Located in Sterling, VA (703) 421-1200

September 2021

"Good to Go" - A Book Review

What is recovery? It comes across as a vague, all-encompassing, and slightly non-specific term, at least as it pertains to exercise and other forms of physical activity. The Webster dictionary defines recovery (in this context) as, "The process of becoming healthy after illness or injury." In an athletic or exercise sense, we could go a little further and say that it's the body's way of compensating after dealing with a stressor (a single bout) and improving upon its previous levels of strength and/or conditioning; it's not just a return to the status quo. Award-winning journalist and former professional cyclist Christie Aschwanden published the best-selling book "Good to Go" in 2019, which discusses the science of recovery. The book also takes a close examination of many of the popular modalities currently being used by elite athletes and weekend warriors alike, ostensibly to promote healing and optimize performance.

Before becoming a science journalist, Aschwanden studied biology at the University of Colorado and worked as a research assistant in a lab. In addition to being a professional cyclist in the early 1990s, she has participated in a variety of other sporting endeavors at a high level, such as skiing and running, well into her 40s. I think that all of those things come through in her writing and give her a unique perspective to share. The author examines some of the practices of professional athletes such as Tampa Bay Buccaneers quarterback Tom Brady, high level triathletes, and also participates in a study with several other weekend runners to see if beer is a suitable post-run recovery drink. One theme that resonates throughout the book is the idea that whether you're talking about weekend warriors, average Joes, or elite athletes at the top of their game, everybody wants a magic bullet. People who have a competitive nature want to get an edge, whether it's real or perceived. This is why the "recovery industry" has become so lucrative, and it's the reason that people are willing to invest a significant amount of time and money in the pursuit of performance optimization.

Aschwanden examines the use of ice and cryotherapy as a recovery modality. RICE protocol (rest, ice, compression, and elevation) has been standard operating procedure in athletic and sports training since the late 1970s, and is especially popular in the treatment of injuries. The thinking is that ice slows blood flow and reduces inflammation in the injured area, in addition to relieving pain. The problem is that this may actually delay the healing process, as inflammation is a necessary component for the body to mobilize resources to repair injured tissue. As Gabe Mirkin, MD, who was once a proponent of icing but has recently reversed course, says, "Anything that reduces your immune response will also delay muscle healing. The message is that the cytokines of inflammation are blocked by icing-that's been shown in several studies." Indeed, Gary Reinl, a rehabilitation specialist who has consulted for several professional sports teams echoes Mirkin's sentiment. According to the author, Reinl believes that "...Icing merely slows blood flow to the area, it doesn't halt it indefinitely. Once the icing stops and the blood flow returns to normal, whatever process you were trying to hinder will proceed again. The swelling will continue and the inflammation will start. The only thing you did was delay things." This is a far cry from what has become the accepted mainstream viewpoint. Cryotherapy, in which the participant enters a chamber filled with refrigerated air or liquid nitrogen that can reach temperatures as low as -250℉, has also become popular of late. While many athletes swear by it, cryotherapy has not been shown to be very effective at treating the conditions for which it is being promoted. The existing studies were all of low quality and there was no convincing placebo to meet the gold standard of a randomized, double-blind study. Keep those thoughts in mind the next time you see an athlete jump into a cold tub or a cryogenic chamber after a rigorous practice.

Sports drink commercials, particularly for Gatorade, are ubiquitous during any televised sporting event. Most people are aware of how Gatorade was invented, which was during the mid-1960's at the University of Florida. It was a rather simple beverage composed of sodium, sugar, monopotassium phosphate, and water. Since the original concoction was not particularly tasty, some lemon flavoring was added. The Gator football team figured it now had a secret weapon, and they believed that consumption of the drink contributed to their 1967 Orange Bowl win over Georgia Tech. Other teams took notice, and soon thereafter Gatorade became available commercially. Gatorade was acquired by the Quaker Oats company in 1983, and then the NFL signed a deal to make it the league's official sports drink. Does that mean that Gatorade (or any of its competitors) helps to improve performance or recovery? According to Carl Heneghan of the University of Oxford's Centre for Evidence-Based Medicine, the answer is no. Heneghan says, "Worryingly, most performance tests used to assess sports drinks have never been validated." Author Aschwanden elaborates: "When Heneghan's team gathered and examined all of the available evidence on sports drinks (they even consulted sports drink manufacturers to ask them for their supporting studies, though not all complied), they found what amounted to a bunch of preliminary or inconclusive evidence packaged as more definitive proof." The so-called research being performed at the Gatorade Sports Science Institute appears to be little more than clever marketing, and can hardly be considered objective science, since the sample sizes are typically very small. It doesn't exactly make you want to "Be Like Mike", a reference to the old Michael Jordan Gatorade ad campaign of the 1990s.

Aschwanden also examines the concept of a so-called "anabolic window" that exists after exercise or sports performance, something that has become an accepted tenet in fitness lore. We often hear that following exercise there is a certain period of time when the body is most receptive to nutrients, in order to facilitate recovery and stimulate growth, and that if we miss this opportunity to replenish the resources that we have used during exercise, our progress can be negatively impacted. Does such a window exist? According to Brad Schoenfeld, the director of the Human Performance Lab at CUNY Lehman College in the Bronx, "...It's not so much an anabolic window, it's an anabolic barn door." Aschwanden continues: "As long as you eat breakfast, lunch, and dinner, it's almost impossible not to get through. The barn door doesn't slam shut 45 minutes after exercise. Instead, it stays open for four or five hours, maybe more." This means that what we've been programmed to believe is, at best, misleading, and at worst, outright false. It's important to understand how efficient the human body is at maintaining homeostasis (a state of equilibrium), and to not worry about every minute detail. Instead, the author says, "...It's important to get the big picture right."

Now that we know that several of the accepted modalities provide negligible benefit, what are some recovery strategies that do work? One thing that is proven to work, costs no money, and requires only a little effort to do correctly is to focus on getting a proper amount of sleep. This is something that I have talked about in previous blog posts, but it certainly bears repeating. Most adults require between 7 and 9 hours of sleep per night, in order to feel refreshed. Keep the temperature in the bedroom around 65℉, with dark enough curtains to block out morning light; ear plugs can block out ambient sounds that make it difficult to fall asleep. Try to establish a consistent bedtime and wake-up time, and minimize your exposure to artificial light in the 30 to 60 minutes prior to sleep. Find ways to relax when you are able. Practicing meditation regularly, or simply being mindful from time to time, can go a long way toward not only helping you sleep better, but being in a better frame of mind and less stressed. While I believe the human body was designed to move and should not be sedentary, it's very easy to overdo it with various types of activities that can tax your body's immune system. This can lead to illness, injury, and a decrease in both exercise and sports performance. Listen to your body; nobody knows it better than you do. If you start to see a dip in performance or are feeling tired or sluggish frequently, it might be time to slow things down and rest.

The placebo effect is very powerful. Even if a modality provides no real benefit, the power of the mind can make one believe it is effective. If you think a ritual or practice is doing something for you, it can provide psychological benefits and relieve anxiety. The science of recovery is inexact and still evolving, and we are learning all the time. The last point I will make is a quote from Nobel Laureate physicist Richard Feynman: "The first principle is that you must not fool yourself-and you are the easiest person to fool."

Posted September 16, 2021 by Matthew Romans

Why I Love Exercise Instruction

I have been in the field of exercise for over twenty years, and I still get just as excited talking about it, learning about it, and instructing it as I did on my first day on the job back in July of 1999. There is always something new to learn, some insight to glean, or someone to show me an aspect of the field that I did not know. The challenge is constant, and that's why things never get boring for me. The technical aspect of being an instructor is what really moves me; understanding the ins and outs of our equipment, how it works, and what makes it so unique and effective. I really enjoy being able to share what I've learned with clients and prospective clients when they come through the doors at Total Results.

I recently finished reading Ken Hutchins' new book "Big Arthur, Little Me." Ken, as many of you are aware, is the founder of our exercise protocol, and this book is a memoir that largely covers his time working for Nautilus founder Arthur Jones. Hutchins has had some health problems recently, and has had to reduce his overall workload, but still remains a prolific and insightful writer on the subject of exercise. I am always inspired and reinforced when I read new stuff from Ken; it makes me want to keep learning. Here is a man in his early 70s, with nearly a half century in the industry, yet he continues to write and innovate. I can only hope my drive is that strong if I am fortunate enough to reach that age.

Many people are aware that the Total Results exercise protocol was developed during the Nautilus Osteoporosis Study at the University of Florida from 1982-1986. While many positive things did come out of that study, the environment was extremely chaotic and the data that was compiled was ultimately worthless, according to Hutchins (who, along with his wife Brenda, were Nautilus' chief employees present during the study). This was due to three reasons. One, the bone densitometry tools (to measure bone density) were inaccurate. Two, the test subjects' blood samples were not immediately processed. Finally, the exercise physiologist connected to the study insisted on using the VO2 Max test, which isn't a valid test of anything. The real value of the study was the refinement of the exercise protocol, the establishment of the clinically controlled exercise environment, a refinement of detailed instructional language, and the first established definition of exercise. If not for all of this Total Results would not be possible, so a great debt of gratitude is owed to Ken Hutchins.

This book in particular reinforces to me what I love about exercise instruction. I enjoy the intellectual challenge of assisting people to get more out of themselves than they thought possible. There is a creative aspect to my work; I can craft different routines to meet individual needs, and everybody that walks through our doors is different. Some may have orthopedic issues/injuries, while others are dealing with chronic disease. I am constantly experimenting with different approaches on how to instruct, while staying within the framework of our exercise philosophy that guides everything that I do. I regularly look for the right verbiage, and anticipate the right time and circumstance to use it. It is about knowing when to make a correction and when to say nothing; timing is everything. Sometimes, what I don't say is just as important as what I do say, and all of the instructions that I issue are for the purpose of getting the safest, and most effective workout experience possible. I strive to be a "looming presence" during the exercise session, but never be a distraction to the client. My work at Total Results gives me an opportunity to meet many interesting and successful people from a variety of industries, but it also allows me to connect with them on a level that goes beyond just exercise. This gives me a chance to explore what makes them tick, and it helps me to learn how to best instruct and motivate each individual, because one size does not fit all. I am very fortunate that I was able to turn into a lifelong vocation, something that started out as a hobby when I was thirteen years old. The new challenges each day brings helps keep things exciting and fresh. The end result of the exercise is certainly important, but I think the process is what means the most to me.

Finally, a new quote from Ken Hutchins really gives us something to think about, and certainly encapsulates what exercise means to me: "Throughout the excursion, constantly strive to find meaningful resistance. Be on the search, the lookout, the quest, the hunt for meaningful resistance! If exercise has meaning in your life, then the essence of the meaning is the resistance-not the weight, not the movement, not the power, not the work, not the repetitions."

Posted September 01, 2021 by Matthew Romans

The Immune System - By Ralph Weinstein

Immune System

The immune system is the body's biological defense system. The main purpose of your immune system is to protect your body from viruses and bacteria. Viruses and bacteria would have free reign and you'd be constantly falling ill. Your immune system works by recognizing the difference between your body's cells and alien cells, allowing it to destroy any that could be potentially harmful. This usually works well but can cause problems if your immune system wrongly classifies some of your cells and attacks them instead, resulting in autoimmune disorders.

The Innate vs. Adaptive Immune Response

The innate immune system is the body's first line of defense against germs entering the body. It responds in the same way to all germs and foreign substances, which is why it is sometimes referred to as the "nonspecific" immune system. The main purpose of the innate immune response is to immediately prevent the spread and movement of foreign pathogens throughout the body. Therefore, it acts very quickly. For instance, it makes sure that bacteria that have entered the skin through a small wound are detected and destroyed on the spot within a few hours. The innate immune system has only limited power to stop germs from spreading, though.

The second line of defense is called the adaptive immune system. It takes over if the innate immune system is not able to destroy the germs. It specifically targets the type of germ that is causing the infection. But to do that it first needs to identify the germ. This means that it is slower to respond than the innate immune system, but when it does it is more accurate. It also has the advantage of being able to "remember" germs, so the next time a known germ is encountered, the adaptive immune system can respond faster.

A strong immune system equates to a healthy body. Here are some ways to help boost your body's natural defenses and fight harmful pathogens or disease-causing organisms.

  • Get sufficient sleep. Sleep and immunity are closely tied. Inadequate sleep may increase your risk of getting sick. Inadequate or poor sleep is linked to a higher susceptibility to sickness. Most adults should get at least 7 hours of sleep per night.

  • Eat more whole plant foods. Fruits, vegetables, nuts, seeds, and legumes are rich in nutrients and antioxidants. The antioxidants in these foods help decrease inflammation by combatting unstable compounds called free radicals which can cause inflammation when they build up in your body.

  • Eat more healthy fats. Healthy fats like olive oil and omega-3s found in salmon are highly anti-inflammatory. Since chronic inflammation can suppress your immune system, these fats may naturally combat illnesses.

  • Eat more fermented foods or take a probiotic supplement. Fermented foods are rich in beneficial bacteria called probiotics, which populate your digestive tract. These foods include yogurt, sauerkraut, kimchi, kefir, and natto. Fermented foods and probiotics may bolster your immune system by helping it identify and target harmful pathogens.

  • Limit added sugars. Added sugars contribute significantly to obesity, type 2 diabetes, and heart disease, all of which can suppress your immune system. Lowering your sugar intake may decrease inflammation and your risk of these conditions.

Immunosenescence is the age-related decline of the immune system and is generally associated with increased susceptibility to infection and reduced responses to vaccination. This decline in immune function affects both innate and adaptive immune systems. Elderly are less likely to benefit from vaccinations as preventative measures against infectious diseases due to the inability of the immune system to mount a successful defense.

The greatest harm to immune function is training/working out exhaustively without giving your body time to recover. There is a cumulative effect whereby an exhaustive workout followed closely by another exhaustive workout compounds the negative impact training heavily has on the immune system. At Total Results, we do one or two 20-minute workouts per week which result in ample time for recovery, generally 48 to 72 hours.

Posted September 01, 2021 by Matthew Romans