Pec and Labrum Repair Saga: part 3

So more time has passed and rehab is coming along. I thought I would bring up what my training is like along with what are some limitations that I currently still have. The basic goal here is to stay in shape (read: not get too fat), and keep on what muscle I can. Due to issues like keeping my arm out of the way I have had to pick exercises that I can keep my arm in the sling and in a position that it won’t get caught/be bounce off something during the exercise. This has required modifications like not squatting as low initially along with other points I’ll get in to.

Dragging my butt in to shape

Initially my training was essentially just dragging a weighted sled using a belt around my lower waist area and riding and exercise bike. The goal here was to load up the resistance as high as I could safely and just get in some good volume of work. For the sled workout I would just load a plate on the sled and drag it 40-120 yards and then add another plate repeat the walking. This would continue until I couldn’t power walk that distance anymore. I would do this forwards, backwards, and sideways and typically do this three days per week initially. Due to the staples in my shoulder and the sling I wasn’t able to do any real heavy lifting so this helps me mentally.

For the bike work I would either do a moderate resistance on the bike and sprint for 10 seconds and recover for 20-50 seconds before repeating those sprints again. Altogether I would do this for 10 to 20 minutes. The other option would be to put the bike on maximal resistance and pedal at a very slow cadence (20-30) revolutions per minute and do this for 20 minutes. I hated this immensely, but it did make my legs tired and helped me burn off some excess energy.

One armed bandit

Well I still had my one good arm so I was sure as hell going to do something with it. This meant training as hard as I could, but obviously doing every unilaterally which naturally limited how heavy I could go on a variety of movements. Between my pride and lack of time training I only used 25lbs. plates for a few weeks since I only had one arm to put the plates on the bar and 45s were hard to pick up and load with one hand. Also with the brace and bolster on it made sitting super low in the squats not really work well, I would have to hike up my brace on my ribs before each set so I didn’t bounce off my arm and make it move each time in the bottom.

Basic set up

I kept with my general lower/upper six days per week training split, only now I was just doing one arm for the upper body, and most of my lower body work was bodyweight or using a safety squat bar.

Day 1 2 3 4 5 6
Main exercise SSB squat heavy Kb military press SSB squat volume Ground base jammer SSB squat speed Machine bench press
Main exercise two   Single arm pull downs   Chest supported rows   Chest supported rows
Assistance exercise 1 Ssb good morning Dumbbell curls One arm deadlift Hammer curls Glute ham raises Preacher curls
Assistance exercise 2 Crunches Cable triceps Some type of ab exercise Db skull crusher Some type of ab exercise Cable oh triceps
Assistance exercise 3 Sled work Upper back work Sled work Barbell face pulls Sled work Bent over db laterals

 

Rehab

Outside of still working out I was doing therapy for about an hour three days per week. The initial work was all about rolling a ball trying to gain range of motion back along with massage work. Initially I couldn’t even lift my arm above parallel to the floor and had little to no external rotation. Progress was pretty constant, but very slow.

Limitations

The key limitations were load and range of motion. Initially the goal was to do essentially nothing with my arm and then I got to remove the bolster and was only a sling and then that progressed to no sling and try to walk and move like a normal human being. The range of motion slowly improved to where I could do movements that would be parallel to the floor and eventually start working on ranges of motion that were getting to be overhead.

Exercises

The first exercise I was given for my arm was to roll a ball across a table. This was done for high repetitions to just get my arm moving again. Then with time I was doing the same ball rolling only doing so pushing it up a wall. Along with this I was given movements like tracing different angles on the wall with a rolled up towel, some 3lbs. dumbbell rows with dynamic movement, and then other very light high rep kinetic chain movements. Push-ups started with simply leaning on a wall and pressing and then worked their way back to true push-ups on the floor. My least favorite thing to do to get by external rotation in my shoulder was to lay on my back with a hot pad on either side of my shoulder and an ankle weight on my wrist pulling my arm in to external rotation. That was really uncomfortable. This would last for ten minutes and usually get my over ten degrees more in the range of motion for a little bit, but it was quite uncomfortable.

Post op report

Almost three months after surgery I finally got the whole story of what they found and what they did. They were happy with their work on the surgery and I appreciate what they did. So here is the basic break down.

Labrum

Most folks when they tear their labrum have what is called a SLAP tear. This stands for superior labral tear from Anterior to Posterior. What I did was tear not only the superior portion but the entire posterior of it. Overall only about 50% of my labrum was still intact so it was good to hear how my pain and dysfunction was well merited. Luckily there was no arthritis or other issues in the tissue it had simply been torn off the shoulder. They used three anchors to get my labrum back down to the glenoid fossa of my scapula.

Pec tendon

As soon as I could use my arm the pec still felt odd when I contracted it and also it was asymmetrical to the other side and rolled up when I contracted it. I talked with some coworkers and they assured me it was correct, and honestly the strength function was already better than pre surgery. Still it was odd, so when I followed up with surgeons I found out that I completely tore my sternal attachment of my pec of the bone and then tendon was so frayed it had to then be sutured on to my clavicular pec tendon. This is why it is asymmetrical and feels odd when it contracts, but functionally it should be able to get back to striking distance of being 100%.

Boomstick application

When I went to the NSCA national convention I was lucky enough to get the boomstick by Kabuki strength used on my pec and shoulder. How this works is they use a small ball that you lay on and then apply pressure with the boomstick and have you move your arm in different ways to break up scar tissue and restore the normal sliding tissues of your body. This was an invigorating amount of discomfort (read pain) when applied but immediately gave me gains in range of motion in multiple planes. I highly suggest having this type of therapy used. Thanks again to the guys from Kabuki strength for working with me and giving me feedback on my lifting technique.

Summary

Still fighting my way back one day at a time. Thanks again for all of the help I have gotten from my friends, colleagues, and physicians. Hopefully soon enough I will be back to 100% with training. Worst case scenario competitive powerlifting is out for me and it is time to commit to strongman and maybe even weightlifting.

Pec and Labrum Repair Saga: part 2

After getting my right pec reattached and my right labrum repaired I got to spend some quality time in a shoulder sling with a bolster on. For the first four days I wasn’t allowed to bath or take the brace off at all. This was not a party, but a necessary evil for the healing process.

Following days

Each day I was a bit less sore and slept a bit better. I really didn’t do much at all other than sit around with my arm propped up. I did get to play some old school RPGs which was fun along with working on a few other hobbies of mine. Slowly I started to walk a bit more and more, but the goal was to limit this severely since if I slipped and fell that would really undo all of the work they did. Not to mention any time I just slightly tripped the rapid shifting of my body would send a righteous amount of pain through my shoulder.

Bandages off

On day four I finally got to have my bandages off and take a shower. To say that it took a while and was uncomfortable to have the weight of my arm hanging there is a slight understatement. The hot water beating down on my shoulder felt great though. The stapled parts of my chest and shoulder were a bit gnarly to see, but that was expected. From there I would take a shower about once every other day initially but then things kept getting better and back to my once a day routine which is nice to come back to.

Bowel movements        

Should have put this in the first post of this series, but turns out the pain killers and the drugs they use to knock you out cause you to be constipated. This was not a party, but thankfully after my “movement” on the day after surgery things were back to normal. Be warned though that you do get backed up when on those drugs. Also squatty pottys are a game changer and I could still use mine while in the brace. Other good news is that I could still wipe on my own which was great news for me, my wife, and my graduate assistant.

Supplementation

So in order to make the recovery go as fast as possible I have been using a number of over the counter supplements to expedite healing. This is what I came up with after speaking with friends, colleagues, and researching. Since I’m taking everything at once I can’t really parse what is making the greatest magnitude of effect, I just want this to be over with as soon as possible. So without further ado here is the list along with the amount that I’m taking each day. If you aren’t sure what different things are just let me know and I will explain it more.

Name Dosage Reason
Fish Oil 8 grams or more Anti-inflammation and perhaps speed tendon repair
Magnesium 500mg Helps with muscle relaxation, and I didn’t want any cramping going on after surgery
Zinc 30mg General health, from hormonal production to immune function
Biosil 5-8 drops Helps lay down collagen which is a big part of the tendon repair I’m trying to accomplish
Pantothenic acid 200mg Possible link to tendon strength and recovery
Fenugreek 1g Potentially increasing testosterone to enhance recovery and healing
Protein Powder 50+ grams Building block for tendons and muscle.
Curcumin 1.5 grams Anti-inflammatory

 

Itching

My wounds were closed with staple (and lots of them), after day three they started to itch some. To be fair the staples never really hurt which is nice. Man, that itching though. Turns out that is normal, but I’m not a fan. I was told not to wash it directly or itch it, so it is a bit annoying to say the least.

Staples out

Two weeks and two days after my surgery, we went in for my follow up. They took x-rays of my shoulder and took out all of my staples. Turns out there was a large number of staples in there (over twenty), but the good news is it really didn’t hurt at all to get them out even the ones that had to be dug in to get after and remove. From there I was told it would be time to start the next phase of my recovery. The funny part is my pec tear wound was so puckered up with skin that they actually missed one staple and it wasn’t for a week or two afterwards when the inflammation had come down that you could tell that I still had a staple left that I had to get removed before my skin fully started to grow back over it.

Rehab

Cue the rocky training montage music. Day one was hardcore; checking my range of motion and then having me roll a ball with my hand on top of it. From there some different movement patterns working on getting my scapulas to move correctly. It was obviously very low key, but that was day one. By day there I was doing towel slides in the vein of the karate kid paint the fence. This did allow me to start singing “You’re the best around” while rehabbing which made the folks in the athletic training room either laugh or give me strange looks.

Soreness

Each time after the training I would be sore and my pec tendon would ache. Makes sense since we are making something move that has been essentially immobile for the past few weeks with major incisions being made in my deltoid in order for the scopes to go in there and do the work.

Summary

So things are moving along with rehab and constantly (though slowly) getting better. In the next post I’ll start writing about what I’m doing as far as training goes (still have three other good limbs). Along with anything else that comes up on this rehabilitation journey. I hope this is useful for anyone that might go through something along the same lines as I have and as always thanks for taking the time to read this.

It’s for the Groom: Burning calories a bit faster

So in order for the groom to get in shape for the same wedding he wants to lose some fat, which he is already a lean guy so this is much harder than it would be if he were obese to start. So simply increasing the amount of steady state cardio and other wise is just going to get him stuck on a treadmill for hours and really not make him too much of a happy camper.

My goal is for him to do 3 days of metabolic conditioning and below will be my basic menu of options for him to do. Before each session he needs to take his time warming up in general and then do a lower intensity 2 or 3 sets of the exercise before he goes maximal effort. The reason for this is, maximal sprinting can easily result in injury especially when you get in your thirties and beyond. Listen to your body and focus on high quality work.

So here are some options:

Track workout

Option 1: Run 4 maximal 400 meter sprints. That’s it. This is an idea from Dan John that works well and will chew you to pieces.

Option 2: Sprint 200 yards walk 100 do this for a grand total of 800-1600 total yards and increase your volume by only 100-200 yards each week (this means add a final sprint of only 100 yards on occasion).

Gym workout

Welcome to barbell complexes, you can also do this with dumbbells either way it is horrible. I like the Javorek complex and if you get to the point where you can do this with 50lbs. dumbbells or with over 95 lbs. on the barbell you are going to be pretty jacked. Without setting the barbell down do 6 repetition of each of the following exercises:

High pull

Power snatch

Squat to press

Lunge

RDL

Power snatch

Looks deceivingly simple, but it will definitely tax your body. Do this circuit for up to 5 times taking a few minutes between each effort to let your lungs recover.

Field workout

Start on one side of the field and simply sprint 2/3rds of it and walk the final third. Hit the other baseline and repeat back. Start off by doing this for 10 total reps and build up to 20. Even feel free to do a set of pushups or sit ups on each baseline to get in some more good work.

Hill workout

Sprint up the hill and walk back down. Find a hill that is long enough and steep enough that after only 2 reps you are questioning how you will ever get to ten reps, then build up to where you are doing 20 reps here. Hills are awesome, everyone who can should do hill sprints.

Sled Workout

With a resistance sled that you either push or pull do a sprint with this for 40 yards and then walk 40 yards before you repeat this for 10 total reps. Build up either the number of sprints you are doing or the load that you are pulling. A good starting point for this will be 90lbs. Be sure to get the slack out of the line before you start pulling hard and then keeping your body low along with using good posture when you do this.

Bonus: The Garth – with two other friends push the sled 40 yards and switch from one person to the next going back and forth. Since there is three of you one will always push the sled to another and gives you about a 1:2 work:rest ratio that will slowly eat away at each of you. Do this for either a predetermined number or until one of you pukes (hence why it was named after Garth). If that is too easy for you ask me about the Hurt Locker.

Bike workout

Get on a resistance bike and do sprints for 10 seconds and pedal easy for 20 seconds and repeat for ten minutes. As you get better increase the sprinting time and decrease the rest time to a minimum of 10 seconds of recovery. Be sure to do this entire workout at a moderate but not too high of resistance.

Summary

Aside from working with your diet, here is a few basic conditioning options do help you burn a bit more fat off and do so in a shorter period of time. These are all things that I have done before, and honestly I like the hill, Javorek complex, and sled work the most. Just pick three of them and push them intelligently to help you lose a bit more fat to get ripped for your hitchin’.

It’s for the Bride: Training program to get a bit more jacked in the arms

The goal here is to help out a bride I know to be able to out flex her groom on their wedding day. I can think of nothing more admirable than helping someone do this. So the goal here is to add in some training that is going to help with building some arm size and give some options to do so at home instead of always having to go to the gym.

For each exercise be sure to control the eccentric for a two count or so and even hold the max contraction for a moment at the top of the rep. If you are already doing this movement then just don’t worry about it, if not be sure to add these in. The total volume of quality work (along with your nutrition) is what will give you the changes in your arm size you are looking for. Also feel free to finish each workout with super high rep (100 total reps possibly in just one set) band tricep pressdowns and curls.

Day 1:

Super set 1

Low row curl in to body weight low row 5×10+10

As this gets to be easier aim to be more parallel to the floor and even possibly elevate your feet. Also you do ten reps of the curl and then follow that up with ten reps of the low row.

Dips (bench or free standing) 5×10-20

As soon as you can do a set of 20 add weight to the movement. Learn from my mistake and don’t get cavalier with how you perform this movement. If possible when you add weight do so through chain weight.

Super set 2:

Skull crushers 5×10

Pyramid up in weight, and do this with an EZ bar or even a straight bar

Barbell curls 5×10

Pyramid up in weight, be sure to control this one

Day 2:

Super set 1:

Chin up negatives 6-10×2

Jump up to the top of the chin up then control yourself down. Try and do this as slowly as possible and add in some pauses at different points in the range of motion

Diamond pushups 5×10 or 50 total reps

Make a diamond with your hands and do these pushups full range of motion, be sure to control yourself and progress this movement so that each set of 10 is truly challenging

Super set 2:

Towel curls and partner triceps 3-5 sets of 10 reps

Use your partner (fiancé) to give you manual resistance on the concentric and eccentric of these movements to help give you a challenge on the exercise. Make sure that the resistance is controlled and doesn’t just hit you hard out of nowhere.

Day 3:

Super set 1:

Close grip bench press 5×8

Pyramid up in weight and try to beat your record each time. Take a grip on the barbell that has your pointers on the knurling just outside of the smooth center of the bar.

Underhand grip barbell rows 5×12

Using the same grip width from the bench press only know with your palms up (supinated), grab the barbell and perform a barbell row with it. Make sure to control the weight here and keep a strong posture the entire time.

Super set 2:

Hammer curls 5×10

Be sure to control the weight again and do so through a full range of motion. Use dumbbells here and you can do this straight in front of the body or across your body

French press (aka overhead skull crushers) 5×10

Use a barbell again and standing up or sitting down perform this movement trying to touch the bar behind your head each time and be sure to hold the lockout for just a moment each time.

Summary

Congratulations to the couple again, I hope this program will be of some use to you both and we wish you the very best with your new life together. Only use this program for about 2-3 months and then move on to a focus on something else that you want to build.

Tier Zero or Starting From Nothing

Most of the programs I write are for people looking to enhance their performance in one way or another. I realize that the real issue is that most people don’t work out at all. So the goal with this program is to take someone who is literally doing nothing and just get them moving in a way that will work for just about anyone. If you have some major issues like diabetes, heart disease, etc. Then don’t even attempt this and start your training in a full blown cardiac rehab center. If you are healthy and just are completely inactive this is a basic program to get your started and working your way up until you decide what type of training you want to really commit to.

So with that preface we will start with attacking fitness on its three pillars (in my mind): strength, conditioning, and mobility. The goal is to build each pillar at the same time in a low intensity and safe manner. If you think you don’t need the baseline here then don’t bother. If you do have glaring issues in one area then start with that area, and if obviously everything is defunct this is way to start off.

Strength

The body is a barbell and some barbells are loaded heavier than others. To start we will be doing only body weight exercises and progressing them accordingly when you hit certain goal levels you will progress to harder exercises. The key with strength training is you don’t pay for your crimes immediately, instead you find your soreness can come one or two days afterwards, so be tentative at first and then slowly add in more volume. Take a day off between each session and LISTEN TO YOUR BODY. Crippling soreness helps no one out, especially someone that is just starting to get in to training.

Your initial program will be the same exercises repeated every two days and as you get a good handle on those then it will be time to add in a day two and day three that give you some variety. Once you can get through the bodyweight circuits easily then it is time to start on barbell training and I have a few old programs on this blog you can search around for or just find some from the internet.

Day 1 2 3
Exercise Bodyweight squat to bench Squats Squat jumps
Exercise Wall push up Push up on knees Push ups
Exercise Crunch Sit up v-ups
Exercise Step up (use a stair case and take two at a time) Lunge Walking lunges
Exercise Leg raises on the ground Leg raises on the ground Flutter kicks on floor
Exercise Clam shells Hip thrust on floor Single leg hip thrust
Exercise Superman on floor Body weight low row (knees bent) Body weight low row

Start with a set of 10 on each exercise and then the next workout aim for 12 and so on and so forth. For the bench squats, sit down to a chair that you can orthopedically and stand up, aim to lower the height of the chair that you are sitting down to each week. For the pushups find a height that you can manage to move through a full range of motion with good control for those repetitions. For the step ups a simple stair case where you take them two or three steps at a time and you can use the hand rail to help yourself balance and even assist you if necessary. The idea is a total of 10 reps on each leg to start. The leg raises on the ground are laying on your back and then lift your legs up off the ground using your hip flexors and abs.

Conditioning

This is your ability to do work, and to keep that work out put up for long periods of time. If you have literally been up to nothing any work will be a novel stress on the body. So here again it will be easy to over stress the body. Aim to start with the least stressful forms of exercise. If you have access to a gym start off with biking, elliptical use, or swimming. Make it your goal to initially just be doing 5-10 minutes of work at a low intensity. You should be able to hold a conversation with someone while doing this. If you have the ability to track your heart rate aim for it to only be between 80-120 beats per minute. If you don’t have access to a gym then start off by simply walking. If you have a step counting device of some sort, aim to add in 50-100 steps each day and listen to your body.

If your knees, hips, low back, ankles, etc. are wrecked after a session of walking then figure out how much work that was and cut back 20% then slowly start working your way back up. The goal here is to progress to higher intensity work with time, but with your training aim to add in one extra minute of work (or the greater number of steps) every other day until you are doing half an hour of constant work (or over 10,000 steps per day). Once you get to this point then it is time to start ramping up your intensity. This means simply to work harder during that time period. You can do this by upping the resistance or incline on the exercise machines you are doing, otherwise try to cover a greater distance working in the set period of time. Same basic idea of only increasing by 5-10% each day. You can use a heart rate monitor here again as a way to show your intensity is higher.

Mobility

This is your ability to move your joints through a pain free full range of motion. If you have been living in chair jail for a long period of time you will likely be tight in the hip flexors, hamstrings, calf stretch, upper back, and shoulders along with potentially have a large number of other restrictions throughout the body. The goal to start is to improve your mobility by using stretches that aren’t hard to do and as always listen to your body when you do them. Aim to do this mobility work once every other day, but you can build up to doing this every day if you want to.

Please do some side reading on rolling out muscles with foam rollers and mobility balls to help, but the goal here is to give you a few simple stretches that you can do at home to help you open up your tighter parts of your body. If you don’t need any mobility work then skip this segment or do what you find to be more intense. If the stretches I lay out for you hurt or you don’t feel them stretching then by all means modify them by trying different angles or just simply don’t do them.

Couch stretch/hip flexor stretch

Full squat stretch

Calf stretch (ok, I’m tired of hyperlinking now. Just look up these ideas on your own. Yoga exercises are good choices here especially when you can be passive in the positions.)

Cobra stretch

Shoulder stretch

Pec stretch

Warm up

Before each of these training days do something to warm up. The goal is to get the blood moving and you don’t necessarily need to do anything too fancy and doing a simple round (or two or three) of a less intense version of what you are doing for your training on that day. Another simple warm up circuit is as written here:

Exercise Reps
Arm circles forward and backwards 20
Trunk twists 20
Side bends 20
Hips go forward and go backwards 20
Leg swings front to back 10
Leg swings side to side 10
Elbow bend and straighten 20
Wrist circles 20
Knee bends and straighten 20
Calf raises 20

 

Summary

So here is a simple program to hit all basic areas of fitness for someone who has been inactive for a solid amount of time. I hope that this helps for some readers out there. Please share it accordingly with anyone that you might think it will be useful for. As always thanks for reading and have a great day.

Fixing Evan’s Knees – ideas for issues with constant knee tendinitis

A friend of mine has very bad knee pain, specifically from tendinitis that requires him to wear knee sleeves when just participating in simple sports, much less trying to lift weights in exercises like squats. Now this program is not meant to be a panacea, and all suggestions should be experimented with and if anything suggested here causes more pain or dysfunction should stop that form of training immediately.

Lifting programming

So the goal with the programming for his lower body is to strengthen his posterior chain, and to pick exercises that will likely not irritate his knees. Start off with lighter loads and then build up with sets of 10 on all exercises. Control the load on the way down (eccentric) of every exercise and even manipulate this to last 4 seconds on certain exercises.

Trap bar deadlift – this can be done from the floor or can be done from blocks depending on what range of motion in uncomfortable. Also is lowering the weight hurts, just drop the bar at the top of the movement and then bend down and reset for the next repetition.

GHRs –  glute ham raises. These are to be done at least twice per week and aim to slowly increase by holding a medicine ball or dumbbell to the chest. Really focus on a full range of motion here and controlling your body on the way down.

Direct calf work – this can be done in seated or standing position. Be sure to control the weight at all time and hold the stretch at the bottom and contraction at the top for a little bit of time on each repetition.

Split squats – these are sometimes referred to as Bulgarian split squats, do these with the rear foot elevated on something that rolls and just start off with bodyweight for sets of 20 reps on each leg. Progress by holding kettlebells or dumbbells while performing this. You can also do lunges while you have your front foot elevated and see if that works for stressing the muscles without hurting the joints.

Pistol squats – these are single leg to a bench a parallel height to start and you can use a lower height bench with time. Keep this for higher repetitions and be sure to not just plop on the box each time.

Peterson step ups – standing on a low box lower yourself down until you can touch the heel of your other leg to the floor and then come back up. Really focus on feeling your hip and quad work while doing this.

Endurance programming

For your endurance side of things I would suggest inclined running on a treadmill, bike riding, or hill sprints where you definitely take your time walking back down the hill at the end. Do this as recovery work 2-3 times per week (especially for the bike and the treadmill) where you perform about 20-30 minutes or work when you do them. Be sure to stretch out before and afterwards. You don’t need to do this at high intensity, instead just aim to get a sweat and make the body move some.

Mobility work

The training here will be about doing some other correct exercises which I suggest he does a simple google search for that. Then It is time to do some foam rolling and other SMR (self myofascial release) therapy to help out his knee in a few ways. Aim to roll out your IT band, glutes, hams, quads, calves and groins. Then using either a ball or a hand tool really try to release the quadriceps right near the knee focusing on the VMO. Also spend some time on the ball working on your piriformis and glute medius and see what happens. When in doubt keep track of which muscle groups you release that then cause you to feel better after you do so and then make that part of your warm up and cooldown from training. Also be sure to do some stretching and even thinking about holding some yoga positions to help open up and free up the joint some. You can even try some voodoo band work on the knees for if it will have a positive effect on performance.

Supplementation

First having a good healthy diet where you are eating a solid amount of vegetables, getting enough sleep, and not boozing and eating junk will go a long way here. Once you have that in line I have a few suggestions which might help. Only start off with one supplement and give it a week or two to have an effect and then from there decide whether you want to try another. So with that in mind fish oil is always a good idea for dealing with inflammation. You can also try glucosamine, MSM, or chondroitin which are common and possibly useful supplements for inflammation. You can also try turmeric (curcumin) which can help with inflammation and also beta glycan. Finally, cissus quadrangularis which can possibly cause remodeling of connective tissue. You pay for the quality of supplements and be sure that you are getting it from a safe and healthy source.

Summary

So there was some work for my friend to do to hopefully get his knees to start to forgive him. Experiment with the ideas here, if anything makes things worse then stop doing it, if anything makes things better then definitely keep it up. Thanks as always for reading and if you have any questions or comments please as always just let me know.

Nutrition for Cheering

If you ever have a chance to watch a cheerleading team train and compete you can see how different not only the roles of the athletes on the team are, but the size and shapes of the athletes. In any sport athletes need to eat in a way to optimize their own performance. This is to be divided in this post by flyers and bases. Now within these general recommendations I’m going to lay out, keep in mind that there will always be individual differences and these are all estimates not hard and fast rules. The body is always right, so make sure that they are adapting and modifying this framework so that they are performing optimally.

Diet for flyers

The basic nutritional plan for flyers is all about maximizing performance, but having little to no effect on body weight. It can be easy to develop a negative relationship with food for these athletes, and the goal is to create and maintain a positive relationship with food. Aim to take in enough calories to maintain body mass, be aware though that as a female athlete your body weight will change during your monthly cycle and don’t freak out when this occurs. Track your long term average bodyweight (more than two months). Aim to be eating three meals per day and even a snack at some point. The big key will be portion sizes and try to have some form of protein and fiber with every meal.

Aerobic protein intake

Overall you are looking to take in about 1.2-1.5 grams of protein per kilogram of body mass. So we can convert that in to American and this gives them about .5-.7grams of protein per pound of body mass. So if you have a flyer that weights 110lbs. you want them to take in 60-75 grams of protein each day. This is to help with recovery from the training and keeping on your muscle mass which in turn helps burn calories.

Carbs and fats

Think of carbs as your energy source for exercise and fats as important for your recovery and overall health. You don’t want to stop eating one or the other at any point, but you can emphasize one over another depending on how much you are training/practicing and finding out where you feel the best in your training. Your carb demand can be anywhere from 3-10g/kg of body mass per day (1.4-4.5g/lbs. of body mass) so giving a hard and fast rule here is not going to work.

Fiber

Yes this is the stuff that helps keep you regular. Just aim to be consistent with your intake on this and you will avoid any bloating or issues with bowel movements. I would however, always suggest that athletes eat more vegetables both for this fiber effect and for the nitrates that they contain.

Caloric demands

The first key when working with a flyer is to use math to find your caloric demands for your activity levels. This means that during periods of hard training you need to eat more and when you are not training at all the demands are lower. Different apps or formulas will give you estimates of how many calories that you need, but there will always be little differences between those estimates and what your actual needs are. Some folks might use more or less calories each day than what the estimates you have would. When in doubt track your bodyweight once per week and be aware that as a female your bodyweight will fluctuate with your cycle and if you don’t have a cycle that is something you need to look in to and maybe see a physician about. Adding calories back in to your diet will sometimes help with alleviating this issue.

Diet for bases

Your goal as a base is to be strong and powerful. Notice how I didn’t necessarily say you need to be big, but some of you will need to gain some weight. We will get in to what you need to do in order to optimize for weight changes, specifically making sure that the weight that you gain is the type that helps your performance, not the kind that makes you jiggle more. Use an app or other method to get an estimate of your caloric needs each day and then make sure you are only eating above that by 500 calories at most if you are trying to gain weight. When you are doing nationals be sure to check your bodyweight more frequently since the demands of those practices will require you to burn a great deal more. You can find a number of energy need estimators online and if you use an activity tracker you will get a good estimate to start off with for how many calories you need each day.

Res. Pro intake levels,

For protein intake we are looking to have you at about 1 gram per pound of bodyweight each day broken up relatively evenly and getting in a good portion of it directly after training to help with muscle recovery. Don’t lose your mind with eating six times per day, but do make sure that you are eating at least 3 times per day with a post workout snack.

Carbs and fats

After you figure out your protein needs (and the calories from it) divide up the rest of your calories each day for the carbs and fats. Doing the carbs before and after training will help with your recovery, and fats tend to help you feel fuller longer so this can be useful for breakfast or later evening snacks. As always experiment with this and figure out where you feel best and perform the best and stay with those intakes.

Fiber

Same stuff here as was mentioned before for the flyers. Do be aware that this also can slow down digestion and so if you are trying to gain weight you might want to cut back on your fiber a little bit.

Weight change guidelines

For flyers or bases the goal when you are trying to gain or lose weight only changing your weight by about half a pound to a full pound per week or think of it as 1% or less of a body weight change per week. Overall only cut or add in more calories to the tune of 400 per day and if you are larger kick that up to 500. Each week track your weight and then depending on how it changes (or didn’t change) stay the same or give yourself some more calories if you didn’t gain the weight you wanted to that week and vice versa for losing. The reason we only want you to lose or gain less than one pound per week is that numbers above that can negatively affect health and performance, and specifically bigger changes in weight tend to be caused by excessive fat weight gain or muscle mass loss, both of which weren’t good for a cheerleader.

Supplementation

Now there are a few supplements that I would suggest for cheerleaders and especially depending on what your roll is on the squad:

Creatine – if you are a base you should try this out. It does cause water weight gain, but helps lead to lean body mass gain, muscle endurance and power output. This should be a no brainer for a cheerleader. Do not load creatine since you will saturate this out after only dosing it for a month. Also, this might help with the avoidance of concussions so there is that. For flyers this weight gain is not worth it. Also if you tumble a lot this might work against you since your power to weight ratio might go down a bit, if that happens then just stop dosing it and your body will flush it out with enough time. Creatine is cheap and you can find it plain online, just mix it in your post workout protein shake or just in fruit juice. Plain monohydrate is your best bet here.

Fish oil – doesn’t matter what you do as a cheerleader you should be taking omega threes since they help with cognition, learning, mental recovery, and avoiding things (along with recovery from concussions. Find a decent source of this and keep it in your fridge. You pay for quality here, and yes they can taste unpleasant, but trust me from having had a severe concussion with post concussive syndrome and friends that have gone through the same thing, take the damn fish oil and help yourself avoid that if you can.

Beta Alanine – this is a variation on the amino acid alanine so if you see the supplement L-alanine know that you aren’t looking at the same thing. What this does is increase intra muscular carnosine levels. When this occurs you are able to better buffer out the proton that comes with lactate that you produce when performing maximal anaerobic exercise (which really is what a national’s routine is). This allows you to go a little longer without getting to be really uncomfortable which is very important when you are running any type of routine, since the less pain you are in will make the performance that much easier to do.

Summary

So that is the basics of my diet advice for cheerleaders to be the best that they can be. This advice can also be used on comparable athletes or people that have general health and fitness goals that falls in line with some aspects of health and performance that cheerleaders.  Thanks for taking the time to read this and if you have any questions just let me know.

ISSN 2017 Conference notes Day 3

Got up early again and climbed a mountain with my friend Jordan Joy and his friend from his master’s program Gina. It was a good hike, but also hot and had a pretty good incline to it. After that I caught a workout with my old GA Travis and got some breakfast with him and some other folks which was fun and interesting.

This day had the posters up so lots of quick hits of interesting information from various projects where I got to speak with the researchers which is always a fun time. Below again are my notes in general from the day.

Lots of interesting bits of information where a chronically dosed spearmint extract was shown to have some effects on improving reaction time after 7 days.

Some folks use social media as a means to recruit subjects for studies. I need to start developing this for the lab to help get more people in (and should have thought of this earlier).

The effective dosage of citrulline seems to be 6-8 grams to have the positive effects on performance. Glutathione is then supplemented with it in the 10:1 ratio due to the half-life of NO being extended thanks to the glutathione.

For supporting the extracellular matrix look at hydrolyzed and intact cartilage. A good food source here is literally the sternum of chickens. Also a few herbs that I need to check my spelling on.

Also k2 (vitamin K2) and curcumin help with joint and ligament repair processes

Carbs help decrease cortisol levels and can improve immune function in athletes around aerobic training bouts.

Female soccer players started to become deficient in vitamin D and iron over the course of a season on average.

IIFYM is not a good long term strategy. Should shift this to IIFYL (if it fits your lifestyle) – Shawn Arent

Eat for what you need to fuel.

Try to conserve calories in athletes.

Citicoline – very interesting used for attention span, helps membrane health in brain, improves neuro transmitters of dopamine, epi, and nor epi. Also can help with mitochondrial functioning, some research shows improvements in functioning with dosage of this in the realm of 1 gram per day. Some research show that this helps with changing up reward processing in the brain. Dosage for most studies seems to be only 250-500mg per day taken chronically. You see benefits from taking this after only 1 week. Has a 4 hour half-life and goes in to the blood as uridine (RNA base) then is converted back in the brain. A stack of citicoline, omega threes, and creatine seem like they would be very useful.

Brain uses creatine and has a transporter for it which can be a limiting factor on how much you can get in the brain. Trying cyclocreatine to see if they have better uptake using that.

Native whey protein is a bit different from your typical whey protein in that it is higher in leucine and a few other amino acids like tryptophan. I’m not a big fan of the differences between them, but something worth understanding the difference between the two.

Traditional keto diet is 30-50 grams of carbs per day but with athletes that number can be bumped up and importantly around the training session for the athlete is the key. Keto salts taste awful and might be a bit cost prohibitive for most folks to try to use.

Tart cherry extract used on muscle cell cultures helps with satellite cell proliferation and with lower immune response from hard training. This research here is so cool and if what he is looking in to pans out will be somewhat ground breaking. So damn cool.

Teacrine has positive effects on mood and anxiety ratings when taken (it is a lighter version of Adderall)

Everyone wants the focus you get from Adderall in their preworkouts, but the legal and safe supplements are not quite there. A number of sketchy companies put in off label chemicals to mimic these effects but they can be harsh on the body. Some will just overload the supplement with B vitamins that cause flushing and otherwise but don’t have an effect on performance. Watch your sources here and be sure the company is reputable.

ISSN 2017 Conference notes Day 2

Got up early and hiked the hills near the hotel with my old GA Travis Byrd which was fun and well, very hot. Had a humming bird buzz our heads at one point which was pretty cool. We were definitely in the desert which is neat since I live in Kentucky.

hiking with travis
hiking with Travis
travis and his poster issn 2017
Travis at his poster

On to the notes:

As we get older we have a greater amount of marbling of fat in our muscles and lower quality (and loss) of muscle mass in general. Aerobic training is not great for increasing muscle quality and quantity.  Each year muscle and bone dysfunctions cost the US $300 million dollars. Resistance training is the best for long term health in this area. Exercise is better than just nutrition in this area but the two working together is key.

Muscle mass loss in older adults is multifactorial (more than one reason to cause it):

Immune issues

Loss of muscle units as we get older

Activity

Nutrition

As we lose more and more muscle mass it begins to show itself in gait issues and eventually becomes bad enough that people are put in homes due to lack of strength.

Creatine supplementation increases creatine reserves in muscle tissue. In meta analyses this helps upper body strength, but not as much in the lower body and nets on average 1kg of lean mass (2.2lbs. of lean mass). So creatine helps increase muscle mass in older adults. It does cause fluid retention, but that is good since the cell swelling causes satellite cell to increase and to regenerate muscle. This doesn’t directly activate fractional synthesis rates, but it turns other pathways on that might lead to growth like IGF-1 production.

Overall protein timing seems to be irrelevant or nowhere near as important as just general amount of protein in and getting in some around training (also with creatine).

Overall your biggest muscle groups tend to atrophy the fastest (glutes, lats). Creatine post work out seems to work better with younger folks, but around exercise seems to be the key with older folks.

Osteoclasts break down bones

Osteoblasts build up bones

There was a study that showed creatine supplementation over 12 weeks was associated with an increase in bone mineral density. Most of the time bone studies require 6 months to see a significant change in density. This creatine supplementation needs resistance training to help with increase bone mineral density

Creatine is safe in anyone that doesn’t have liver of kidney disease. Looks like the dosage in adults is .1g/kg of body mass each day (this seems real high, I wouldn’t follow this dear reader). There might be an interaction with caffeine and creatine to supplement them separately. Tends to washout after no more supplementation in 12 weeks or as little as 30 days.

Caffeine and genetics – genetics are a major factor on how caffeine is tolerated and the ergogenic effects that it has. When working with teams or individuals always track the individual response to caffeine supplementation.  The gene that has been shown to effect this is CYP142, slow metabolizers of caffeine seem to have greater issues with it than those that are fast metabolizers.

The area of science looking at how your genetics effect your dietary intake is nutrigenomics. This even seems to have effects on things like food behaviors, preferences, mean metabolism.  However, there are a lot of charlatans in this area.

There is a gene for how your body puts down collagen and this influences how your body can respond and repair damage to your joints. All food info (RDAs, etc.) is not based on individual genetics, keep this in mind.

Protein timing every 4 hours doesn’t seem to have that great of an effect compared to longer or shorter windows for anabolism.

These genes can also effect how you can use iron or calcium to help enhance your performance in certain sports (iron for mice on treadmills had an ergogenic effects as did calcium for cyclists.

Diet in military – Pasiakos presentation

Take protein for your training phase, not for your training type. .8-1.6g//kg when at rest 1.5-2.0g/kg when doing maneuvers, post training aim to take in 20-25g or .25-.3g/kg body mass for recovery.

MREs are packaged to have 1,300 calories each and 48 grams of protein. They need to be shelf stable for 9 months in the heat.

When the special operation people are on maneuvers they can spend over 7,000kcals per day in the field. They are constantly running a caloric deficit. The warfighters tend to not have as great of food availability as they would need to keep the weight on, but these operations can last 1-7days, where they are moving for 20hrs per day. Their appetite is suppressed, they aren’t sleeping much, and they tend to become hypo gonadal (low testosterone) from doing this. At the end of ranger school some guys have a free test level of 70-100mg/dl of testosterone (this is pre puberty male levels). There is also a decrease in firing accuracy after these long days.

Participants in SEER school lost 5.8kg of body weight (7% body mass) and 3.1kg of lean mass. With a 40% caloric deficit, people last just a bit less than half of lean mass over 3 weeks. The goal for protein intake might be 2.3g/kg for this amount of volume of work (tipton et al reference). Post exercise aim for 40g of protein to enhance recovery as fast as possible (Willard). Also total body training seems to get better protein results from 40g of protein then 20g (McNaughton 2016). The higher protein intake lowers total body protein breakdown.

A new way to look at protein digestion and availability is by the digestive amino acid score (DIAAS) – this leads to the leucine threshold (how much leucine you need to fully enhance protein synthesis in the muscle.

The combat rations and amino acid profile aims to get in at least 12% leucine. Trying to make sure that the warfighters make time for food since deficits of 40-60% can occur.

However Magnolis et al found that the warfighters threw out 1,500 calories of the MRE (food they didn’t like), where in a massive negative protein balance, and lost lean body mass. They were then given protein bars and found that they ate the bars but just threw out more of the food from the MRE.

Energy intake and protein balance are the biggest factors.

Warfighters have more energy expenditure and carb needs when at altitude. Also get sick and tend to decrease lean body mass and performance when working at altitude for long periods of time. In a study at altitude over 41 days the participants lost 8kg. there was no different in taking in 1g-2g/kg of protein per day in lean body mass, but they did see a difference in that individuals with better aerobic fitness lost less lean body mass and this wasn’t related to starting lean body mass. (even the mTOR response was lower in the individuals with chronic lean body mass loss at altitude).

With this population they just can’t eat more, trying to make better rations and a more targeted approach can help. Overall the most important factor is energy balance with the bigger crash leading to greater lean body mass loss. They haven’t done many investigations with creatine, omega 3 fatty acids, and so on (so far).

Nitrates and health presentation

Nitrates lead to greater NO (nitric oxide) in the heart and not so much in the liver, but enough in one area can increase plasma levels which in turn has hermetic effects.

Lightning helps fix nitrogen in the soil and this goes in to plants which we in turn eat.

The human nitrogen cycle – eat it> swallow it > stomach activates it > absorbed in intestine > has effect on vasodilation in the body.

50% or more of NO determined by the diet, in your microbiome. Green leafy vegetables best choice.

300-400mg need to see improvement in blood pressure or exercise. Avg. American only consumes about 150mg. in order to have this effect need more leafy greens. Different social conditions throughout the country. Some foods have 4-5x less nitrogen composition and organic foods are often lower than normal produce since the nitrogen fertilizers aren’t used as much. We need bacteria in our body to break this down.

Human genome is made up of about 23,000 genes.

Bacteria in the mouth effects the NO production in the mouth. If you eradicate oral bacteria through mouthwashes there was an observed increase in blood pressure in some participants (1 of them went up by 28mmhg). There are certain bacterial strains that are related to BP and we need enough. More nitrates help with avoiding inflammation and clotting in the arteries. Nitrates are also related to visceral adiposity levels. NO can increase glucose sensitivity by increasing GLUT 4 receptor sensitivity. Increase NO when at altitude.

Dialysis machines remove nitrates and nitrites from the blood which might be a cause for why folks on dialysis are more likely to have heart attacks and strokes.

Breast milk is high in nitrite. The more you know.

Aim to get in .25mg/Kg nitrites each day (maybe). Avoid mouth wash and tongue cleaning (or at least stupid amounts of mouthwash and tongue cleaning).

NO lozenges are very effective as vasodilators. Cause an increase of dilation by 13% and increase blood flow 34% after half an hour.

Also protein pump inhibitors lead to increased heart attack risk since this shuts down endogenous NO production.

NO (and the precursors) needs to be classified as a vitamin due to all of the positive health effects.

All beet products not the same, nitrate and nitrite levels vary in the products. Liquid NO products never work here and more is not necessarily better in this area.

All truth passes through three stages:

1st it is ridiculed

2nd it is violently opposed

3rd it is accepted as being self evident

  • Arthur Schopenhauer – German Philosopher

 

30-40% of people can’t convert nitrates well. Feed the body nitrates before training for better recovery.

PA flow chart issn.jpg

Phosphatidic Acid (PA) supplementation presentation

PA directly effects mTOR activation in the muscle.

Might be useful to help people on bedrest with muscle wasting. Pa helps with muscle development and repair. The mediator PA version might be more readily absorbable. Hoffman 2013 found that on a monitored training program 750mg of PA per day had greater LBM changes at the end of the study than the control group. Wilson et al also found some significance.

Timing of PA doesn’t seem to be that important, but peaks in the blood 2-3 hours after intake and then seems to be in the blood for about 7 hours (more of Wilson’s work here). The supplement here doesn’t seem to be that impressive.

60% of people are looking for a good alternative to caffeine for energy (god forbid the folks find a way to sleep more).

6-8 grams of citrulline malate possibly helps with muscle protein synthesis. Seems to have a great effect when taken with glutathione (10:1 ratio here).

Keto adapted endurance athletes have nearly the same glycogen stores and exercise response as normal athletes. However, there weeks of keto for race walkers didn’t have any positive effects on their performance. Low carb also doesn’t seem to bolster maximal aerobic performance, and the best aerobic athletes tend to take in 60% or more of their daily calories in the form of carbs.

Train low (with less carbs) might work, but do 2 sessions a day w/ no carbs after the 1st session so you are glycogen depleted for the 2nd. This causes better adaptations in the muscle, but didn’t seem to have a great effect on performance when compared to a control session.

Ostraine works and seems to increase LBM and decrease BF after 4 weeks with no major side effects, but this is now incredibly hard to get.

Can there be too much PRO in diet from high intensity exercise? Maybe from acid/base balance, but supplementation can’t recover the difference.

Acute carb intake 30-60g of CHO/hr

Ultra endurance athletes aim for 90g of CHO/hr

Really only care about glycogen levels in sport activities that last longer than 90 minutes.

High protein and low carb is not the way to work with most aerobic athletes.

2g of citrulline with .2g of glutathione seems to be the adequate dosage to go with for enhancing an anabolic effect of training.

Data blitz – This was interesting, each researcher was given 1 minute to give the short version of their research. A buzzer was used when people when over so this got intense real quick which was neat to say the least.

Antonio – 3.2g/kg or 4.8g/kg in two separate women and their bone mineral density was checked after a few months and no changes in bone mineral density.

Willoughby – elevation masks when wearing it you have a decrease in performance but no hormone or gene expression changes compared to control.

Von Dusseldorp- .22g/kg BCAA (branch chain amino acids) had no effect on muscle performance, but did help with soreness.

Andreas – protein before bed and after waking up led to better lean body mass changes over time.

Walker – soccer women low in iron and vitamin D levels over the season.

Arent – teacrine supplementation and caffeine and supplementation had no significant effects.

Campbell – no difference from supplementation from the different types of whey protein for supplementation.

Ziegenfuss – sensoril ashwagnda might have a positive effect in power athletes

Primavie – in cross training might have effects.

Kaumann – high protein in MMA- whey vs. rice no big effects on body comp and BF%.

Peacock – higher bone mineral density in mma athletes compared to other athletes.

Schonefield – mind muscle connect – more muscle growth than just lifting weight (really controlling and feeling the load when lifting weights).

7.1g/kg protein in one guy and no negative kidney function effects with this intake.

Total protein seems more important, but protein quality of the food does matter.

Kerksick – 6.4g/day of beta alanine in rugby athletes helped with power and sprinting

Body comp in athletes is important, bod pod has best agreement followed by DEXA and then ultrasound by way of error.

Gonzalez – citrulline dosed at 8g 40 minutes beforehand had no acute BP effects.

Escalante – steroid users have less anger after cycling than they did before their cycle.

BCAA metabolism matters how you train.

Contreras – upper glutes have best activation with hip thrust where bands around the knee. Followed by frog stance and then max contract.

Heavy load hip thrust is not the best method for activation here.

Caffeine sensitivity and genes have an effect of handgrip, but not much of one.

Sexual function related to body composition, aerobic performance related to arousal. Likability is more important.

Summary

And that is a wrap on day two. The big take homes here is just about everyone should be on creatine and get in enough nitrates. So eat your dang vegetables and red meat. After that there are a few interesting points or decent gems weaved in.

ISSN 2017 Conference Notes Day 1

I had the opportunity to go the international society of sports nutrition (ISSN) national conference in Phoenix Arizona in mid-June. It was a great conference where I learned a lot and had fun. Meanwhile Phoenix had high temperatures of 118 while I was there, which was brutal to walk around in. Below are the notes that I took on each day of the conference. As usual my note taking often has pieces of information and rarely comes in paragraph form. *post script, due to the length of this I’m breaking this up in to three different posts due to the length of it.*

Day 1

Fenugreek helps with glucose control but not so great with testosterone enhancement.

There are a number of factors that ad up together to give athletic performance: (upper left reads “genetic endowment”)

athlete stuff ISSN.jpg

Vanheest – Down the Rabbit Hole presentation

There is partitioning of metabolic fuels (split between carbs and fats broken down for energy).

Interesting point of the expendable functions of the body: reproduction and fat storage

Reducible functions: thermoregulation, growth, and movement

Essential functions: cell maintenance, circulation, and brain function

In the animal model, when gerbils are calorie restricted they don’t ovulate.

The female athlete triad was identified in 1992, position stand was made in 1997, the female athlete triad is a spectrum that can lead to osteoporosis, amenorrhea, and perhaps an eating disorder.

RED-S – Relative energy deficiency in sport. This effects performance by decreasing coordination, and health by decreasing immune function. There is a link between performance and food intake.

The macroeconomic view of energy balance (how does this work over the long term).

hormone flow chart ISSN.jpg

Free living athlete study designs are muddy

In female athletes ovarian suppressed women had a significantly lower energy balance and a suppressed IGF-1 and T3. They in turn had a significant decrease in performance, and taper in the female swimmers had no effect to recover performance. The rate of performance improvement linked to energy status.

Amenorrheic haven’t had a cycle in the past three months, oligorrhea is not having one in the past 30-90 days. Bigger caloric deficits linked with menstrual issues especially when over 400 calorie deficit per day. T3 hormone changes related to change in performance with a strong positive relationship.

The stopping of hard training recovers the cycle in female athletes, but the resuming of hard training makes it go away again. Backloading calories (all at the end of the day) in athletes has been related to a decline in performance.

The same negative hormonal adaptations occur in male swimmers when they go through intensified training cycles.

Nutrition in elite athletes is not as great as you would guess especially in the collegiate level and younger.

State of the Female Fitness Industry – Kleiner

Title 9 has led to a 10x increase in female participation but the amount of money in female sports is much lower than male sports (specifically football).

Collegiate athletics for women on average is not very diverse outside of basketball and another sport that I didn’t write down in time, maybe soccer. There are still some issues with religious practices in sports (hijab). Most female collegiate athletes are coached by men. Very little research in sport involves women, performance and injury data from females is under represented. Need to follow the cycles for women for research.

Marketing preys on women and doesn’t have great information. More research must be done so real facts can be presented.

One tennis player was quoted “I would rather lose to Serena (Williams) than have her body” – Woof.

There is a frequent issue with under fueling, hydrating, and vitamin D intake in female athletes. Some differences between the sexes are: pre fueling – women use more fat oxidation. Their energy needs do increase during pre-menstruation, tend to be less sensitive to carbs, need more powerlifting for aerobic performance, need physical activity for pelvic floor health, early physical activity is health protective, but you need to be aware of the increased risk of under fueling.

Some points of concern: drive for protection an issue, lack of female data, over training and over reaching.

Negative trends – women uncomfortable in the gym, put fitness last, too much focus on aesthetics in the media for women.

There are some difference in training the genders, aim to focus more on individual accomplishments and the joy of movement with women.

There is a female athlete conference in June of 2018, I should look in to it.

FITR women App for research

Recently the US women’s soccer team sued to be paid the same as the men’s US soccer team.

In the military a study of female cadets were given iron supplements and that group shaved 2 minutes off their two mile time by the end of the study compared to controls.

Be wary of using the ketogenic and low carb diet, this can work, but not necessarily works well for everyone.

The concept of “train less and eat more” is something distance and competitive athletes need to ponder as a means to optimize both health and performance.

The Minnesota starvation diet study – subjects lost 25% of their body mass, had symptoms of depression, preoccupation with food, hysteria, decreased libido and brain function, had social withdrawal.

Food is fuel, exercise is not punishment

If doing a thyroid check you need more than your TSH ran, get your T4 and T3 ran so you really see how you are functioning.

Suffering is not a badge of honor.

Teaching women to train, start something like this on campus.

“Eat less, move more” is not a panacea

Work on a friendship with food,

You can’t outsmart your physiology

Beware of social media – lots of mistakes here

In athletes – certain diet patterns might need supplementation (vegetarian, vegan) to get all of their needs met.

Know there is a difference between normal blood values and optimal values

Compete and be healthy – not treating this like they are mutually exclusive (in sports)

Compare food logs (5-7 days) with their activity. For some athletes just start with a recovery stage of nutrition.

Post pregnancy training – liability is the major issue here not the training itself. Be aware of the caloric needs of pregnancy and nursing (higher during nursing than pregnancy).

Peg creatine might be a better choice for you since you have to take less of it each day, but what you save in time might increase in cost. Also try and space your creatine intake to be away from the time you are training.

Beta glycan supplementation might help with inflammation

Summary

The big take home points from this day were about working with female athletes. Make sure that you are appropriately monitoring them and that you are not causing negative relationships with food. If athletes are not taking in enough calories this can show with changes in the monthly cycle of the athletes. More research must be conducted with women and focus on positive relationships with diet and exercise.