RECOVER: It's Such a Pain in the Neck

Spoiler Summary: Not too little (compressed), not too much (unstable), but -- a neck that moves right.

Last week I talked about the need for the body to "move right" and the fact that many times finding where the body does not move right and dealing with it quickly can prevent future problems.  Although a simple enough concept, to make it work in the real world requires knowledge of what you're looking at and why it matters.  Over the next few weeks I will discuss some of the more common patterns that my team sees.....starting from the top down.

The Neck

The neck (cervical spine) is a cluster of 7 bones which house the spinal cord, some major arteries and a few other key tissues that connect the brain to the body.  It is a highly mobile area of the body allowing for as many as 6 different motions in order to position the major senses to be most effective (sight, sound, smell and taste).  The benefit of all of the motion is that when it's working well and balanced, we can be highly attuned to our environment and the stressors we (literally) "face", allowing us to stay safe. The drawback, if it isn't working as well, the joints tend to compress, the blood supply to working tissues can be interrupted and everything from very painful headaches ("cervicogenic" headache) to pains anywhere along the upper extremity can result.

So what does "working well and balanced" mean?

Think of a sapling tree that's just been put into the ground.  It's got a ball of roots that have been placed into the ground and given some support by the dirt packed around it.  However, since the roots have not grown into the soil the trees is still easily moved.  Since nobody wants a crooked tree, the owner might place stakes in the ground and attach guy-wires, taking special care to keep them under the proper equal tension.  Assuming this equal tension is maintained, the tree (with good fuel and the right exposure/recovery balance) grows tall, straight and strong. 

The neck is under similar conditions. Without muscle tension to provide stability, the neck would crumble under the weight of the head. Too much tension ("muscle stiffness") on one side without equal opposing pressure on the other and the structure will lean or tip, compressing one side as it bends and pulling at the other.

Of course, since it's guy-wires are living tissue, the neck is a bit more complex than the sapling. With near constant flexing and bending to react to the world around us we are activating many of, but not all equally, the tissues that support the neck. For example, the more times we repeat a motion or the more hours we maintain a posture, the more we tell the body to alter the tension -- to tighten some guy-wires and relax others.  The more this happens, the more potential for uneven wear/tear and eventually aches & pains.

Perhaps the most common movement imbalance we see at the neck is a "forward head posture" which, just like the name implies, is the head sliding forward in front of the shoulders.  If you imagine a picture from the side, instead of the ear inline with the shoulder, we would see the ear is "forward", in front of the shoulder. This happens with gravity during sitting, driving, computer work and (more and more commonly) while using a mobile device.

Although the body can handle some exposure to this position, it's better in low doses as the bones/joints tend to shear on each other and we compress soft tissues as we compensate eventually contributing to a host of painful conditions. One of the most common early warning signs that go along with this posture is the "knot" in the side of the neck and the upper trapezius muscles -- sometimes painful enough to be labeled a "trigger point" as these muscles become overactive and overused while doing the extra work required in an attempt to make up for the poor position.

If forward and compressed is the problem, backward and elongated is very often the solution to restore balance and ease pressure. Sometimes it requires specialized exercises, sometimes it requires changes in work-position to impact posture and sometimes it requires both.  However once normal motion is re-established, rebalancing soft-tissue tension, including strengthening the front of the neck, and tissues that anchor the neck to the shoulder and upper back (the roots) is critical for a long term fix.

If you feel like your posture is "forward" or if you feel like you're losing motion in your neck, we hope you'll deal with it early - when it's easiest to do so. Let us know if you've got a pain in the neck that you're ready to deal with....it might be as simple as moving right!

Have a great weekend,

Mike E.

FUEL: Move then FUEL

MOVE...then FUEL...

"stronger, happier people through better health"

In mid 2012 we decided it was time to take our programs geared for the adult population to the next level of specificity, and not only embrace the element of "MOVE" to improve strength & fitness (and ward off sickness & disease), but to act upon "MOVE" in such a way that would help clients to do so more efficiently....correctly and more freely...without pain...and with a continual focus on preventing injury.  We knew that if we could further incorporate some of the knowledge & experience our PT's had, and find a way to develop more specific programs, geared to the individual, even in a group model...we could continue to drive training innovation and greater results!

Of course, like any good evidence-focused group would...our team knew the critical nature of assessing the situation, and starting with a small pilot group, prior to rolling out and incorporating more globally into our training mix...and after promising results in the pilot, in late 2012, we encouraged (strongly twisted a few arms on occasion) all of our adult clients to complete a newly improved annual assessment, inclusive of the Functional Movement Screening (FMS)...a tool developed by physical therapists to identify movement efficiency...or lack thereof....and objectify injury risk...thereby allowing us to further develop more-specific programs based on the findings.

That year, and upon annual assessments entering 2013, we were a bit surprised to find almost 58% of our adult population to be in the high injury risk zone.  Fast forward two years with consistent individual progress checks and program modification...and we are incredibly pleased to announce a 25% reduction in the number of high-injury risk individuals in our adult client population! And although our work isn't done (it never is)..maybe it's not just about "moving"...but "moving in the right way...and in the right amount"..aka specificity of dosage!  An achievement for sure, but not time to celebrate just yet...

Earlier this year, as our team continued to dive into the data, we realized that it was time to really double down our efforts on "FUEL", as the results from this year's annual assessment uncovered that the metabolic health of our adult clientele was unfortunately no better off than that of the US population.  In fact, slightly more than 50% have (or in some cases had...more on that in a bit) at least one significantly elevated risk factor associated with poor metabolic efficiency (blood pressure, LDL cholesterol, triglycerides, glucose, BMI, waist circumference).  And since we've long known it's darn near impossible to exercise your way to total metabolic health....and that Fueling in the right way...and in the right amount...aka specificity of dosage...is the right way to tackle metabolic risk....we decided this would be the year!

So, in the first quarter of 2015, we decided we would repeat what has become a successful formula...assess regularly and start small.  And although most of you heard a piece of it when I visited your sessions last week and we discussed upcoming and consistent progress checks / re-assessments (I'll reach out to those who were MIA that day)...what we didn't get to talk about was the progress made on the other component of the formula....and the results of our pilot  "Metabolic Health Coaching" program...a 10 week initiative that focused on evidence-supported, whole-food & plant-based fueling strategies...INclusive dietary guidelines (vs. exclusive "diets")...learn-by-doing cooking demos...and unwavering social support.  We are incredibly excited for the progress this group has made, and although some are still finishing their initial 10 weeks, the results thus far have been nothing short of extraordinary....and inspiring!

Avg. Total Lbs. Lost	Avg. % Weight Lost	Avg. Total Cholesterol Reduction	Avg. LDL (Bad) Cholesterol Reduction	Avg. Triglyceride Reduction
10.04	4.32%	15.47%	11.35%	7.51%

But maybe most powerful is personally knowing so many of these participants who are literally fueling themselves from high risk to minimal...real people just like us...people that you train with...people you know...people that you too care so much about...people who are getting results and have developed a new outlook on what's ahead...and in their words....

"Down another pound! This program has given me a new healthy relationship with food.  After years of dieting there is something freeing about knowing nothing is off limits...The great support and helpful conversations made a huge impact and has helped me to make healthy choices" - Elizabeth Z.

"At first I was skeptical about becoming a plant based eater, but I found that if I prepare and make sure I always have fresh vegetables and fruits on hand, I can eat this way.  My red line numbers have dropped considerably and I no longer have a pain after eating." - Patti D.

If you or someone you care about is ready for the next phase...one that moves you to metabolically fit....and one that FUEL's so GOOD...I hope you'll consider spreading the word that we are too, and we're anxious to get started!  Click Here to get moving (and fueling).

Happy Training,

MOVE: The Godilocks Principle for Dosage

Spoiler Summary: We've learned a ton, but there are still many unanswered questions in regards to healthy lifestyle.  For now, what we know is....it works; what we're learning is, the dose required to get the results. 

The era of lifestyle "dosing" is almost here. Although science hasn't brought forth an exact best-dose for every disease or risk we face (for example a group in Australia recently showed that all forms and volumes of exercise significantly reduced liver-fat and visceral fat--the dangerous organ fat that predicts health complications--even without weight loss in about the same amount), in many cases, researchers continue to scour the data and seem to be getting very close to being able to tell us exactly how much MOVE we need.

If things continue at the pace they're on, it won't be long for example, that professionals will be able to make recommendations that sound much more like reading the instructions that come with a medication ("adults should take X every four to six hours", "don't exceed Y in a 24 hour period", etc) than the general, vague and sometimes hard to follow recommendations that have been in the conversation for a very long time: "You need to eat less and exercise more".  It's great news for people who know they want to improve their health and quality of life through healthy-lifestyle but have struggled in knowing how best to do it.

So what do we know so far?  If there's a label that can be applied, it's probably reasonable to say that we're in "effective range testing", learning the minimum dose required and trying to know if there's a maximum effective dose (before harm is being done).  For example, an important recent study published in the Journal of the American Medical Association showed that meeting 1-2x the "minimum standard" for moderate activity per week (150-300 minutes per week during leisure time) had a major impact on risk of dying (30%).  Increase the dose to 3-5x (450-750 minutes per week) and get an even better impact (39% reduction).  Even though the effect seemed to level off there, suggesting 450-750 might be the sweet-spot, there was still an impact for those who didn't meet the minimum (20%) and there wasn't any significant harm for those who logged as much as 10x the recommended minimum (31% reduction for 1500 min per week) and far-exceeded the sweet spot....but that's not all.

In March, a group of researchers showed that, again, not unlike some medications, some doses are particularly effective when taken with food.  For example, adolescents who aren't quite "there yet" in regards to healthy nutrition may be able to use pre-meal exercise to minimize the negative blood-vessel impact (reduced blood flow) that follows a not-so-healthy meal choice. Specifically, 25 minutes of moderate exercise pre-meal had a significant impact.  HOWEVER (great news for those who are pressed for time), as little as 8 minutes of high-intensity (90% max) exercise had an even slightly better effect....so maybe it doesn't take the major time commitment we sometimes tell ourselves?

And if you really want to get creative think about this.....in some cases, it doesn't have to be traditional exercise at all....an early study suggests that dancing the tango seems to help individuals with early Parkinson's Disease. 

So what's the "take home" message on the science of movement to prevent and treat disease?  If there's a "too cold" - it's doing nothing.  If there's a "too hot" - it probably has more to do with knowing your personal limits than simply a number of minutes in general......and, like most things the more we learn the more we realize....there's likely a "just right".

The Consistency to Endure

Spoiler Summary: "Long term consistency trumps short term intensity" - Bruce Lee

I have a special place in my heart for endurance sports and the achievement that comes with them. It could definitely be due to the fact that growing up I watched my Dad, a self-proclaimed non-athlete, train and complete the local marathon more than a few times. I've always been inspired by the fact that after many attempts (and some heartbreaks along the way) he didn't give up. No matter the setback, he would dust himself off, start again and somehow find a way to achieve his long term goal, in this particular case, by less than 1 second....but that's really the smallest part of the story.  The proverbial "moment in the sun" is truly only a moment.  Standing by itself, it's not really that big of a deal....but in the context of the hours of dedicated training, of the focus and consistency required despite life's many distractions, of the time spent working through discomfort and setback, of the search (and ultimate "find") of new and deeper wells of strength....in that context, that moment in the sun, as short as it might be, is more like the cover of a great book, it only provides a glimpse of the amazing story that comes with it.

After having several conversations over the last few weeks with people at various work-sites who are training for these types of events (best luck BTW to a solid group of 1/2 marathoners this weekend, a few first-time marathoners in 2 weeks and an accomplished spartan-racer who is trying to set new records for himself this year), I was once again reminded how closely these stories parallel with the health and safety journey we are all on and how achieving safety and health so often requires the ability to ENDURE. 

Both are working toward a lofty goal: One might be to run 13.1 miles (or more). The other might be to get through a full year (or more) without getting injured.  

Both have moments of doubt: One might be in the midst of a training run when something starts to hurt more than it should and (miles from home) being forced to decide whether it's "just" pain or truly injury. The other might be on a day when something (seemingly out of personal control) just happens and we wonder if it's not all just random or luck.

Both have a common enemy in distraction: One, instead of sticking to the training plan and making incremental improvements, might be tempted to try some new "too good to be true" concept that promises to be more effective than time-tested approaches known to work; or worse, might the result of a decision not respect the limits of the body and have to pay the price for pushing too hard. The other might be in a moment of straying from the fundamentals and instead cutting corners in favor of something that promises a quick-fix; or worse, forgetting, even if only for a second, how dangerous work can be.

And the list goes on...

Safety and health are games of endurance - because the winners are not always the individuals and groups who can move the fastest or do it in the flashiest way, but those who can maintain focus and keep moving forward day in and day out, for years if need be.

If you take the time to speak with someone who was willing to apply consistent effort to a proven approach they will often share (in looking back) that it wasn't as hard as they thought it would be and that they actually enjoyed the effort.  They will tell you, (with a certain humility in knowing the job isn't done)  that there's still room to improve but everyday they get another chance to learn and grow is a good day. They will explain, in their own words, that with consistency, something that seemed almost insurmountable at first, became possible and then doable and then done.....until the next challenge. 

Is "high quality of life" on your priority list? If so, aren't safety and health important prerequisites? 

Is there something you believe you can do every single day to improve your odds of long term success? Is there something (anything!), no matter how small a step it might seem at first, that you know you can stick with?

  

If the answer to any of those questions is yes, I hope you'll start today.  You might just find yourself enjoying the effort and adventure.....and armed with a few more moments in the sun.