there in your chairs, you are ALL in the fat-burning zone." By this 'fat-burning zone' logic, a completely sedentary TV-watching slug should be the fittest, leanest guy in Red Rock, because he's burning fat all day long.

Moderate exercise, like brisk walking, or a round of golf, should be considered something you do IN ADDITION to formal exercise, not in lieu of it. It's just not strenuous enough to create a training effect. Walk a mile a day with no attention to the time it takes you or the effort involved, and over time you'll just get slower and slower until pretty soon you're cutting it down to a half-mile, then a quarter-mile, then watching people walk around a track on the Wish-I-Could-Still-Do-That Network. I'm not saying NOT to do these activities; just not to fool yourself that they're going to help you make significant improvements in your health.

2) Few Specifics on Strength Training Parameters. Using the new ACSM/AHA guidelines, I could go into the gym and do a single set of eight reps each of bicep curls, concentration curls, dumbbell curls, EZ-bar curls, preacher curls, tricep kickbacks, tricep pushdowns, one-arm dumbbell tricep extensions, crunches and calf raises with weights so light they practically lift themselves, and skip home whistling "When the Saints Go Marching In."

Alternatively, still sticking to their program, I could do three sets of twelve reps each of squats, rows, chins, deadlifts, bench presses, overhead presses, dips, hanging leg raises, and lunges, all with weights that I can barely handle, and need to be airlifted home. One workout will do almost nothing for all but the frailest gym-goers; the other would probably come close to over-training all but the fittest athletes.

So what exactly is meant by "2 sessions of 10-12 exercises of 8-12 reps per week?" Well... not a whole lot.


1) No Mention of Progression. "Strength Training" used to be called "Progressive Strength Training." Essential to the inaugural strength trainer's program was that Milo was shouldering a calf that was growing a little bit each day. No growth in the cow would have meant no growth in Milo's muscles. And it's really the same in the realm of 'cardio' as well. You've got to keep trying to get better: a little stronger or faster, maybe, but perhaps just slightly tighter form, a little more volume... heck, maybe even just ten minutes watering the lawn on an off day, or stretching for a couple of minutes when you get up in the morning. Something new, something different, something just a little harder is enough. And maybe you can't swing it every day. But in the big-picture sense, trying to progress should be part of the equation.

Why is progression so essential? Because 'stasis' is the primrose path to 'backsliding.' Here's a slightly off-topic analogy: there's a debate raging at the moment about the value of working to failure -- i.e., temporary exhaustion -- when training with weights. Prudent trainers are starting to advise against it, and although the science behind the anti-failure argument seems sound, I'd counter that counseling trainees not to work to failure is tantamount to telling them not to push themselves. So few people even approach muscular failure in the gym that warning them against it is like telling a pothead community college dropout not to spend too much time on his homework.

The same applies here: by failing to emphasize progression, the ACSM and AHA are essentially granting permission for exercisers to stop trying -- or even get worse.

2) Vague Language. Great that the word "vigorous" is in there. But what does it mean, exactly? We don't know, because there's no indication, not even so much as a single, measly reference to the Borg RPE scale, as to what constitutes 'vigorous.' It's just not specific enough.

Moving into stickler territory here, the term 'cardio' is fast approaching five-minutes-ago status, as it implies that certain forms of exercise -- or activity, or even complete catatonia -- don't require a boatload of support from the cardiovascular system. The distinction between strength work and cardio work is kind of blurry anyway: as I've said before, I can put a barbell in your hand and get you to huff and puff like you've just been doing wind sprints, or I can run you up a hill with everything you've got and get your thighs burning like you've just been doing squats. For the time being, let's refer to running, biking, swimming and the like as 'energy systems' training until someone comes up with a more elegant term. "Cardio" is misleading.

3) Combining Moderate "Cardio" Activity with Strength Training. This final "ugly" observation probably only applies to people who are serious about training and seeking significant improvements in strength or muscle mass, but it's worth noting that doing these two training methods concurrently usually leads to a compromise in strength training gains. That is to say: if you do intense strength training for an hour 2-3 times a week and a 45-minute jog on three other days of the week, you wouldn't get as strong or build as much muscle as you would if you were only doing exclusively strength training. This "interference effect" has been pretty extensively studied, so it's rather odd that the ASCM would recommend exercising in this less-than efficient manner. The solution is a carefully laid out periodization plan, but I suspect that the ASCM and the AHA just didn't want to go there for fear of the yawns and groans of boredom that would result. Funny, that's never deterred me...

So, to sum up my entirely subjective, unscientific rundown of these new suggestions: some genuine progress, some questionable calls, and a few things I would personally consider missteps in wording that another trainer might well quibble with. Overall, though, I'd have to say that as far as exercise parameters for the every man, woman, and child in the known universe go, these are pretty good, and they're certainly leaps and bounds beyond what we've had in the past.

Most of the criticisms I have for the program are tweaks, anyway: caveats and qualifications that would be more or less lost on an exercise-hater just looking for hard-and-fast rules on how to stave off early heart failure. Which is to say, the target audience for this sort of information: people who are, unaccountably, less fascinated by the minutia of exercise science than I am.

What a bunch of weirdos. Geez.

Your own comments on the ACSM/AHA report are welcome below. What do these suggestions mean to you? Do they seem excessive, overly cautious, confusing, contradictory? Write in and let me know what you think. Everybody's doing it.


Wednesday, August 01, 2007

Nerd Alert!

Recently I joined the National Strength and Conditioning Association, which is the hoop-di-doo club for people who take this fitness thing a liiiitle bit too seriously. Like, well, ME. One of the perks of membership is that you receive a quarterly journal packed full of scientific articles with titles like "Effects of Electromyostimulation Training on Muscle Strength and Power of Elite Rugby Players." (Upshot: said effects? Good.)

For me, these articles fall somewhere along the fascinating-incomprehensible continuum; still, I have a fun time trying to figure out what they’re saying. Plus, I feel all smart and everything carrying a scientific journal around, even if most of the experiments involve things like making dozens of elite athletes hop repeatedly down a football field on one foot while holding brightly-colored Swiss balls over their heads. The articles are written in scientist-ese, naturally enough, but there’s a distinct whiff of "Revenge of the Nerds" between their lines of polished, objective prose. Which I personally find hilarious. As in

Doctor of Exercise Physiology #1: Well, Doctor, do you think we’ve proved conclusively that the propeller beanies and aerodynamic gold lame leggings don’t in fact aid in base-running speed in these high-level college athletes?

Doctor of Exercise Physiology #2: I remember some of these ball players from high school. They took my lunch money and shoved me in a locker. Let's keep the experiment going for the rest of the season.

I've managed to get through a few dozen of these articles, and what keeps coming up is essentially a reiteration of one of the first principles of physical training of any kind: specificity.

One of my first blog entries EVER was on the SAID principle, which is one of the most elegant theories in the field of exercise science: it states that the body Specifically Adapts to any Imposed Demand: practice holding your breath and you get better at holding your breath. Practice doing pushups and, yes, you’ll get better at pushups. I thought I had a pretty good grasp of this notion, but until I started delving into the scientific journals, I didn't quite have a grasp on just how specific those specific adaptations were.

Take, for instance, a study headed up by Eric Cressey (whose contributions to the field at a very young age I resent at length here). In "The Effects of Ten Weeks of Lower-Body Unstable Surface Training on Markers of Athletic Performance," Cressey and his colleagues take one of the most common exercise modalities that falls under the "functional" umbrella -- stability training -- and tests it in actual practice.

We've all seen stability devices in gyms over the last few years: Swiss Balls, Bosu Balls, wobble boards, Dyna-Discs, Nike "Core" Boards, and their kin, all of which are supposed to improve our balance, and thereby (it is often claimed), our ability to, say, walk or run on an uneven surface, or respond more quickly to changes in direction or speed during an athletic contest.

Stability training, Cressey points out, has proven effective in a rehabilitative context. The question he asks here is, will training on an unstable surface help a healthy athlete get even better?

Without getting into too much detail, the answer is a resounding 'no.' Comparing two groups of soccer players, one of which followed a standard stable strength and conditioning protocol and another of which used instability training, the stable-environment group left the instability trainees in the dust. The data suggest that training on an unstable surface might make an athlete less "springy" off a stable surface (Cressey writes that "Torque developed by the antagonists decreases net torque in the desired direction," but I'm pretty sure he means that they get less 'springy.")

The reason comes down to the good ol' SAID principle: since soccer matches are not held on unstable surfaces, and since players' feet are rarely fixed in place for even a second at a time, performing, say, lunges on an unstable surface, as the athletes in this study did, will have very little direct application on a soccer field (or on performance tests designed to gauge an athlete's performance on such a field).

Now, if I were to open up shop in Venice and the local gondolier squad came to me to help them put together their program, I'd point them in the direction of the unstable surface lunge before they could say "Ciao, bello." Their vocation demands that they keep their balance in all kinds of tricky positions on a long, narrow boat floating through choppy waters of the Grand Canal, with drunken tourists creating further testing their sea-legs by vomiting over the side at regular intervals.

But that's a pretty narrow demographic there, Freckles.

The question that studies like this can effectively answer is "is system x -- which is designed to help trainees with problem y -- a magic bullet that will benefit all of us in some mysterious way? Is system x the holy grail of training methods?"

And time and again the answer is no. The body adapts specifically.

The patently obvious but oft-ignored take-home point for the average Joe or Jane trainee is that behavior must align with goals. The simple question to ask is, "Does what I’m doing in the gym (and my diet, sleep habits, etc.) support my goals?" If your goal is "better athletic performance," and all you do is tricep kickbacks, the answer is no. If your goal is "fat loss" and you diet without exercising, the answer is no. If your goal is "better posture," and all you do is bench presses, you better believe the answer is no, and then go back and read "External Rotation for Fun and Profit," and this time, pay attention!

Want to know the ultimate secret of being a fitness coach? Here it is, folks:

1) Do “X.”
2) If you can’t do “X,” break down “X” into pieces you CAN do and practice those until you can do “X.”
3) Do “X.”

If you feel like reading a larger 'life application' into the the above principle, go right ahead...