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Total Results Blog

All You Have to Do is Nothing

I recently watched a lecture from several years ago given by Dr. Doug McGuff, who is the co-author of "Body by Science" and "The Primal Prescription." Both books are must-reads, in my opinion, for anyone that wants to learn the nuts and bolts of exercise as well as the paleolithic nutritional philosophy. Dr. McGuff is an emergency room physician and the owner of Ultimate Exercise (a studio with the same philosophy as Total Results) in Seneca, South Carolina, and is a highly sought-after speaker. In the above-mentioned lecture, Dr. McGuff spoke about the pitfalls of the current U.S. medical and insurance systems, and the picture that he painted was not a pretty one.

Dr. McGuff gave an interesting history lesson on how the system got to this point, and detailed the origins of medical insurance going back to the Great Depression (much of this was talked about in "The Primal Prescription"). The good doctor's advice is to stay out of the medical system at all costs, because it is a chaotic mess as it's currently constructed. This is unlikely to change anytime soon; in fact, it's likely to get worse. He treats an increasing number of patients that are suffering from chronic, rather than acute conditions, and he describes his emergency room as crowded and short-staffed. Frankly, it doesn't sound like somewhere I would want to be. During the question and answer period at the end of the lecture, someone from the crowd asked how Americans became so collectively unhealthy. The doctor's answer was pretty simple: all you have to do to become chronically diseased is nothing.

Physiologic headroom can be defined as the difference between the most that you can physically do and the least you can physically do. When those two points overlap, death occurs. Dr. McGuff also pointed out that, "The essence of life is fighting entropy." Entropy can be defined as, "Lack of order or predictability; gradual decline into disorder." The sad truth is that an increasing number of Americans are suffering from chronic disease, which in turn increases everyone's medical and insurance costs. If you go to any place where a large number of people gather (stadium, amusement park, airport, or even the grocery store), you will likely see a startling number of people who are obese, look generally unhealthy, or use some form of assistance to get around. From my office front door, I see diseased people walking in and out of Quest Diagnostics every day. Many of them have canes, walkers, wheelchairs, and oxygen tanks. This is sad to see, and even more disappointing to know that it was preventable. The infirmities that these people suffer from didn't happen by accident; it is a product of one's lifestyle.

If you regularly consume processed foods and refined sugars, cook with vegetable oils, take prescription medications, smoke, drink excessively, and do nothing to improve your strength, functionality, and immune system, this can happen to you! Remember, to become diseased, all you have to do is nothing. Over 100,000 people in the U.S. die each year from taking the prescribed dosage of medication as instructed by their physician. Yes, you read that correctly: the prescribed amount. Why is there no outrage from our elected officials or the FDA, and why is there little to no accountability from the pharmaceutical companies? Dr. Jennifer Daniels, a board-certified physician, posted two videos on YouTube, titled "Murder by Medicine", that detail how this happens. They are worth watching. While we're on the subject of medicine and bureaucrats, Dr. Anthony Fauci has been considered (at least by the establishment) as "America's Medical Authority" for nearly 40 years. During that time, the rate of chronic disease in this country has skyrocketed, yet he has kept his job. During the height of the Covid insanity two years ago, did Fauci ever talk about preventative measures? No, it was largely about quarantining the healthy and waiting for FDA approval for a "vaccine." Not once did I hear Fauci talk about the importance of proper nutrition, exposure to sunlight, supplementing with Vitamin D, exercise, or anything that might boost one's immune system against Covid, which is a virus that disproportionately affected the diseased and the elderly. This just underscores the fact that you cannot sit around and wait for your government or establishment medicine to take care of you.

How do we keep this from happening to us? Educate yourself and be your own advocate. There is a wealth of information out there from numerous reputable, non-establishment sources. Modern medicine has devolved into doctors examining a patient for less than five minutes before writing a prescription. Do not blindly follow what your doctor says, simply because he or she wears a white coat! Challenge your doctor to consider alternative therapies and natural treatments. If they are not comfortable with being questioned or open to a discussion, consider finding a new doctor. Consume a diet largely consisting of single-ingredient whole foods. This will give you the most bang for your buck, and help you to meet all of your body's nutritional requirements. What you put into your body is going to have the greatest impact on your outward appearance. When you shop for groceries, stick to the perimeter of the store. The most nutritional food (meats, produce, dairy, etc.) is on the outer edge, and the junk you don't want is typically in the middle aisles. Proper supplementation will help to fill in any nutritional gaps and boost your immune system. I recommend taking the following: zinc, Vitamin C, Vitamin D, fish oil, and magnesium.

Get regular exposure to sunlight. One of the worst consequences of the draconian Covid lockdown was that people spent way too much time indoors. Allowing the sun to shine on your skin in reasonable doses helps the body to produce Vitamin D, which is essential for health. Strive to get between seven and nine hours of sleep per night, with a consistent bed and wake time each day. Limit your exposure to artificial light in the hour or so just before bed, as this can disrupt your body's production of melatonin. Stress management is also key. Practice mindfulness, meditation, or some other means of quieting down your brain in order to relieve stress and improve sleep.

Finally, exercise! One or two high-intensity Total Results workouts will do wonders for reestablishing functional independence, improving insulin sensitivity, increasing metabolic and cardiovascular conditioning, and will build a level of strength that makes everyday tasks much easier to perform. It doesn't matter where you are now; all that matters is that you have the desire and fortitude to get to where you want to go. Less than one hour a week is all that you need. Don't wait; DO IT NOW!

Posted May 26, 2022 by Matthew Romans

"The Brain's Way of Healing" - A Book Review

Norman Doidge, M.D., is a psychiatrist and psychoanalyst at the Toronto Institute of Psychoanalysis. He has written over 170 articles, many of which are academic papers on neuroplasticity, so he has extensive knowledge and experience on the subject. Dr. Doidge first wrote "The Brain That Changes Itself" in 2007 (which, in the interest of full disclosure, I have not read), and he followed that up with "The Brain's Way of Healing" in 2015. This book takes up the mantle where the previous book left off, and the central concept is that of the aforementioned neuroplasticity, which is "the ability of neural networks in the brain to change through growth and reorganization." Neuroplasticity is a relatively new theory in the study of how the brain works, and for many years scientists believed that the brain's abilities were static, particularly in the case of traumatic brain injury and genetic disorders. While this field is still evolving, there is a significant amount of scientific and anecdotal evidence presented in this book that supports Dr. Doidge's (and many other scientists') theories, and gives hope to people suffering from numerous brain difficulties.

I think it is important to briefly discuss what Dr. Doidge calls "the stages of neuroplastic healing." The first stage is neurostimulation. In this stage dormant circuits in the injured brain are revived, so that homeostasis can be achieved. Next is neuromodulation. This is where the balance between neural excitation and inhibition is restored, and the noisy brain is quieted. The brain cannot heal if it is stuck in a hyper-anxious state. The third stage is neurorelaxation, and here is where toxic buildups and waste products can be discharged from the brain through the cerebral spinal fluid. It also leads to more restful sleep. Finally, neurodifferentiation and learning occur. The brain is now rested and the circuits can regulate themselves.

The first chapter of the book discusses the nature of chronic pain and contrasts it with acute pain. Dr. Doidge talks with Michael Moskowitz, M.D., who is a psychiatrist-turned-pain-specialist who has had his own experiences dealing with chronic pain (he once suffered a broken femur). The author sums up the difference between acute and chronic pain by saying, "Acute pain is a sensation we feel, an 'input' that comes into the brain from the bottom up, from our sense receptors. But chronic pain is more complex and more a top-down process." Dr. Moskowitz believes that a person suffers from chronic pain because the cause of the acute pain has never truly been remedied, which causes damage to the central nervous system. He is convinced that, "The body's alarm system is stuck in the 'on' position." Our brain has "maps" for pain that get damaged and continuously send false alarms; we think that the problem is in our body, when it's really in our brain. Dr. Moskowitz has his patients work to rewire and repair those maps by simply performing those activities that are painful, as a way of counter stimulating the brain and weakening the pain circuits. He also uses visualization techniques in order to stimulate neurons and activate portions of the brain that have been underutilized. Slowly but surely, the majority of his patients have seen their chronic pain decrease and even disappear. This is a far more effective and safer strategy than using opioid drugs to simply treat the symptoms. As Dr. Moskowitz says, "I don't believe in pain management anymore. I believe in trying to cure persistent pain."

Dr. Doidge profiles a South African man named John Pepper, who was diagnosed with Parkinson's disease in the mid 1990's, although he had first started showing symptoms in the late 1960s. Medications that he was given to treat the symptoms of the disease had started to wear off after about five years, and his abilities had slowly started to diminish. The cognitive and physical decline in Parkinson's patients is often self-fulfilling. As their abilities recede, there can be less incentive to try and use what they have, which often sends them spiraling further downhill. As the author says, "...Our brains are more likely to waste away from underuse than to wear away from overuse." The same is likely true for our physical capabilities. Pepper decided to start a regular walking program, beginning slowly and covering short distances (with days in between for recovery) before working his way up to greater intensity and mileage. Because the effects of Parkinson's had done damage to his basal ganglia (the brain's subcortical nuclei that control motor learning and executive functions), Pepper had to do this very consciously and deliberately, in order to avoid injury and maximize the benefit. This regimen has worked wonders for him, arresting his Parkinson's symptoms and giving him a freedom of life that many sufferers of the disease could only hope to attain. In order to stimulate his brain, he also does crossword puzzles, plays chess, and learns French. He finds that when he decreases his activity his symptoms increase, so he stays as consistent as possible. Movement has been shown to be an effective treatment for other degenerative diseases, such as Huntington's and Alzheimer's. As Dr. Doidge puts it, "Perhaps the worst thing a patient can do, on getting the diagnosis, is to decrease their activity."

Light therapy and music therapy are emerging treatments that are discussed in detail. Low-level lasers help the body to harness its own energy, improve circulation, trigger the development of collagen tissue (which makes bone, tendons, ligaments, and even skin), and promote healing in a variety of conditions, such as fibromyalgia, joint injuries, traumatic brain injury, and some psychiatric disorders. Better still, there are no side effects. The positive effects of low-intensity lasers have been known to scientists since 1965, yet sadly, the FDA did not approve its use in the United States until 2002. Just think of how many lives could have been improved in that time frame! Music therapy has also been shown to be an effective treatment for children with dyslexia and autism. Dr. Doidge details the work of Alfred Tomatis and Paul Madaule, who have made great strides in the arena of music therapy. According to the author, this therapy works because, "The music in sound therapy turns on and enhances the connection between brain areas that process positive reward (which gives us a feeling of pleasure when we accomplish something) and the insula, a cortical area of the brain that is involved in paying attention." He adds that, "Since neurons fire in unison to music, music is a way to change the rhythms of the brain." Music therapy has been shown to improve the cognitive and social abilities of children with Down's Syndrome as well.

Exercise and lifestyle are also mentioned in the book, which was refreshing to see. Dr. Doidge lists five factors that will promote the general health of neurons. These include exercise (which is, "...the most powerful contributor to decreased risk of both general cognitive decline and dementia."), a healthy diet, normal body weight (defined as a BMI of between 18 and 25), low alcohol intake, and no smoking. These are the things that we should be doing every day. Dr. Doidge appropriately quotes late author Norman Mailer, "Every moment of one's existence one is growing into more or retreating into less. One is always living a little more or dying a little bit." If we don't use it, we lose it.

This book is pretty heavy reading at times. It took me a while to finish, and even now I'm not sure that I absorbed all the information, but "The Brain's Way of Healing" solidifies my belief in exploring ideas outside of the traditional viewpoint of the medical establishment. Dr. Doidge writes very well; he takes a complex subject and makes it interesting by relating stories of real people and their astonishing recoveries that traditional medicine did not think were possible. I see some distinct parallels between the growth mindset (the viewpoint that intelligence and achievement are not simply fixed by genetics) and neuroplasticity (where the brain can improve and heal itself in spite of injury or genetic defect). The information contained in this book can change the way we think about what the brain can do and how it can recover from physical and emotional trauma, and it shows that great things can be achieved with a combination of technology and grit. It is worth reading and just may provide you with some inspiration.

Posted May 13, 2022 by Matthew Romans

What Does It All Mean?

The desired outcome of any exercise session is to achieve a meaningful stimulus that provides the body with a good reason to make physical improvements. A clinically controlled environment and private setting within the Total Results studio enable us to eliminate the distractions that can interfere with achieving the best exercise experience possible. Specially engineered equipment combined with our unique exercise protocol form a combination that cannot be replicated or matched in a traditional gym setting or group exercise environment. As important as all of those elements are, none of them matter very much without a willingness on the part of the exercise subject to learn and give their best physical and mental effort. An experienced, conscientious, and diligent instructor is just what is needed to ensure this level of performance.

My friend and fellow instructor Al Coleman has said that exercise instruction is as much art as it is science, and I believe he's right. Sure, knowledge of anatomy and physiology, chemistry, and biology are important, but I think having an understanding of people is just as critical. Life is about relationships, and the instructor and client must be able to connect before they can truly form a partnership. When a personal connection is made, that is when the pupil and teacher can bring out the best in each other. There should be a clear understanding between both parties from the very beginning as to what the expectations are, so that there is no confusion. Communication is paramount and must be a two-way street.

Exercise instruction is not a physically demanding occupation, but it does require stamina, patience, attention to detail, and a willingness to be critical. The last part scares some people off from the profession, because it isn't everybody's cup of tea. However, a part of the job entails telling people (who are paying for your services) things that they may not want to hear. The exercise instructor critiques performance, makes corrections, and provides the information that the client needs in order to optimize the exercise stimulus on every exercise of every workout. Some clients will get frustrated by being repeatedly corrected, but this goes with the territory. Being an instructor looks much easier than it is. There is a lot to observe, and it entails keeping track of weights, settings, and time under load, in addition to ensuring the safety of the client above anything else. When instructions are given, they should be concise; what I say is just as important as what I don't say, and it's about giving the right instruction at the right moment. I must avoid overloading the subject with too much information at once, so it's best to keep things as simple as possible. If multiple form discrepancies are being committed at once, I will correct the mistake I believe to be the most egregious.

There should be very little (if any) talking done by the client once the workout is under way. It's not that we don't enjoy conversing with our clients; we chat with them before and after a session. It's just that our studio is not a social setting, and we want to eliminate any potential distractions. Every so often I may have to ask a client a direct question pertaining specifically to their workout. In this case, a brief response is all that is required. I also don't consider myself to be a motivator, even though I do help to push clients beyond a level of effort that they would be able to produce on their own. The best motivation, after all, is intrinsic rather than extrinsic. My function is to communicate specific information in order to achieve a certain outcome, not talk as much as possible. Many "personal trainers" babble incessantly, shout, or simply offer nonsensical platitudes and cliches. That may be acceptable for social media videos and marketing, but I don't believe that is instruction. I also consider myself to be a teacher, but teaching and instructing are two different things. Instruction is what goes on during a session, while teaching happens outside the heat of the moment. When an exercise subject is experiencing labored breathing, extreme muscular discomfort, and is mentally coming to grips with the onset of momentary muscular failure, intellectual information simply will not get through. Any teaching that will take place needs to happen outside of the exercise room. Whether teaching or instructing, I believe it's important to vary my verbiage and not say the same things all the time in order to keep things fresh.

Achieving an optimal exercise stimulus requires focus and concentration on the part of the client. While the workouts only last about twenty minutes, they require tremendous mental and physical effort. The elimination of mental distractions is paramount, not only for efficiency of form but also to maximize safety. I have seen many clients over the years lose focus and take liberties with their form, and they have injured themselves due to their own behavior. For the duration of the workout, the client needs to be 100 percent present and not thinking about something else during that time. This may sound very difficult, and it is, but it is something that can be improved over time.

The exercise subject should strive for as smooth a movement as possible, in order to maximize muscular loading. When we say that the muscles are "loaded", it means that they are under meaningful tension. We don't want the musculature to get even a momentary respite during an exercise, because this runs counter to our main objective of inroading the skeletal muscles. The more effectively the muscles are loaded, the better the eventual exercise stimulus. Moving slowly is important, but it isn't enough. Going too slowly (more than 12 seconds in each direction) encourages segmentation of the movement, which alternately loads and unloads the musculature and thwarts the stimulus that we seek. Novice clients often have some difficulties with pacing and segmentation early on, which is to be expected when learning something that is new. This usually will improve over time, as one builds skill and works toward a more meaningful level of resistance. Clients that have motor control difficulties may be better served by moving at a slightly faster speed, in order to achieve a smoother movement, but I still believe that moving any faster than 6-8 seconds in either direction is too fast.

Remember what we are working toward: we want to reach the point of momentary muscular failure, because it is the only way to ensure that we have given a maximum effort on each exercise. Efficiency is the key, and it's important to remember that exercise has a narrow therapeutic window. This means that, just like with medication, not enough accomplishes little to nothing, and too much is toxic. We want the minimum dosage of exercise necessary to stimulate positive change. Attention to detail as far as pace, speed, and turnarounds help us to fatigue the muscular more efficiently and without wasted movement. Lower turnarounds are especially critical, as this is where clients often will unload the musculature momentarily or fire out of the stretch (bottom out) position. Keep in mind that the body's recovery resources are finite, and that we don't want to artificially prolong the exercise just to complete an arbitrary number of repetitions. We desire to achieve the stimulus without overtraining. That is the key to sustained progress and avoiding injury. When muscular failure has been reached and the client continues to push against the immovable movement arm for an additional five to ten seconds, he or she has done everything they can possibly do to create positive change.

Anything that is worth doing is worth doing to the best of one's ability. My personal purpose is to attain something meaningful every day, and I believe that exercise instruction and connecting with Total Results clients is a worthwhile endeavor that makes me look forward to getting up at the crack of dawn every morning. I hope that our clients see their workouts and the entire exercise experience as an opportunity to achieve something great every time they walk through the studio doors. Together, we are capable of accomplishing extraordinary things.

Posted April 28, 2022 by Matthew Romans

Adaptive Stress

The human body is a wonderfully adaptive organism. Given the proper resources (nutrients, water, sleep, and time), it can heal itself from disease, repair injuries, and grow stronger as well as more resilient. When one follows a ketogenic diet (in which few, if any, carbohydrates are consumed), the body can manufacture the glucose necessary for intense exercise out of protein, fats, or ketone bodies. Most of us are aware that the body's main desire is to maintain homeostasis, and whether the current state of the body is good or bad, it wants to conserve resources whenever possible. In order to elicit change in the organism, the body needs a good reason to spring into action. This change usually occurs as a result of an external factor, such as when exposure to sunlight spurs the body to produce Vitamin D and causes the skin to darken. If you want to stimulate an adaptation, then the body must be periodically exposed to manageable amounts of stress.

Think of the above example. If you go out into the sun once over the course of a summer for just a few minutes, but do not go outdoors again for the rest of the season, you won't develop a suntan (and you'll likely have suboptimal levels of Vitamin D in your system). There is a balance to how much stress one should experience without going overdoing it, and some people are more physically and mentally sturdy than others. Your immune system is a microcosm of this concept. How resistant you are to illness is due to a combination of factors, both genetic and in terms of your lifestyle. One thing, however, is certain: you cannot live in a completely sterile environment. We regularly see commercials for antibacterial soaps and cleaning products that claim to "kill 99.9% of viruses and bacteria." The germ theory of disease is part of the foundation on which establishment medicine (and the pharmaceutical industry) was built, but a lot of holes have been poked in Pasteur's hypothesis as of late. While I don't propose that we live in unsanitary conditions or surround ourselves with Asbestos, I believe it is important to strategically expose your immune system to pathogens. This is another form of stress, and it can be as simple as being around other people, getting fresh air, and not wearing masks in public places. Your immune system needs exposure to different pathogens, so that it can recognize them, fight them, and kill them if they try to invade your body. An unintended consequence of the draconian Covid lockdowns is that kids were forced to stay home instead of being in school, and they were no longer routinely exposed to other kids, so many ended up getting sick because their immune systems were thrown into flux. By all means we should use common sense, wash our hands, and practice responsible hygiene, but let's not think that a paper or cloth mask is going to protect us. In most cases, they do far more harm than good.

Our emotional health and mental well-being are also optimized by periodic exposure to stress. I believe this to be absolutely critical during childhood, when the brain is most malleable, and it sets the course for how we deal with life as we journey into adulthood. Overprotective, but well-intentioned parents often try to shield their children from stress or adversity in the hope of sparing them from potentially damaging trauma. This is completely understandable, but as we know, the world does not work that way. Somewhere along the way adversity will make its presence known, and how we deal with it and learn from it determines our character. Daniel Goleman talks about this in his 2006 book "Social Intelligence." Goleman discusses a study performed at the University of Wisconsin that involved about ten thousand high school seniors from the class of 1957, and they were interviewed when they were in their teens, at the age of 40, and again as they approached age 65. The researchers also studied activity in the frontal lobe of their brains, and found that those with higher activity in the right prefrontal area relative to their left more often had intense distress and recovered more slowly from emotional setbacks. According to Goleman, "But those people who had been exposed to manageable levels of stress during childhood were most likely as adults to have the better prefrontal ratio." This means that they dealt with adversity better and bounced back more quickly. My take on this is that too much low level, constant stress leads to anxiety and maladaptation, while not enough stress can lead to a false sense of security and fragility when things eventually don't go right. It appears that if we experience just the right amount of occasional emotional stress (while in a safe and nurturing environment) it is essential for building robust emotional health. The ability to bounce back quickly after a setback is a key component of life success, and it drives performance and achievement. There are strategies and exercises that one can do to improve mental toughness. Two good books that I recommend are "Fortitude: American Resilience in the Era of Outrage" by Dan Crenshaw, and "Antifragile: Things That Gain From Disorder" by Nassim Nicholas Taleb.

Stress is a key component of Total Results exercise. Take a moment and really consider what it is that we are doing during the course of a workout. We are putting the body through a brief, but intensely stressful experience once or twice per week for twenty minutes or less. Exercise sessions are physically and psychologically stressful, which is why the workouts are so brief and infrequent. What we desire is a physical adaptation, i.e., to grow stronger muscles, improve cardiovascular and metabolic conditioning, and protect against injury. The best way to do that is to expose the muscles, bones, and connective tissues to safe and appropriate levels of stress, and since the body needs a good reason to adapt, the intensity of effort needs to be very high. This allows us to stimulate the growth mechanism, which spurs the body to make an adaptation. Exercise, like medication, has a narrow therapeutic window, meaning that there is a fine line between too much and not enough. Not exposing the body to any stress accomplishes nothing, while too much stress (in the form of too much force or too frequent bouts of exercise) will lead at minimum to a stagnation of progress, and in the worst case scenario will lead to illness and/or injury. We want the minimum dosage of stress (the workout) necessary to achieve optimal results, and while pushing each exercise to and beyond muscular failure is no doubt stressful, it is perfectly safe if done properly under the watchful eye of an instructor.

We know that the human body is a wonderfully resilient and adaptive organism, and it can often achieve amazing things even in spite of bad habits (many professional athletes are living proof). It does, however, have its limits, and it is wise not to push things too far. This can vary from one person to the next. On the other hand, modern conveniences like delivery and food apps are great, but in many ways contemporary living has softened us mentally and physically. We all need some stress in our lives in moderation in order to help us to grow physically, psychologically, and spiritually. It is a necessary and unavoidable factor in our lives, and stressful situations are an opportunity to accomplish something great and learn exactly what we're made of. As the ancient Stoic philosopher Musonius Rufus once said, "Do not be irked by difficult circumstances, but reflect on how many things have already happened to you in life in ways that you did not wish, and yet they have turned out for the best."

Posted April 15, 2022 by Matthew Romans

"How We Learn to Move" - A Book Review

Rob Gray, PhD, is a professor at Arizona State University and has worked in the field of movement, specifically perceptual-motor skill, for over a quarter century. Gray has worked as a consultant for several sports teams, Nissan, and the United States Air Force, and in 2021 he self-published the book "How We Learn to Move." This book discusses new information in the field of motor learning and puts forth some alternative ideas to consider. Upon reading this book, it may just cause us to reevaluate how we learn and teach movement skills, as well as open our eyes to suggestions of how the youth sport experience can be improved.

Dr. Gray starts the book by discussing former Soviet scientist Nikolai Bernstein's study of blacksmiths cutting sheet metal. This may seem like a strange topic to cover in a book about sports movement skill, but it has far-reaching implications throughout the text. Bernstein discovered a subtle difference between novice and experienced blacksmiths. The novices did not hit the head of the chisel with the hammer on the same spot each time when cutting sheet metal, so their results varied. In contrast, the experienced blacksmiths hit the same spot each time, but without repeating the exact same movement on each strike. As the author says, "Skilled performance did not involve one correct movement technique. Instead, it involved using a slightly different technique with every execution. The key to becoming skillful was not strict repetition. Instead, it was repetition without repetition - learning to produce the same outcome by using different movements." This idea flies in the face of conventional wisdom, in that we have been taught for years that maximizing skill involves practicing the same exact movement over and over until we get it perfect. The idea of using slightly different movements and being adaptable to one's environment is the theme around which this book is written, and there is significant scientific evidence to support the thesis.

Anyone who has played, coached, or had their child participate in youth soccer is no doubt familiar with drills that involve dribbling the ball around cones set at predetermined distances in the hope of improving ball handling ability and coordination. Since these drills have been used for years they seem logical, but the truth is that soccer is not played in anything close to a static environment. Worse yet, these drills involve a couple of kids moving, while the rest of the team stands and waits for their turn. In a real game, conditions are always changing and you have defenders that block your path or try to steal the ball from you. An athlete needs to be adaptable to the environment around them, and if a player simply follows a prescription plan in practice he or she will be totally lost once the game starts. Dr. Gray believes that a practice environment should be set up as close to game conditions as possible, and he believes in the concepts of variability and imposing constraints. By utilizing something called a "small-sided game" (where the size of the field and the number of players are reduced) soccer players can work on adaptability by adjusting to changing conditions (having to dribble and pass in a smaller space) just as may happen in an actual game. Tennis gives us another insight. Legendary player Rafael Nadal has hit millions of shots in his life, and perhaps to the untrained eye these shots look similar if not identical, but he says this is not so. According to Nadal, "The differences might be minute, microscopic, but so are the variations your body makes - shoulders, elbows, wrists, hips, ankles, knees - in every shot. And there are so many other factors - the weather, the surface, the rival. No ball arrives the same as another; no shot is identical." This means that Nadal has to constantly practice a variety of shots, and if he wants to produce the same outcome (a successfully placed shot), under constantly changing conditions, he will have to use a slightly different movement each time.

Chapter eleven discusses coaching youth sports and the problems with the traditional models that have been used for years. Many of the things that are practiced in sports, such as running through agility ladders in football, hitting off tees in baseball, and doing passing lanes in basketball are based on flawed assumptions. We have been taught that we need to learn proper fundamentals before moving on to more complex skills, but these drills that I just mentioned have very little to do with how each of these games are actually played. Dr. Gray brings up a good point near the end of the chapter. "What exactly is a 'fundamental' anyways? The concept comes from the long-accepted assumption that there are basic building blocks that we must put together to become skillful, like the example shown in Figure 11.3. But this idea suffers from the same problems that we have been discussing throughout this book. It assumes a linear, deterministic relationship between fundamental movement skills (if we want Skill 1 we just add Fundamentals A, B, and C) that is not consistent with what we have seen in an adaptive complex system like an athlete." Skills are highly specific to a game-like environment, and nobody hits off a tee in a baseball game. In order to maximize skill, the athlete needs to be able to adapt to the information available to them in a game environment, so coaches should structure practices to be as close to the game experience as possible. This will enable players to make the right decisions in real time and be able to "think on their feet."

Injury prevention and adaptation are talked about at length in Chapter 14, and there are multiple references to baseball pitchers having Tommy John surgery (replacement of the Ulnar Collateral Ligament in the elbow). I have often wondered why this injury is so common, but Dr. Gray explains the flaws in pitching mechanics that lead to this injury. Injuries are going to happen in sports; that is just the nature of the business. However, anything that can be done to lessen the frequency and severity of injuries only serves to help the competitive athlete. It begs the question: with advancements in training techniques, nutrition, and recovery, how does one account for the rise in ACL (Anterior Cruciate Ligament) and UCL injuries? According to Dr. Gray, "An overemphasis on planned movements creates patterns (greater angles, rotations, and energy absorption) that are likely to cause overuse injuries." The author suggests, "Adding more unplanned and unpredictable movements in practice is not only more representative of what a performer is going to actually face in competition, but is also likely to give more opportunity for them to develop this injury reducing adaptive variability." Keeping things fresh and not using the same movement patterns over and over will reduce the likelihood of an overuse injury, it will pay greater dividends in a game and help to prevent boredom and mental burnout as well.

I believe there are some takeaways from this book that have relevance to Total Results exercise. Think about what is happening with the exercise subject and the instructor during a workout: there is regular feedback given by the instructor, and the client needs to be able to process the information that is provided and execute the instructions. There is both verbal and visual information (hand gestures, etc.). It is important to give cues to the client without programming them. In addition, as much as we try to standardize each repetition, even the most proficient trainees will have variations in speed, pace, and turnaround technique from one repetition to the next. Remember, not all ten seconds are created equal. According to Dr. Gray, "Acquiring and improving a skill involves developing the controller's general abilities: perception, attention, anticipation, memory, and decision making." I also like the discussion about internal versus external focus and how it pertains to weight training. Gray says that an internal focus (something I believed was an effective strategy) in fact, "...not only leads to less force generation, it also is associated with greater muscle activity, as measured by surface EMG." Since the primary purpose of a muscle is to produce force, it makes sense that we should focus on trying to move the body part (an external focus), rather than simply concentrating internally. This leads to a greater exercise stimulus, or so it would appear.

I enjoyed this book and would recommend it to anyone who works in a movement-based field or has an interest in motor learning. As a former athlete and youth/high school football coach, I can certainly relate to the scenarios presented in the text, as well as the new information that is shared. It is my belief that early specialization in one sport, as well as boredom, often lead to kids losing interest in sports before they have a chance to experience the joys as well as the life lessons that are a part of competition. New thinking about practice structure and skill development can make for a more fun and fruitful experience. The major disappointment about "How We Learn to Move" is that it has terrible proofreading and editing. In several passages there are words missing and a lack of punctuation that could very easily have been corrected; I am told this is common when a book is self-published. I simply choose to look past those flaws and focus on the excellent information that is given, as well as the sound research that supports Dr. Gray's theories. This could cause a sea change in the way athletes are coached and skills are learned, leading to a greater experience for players and coaches alike.

Posted April 01, 2022 by Matthew Romans