bewellchiropracticpcbewellchiropracticpc Milk for Recovery?]]>Matt Hartenburg D.C., 28 Oct 2019 13:16:10 +0000
I've been spending a lot of time driving lately, which means a lot of time at gas stations, which means a lot of time walking past cooler after cooler full of random beverages just to get to the one door that contains bottles of water (which is all we really need to be drinking if we're thirsty while driving).
Maybe I just haven't paid much attention to it in the past decade, but it seems like I am seeing a lot of increased advertising of chocolate milk being a good recovery drink for athletes. I remember seeing a lot of advertising like this about ten years ago (more on that later), and some of my running apps I use will have pop up ads related to athletes drinking chocolate milk, but for whatever reason it seems like I have been seeing much more of it lately.
There are several studies out there that look at utilizing chocolate milk as a recovery drink for athletes, however, I am really only familiar with one of them from 2010. I wanted to write a quick post examining the study from 2010 that I have read a few times.
The first time I remember hearing a lot about chocolate milk and recovery was back in 2010. University of Connecticut had put out a study and subsequent press communication about the study on September 27, 2010 (which happened to be "National Chocolate Milk Day") touting the benefits of chocolate milk for athletes. Let's look at that study a little closer.
First, what did the study look at? The population in the study was 6 moderately trained college aged male runners. Not exactly a profound sample size or diverse sample. In the study, the athletes would run at a moderate pace for 45 minutes at 65% of their peak Vo2 max and then would consume either chocolate milk post run or kool-aid. Following ingestion of the chosen recovery drink, researchers would look at blood samples and muscle biopsies that found greater amounts of protein synthesis in the group that consumed chocolate milk. Protein synthesis and amino acid profiles are important for endurance athletes, as muscle breakdown from long bouts of endurance activity can be a limiting factor to performance.
If that is what the study is actually looking at, can we extrapolate that chocolate milk is a great recovery drink? No. We can't. But that didn't stop the folks at UCONN from writing an article claiming that "Chocolate Milk is Choc-full of Goodness."
What can we say from looking at this one study? Well, we can say that chocolate milk is a better recovery drink than kool-aid. Not exactly an exciting headline is it? Anyone with any amount of common sense could probably tell you that there are many things out there that are better than kool-aid. That doesn't mean that we should all be rushing to the fridge post run and start massively consuming chocolate milk.
One more thing to keep in mind. The study was funded by the National Dairy Council and National Fluid Milk Processor and the press release went out in time for "National Chocolate Milk Day." Now, it's important to remember that who funds the study is not always a determining factor to the validity of the study, but it should be viewed through a contextual lens.
What do I recommend to consume post workout? That is up to the individual. I don't like to eat immediately post run, but I do try to ingest several hundred calories consisting of about 50-80 g of carbs and around 30 grams of protein. Generally, I'll get those from fruit and whey protein in a blender which has always worked for me. It is important to replace carbs and protein post run or post workout, but there isn't much need to take in more than the amounts I mentioned above immediately.
I wanted to write this quick post to remind everyone the importance of not just taking the press release of " a new study shows" at face value. Examine the study to see what the study actually looked at. In this case, chocolate milk outperformed kool-aid, but that doesn't mean that chocolate milk is a great recovery agent.
Slow Down to Go Faster]]>Matt Hartenburg D.C., 21 Oct 2019 16:08:04 +0000
Hi everyone! Dr. Matt here. Some of you may have heard I am back in town earlier than expected. Long story short, I had a strange accident during TACP prep (basically a selection week) and I injured my knee. The injury wash back on top of the additional training pipeline extensions made it unrealistic for me to continue training and still maintain a civilian life and career. I am in the National Guard after all. We do have civilian lives as well.
Anyways, no need for condolences or well wishing, it actually worked itself out very well. More on that later. This article isn't about the injury, it's about the positive consequences of what happens when people (ie. me) listen to their coaches.
I have been running recreationally for nearly 15 years now. When I enlisted in the Army 5 years ago, I began running for training purposes and started taking it much more serious, and rekindled a love for running. I'm generally 205-210 pounds at 5'10 so needless to say I don't have the genetically gifted runner's build, but I do the best I can with what I have.
For much of my early running career, I made the same mistake that I see far too many novice and recreational runners make, and that is attacking every mile in their training with high levels of intensity. For the past year, while I was training for TACP I finally took a step back and listened to coaches and other runners and slowed myself way down to improve the efficiency of my training. What were the results? I'll share that at the end.
First, understand that this is not a new concept. People like author Matt Fitzgerald, Dr. Phil Maffetone, Hal Higdon, Arthur Lydiard, and Jack Daniels have been espousing this for generations. Matt Fitzgerald popularized the 80/20 programwhich advocates for performing 80% of your training miles at a lower intensity and 20 percent at higher intensities. Dr. Phil Maffetone advocates for most training to be done at a specified heart rate found by subtracting your age from 180 (this is similar to what I followed, and at first seems DEVASTATINGLY SLOW). Dr. Jack Daniels has a far more scientific approach to calculating training pace, but it largely follows the same methodology. Last but not least is one of the most popular running authors, Hal Higdon. Anyone who has ever followed a Hal Higdon program knows that the majority of his long runs are done at what he calls a comfortable pace where you can easily carry on a conversation.
While none of these are new concepts, I have found that most runners (including myself at one time) never follow the prescribed intensities. Why is that? Because we have been taught to "feel the burn." A popular theme in exercise these days is that high intensity wins the day. If a workout doesn't leave people in a sweaty ball of muscle cramps laying on the ground participants consider it a failure. As I have grown up and continued my strength and conditioning education, I have realized how wrong this mindset is.
Why go slow? It's simple. If you enjoy running and endurance events you have to develop the aerobic system without accumulating too much fatigue. You aerobic system is what drives most of your energy production for events that last longer than the first couple minutes. Going slower allows you to maximize that energy pathway while avoiding getting into a more glycolytic pathway that will leave you full of lactic acid and sore muscles. Your aerobic system not only provides much of the energy for longer events, it is what allows you to recover between training sessions, and run stronger for longer. In the past, when I was training at higher intensities and hitting a lot of intervals, I was able to maintain a fast pace for about a mile but then I would have to slow down due to accumulated fatigue. Now I am able to maintain roughly the same speed for distances up to 5K and am able to hold better paces at lower heart rates at the longer distances.
How did my previous year of slow training affect me? Well, once I got used to slowing myself down (and even stopping to walk to lower my heart rate, at the expense of pace) I actually enjoyed training a lot more, was hurt a lot less, and recovered far better in between workouts. I eliminated a lot of the junk mileage which I had put in before. There is some debate as to what leads to over training more; volume or intensity. I believe that comes down largely to the individual, but I do feel confident in making the generalization that a lot of volume combined with high intensity can be a recipe for disaster for MOST people.
Leading into the selection week we were treated to a 2 week buildup of workouts designed to mimic the rigors we would face in the coming training. We did a great deal of running and rucking. 2 examples of this were the day we ran a fast 3 miles (I ran 19:57) and followed that immediately with a 4 mile ruck carrying 45 pounds (i went under 50 minutes). The following day we tested a 1.5 mile run (9:27) and followed that with 8x400 meters with 1 minute rest (I ran sub 1:30 on all repetitions). Prior to having focused on training for aerobic capacity, I wouldn't have been able to maintain those paces on top of the additional workload. Unfortunately, like I mentioned before, a weird accident involving high repetition calisthenics in the mud caused me to hurt my knee and prevented me from finishing the training.
To conclude, many novice and recreational runners follow a wide assortment of training programs to determine running mileage, but very few follow the prescribed intensities. It's important to understand the purpose and methodology of the training program and to run slower than you would think necessary when called for. Understand the importance of periodization (in season vs off season would be a good starting point) and don't sabotage your miles by constantly red lining.
Preview of Next Week's Workshop]]>Matthew Hartenburg D.C., 25 Apr 2019 13:57:08 +0000
For those of you who haven't signed up yet, we have 7 spots still available for Monday night's "Demystifying Fat Loss" workshop. The class will begin at 6 PM sharp at Be Well and will last approximately one hour.
Now on to the preview.
If you have been to workshops in the past, you know that I don't like to base workshops off the premise of "weight loss" or "fat loss." I prefer to approach nutrition and exercise from a health first standpoint. So, why is this one based on a fat loss approach? Is it merely to jump on the bandwagon of hot advertising words? Not really. This one centers around fat loss for 2 reasons:
1) It's always been prevalent, but this year I have noticed it more than ever. GIMMICKS. Every where you turn there are more and more gimmicks which has led to confusion about what is actually required to lose weight and (more importantly) change body composition to favor muscle rather than fat. Quick fixes, juice fasts, 30 day challenges, special teas or coffee additives, supplements, and other ridiculous (and often times expensive) fads. "This diet is better than this one," "no, this one is better," "no, this one is better because it's the one that (random celebrity) does. It's time to cut through some of the noise in the fitness and nutrition world and examine weight loss from a practical perspective. Hint: it's not as complicated as people will have you believe.
2) Fat loss (when done correctly) is accomplished through the creation of healthy and sustainable habits. Healthy and sustainable habits and routine is what creates not only long term results, but also positive changes in terms of health. Simply lowering body fat percentage has been shown to improve a multitude of factors including but not limited to insulin sensitivity, cardiovascular measures, and even chronic pain. While this workshop is centered around changing body composition, it's near impossible to improve body fat markers without improving health.
What will we cover in the workshop?
First, we will go through some popular myths surrounding some of the diets and gimmicks. Of all the different popular "diets" that exist, what can we learn from them? What do they have in common? Where do they differ?
Next, we will explore the simplicity of fat loss and give some simple action steps on how to begin to develop good habits. Hint: it begins by identifying the Standard American Diet.
Last, we will briefly cover common exercise myths and a "how to" on beginning an exercise program.
Like I said before, we have about seven spots left for those who wish to sign up, and if you already are signed up we look forward to seeing you Monday night!
5 THINGS I HAVE LEARNED FROM MEASURING HEART RATE VARIABILITY]]>Matthew Hartenburg D.C., 01 Apr 2019 15:39:08 +0000
I have been exploring heart rate variability for around 7 years. What began as curiosity has transformed into a constant yearning for understanding of our physiology, how to measure it, and what effects it. I have been measuring heart rate variability (HRV) for the past 5-6 years thanks to the accessibility and reliability of the app HRV4training. You can read more about the app at the link I provided.
In the time that I have been measuring my HRV, I have gained a great deal of insight and understanding into how my body responds to different metrics including but not limited to: training methods, how I eat, how I sleep, and weight loss vs weight gain.
Before I explore those insights lets cover what HRV is (as short and sweet as I can).
Homeostasis is defined as is the ability or tendency to maintain internal stability in an organism to compensate for environmental changes. Maintaining a constant temperature of 98.6 degrees, blood pressure around 120/80, and blood sugar around 60 are all examples of your body constantly working to maintain a stable internal environment (homeostasis).
The autonomic nervous system is primarily in charge of regulating these responses in order to maintain this balance. The nervous system is constantly monitoring changes in the internal and external environment and delegating physiologic responses to adapt to changes in the environment. For example, lets say the kids are running late in the morning and you have to get them to the bus stop to avoid driving them to school for the fifth time this month. You hear the bus down the street so you grab your kids hand and sprint with them to the bus stop. In order to do this, your heart rate will have had to increase to transport blood to your legs for running, your respiration (breathing rate) will have to increase to transport additional oxygen to the extremities to allow you to run, and depending on the temperature you may even have started sweating to keep your body from overheating. All of these events seem to happen independently, however it is the nervous system reacting to the stress and coordinating these adaptations.
The autonomic nervous system is comprised of two primary divisions: sympathetic (fight or flight) and parasympathetic (rest and digest). These two systems work together (yet somewhat antagonistically) to maintain homeostasis. Each of these systems exerts different effects on the body depending on different situations. In a stressful situation such as a near miss car accident, kitchen fire, traffic jam, angry spouse, or worthless boss and middle management, the sympathetic nervous system will take over. The sympathetic system will increase heart rate, increase blood pressure, increase respiration, cease digestion (leaving you feeling nauseous), and shunt circulation from the core to the extremities. 10,000 years ago these were very necessary responses in harsh environment we lived in. Think about it, if you encountered a lion you would need to fight the lion or run away. This is necessary for survival. Today these responses are less essential. You don’t necessarily need to fight your boss or run away from them if they shorten your deadline. However, this is still a stressful situation and your body will respond accordingly. The primitive part of your brain will have the same response to the lion entering your village as it would have to the driver that pulled out in front of you dangerously close. The sympathetic nervous system is also predominantly at work when you are exercising.
The parasympathetic system has quite different effects on the body. The parasympathetic nervous system will lower your resting heart rate, shunt circulation to the core away from the extremities, and lower your respiration rate. That is why the PSNS is referred to as “rest and digest.” When at rest this should be the division of the nervous system that is primarily working. This parasympathetic system (along with insulin) is responsible for that lethargic feeling we have after stuffing ourselves on thanksgiving (rest and digest). Parasympathetic nervous system activity is what allows us to recover from exercise in the hours and days following exercise.
So, what is heart rate variability?
Heart rate variability gives us a means of measuring activity of the autonomic nervous system and gives us an idea of whether or not we are in a sympathetic or parasympathetic state by measuring the difference in beats of the heart.
The following definition of HRV and what it represents was reproduced with permission from and the app developer Marco Altini.
What's HRV?
Practically speaking, our heart does not beat at a constant frequency. So even if we measure our pulse, and get a 60 beats per minute reading, it doesn’t mean we have a beat every second. The time differences between beats are slightly different, they can be 0.9 seconds, 1.2 seconds, and so on. When we talk about HRV, we talk about ways to quantify this variation between heart beats.
This explains also why HRV is not a single number, and there is sometimes a bit of confusion on different metrics to measure HRV since we can quantify these beat to beat differences in different ways (called features). Especially in the context of using HRV to monitor physiological stress, like training load and recovery, the community settled on one specific feature which is called rMSSD. It’s a time domain feature, easy to compute. So HRV4Training provides you with a transformation of rMSSD to make the value a bit easier to interpret, i.e. the Recovery Points. If you are an advanced user, you can also display actual features by selecting HRV View - Advanced from Settings.
What does HRV represent?
Here we need to take a step back and talk a bit about the autonomic nervous system. The autonomic nervous system regulates many body functions, mainly unconsciously, such as respiration, the heart beating and so on, and consists of two branches, the sympathetic and parasympathetic branches.
The sympathetic branch, is in charge of the fight or flight response, while the parasympathetic branch promotes a rest and recovery. Making a few simplifications, since the autonomic nervous system maintains an adaptive state of balance in our body, we can understand how we react to stressors, by analyzing autonomic function.
This means we would expect higher parasympathetic activity under conditions of rest, when we are well recovered. Since the autonomic system regulates the heart beating, we can use HRV as a proxy to autonomic function, and therefore use HRV as a way to measure how we react to stressors like a workout for example. This is where collecting HRV data can become very interesting, because we can, for example, better understand how much time our body needs to get back to normal after an intense workout.
Thank you Marco, back to me.
How do I measure HRV?
I use the app HRV4training. This app does not require a chest strap (though you could use one if you wish), it has been reliably validated numerous times, and is commonly used in HRV studies on different populations of athletes that are published in scientific literature.
I measure first thing in the morning within a couple minutes of my alarm going off (I usually allow a few minutes to go by while laying in bed before measuring because, let’s face it, the alarm can sometimes be stressful). Consistency is incredibly important in measuring HRV. First thing in the morning is the best time to measure. When you get out of bed, make coffee, let the dog out, and then measure, there is a lot of “noise” in the reading and makes the reading far less accurate. Measuring at the end of the day or middle of the day is practically useless, in my opinion. Did you drink coffee? Get stuck in traffic? Fight with your boss or spouse? These are all stressful situations that will change your HRV reading. Be consistent.
So, what have I learned from measuring my HRV?
There is a marked difference in my heart rate variability depending on whether or not I’m primarily training aerobic endurance or more anaerobic conditioning and strength. My military fitness requirements necessitate that I possess a great deal of aerobic endurance to be able to run or ruck long distances as well as possess the ability to run short sprints, exert high amounts of work in a short time, and be able to lift and carry a great deal of weight. These differing requirements force me to periodize the way I train throughout the year. Part of the year I will predominantly train aerobic fitness and endurance while maintaining a baseline of strength. Other parts of the year I will prioritize anaerobic conditioning and strength while trying to maintain a baseline of aerobic fitness. During times when I train aerobic fitness my resting HR is very low and my rMSSD increases. These are both signs of parasympathetic dominance. When I’m training more strength and anaerobic conditioning my resting HR goes up and rMSSD goes down, indicating more sympathetic stress. Is this significant? To me it is. Remember that HRV is a very individualized metric. However, this does fall in line with what some of the scientific literature says.Sleep is important. Very, very important. On days where I don’t get much sleep (less than 6 hours) I exhibit more signs of sympathetic nervous system activity. Not exactly conducive for training. When I am away with the National Guard, I generally don’t get a great deal of sleep and my HRV reflects this. If you are not sleeping, you are not recovering adequately. Measuring your HRV gives objective insight into this, as opposed to gauging your recovery subjectively based on how you feel. When I gain weight, my HRV exhibits more sympathetic activity versus when I have lost weight. When I came home from JRTC (Army training rotation in Louisiana) I weighed 198 pounds. The lowest my weight has been since my senior year of high school. As a result my HRV was high and resting heart rate was low. All parasympathetic signs. At the end of this winter, I was around 210 pounds and my HRV went the opposite direction and was showing a great deal of sympathetic activity. Again, I stress that this is an objective individual response that I have noticed in myself, but I have made a few individual inferences about this response. Speaking generally (very generally), less sympathetic activity is a good thing in regards to overall health. Parasympathetic activity is a better indicator of overall health than sympathetic (though not too much parasympathetic activity, but I don’t have time in this post to dig too deep). I don’t think there are too many people that will argue that carrying around an extra ten pounds is necessarily a good thing for overall health.I’ve learned the importance of being able to measure objective metrics such as HRV. Technology is fantastic, but yes, I do think we are TOO plugged in these days. While it may not be necessary to monitor every aspect of your physiology at all times with fancy watches and rings, having the means to measure ANS activity in the morning can be incredibly helpful. All of these aforementioned insights I have gained have helped to guide me in my training, eating, and lifestyle to maximize my response to what I’m doing. I’ve learned what works for me in training and what doesn’t work based on HRV and its correlations to performance and my subjective feelings of recovery. Sure, I’ll concede that subjective responses have been adequate for athletes for generations, but we have the means and availability to monitor an important metric from the convenience of our own bedroom, and the best part is that it is all backed by evidence. Last, the day after I get adjusted by my chiropractor (my lovely wife), I notice an increase in parasympathetic activity. While i haven’t taken the time to really quantify the changes, it is merely an observation. I am first and foremost a chiropractor. Yes, I train people and yes I am furthering my career in the reserve component of the military, but this initial inquiry into HRV began as an exploration into a possible objective outcome measure for care in our office. Inconsistencies in measuring patient’s HRV in an office setting posed a very real challenge to making this an effective outcome measure (and getting people to download an app and measure each morning proved even more difficult), but I have spoken with many chiropractors who are utilizing the app and they all say the same thing. While this is all anecdotal, there is some preliminary evidence that chiropractic (and other modalities referred to as “manual therapy”) can affect HRV. Someday I hope to be involved in more in depth research to understand and quantify what these changes mean and how reproducible they are.
Whether you are an athlete or not, I recommend downloading the HRV4training app and measuring your own HRV. The science has been around for a long time, but has garnered a lot of recent attention and is showing a lot of promising applications.
5 Reasons Why Keto Won't Work For You]]>Matt Hartenburg D.C., 11 Feb 2019 13:25:28 +0000
Gotcha! Yes, once in awhile I'll use a click bait title that I think people will click on, but it isn't to drive traffic to my website (well, maybe it is) or to sell a product of some kind.
Truth be told, I believe the ketogenic diet can be a fantastic tool for many people (not all) if done correctly. Several times throughout the year I will draw back my carbohydrate consumption and increase my fat consumption to put myself into a state of nutritional ketosis for a period of time depending on how I am training. If I am prioritizing aerobic endurance during my training I find that I do far better on a very low carb, moderate protein, high fat diet since the training I do during these periods prioritizes fat as a primary energy substrate. I know this works for me because I have spent a lot of time tweaking how I eat and train and experimenting with many different variables. Anytime I head out and do a longer training exercise in the Army out in the field I will generally be eating very low carb and high fat due to the fact that even though we are completing a lot of work, much of it is at a low intensity and I have found that eating the carb laden MRE's they give us creates a lot of very large energy fluctuations leaving me wanting a nap 2-3 times per day. Last, I believe that metabolic flexibility is the a big factor in overall health. Your body will eventually adapt to whatever it is you are doing. Ever notice that you could go on a diet but at some point you stop losing weight or maybe even gain some back? Chances are your body has made some sort of long term adaptation to what you are doing. By employing a ketogenic diet periodically I have found a way to periodize my eating in the same way I periodize my training.
Yes, that is very anecdotal and based on my personal experience, and much of this article will be based on experience I've had with patients and some of the advertisements I have seen in the past several weeks since the New Year (anyone else notice how much media time the ketogenic diet has received this New Year?). This is not meant to be a "how to" guide on keto, but just to address some of the shortcomings I have seen in some people's application of the ketogenic diet.
Reason #1) You are learning Keto from a blogger or some other erroneous source.
Sorry, not sorry.
There are experts in the ketogenic diet. In fact, there are people who have dedicated their entire scientific careers to studying the effects of a very high fat very low carb diet. Then on the other hand, there are people who discovered the ketogenic diet, lost weight on it, and proclaimed themselves to be internet experts on the topic despite having no physiology or biochemistry background. When I first began exploring the ketogenic diet (KD) I learned from a few different sources that I will list below. I will repeat myself once again, this is not meant to be a "how to" keto blog. I would like to emphasize that since I just suggested you go to the experts and avoid the bloggers. I am no expert on the topic, so I will direct you to those who are.
Dominic D'Agostino PhD: Dr. D'Agostino is a professor in pharmacology and physiology at University of South Florida. He began investigating ketosis for navy divers as a means of improving their performance in the extreme environments in which they operate. From there, his research efforts started to venture into the effects of ketosis and epileptic seizures and has been doing a great deal of work looking at the effects of the KD on certain types of cancers (full bio in the hyperlink I provided).
Dr. Jeff Volek and Dr. Stephen Phinney:Dr's Phinney and Volek have also contributed a great deal to the academic lexicon of the KD and written several books available at the link provided above that are a little more accessible to the average reader who doesn't want to spend hours digging through PubMed.
Robb Wolf:Robb is a former research biochemist who has written 2 New York Times bestsellers on the topic of nutrition. I have been following Robb for years and listening to his podcasts for as long as I can remember. He is a master of taking difficult topics and breaking them down for people to understand and apply them to their lives.
Mark Sisson:Mark is a former professional endurance athlete who has adopted and popularized what he terms the primal lifestyle. Very good resource for anyone looking for additional advice.
Reason #2) You aren't measuring ketones.
Unlike many other diets out there, the KD has a very specific biomarker that helps to determine if you are following the diet correctly. That biomarker is the ketone body. In short, ketone bodies are produced when your body shifts it's energy metabolism from glucose (blood sugar) to the breakdown of fats. Ketone production happens primarily in the liver as a result of the body mobilizing stored fat tissue or from dietary fats (that is a very short synopsis, not all inclusive). If you are consuming too many carbs and producing insulin shifts, or if you are consuming too much protein your body will not produce ketones. Ketones can be measured via breath, blood, or urine. Breath and blood are probably the most accurate, urine is easiest. If you are not measuring ketone levels, you may not be following the ketogenic diet.
Reason #3) You are eating too much protein
I have had encounters with people who are trying to follow a KD but are regularly sitting down to a plate full of lunch meat and chicken several times per day (more on lunch meat later). If you are consuming more protein than you require there is a CHANCE that your body is breaking down the excess amino acids into glucose thus creating changes in insulin levels, and keeping your body from entering into ketosis. A KD that is well formulated will contribute moderate amounts of protein but not an excess.
Reason #4) You think the KD gives you carte blanch to eat bad foods and excess calories
The KD is not an invitation tosit down and eat a tub of bologna and a tub of peanut butter. Food choices should still be primarily whole foods based. If you were to follow me around for a day and watch what I eat, you will notice that the majority of the VOLUME of food I consume during the day comes from plants. Avocado, lots of vegetables, bell peppers, onions, fruit pre/post workouts (I often times workout a couple times a day so I can get away with a larger amount of carbohydrates and stay in ketosis), and nuts and seeds. The remainder of what I eat comes from animal products from local farms that we know are grass-fed and from grazing/pastured animals. No, the KD is not an open invite to eat bacon and eggs 5 times a day and wash it down with a 500 calorie cup of coffee laden with butter and coconut oil. Caveat to that: if you are training a great deal, you will likely need those calories. While were on the topic of calories, let's not ignore the fact that a lot of the weight loss and lean physique results people experience from a KD come from caloric restriction. While there are many potential metabolic benefits that come from the periodic restriction of carbohydrates, weight loss still requires a certain degree of calorie restriction. If you are a desk worker who doesn't regularly exercise, chances are you will still gain weight on the KD if you are consuming too many calories.
Reason #5) Maybe the KD just isn't that into you?
Remember the movie and book "He's Just Not That Into You?" I said it above and I'll say it again. The ketogenic diet is a great TOOL for many people, not all. Some people do not respond favorably to the KD. My personal opinion is that it may have a lot to do with ancestral lineage, but I won't go too deep into that. Remember that it is *A* tool not *THE* tool. There are a great deal of keto-evangelists out there who say that it is the way to go for all people. It probably isn't. For example, if we took someone who descended from ancestors who existed for millennia on the savannas of Africa and started feeding them a diet that you would see consumed by the Inuit in Alaska, you would probably see somewhat unfavorable results. I have encountered people who follow the KD protocols to a tee and make fantastic food choices, but sometimes the high fat consumption (even good fats like avocado, fish, olive oil etc) simply doesn't agree with their body. If you think this may be you, check the amount of calories you're eating, monitor ketone levels, and consult with someone who understands the KD to determine if it's right for you. Quick rant: I believe this reason applies to all diets in general. Some folks do very well on a vegan diet, some do very well on paleo, some do well on carnivore, but that doesn't mean that EVERYONE will. Stop evangelizing diets and understand that everyone's physiology is not the same.
To conclude, the KD can be a fantastic tool if done correctly, but avoid the nonsense. You don't need to buy the keto supplement program from the infomercial and you need to be cognizant of the good information sources out there. Find someone who can help you along the process and see how it works for you. I'm a big believer in experimenting to see what works for the individual. Begin to experiment for yourself by FIRST looking to find out what is sustainable and promotes adherence for you. If it is not sustainable and you can not adhere to it, it likely won't work for you in the long term. Start there rather than jumping into something like a strict KD.
Got Foot Pain?]]>Matt Hartenburg D.C., 28 Jan 2019 14:59:45 +0000
Doc, what do you think of these new ‘brand x’ orthotics they sell at ‘random store?”
“Doc I just bought these new super padded walking shoes I saw on TV. What do you think of them?”
Before I answer any more questions about individual orthotics and highly engineered walking and running shoes, let me explain my thoughts on the human foot first.
First, I will share a couple personal anecdotes.
In my younger, rugby playing days, I was prescribed a pair of custom orthotics to train in from a podiatrist who was very well known in my hometown. I didn’t know much about training or anything about anatomy at the time, so I was excited to start wearing them. I inserted them into my shoes and carried on with regular training.
While doing speed training in the offseason, I felt a sudden pinch in the sole of my right foot. I ignored it (as 20 year olds often do) and carried on training for the day. When I got home and got my shoes off was when I felt the searing nature of the pain. Turns out I had torn my plantar fascia. I managed to get in to see another podiatrist who had informed me that there was some preliminary evidence showing that certain orthotics have been linked to actually CAUSING tears in plantar fascia and predisposing people to plantar fasciitis.
Wait, what?
Fast forward to my early 30’s. I had enlisted in the Army National Guard and was preparing to go to basic training. Up to that point I had been running in a minimal shoe. I took the necessary steps to effectively run in a minimal shoe without injuring myself. In the 5-6 years preceding my enlistment I had run several longer races in minimal shoes, made my running gait more efficient, and had spent time training my feet to grow stronger and improve balance and proprioception in my feet and ankles. I was pretty well versed in running in a minimal shoe. (*side note:* this past November, I ran 33 miles in a single day in a minimal shoe and had zero issues with foot or lower leg pain. I couldn’t say the same about my stomach however). Making the switch to a minimal shoe had eliminated the ankle, and shin problems I had become accustomed to.
When I shipped to basic training I was informed that I had “flat feet” and was forced to wear a very highly engineered, super padded, highly motion controlled shoe because of my “flat feet.” By the second month of basic training, I had developed plantar fasciitis so bad I could hardly walk in the morning. Each morning I awoke with searing pain in my heel that would only remit after we started doing our warm up for the day’s physical training at 5 AM. To be fair, I’m not putting all the blame on the running shoes; the standard issue boots the army gives are pretty terrible as well. The key point to the running shoes is that they were so padded and motion controlled that it once again altered my running gait back to a heel strike rather than the POSE method mid foot strike I had for so long. It took some very good acting for me to hide the injury in basic training, and was only asked about why I was limping the day before we graduated. The pain continued for about 6 weeks after basic training (yes, sometimes it takes that long to rehabilitate).
So, what do I think about orthotics and big clunky walking and running shoes? Here is what I think about feet.
The foot is a marvel of design. Millions of years of natural selection lead to the development of a structure consisting of 26 bones supported by a vast system of muscles and ligaments. These structures evolved to support humans standing, running, and walking in an upright posture (as opposed to our four legged friends). Much of this standing, walking, and running was performed in little to no footwear, often times footwear consisted of just enough protection to protect the soles of our feet from sharp rocks and environmental hazards. Highly padded shoes that are advertised as being supportive and for certain feet types are a modern invention.
The structure of the foot depends on the strength and integrity of many of the muscles in the foot. Yes, there are muscles in your lower leg and feet, lots of them. The muscles of the lower leg act to support the arch. Just like any other muscle in your body, if you don’t use them you will lose them.
Imagine that you broke your arm. Chances are you would be put into an arm cast for 4-6 weeks, maybe even longer. When the cast is removed, what happens to the muscles of the arm? Are they as strong as the muscles of the other arm? Are they as strong as they were prior to being put into a cast? Of course they wouldn’t, you haven’t used those muscles for the length of time they have been in the cast. A certain degree of atrophy will have set in during that time. Depending on the length of time you were in a cast, your ortho may even prescribe physical therapy to rebuild the strength and function of the arm.
In astudy titled “The effects of short foot exercises and arch support insoles on improvement in the medial longitudinal arch and dynamic balance of flexible flatfoot patients,” the authors noted:
“Although the feet occupy only 5% of the areas of the human body, they control postures through afferent information obtained through the sense of the soles, provide stability for maintenance of balance, and absorb impacts1).
The deformation into flatfoot is induced when the medial longitudinal arch (MLA) has descended because the arch had been excessively relaxed to the extent that the arch cannot be maintained and causes the feet to be excessively pronated compared to normal feet so that heel eversion appears and the weight load is shifted inward to compress the MLA2, 3). When the MLA has descended or has been completely lost leading to structural or functional deformation, the ability to absorb impacts will decrease and the sense of balance will be lost so that stability decreases during walking or running leading to walking difficulties and endurance decreases4, 5).”
The sections I put in bold are important. Your foot is a dynamic structure. It adapts to different stressed being placed on it. Ever go for a barefoot walk on the beach? How your your lower legs and feet feel after the walk? Chances are, they are very sore and fatigued from having to work so hard to maintain your posture and balance on the soft sandy surface. That is a straight forward example of your body and muscles at work to adapt to the environment.
Ever try to balance barefoot on one leg? Better yet, ever try to balance barefoot on one leg with your eyes closed? Go ahead, try it (make sure nobody is watching). Was it difficult? That type of balance is dependent upon the strength and proprioception of the muscles of the hip, leg, lower leg, and foot. Did you feel your foot collapse inwards while trying to balance?
Your foot behaves in the same manner as any other joint structure in your body. Want to improve your leg, hip, and core strength? You’ll probably need to develop some squatting and deadlifting ability. Just like any other system in the body, the feet, ankles, and lower legs can become de-conditioned, weak, and prone to fatigue leading to potential injuries.
So what do I think about the fancy new shoes and insoles on the market? I think in the case of acute injury they can be very necessary. When your foot is in pain, I am all for some type of custom orthotic to get you through the acute phase of pain. However, you had better be rehabilitating your foot. Just like the arm cast example I gave above, long term dependence on orthotic insoles and large highly engineered running and walking shoes can lead to de-conditioning of the muscle groups I had mentioned above, which could prevent a chronic condition from improving, or worse yet, make it worse.
In an article titled: “Avoid Running into Trouble: Orthotics Can Cause Problems if Improperly Prescribed,” Rick Positano DPM states that "Orthotics are like prescription drugs," Dr. Positano explains. "When indicated and prescribed correctly, they are beneficial to the user. When unnecessary or prescribed incorrectly, they can be dangerous." Some over-the-counter orthotics may exacerbate pre-existing medical conditions, Dr. Positano says. Those at particular risk are people with heel pain, achilles tendon pain, back or knee problems, or those who have a high arch foot type or flat feet. Exercise enthusiasts who engage in high impact or high velocity sports often buy orthotics to provide support or serve as shock absorbers. That, too, can spell trouble.”
The article goes on to say: “Orthotics are not used to correct foot and ankle problems. Health care professionals prescribe them to stabilize a joint, reduce pain, prevent deformity, provide better positioning or improve the biomechanical function of the foot, according to Dr. Positano.”
Improper footwear and long term use of orthotics have the potential to cause your feet to lose their adaptive capabilities and strength. By controlling motion and controlling the mechanics of your feet, they are negating your own muscle's ability to support the structure of the feet therefore potentially causing the muscles to atrophy (just as postural muscles in your core lose the ability to support your trunk if you sit at a desk all day.
Over time, this loss of functional ability leads to a foot that can't do what a foot is supposed to do. Support your body, balance, and provide feedback to the rest of the body in regards to posture.
To summarize, if you have an acute condition, by all means hit up your podiatrist and have them examine you, but make sure you are taking active steps to rehabilitate the muscles of the lower leg and foot. Your foot is a dynamic structure that behaves like any other part of the body. Rehabilitating and strengthening the structural integrity of the foot and lower leg can be very time consuming, but it is an incredibly important step towards developing a pain free and strong foot.
1) Kim, Eun-Kyung, and Jin Seop Kim. "The effects of short foot exercises and arch support insoles on improvement in the medial longitudinal arch and dynamic balance of flexible flatfoot patients." Journal of physical therapy science 28.11 (2016): 3136-3139.
New Year's Resolutions: Welcome to Running. Part 3]]>Matthew Hartenburg D.C., 21 Jan 2019 13:52:56 +0000
Two weeks ago, the inspiration for this series or articles was the unseasonably warm weather that brought more winter runners and beginner runners out of the woodwork. Wouldn’t you know it, in typical midwest fashion, we have been hit with all of winter in the time frame of two weeks. Maybe it’s time to set some weather related left and right limits on what is acceptable to run in. How cold is too cold? For me, if there is wind blowing harder than 10 MPH, 25 degrees is my cut off for outside running. If there is no wind, I will run outdoors down to 20 degrees. Anything colder than that and I go to the indoor track at the Mokena Park District facility. After a couple minutes of warming up, 20 degrees really isn’t that bad. After all, when my cousin and I started our run in the Grand Canyon in November, it was 15 degrees at the top of the South Rim. It’s good for you to acclimate somewhat to colder temps.
Now that we got that out of the way, the main point of this article is to give some ideas and resources on how to provide some variation to running to keep it interesting. Most beginner runners pick up the sport and start running long miles at a low intensity. There is a time, place, and purpose to that and I encourage it. Developing an aerobic foundation is important not only for running performance but also for health (lower resting heart rate, lower blood pressure, etc). After some time of long slow distance (LSD) people often times become bored, tired, or both. At that point, it is time to begin adding some variation to training.
Long slow distance is incredibly effective at developing aerobic capacity, especially at first. However, after long periods of time doing solely long slow distance, people tend to hit a plateau in performance (and often times stop losing weight and even begin to gain weight). Not to mention that the long miles have a tendency of adding up leading to achy joints and sometimes overuse injuries. The next step that is often overlooked is beginning to improve your anaerobic capacity and lactate threshold. Lactate threshold is the point at which your body switches over from aerobic energy systems to anaerobic glycolysis. This generally happens at a higher heart rate. I’ll spare you the physiology as to what is occurring and make a general statement saying that this is the point where your legs and muscles begin to “burn.” (Yes, I know that is over generalized, but this article is meant for beginners, not PhD candidates in physiology).
Time to pick up the intensity. Here are a few of my favorite ways to do that:
-10x30 second hill sprints with 2 minutes rest
-6-10x200 meter sprints with 1-2 minutes rest
-4-8x400 meter runs with 2 minutes rest
-2-4x800 meter runs with 3-4 minutes rest
-20 minutes: at the start of each minute, sprint 100 meters
-Fartlek (yes, thats a real word). Go out for a long run and intersperse high intensity intervals followed by active rest of jogging. For example, go for a 30 minute run starting with a 5 minute warm up at a slow pace, followed by the remaining time do 1 minute hard run followed by 1 minute slow jog. Repeat until the 30 minutes is up. That is one example of about 1,000 different ways you can perform this workout.
Beginner runners (and even intermediate runners) often times avoid what is referred to as “speed work” because it can be very difficult and uncomfortable. However, elite runners understand the importance of incorporating this type of training on a regular basis. The benefits of this type of training include improved running efficiency, increased muscle and improved body composition, improved lactate threshold, and often times improvement in rate of weight loss (let’s face it, isn’t that why most people begin running?). If you are looking for good running programs that mix aerobic and anaerobic efforts, check out runrx.
The next level individuals must go to is strength training. Elite runners understand the importance of strength training. Muscle and strength is important. It improves insulin sensitivity, increases basal metabolic rate, decreases chance of injury, and makes you look better. Strength training is avoided mainly because of a fear of “bulkiness” and a lack of general knowledge on where to begin. Here are a couple good resources: lift heavy run long, and stronglifts. Both of these programs will take you from beginner to intermediate and help you fall in love with strength and teach you how to correctly approach it.
The primary reason I am so adamant about strength training for people beginning a fitness program (besides the health benefits) is that very very few of us have the potential to be elite runners. Sorry to say but it is what it is. Most humans respond very well to programs that blend base levels of strength and base levels of endurance. We are not specialists by nature. Our ancestors were able to run long distances, lift and carry heavy objects, climb objects, and moved upwards of 4-6 miles on a daily basis. When it comes to general health, a lot of evidence is pointing towards training programs that mimic that level of functional work capacity. Strength often gets ignored by new years resolutioners, but it should carry as much importance as anything else. If your goal is to run a sub 3 hour marathon, your training should reflect that, but if your goal is to improve overall health and fitness variation is your best friend.
Last, let’s face it, this time of year is not conducive to a lot of running. I just checked my weather app and it is 7 degrees outside. 7. That’s too cold. Not to mention there is nearly a foot of snow on the ground, which leads to a game I like to refer to as sidewalk roulette. 50% of sidewalks are cleared and the other 50% aren’t. The game gets really interesting when people neglect salting their sidewalks! Not a fun game to play. This time of year, I’ll typically break out the row machine and do a lot of those aforementioned interval workouts. Another favorite of mine is heading up to Lemont and doing some cross country skiing. I have never tried snowshoeing but that may be next on my list. Our area also has some fantastic crossfit gyms that spend a lot of time developing proper programming and individual attention.
To sum up, variation will not only improve your overall health and fitness, it will keep you interested in training and running for the long term.
New Years Resolutions: Welcome to Running. Part 2.]]>Matthew Hartenburg D.C., 14 Jan 2019 14:09:29 +0000
Last week’s article on running was pretty long. This one will be considerably shorter. I mentioned last week that I was going to write about higher intensity anaerobic training for the next edition to the newsletter, but after some contemplation I decided I would go a different direction and get to anaerobic training next week. If you didn't read last week's article, follow the hyperlink above to read it before moving on. Also, for those of you who didn't read last week's article, understand that this newsletter series is meant for beginners. If you are an avid or intermediate runner and you read this thinking "wow, this is really elementary information," you are correct, and it is designed to be.
This week I’ll be talking (ranting) about something I have found to be a limiting factor for many folks when they get into any sort of exercise program. That concept is progression. Ask yourself the question, what are you working towards?
Aside from operating the Be Well Chiropractic facebook and instagram pages, I don’t have much interaction on social media anymore (something I strongly recommend). I have a personal instagram page with very few people I “follow,” and few people who “follow” me, no facebook page, and still don’t really know what twitter is. Even with the relatively little amount of social media bandwidth that I occupy, I have been over run this New Year with ad after ad about random fitness and nutrition programs and “challenges.” 30 Day fix this and 21 day challenge that, reboots, and resets galore have managed to occupy my otherwise bare instagram feed. Ten years in practice including several years of being an owner of a crossfit gym has provided me ample opportunity to interact with thousands of people on a daily basis, many of those interactions have centered around developing a better lifestyle including eating better and exercising. The limiting factors that I have noted time and again in developing a healthier lifestyle deals with a lack of tangible goals and lack of progression, especially long term progression. These New Year fitness fads lack any real long term change. Sure they can act as a great starting point, but the long term progress is up to the individual. If i had a dollar for the amount of people I have met who have done numerous whole 30 challenges (etc) numerous times, my student loans would be paid off.
First, let’s talk about lack of tangible goals. Keep in mind that this newsletter series is being directed towards people who are just beginning running as a fitness pursuit, not the intermediate or avid runner. Running is often times the entry level to a world of fitness. As I discussed last week it is the most accessible means of exercise and requires only shoes and some will power to start with. As a result of this ease of accessibility, many people enter into a world of running by saying they will run “X” miles per week or a certain amount of time spent running each day. While we all have to start somewhere, I encourage people to have some type of measurable goal with a completion date. It makes the entry stages of running far easier and more enjoyable. Not to mention, it provides an additional level of accountability. I have found that performance goals far outweigh aesthetic goals for the beginner. “I need to start running to look better in my summer clothes,” only takes you so far. “I signed up for my first 5K on March 12 and I have to finish it because I told everyone I would,” tends to produce more meaningful results.
Weight loss and aesthetic goals can be incredibly fickle. When you start running there is a possibility that you will build muscle in your legs. That will be reflected as weight gain on the scale. This upsets people who live and die by what the scale says despite the fact that it is a positive result. Rather than a weight loss goal I recommend a performance goals. Athletes have performance goals, and as a result, they have lean muscular bodies as a result of the habits required to get them to their performance goals. When you train towards a performance goal of some sort, you are forced to eat better and less likely to skip workouts.
What does a performance goal look like? Well, it should be somewhat intimidating but not impossible. If you’re just beginning start looking at local calendars for 5K or 10 K races and get yourself signed up. Pick one that is about 8-16 weeks away to give yourself ample time to train, then tell everyone you are doing it, or better yet, sign up with a co-worker or friend who has some running experience. They will hold you accountable and help you train for your first race. Don’t do what I did in my first foray into running and sign up for a marathon right out of the gate. That was dumb. A first race should be somewhat intimidating but you should still be able to do it. The vast majority of people have no idea what their bodies are capable of accomplishing. Just because you haven’t before doesn’t mean you can’t.
Don’t want to enter a race? It doesn’t have to be an organized road race. In the past few years Dr. Anna and myself have hiked pikes peak, run through the grand canyon, hiked turtle head peak in Las Vegas, and will soon be doing an overnight backpacking trip through the grand canyon. We love the outdoors and will often times choose an outdoor activity that requires us to train for it. I love these types of challenges because they offer us the opportunity to explore parts of the country that few people have a chance to experience despite the relative ease of getting there, and still motivate us to train for it to ensure that it is an enjoyable experience rather than a weighted forced march.
Having a measurable goal with a time element attached to it (ie complete my first 5k on March 12) is the starting point towards success. "My goal is to run more this year," is not tangible, measurable, and will not produce results.
Next, let’s talk briefly about long term progression. So you have run a 5K or 10K. Maybe you have completed a couple. Now it is time to see if you can improve on your times. If you have fallen in love with running as a fitness protocol and have entered and finished a couple distances, now it is time to train to improve performance. Let’s say you have done a couple 5K’s and really enjoy that distance, and finish around 30 minutes. Take some time and periodize your training and find someone who can help you cross the finish line in 25 minutes. Working towards improved performance measures will cause you to modify your training, eating, and general lifestyle habits. In my opinion, this is when you transition from running enthusiast to athlete, and now you have to start living the athlete lifestyle (this is also the time when well meaning relatives will try to warn you about the dangers of excessive running. I usually respond by telling them the dangers of excessive couch sitting).
Long term progression in performance require you to prioritize not only training but also recovery and lifestyle factors such as amount of sleep, dietary protocols, and taking care of the musculoskeletal systems. On a personal note, this is what keeps me going. I’ve heard my entire life that the things I do only get harder with age. At 35 I have learned that is true, but it has become a game for me to see how far I can push myself and what I’m capable of doing. I’m 35 years old and leaner, stronger, and faster than I was at 18. When I’m 70, I won’t be able to do what I’m doing at 35, but it doesn’t matter because I will still be attempting to do as much as I possibly can for my ability level at that time. THAT is long term progression. Not just improving upon your capabilities for the next 8-12 months, but for the next 20-30 years of your life. Developing habits and progression now will serve you in the future.
To sum up part 2 of this series, it may have been a weight loss or aesthetic goal that brought you into the world of running, but it will be a performance goal and long term vision that will keep you running. Challenge yourself. As I mentioned before, most people don’t know what they are capable of. Beginning a journey of discovery towards breaking through mental limitations will provide the motivation necessary to develop life long habits rather than a two month fling with running. Next week, I will talk about mixing high intensity anaerobic training into your running and how to avoid the specialization that ends up slowing recreational runners down.
New Years Resolutions: Welcome to Running. Part 1]]>Matt Hartenburg D.C., 07 Jan 2019 15:39:10 +0000
Resolution season is in full swing and the weather is unseasonably warm for January which means I have seen more people on the running trails than I usually see this time of year. My Saturday morning run was the inspiration for this series of blog posts.
This winter reminds me of the fall and winter of 2012.
That year, Dr. Anna and myself signed up for theRed Rock Canyon half marathon in Las Vegas. One of the most scenic, yet challenging half marathons in the country (so scenic, in fact, that we ended up getting married at Red Rock Canyon the following year). We signed up for the race in October and dedicated ourselves to training during the winter regardless of the cold weather that was sure to come. Good news was that the cold miserable weather never came! It was a gloriously mild winter that year and allowed us to train through December, January, and February. So far, this winter has been much the same and as a result we are seeing far more people along old plank trail and the numerous forest preserves in the area out running. We love seeing this, after all, our slogan is live life, be active, be well.
As we all know, New Years resolutions have a tendency to drop off. This post aims to prevent some of that drop off for the 7-8 people that click our links and read these articles.
Caveat: this series will not be an exhaustive review of the scientific literature, nor will it be an attempt to provide you with a running program. This will merely be an anecdotal account of methods I have used to keep myself motivated to run beyond the point where the endorphin rush of the new year has worn off and I have lost all motivation. This post is not for the intermediate or advanced runners. This is for the person who just hit the road and trail for the first time and wants to avoid the staleness and boredom that often comes with running.
I have not been blessed with the body of a runner. I am 5’10 and 200 pounds, with legs that are meant to pick things up and move them and a torso that is built more in the shape of a 55 gallon drum than an elite runner. I am also unwilling to compromise the strength that I have built during the years in favor of running a 3:15 marathon. I have come to terms with this. Over the years I have learned how to adapt my training methodologies to reflect this lack of genetic running potential. Experience has taught me that because an elite runner can put in “x” amount of miles each week in preparation for a 5K, 10K, half, or full marathon, that doesn’t mean that I am able to do the same.
I first started running when I was 21 years old (that was when I started running beyond that of a means of being in shape and started signing up for the occasional race). I was in college, eating a poor diet, enjoying my Friday and Saturday nights on the town, and had found myself a whopping 250 pounds with 26% body fat (I’ll never forget those numbers). This doesn’t bode well when your primary sport is rugby which requires fantastic endurance and stamina to last through an 80 minute game and a 12-14 game season. I had to get in shape. That was the first time I jumped into a marathon. In hindsight, knowing what I know now, there are far better ways to get into shape for rugby, but running is what people typically default to due to its accessibility and ease of entrance (all you need are shoes and some motivation, right?). I’ll keep the rest of the history short. In the 14 years that have passed since I first endeavored into the sport I have learned that it has always been one of the biggest bang for your buck means of aerobic and anaerobic fitness out there, and despite forays into other means and methodologies of training, I have always found myself coming back to running at least 2-3 days per week and this past fall completed my first ultra distance run of 33 miles in the grand canyon with about 12,000 feet of vertical gain.
First, some of you may be thinking “wait a second, didn’t you tell me running was bad?” I don’t consider running to be bad, if you are running correctly and addressing good biomechanics and approaching it like an athletic endeavor rather than just pounding out miles. Running is very accessible, which leads to problems in that we think we can just head out to the road and trail and start running without regards to form. After all, we all learned how to run at an early age right? How hard can it be to pick it up as adults? Keep your eyes pealed to our events calendar as I will be doing a running form workshop at some point this year. “Wait a second, isn’t excessive running bad for you?” What is excessive? Excessive is very subjective. What is excessive for me might be a warm up for Scott Jurek. What makes running dangerous is lack of recovery. Yes, recovery is also subjective, but it’s where most people’s issues with running stem from. For example, if your schedule is so hectic that the only chance you get in a day to run is at 4 in the morning, and you are sacrificing sleep to get in your 4-5 days of running per week, then it is very possible that those runs are doing more harm than good. If you’re regularly burning through an additional 1000 calories a day from running and you’re not eating enough to sustain that amount of training (usually in order to lose weight), you will find yourself in a world of hurt. If this describes you, come talk to me in the office and I will give you a little more guidance on how to approach this in a safe manner.
Now, how can you keep running fresh and fun so that you don’t wind up another New Years resolution statistic? One word: progression. Being a beginner and embracing the mindset of a beginner is where the magic happens. This early stage is when you will see the most rapid improvements and begin to lay the foundation (good or bad) for future training. When you start off the right way and begin to see progress in your abilities and fitness, you will start to catch the bug that so many others have caught. Where to begin?
One method that I have been utilizing for the past 6 months is the MAF method. MAF stands for maximum aerobic function, and was developed by Dr. Phil Maffetone. This method is relatively simple, however for a more detailed accounting of this method head to this link and read more for yourself.
Buy a heart rate monitor (I use the PolarH7 monitor) and start wearing it on your runs. Gauge your heart rate during the run. The MAF method recommends taking the number 180 and subtracting your age (146 for me). That is your max training heart rate. If you are brand new to training, subtract an additional 5 (141 in my case). If you are a crafty veteran of the running world and have been constantly training upwards of 5 years you add 5 to the number (151 for me). This number is your magic number. Let’s say you go for a run, 5 minutes into the run you look at your HR watch and see the number is far exceeding your magic number. Slow your run down to a walk until the HR recovers. Do not allow your HR to exceed the prescribed number even if that means walking more than you would like to. By doing this, you will be increasing the amount of work capacity you can perform at a given heart rate. This was incredibly frustrating for my ego when I first started following this method. At the time I was capable of running a low 6 minute mile pace for 1-2 miles and able to hold a low 7 minute pace for 5 miles, but I never paid attention to heart rate. When I first put the HR monitor on I was unable to maintain even a ten minute mile pace at distances greater than 8-10 miles without my heart rate exceeding my magic number. My first 15 mile run at a heart rate of 151 BPM was at an 11 minute per mile pace because I had to stop and walk so often. Last week I ran 10 miles at the same heart rate and was able to maintain an 8:35 minute per mile pace. That is progression, and progression is what keeps me motivated. (Don’t you want to see how many metrics you can improve in?)
Now, when I conduct tempo runs and I’m pushing my pace back into the 6 minute per mile range I am able to maintain that pace for far longer at a lower heart rate which will lend itself to faster times and greater work capacity. Not to mention, I am training my body to utilize fat as an energy source rather than being completely reliant upon carbohydrates, and increased aerobic capacity lends itself to improved recovery in between runs which is important for a 34-35 year old male who is trying to stay at the top of his game.
While the MAF method isn’t perfect, and not meant for everyone, it is a fantastic starting point for those of you who are jumping into the running world as a means of getting fit. Just because I am focused on aerobic at the moment doesn’t mean I have turned my back on the high intensity world I have become so accustomed to. High intensity is everywhere these days and is a fantastic training domain for a lot of people, but because this is America and we are a nation of polar extremes in fitness and nutrition, many people including myself have abandoned aerobic training for high intensity and/or have gone all in on aerobic and forgot to balance intensity. More on that in the next article in the series.
THE MOST FUNCTIONAL EXERCISE THAT FEW PEOPLE DO]]>Matt Hartenburg D.C., 03 Dec 2018 13:46:10 +0000
Generations ago we used to live very physically demanding lifestyles. Whether we’re talking about agrarian periods of human history, or hunter gatherer periods of human history, our ancestors were much stronger and in far better shape than we are now (generally speaking).
Strength training is a fantastic means of mimicking the physical environment in which humans evolved under. As a result of the fundamental demands strength training places on us, it causes our body and our physiology to activate genes in response to the stress that comes from weight training. The adaptation to this stress is what leads to positive changes in health including more muscle mass than body fat, increased bone density, improved insulin sensitivity, and many others, far too many to list here.
Despite the many advantages, most people shy away from strength training. In my experience, I have seen a few reasons why people don’t begin a strength training regimen. 1) They don’t think it’s necessary. This is a separate conversation. 2) They are intimidated by it and fear becoming “bulky” like a body builder. Body builders don’t look like that on accident. They look like that as a result of years of dedicated training and dietary protocols. 3) People don’t strength train because they don’t know where to begin. Yes, this one is easy to understand. Years of fitness advertising and general misinformation in the fitness industry has lead to much confusion. The best starting point is to develop mastery of bodyweight movements (push ups, air squats, pull ups etc). Begin to develop strength by mastering your own body weight.
This article isn’t about bodyweight mastery, though I will likely devote some content space to that in the future. This article is about adding a little weight to your training, or adding another exercise you don’t typically do. The most basic and simple (not easy, but simple) exercise most people don’t do is the farmer carry aka farmer walk. Think about it, what is more functional and necessary than picking up an object and walking with it? The farmer walk builds grip strength, core strength, shoulder strength, and leg strength in minutes a day. If you are already strength training (great, keep it up), add these at the end of your workout 2-3 times a week. If you are not strength training this is a great place to begin.
Here’s how to start. Pick up a weight in each hand, walk with it, set it down and rest. Start light and learn what you are capable of. If you start with 2 pounds in each hand, who cares? You’re starting somewhere. It is that simple…..
There are key points of performance to pay attention to. Number 1: maintain an upright posture with your shoulders retracted down and back and your ears over your shoulders, shoulders over hips, and hips over knees. If you are unable to keep your ears over your shoulders you are likely using too much weight. Number 2: maintain slightly shorter than normal strides. A normal stride will work at moderate weight, just make sure you don’t elongate your stride unnecessarily. Number 3: maintain straight elbows. Don’t attempt this workout with flexed biceps. Just trust me on this one.
By adding weight to something as simple as walking you are forcing your body to activate stabilizing muscles in the core, shoulders, hips, and legs. By adding this simple exercise into your training you will be challenging your body to maintain an upright posture while moving a weight over a long distance. Being able to carry something heavy while transporting yourself is one of the most primitive exercises we can do. Think back to a time before suitcases had wheels? Ancient, right? Remember having to carry suitcases through airports and hotels without the luxury of ergonomically friendly handles and wheels? Remember how much of a workout we used to get from something that simple?
As with most exercises, there are many thoughts on the proper number of sets and reps, and every author claims there method is the best. I don’t know if mine is best, but this is what has worked for me in the past. Do 5 rounds of 30 seconds walking 30 seconds resting. After the fifth set, rest for two minutes and repeat the 5 sets one more time. Start light and perform the exercise 2-3 times per week and add a little weight each time until the load becomes too heavy to maintain proper posture and form. Once you reached a point where the weight becomes difficult, reduce the weight down by 50% the following week and start the linear progression again.
Yes, it is really that simple.
A Few Notes About the Holidays]]>Matt Hartenburg D.C., 26 Nov 2018 12:59:24 +0000
Let's get the elephant out of the room. We hear a lot about how the average person gains 7-10 pounds during the holiday season. According to Stanford's Be Well blog (should we go after them for using our name?) the average person gains closer to one pound during the holidays. One pound is very different than 7 pounds, but is still nothing to shake a stick at.
Let's take a closer look at what we consider to be the holiday season. First up is Halloween. Bags of candy laying around the house for a couple weeks. Next up is thanksgiving. 1-2 big days over the course of a weekend of stuffing ourselves. Right behind turkey day we get into the Christmas, Hanukkah, and New Years season. Everywhere you look, you will be presented with plates of cookies, chocolate, possibly alcohol, and other assorted snacks and treats.
Basically, from late October until early January we are presented with numerous opportunities for indulgence. Couple that with the fact that we are biologically inclined to pack on pounds during the winter (an evolutionary trait that helped our ancestors get through cold harsh winters before the invention of year round 70 degree environments) and you have a recipe for weight gain.
In the past decade '+' that I have been in this crazy healthcare world, I've learned a few strategies to help get through the holidays while still prioritizing health and minimizing the impact of the plethora of sugar, salt, and fat we are introduced to.
1) Remember what the holidays are.
What are the "holidays?" Moreover, what is the "holiday season?" Halloween, Thanksgiving, Hanukkah, Christmas, Kwanzaa, and New Years. The stretch from Halloween until New Years day stretches just over 60 days, yet the ACTUAL holidays only comprise 6 days of that stretch (14 if you include the 8 days of Hanukkah, and 13 days if you include Dec. 26-Jan 1 of Kwanzaa). That's it. 10-20% of the "holiday season" is comprised of actual holiday days. Yes, this time of year poses complications to even the most ardent of health enthusiasts, but the first strategy I recommend to people is to keep the celebrating to the actual holiday days themselves (or whatever day it is you celebrate with your family). For example, on December 24 and 25, enjoy the holiday, December 1-23 live your normal life. Don't fall for the "it's the holidays justification" that causes us to eat (over eat) for the entire time frame of October 31-January 1 at all the different holiday parties and events we go to. Enjoy the holidays but maintain discipline during the "season."
2) Don't beat yourself up.
Please, please, please, don't beat yourself up for eating the dessert, or the candy, or whatever it is that you ate on thanksgiving that you wouldn't normally otherwise eat. The key to maintaining a life long healthy lifestyle is to develop a good relationship with food and exercise. Obsessing over the cookie you ate, "punishing" yourself with a post holiday workout, or "earning" your food via intense workouts are all signs of a poor relationship with food. Eliminate the obsessive tendencies and the self deprecating thought processes that occur during the holidays. You had a few cookies? Oh well. You had an extra piece of pie on Christmas? Eh, no big deal. Remember, if you stick to strategy number 1 and are disciplined during the remainder of the "season" the effects of a couple days will be minimized. We don't punish ourselves for enjoying the holidays, nor do we shame ourselves anymore. Our body does that for us when we eat too much by reminding us how bad we feel from eating the extra pie.
3) Use caution with the post holiday fads and health challenges.
To piggy back what I said above about a good relationship with food and exercise, watch out for the post holiday trends that have become so popular lately. For example, last year I saw a lot of people begin a fasting protocol after the holidays. Fasting can be an excellent health strategy when used correctly, however, using fasting as a punishment of sorts for holiday indulgence is a dysfunctional behavior. In the proper context, fasting can be a great protocol for slight caloric restriction and has been shown time and again in different types of trials to be a key to overall health and longevity, but if done improperly (ie. fasting vs chronic starvation or fasting) can lead to unwanted and unintended metabolic consequences. Participating in New Years weight loss competitions can lead to more unintended consequences by leading to yo-yo weight loss and weight gain cycles. Remember, this is a long term game, not how quickly you can lose ten pounds. I've seen and personally participated in enough of those challenges for the past 15 years to see the patterns that develop as a result of them. Eating right and exercising are habits to be formed, not 30 day challenges. Exercise because you enjoy it. Eat right because it makes you feel better. Remember my rule on "diets:" if a diet requires you to take a supplement, it is not a complete diet.
4) Don't trust the scale.
In order to gain a pound of fat it requires an OVER consumption of nearly 3500 calories (not taking into account other contributing factors like macro nutrient ratios and glycemic index of course). Considering the average person will burn about 1000-1800 (basal metabolic rate) calories just by being awake and not counting any additional physical activity or exercise, you would have to eat an absurd amount of food to gain a pound of fat in a day or two. When you step on your scale on December 26 (don't) you may be shocked to see that you are 2-3 pounds heavier than you were the day before. You didn't gain 2-3 pounds of fat. You more than likely gained water weight from the salt and excess carbohydrate consumption. Don't trust your scale this time of year. It doesn't give the full picture. Stepping on the scale during this time of years depressing and it doesn't have to be. 1 Gram of glycogen (stored carbohydrate) can hold up to 3 grams of water. Salt also holds a great deal of water. The 3 pounds you gained on a single day is almost entirely water weight. Just get back on track with healthy habits and you will be fine.
Keep it simple. Maintain discipline and priorities during the Holiday "season" but enjoy the holiday days. If i had to encapsulate my thoughts on this topic into one basic conclusion, I would say that the major key point is having a healthy relationship with food rather than a compulsive relationship. As I said in the workshop series we concluded last week, the most freeing mindset regarding the holidays and food consumption is when you are able to make the switch from saying "I can't have that food," to "I don't want that food." Enjoy your holidays but stay disciplined. As Jocko Willink says, "discipline is freedom."
Stay tuned to our facebook page over the next few weeks and we will be sharing some of our favorite holiday recipes and other tips!
BLACKENED SALMON]]>Matt Hartenburg D.C., 06 Nov 2018 22:38:32 +0000
Are you eating enough salmon? Salmon contains healthy fats that can improve heart health, skin health, and ample protein to support lean muscle growth. Salmon is also high in the antioxidant astaxanthin which has numerous known health benefits.
What you need:
2 TBSP Paprika
1 TBSP Cayenne Pepper
1 TBSP Onion Powder
1 TSP Salt
1 TSP Black Pepper
1/2 TSP oregano
1/4 Cup Melted Butter
What to do:
Mix seasonings together in a bowl
Coat outside of salmon fillet in melted butter
Lightly coat Salmon fillets with seasoning mixture on both sides
Place Salmon into pre-heated pan (cast iron if possible)
Cook salmon in pan 3 minutes first side and 3-5 minutes on the second side.
What I Eat In The Outdoors]]>Matt Hartenburg D.C., 09 Oct 2018 18:14:48 +0000
It's that time again.
The time of the month where I leave the office for a few days and head to drill with the Illinois Army National Guard. This month we will be sleeping in the field for a 4 day drill, meaning food selection will boil down to maybe one "hot meal," and 2-3 MRE's per day.
I loathe MRE's. They are awful. To make matters worse, the "hot meal" we are usually fed 1-2 times per day is basically the same thing as MRE food that gets cooked in a plastic bag that was immersed in boiling water. Sound appetizing?
Yes, they are pretty nasty, but I will say this, when we are at an extended training rotation and in the field for a considerable amount of time working hard I'll eat anything.....including MRE's. For four days in the field this coming weekend, I'll improvise.
You see, next month my cousin and I will be doing a 20+ mile trail run in the grand canyon. I am training for this run and watching what I eat. A four day drill will obviously bring complications to my training schedule. That's ok, I can adapt the training schedule to fit the week and make up for the four days I lose. However, when it comes to eating right, I won't make an exception. I guess I'm one of those crazy people who anecdotally believes that what I eat has a direct impact on my performance and recovery. Crazy, right?
At this point you may be thinking, what does this have to do with me? I'm not in the Army, why would I need to worry about packing food for a field training exercise?
Maybe you aren't in the Army, but chances are you have gone hiking, or camping, or something else out doors? The problems with army food carry over into a lot of outdoors products as well. High sugar, high salt, high glycemic foods are not only pervasive in Department of Defense MRE's, but they also stock the shelves of your local outdoors store and running stores. I have a couple issues with MRE's, Army food, and commercially available backpacking products. The first deals with the high levels of salt used in food preservation. MRE's have a shelf life of up to 12 (maybe more) years. This salt content can wreak havoc on your digestive system. It leads to a game that I like to refer to as "chances are I won't need it, but where are the porta-potties, and in case I need it in a huge hurry, how quickly can I get to them?" Use your imagination to figure out how that game is played, in the meantime, I'll spare you the details.
The second problem is performance. Yes, in the field we are generally busy in the army, much like a backpacker is quite active and covers a great distance. Calories are important when you are that active. However, the type of calorie is important too. Think of your body as a steam powered locomotive. Generally speaking, the steam locomotive is going to use coal to stoke the fire to produce long lasting slow burning energy to supply steam (in the case of the body, we're talking about healthy dietary fats and stored fats). If the conductor all of the sudden started utilizing paper and small pieces of dry kindling wood in place of coal, the fire would start to burn incredibly hot but burn itself out in a short amount of time (in this case, that paper and kindling wood would be high glycemic carbohydrates like granola, crackers, and other sugary products). Think of a five year old that just broke into the halloween candy stash. Picture the sugar high followed by the sugar crash that this child will experience (and the parents will have to deal with) and you'll begin to get an idea of what I'm talking about.
Most of what we do in the Army and what backpackers and outdoors people do is aerobic, meaning it is a lower intensity and will primarily utilize fat as the necessary energy source. Next month, when we run the Grand Canyon, we will be dipping into more anaerobic energy systems which will require carbohydrates as well as fats. In that case, I will make a more conscious efforts to intelligently replace carbohydrate stores during the approximately 6 hour run. But this weekend I will primarily be walking around and moving at a slower pace. It is with this in mind that I plan four days worth of eating primarily around healthier fats and proteins. You may be wondering why MRE's and backpacking go-tos are so high in carbs. Short answer, because carb's are cheap. Go for a drive down I-80 and what do you see for miles and miles? Avocado fields? Nope. Almond fields? Nope. Coconut fields? Nope. Corn, Wheat, and soy. These are abundant crops that are subsidized. I won't go too deep into food politics, but I think I've painted a pretty clear picture.
For all you label reading, health junkies out there, keep in mind that when it comes to planning this type of eating, I have to keep space and weight in mind which limits my options to what I consider to be the best of the worst. Sure, there are some options here that aren't exactly super healthy options, but they get the job done in this context. From here on out, refer to the picture above.
"Wait a sec, didn't you just say you didn't want carbs?" I don't want ONLY carbs. I want a variety. At home, I don't eat oatmeal. In the field I do, because they are a quick source of calories, and the particular kind in the above picture don't affect my blood sugar too much to cause a sugar crash.
Almond Butter
This is simple. Calories per dollar spent. The packets of Justin's Almond Butter in the picture above cost about $1 and pack 180 calories. And they taste fantastic. I always have these on me and will have them in the canyon as well.
Bag of Trail Mix
Cashews, almonds, macadamia nuts, and more. I buy these individually and pour them all into one bag to give me a simple snack that packs a high amount of fat, protein, and good low glycemic carbs.
Starkist Chicken Creations
I love these and they are a nice break from tuna. Lots of flavors available and only run about $2 per pack. Good source of protein, but a drawback is some trans fats I would normally avoid. Oh well, still better than MRE's.
Starkist Selects
Yellow fin tuna in extra virgin olive oil. That's it. That's all thats in there. Good fats and good proteins that are satiating and taste great.
Chocolate Chip Cookie Dough Quest Bar
I'm not one of those quest bar zealots who believes that quest bars are the healthiest thing in the world. These merely quench my sweet tooth and are better than candy. At 190-200 calories per bar they're a great quick calorie source without the pitfalls of hydrogenated oils and corn syrup.
Last but not least, starbucks instant coffee.
Let me explain.
I LOVE coffee. I hate instant coffee. I also hate Starbucks coffee. For some weird reason, I enjoy starbucks instant coffee, and the convenience can't be matched. I strike up my jet boil in the morning, boil some water in less than two minutes, and add instant coffee in my canteen cup and voila, my coffee is ready before the good idea ferry shows up. Who is the good idea fairy? The good idea fairy is well known to anyone who has ever served in the military. This fairy is the mysterious entity that shows up and ruins plans. For example, if wake up time is 0500 and breakfast is at 0600, the good idea fairy generally shows up at around 0545 to suddenly change plans to have everyone hurry up and wait for further instructions. If I have had coffee prior to the arrival of the good idea fairy, I'm usually pretty well able to handle the nonsense. If I haven't had coffee, the good idea fairy and myself will likely butt heads together.
So there it is, my shopping list for the field and other outdoor adventures. I buy enough of these things to last me 4-5 days, the total weight usually comes out to only around 5 extra pounds in my ruck sack or back pack, and the cost is usually only around $50-$60. Enjoy!
A Few Thoughts on Barefoot Running]]>Matt Hartenburg D.C., 09 Jul 2018 14:51:54 +0000
First and foremost, I am not an elite runner and have no ambitions to be one. I primarily focus on running 5K distances (5K PR is 20:08, not bad for a bigger guy). It has been several years since I have run a half marathon or greater. At 210 pounds, I have accepted the fact that even though I enjoy running, my body is not well suited to running incredibly long distances on a regular basis. However, I will on occasion run longer distances for the challenge and fun of it.
My running training revolves around being prepared for the Army Physical Fitness Test (APFT) that we conduct twice a year, and having a good aerobic base in case I go to a school for the Army where we will be asked to run a set distance in a certain amount of time OR if we have to ruck a set distance. For example, this past spring I went to Air Assault school where we were asked to complete a 2 mile run, 6 mile ruck, another 4 mile run, and a 12 mile ruck in a ten day time frame. My fitness goals revolve around being prepared for events like that.
Before I dive into the content of this article I wanted to qualify myself (or disqualify) so that the reader would know who the author is. I am not a writer for a fancy running magazine or a running web outlet. I am the farthest thing from that, and I will remain that way for a reason. A lot of popular running media outlets write training articles touting what training methods and lifestyle methods elite runners undergo. Average Joes subscribe to these magazines and read them thinking "well if that is what the kenyans do then I should do it too." Chances are, if you are reading this you are not an elite marathoner or runner (maybe you are). Parroting training methods of elite runners if you are an average person like myself is a sure fire way to find yourself getting hurt or overtraining (believe me, I have done it).
Here is a brief history of my running career:
-My first year of grad school I got big....really big. 250 pounds and 30% body fat. My friend challenged me to run a marathon with him. I did, and I was hooked. Body weight dropped to 205.
-Following the first marathon I set out to run 2 more. One I trained effectively for and ran a faster time, the next I overtrained and got hurt and decided I was done with 26.2 and was going to focus on distances more suited to my body type.
-I continued running for fitness related to rugby.
-After college, I ran in about 1 half marathon a year to stay fit while doing crossfit.
-During this time I discovered the POSE method of running and switched to a minimal running shoe (New Balance Minimus has been my go to for the past 6 years). Changing my running style and footwear led to greater speed and less injuries.
-In my mid to late twenties I fell in love with the sport of weightlifting, and running went on a hiatus.
-At 30 years old I succumbed to my midlife crisis and joined the Army National Guard.
-At Basic training I was classified as having a flat foot and was given a very large, clunky, motion controlled shoe (and several pairs of cheap standard issue boots).
Here is where the story gets interesting.
During basic training I was not allowed to wear a shoe other than the ones that were given to me. Between running in my big, clunky, motion controlled shoes in the morning, and marching in my cheap boots all day, my feet ended up in really bad shape. I had plantar fasciitis so bad that I couldn't walk in the morning. I hid this injury from my drill sergeants for the remainder of my time at Ft. Leonard Wood to avoid being recycled due to injury.
When I returned home I focused on rehabilitating my feet and switched back to a minimal shoe. Over the course of the next 6-8 weeks I was able to restore strength in my feet and my running form and mid foot strike. When I had switched to the larger shoe I regressed back into a heel strike running form. Heel strike is when the heel of your foot strikes the ground in front of your center of gravity, as opposed to a mid foot strike directly underneath or close to underneath your center of gravity. The heel strike in front of the body translates to a lot of lost momentum and a great deal of impact traveling up the kinetic chain (foot, knee, hip, back, torso). Big running shoes with a great deal of padding in the heel promotes a significant amount of heel strike. A 200+ pound runner like myself should avoid heel strike at all costs.
Think about it this way. Have you, or anyone you know, ever been in a leg or arm cast? I broke my foot in 6th grade and was in a cast from the knee down for 8 weeks. When the cast came off what do you think the muscles in my leg looked like? Do you think I had good balance on that leg? The muscles in my leg were atrophied from not being used for 8 weeks, I found walking to be awkward, and my leg was so de-conditioned that I had to relearn how to do most normal functions. This is why most people undergo physical therapy after taking a cast off, to re-learn basic functions.
Large motion controlled shoes affect your feet in much the same way a cast affects your leg or arm muscles. By wearing shoes that do not allow your feet to respond to the ground while walking or running, you are changing the biomechanics of your feet and not allowing them to do what they were designed to do. I get asked questions on almost a weekly basis about plantar fasciitis, and receive very strange looks when I tell people they need to strengthen their feet (I think most people expect me to prescribe them an orthotic). Yes your feet have muscles in them. Muscles that developed and evolved over millions of years of our species learning how to walk upright in a bipedal stance. By introducing motion controlled shoes at a very young age and wearing them our entire lives we "inactivate" the very muscles that are supposed to maintain the arch and allow our feet and ankles to act similar to a spring that interacts with the ground.
So, what do I think about orthotics and motion controlled shoes? I think they are necessary during acute injuries in the same way that a brace or cast is necessary during an acute phase of an injury. They provide support for tissues that may be undergoing healing, but once the injury is healed it is time to return to normal function. In order to return to normal function, we must strengthen the feet and build ankle mobility.
Enter barefoot running and minimal running. First, what is the difference between barefoot and minimal? Exactly like it sounds. Barefoot running is completely barefoot, while minimal running involves shoes that do little more than protect the soles of your feet. Personally, I do my warm up exercises barefoot, and do my run in minimal shoes.
Before I share my thoughts on barefoot running, let's explore the controversy that surrounds it first. Just like anything else in America, people have become polarized on this topic. Minimal running emerged a few years back and was touted as possibly being a good tool for fixing running form (which I happen to agree with, it is a great tool, not the end all be all). Just like we do with anything, camps emerged that started advocating barefoot and minimal running as the best thing to ever happen to running. Minimal shoe companies started emerging making some incredible health claims in regards to their product for barefoot running. On the other end, articles started coming out talking about the negative effects of this style of running. Both camps became diametrically opposed to each other. But, as history has always shown, the truth of the matter always seems to lie in between the two extremes.
Before anyone jumps into minimal or barefoot running they must first prepare their feet for it. Think about it, you have likely worn big, cushioned, motion controlled shoes your entire life. You can just go from running in normal shoes and jump to minimal for the same reason you can't walk into a gym tomorrow and squat 500 pounds. You have to build to it. You must developed strength in your feet, balance, and coordination. Moreover, you have to realize that your old heel strike running form that you employed with your old shoes can not and will not translate well to a minimal shoe. You have to re-learn how to run.
I believe that many (NOT ALL) people can transition into a minimal shoe, but it requires time and a willingness to rethink how they use their feet. Once you have established a baseline of strength and coordination and are ready to begin running in this style you have to slowly introduce mileage, almost as if you are starting all over.
Minimal running can be a very effective tool and may actually improve your running efficiency, but you MUST be willing to put the time time in to prepare for it and build the strength and coordination necessary to do it effectively. This includes rebuilding the muscles in the feet, legs, hips, and lower back. Do not (I REPEAT, DO NOT) go buy a pair of minimal shoes and go running in them right away.
This week in the office I will be teaching a quick 15 minute workshop on how to begin strengthening your feet and developing ankle flexibility. Tuesday July 10 at 4 and 5 PM, Wednesday July 11 at 10 AM and 4 and 5 PM, I will be leading a quick class in the back of the office on how to do simple at home exercises to rebuild your feet. The class will be open to 10 participants during each class time (50 total over the course of two days). We will cover balance exercises, rehab exercises, deep tissue work, and how to effectively strengthen the hip to restore foot biomechanics.
When Are Sports Drinks Necessary?]]>Matt Hartenburg D.C., 19 Jun 2018 00:14:24 +0000
I love youth sports.
Young kids getting outside, learning how to work as a team, having fun, and learning new skills. What could be better? The reason I volunteered to coach youth wrestling is that I wanted to give back to a sport that had such a major influence on me growing up and hopefully be a positive mentor to kids like the mentors I was fortunate enough to have had in my coaches growing up.
There is one thing that I don't enjoy about youth sports, however, and that is the ubiquitous branding of certain sports beverages everywhere I look at youth competitions. I'm sure you know which ones I am talking about so I won't mention them by name. I'm sure you would even recognize the slogans and commercials.
The advertising of these drinks show high level athletes performing hard, sweating profusely, and requiring a sports drink in order to adequately refuel. Is there a time and place for that? Likely, yes, but I will get to that in a bit. First, let's talk about where we see these beverages primarily being consumed.
Our wrestling practices are only two hours long, three times a week, and we don't push the kids at an extremely high level. At the conclusion of each practice I see well meaning and well intentioned parents purchasing sports beverages from vending machines and concession stands because after all, that is what we were conditioned to do. I was too. I remember hitting the sports drink vending machine outside my locker room in high school and college at the conclusion of practices and games. That's the purpose of effective advertising, to get us to make unconscious purchasing decisions. The algorithm in our brain is simple: I worked out, I sweat a lot, I need a sports drink. Advertising genius. The major name brand sport drinks have been able to effectively position themselves as being superior to water, but are they?
According to commercials and billboards, those young wrestlers MUST rehydrate with a sports drink right?
At a youth baseball game several weeks back (on a not very incredibly hot day) I saw numerous young kids consuming sports drinks as well. Once again, isn't that what we were taught was the right thing to do? Years of conditioning from advertising has us convinced that is the right way to hydrate, right?
Not exactly.
We are told that during and after exercise we have to rehydrate and replenish electrolytes. What is an electrolyte? Just like their name implies, electrolytes conduct electricity when dissolved in water. Without giving a chemistry 101 class, just understand that an electrolyte is a metal salt. Potassium, sodium, magnesium, bicarbonate, phosphate, and chloride are all examples of electrolytes. They are both classified as metals and salts. They are essential for many functions in the body, and YES we do lose a great deal of electrolytes when we sweat and sports drinks do have electrolytes in them. BUT, sports drinks also contain other ingredients that we should be aware of. The one in particular that should most concern us is sugar.
A popular 20 OZ sports drink that I see consumed regularly by youth and recreational athletes has 34 grams of sugar in it and 140 calories. One gram of sugar contains 4 calories, meaning that this particular 20 oz sports drink contains 136 calories from sugar alone. To put that in context, the American Heart Associationrecommends no more than 100 calories PER DAY of added sugar for adult females and 150 calories of added sugar for adult males.
Now, you might be thinking, don't we burn a good deal of sugar (glucose and glycogen) during exercise? The answer is yes we do.....during intense exercise for a prolonged duration. An endurance athlete, cross fitter, or high level athlete in training utilizes a great deal of glucose and glycogen; a 7 year old playing youth baseball or softball does not utilize a high amount of glycogen. Even endurance athletes are moving away from sugary sports drinks in favor of lower glycemic carbohydrate replacement drinks and gels due to the gastric distress that many athletes experience from pouring that much sugar into their body.
So, am I saying to avoid all sports drinks in every form? No. There is a time and place for those beverages, namely for endurance athletes who have made it their drink of choice. What I am saying is that they are unnecessary for young athletes, and dare I even say that there are more downsides to beverages like that for young athletes when you take into account the spike in blood sugar and subsequent rise in insulin they will cause.
So what should kids drink instead.
First and foremost, if they are outside playing or participating in a low impact team sport, water will work just fine (as long as it isn't distilled). Lost in all the sports drink marketing is that water itself contains electrolytes (as long as it isn't distilled). Quick chemistry lesson. Water conducts electricity right???? Wrong. H2O does not conduct electricity by itself. Water is made up of 2 hydrogen molecules and one oxygen molecules. These two molecules alone do not conduct electricity. Distilled water is pure H2O. You could put a live electrical wire into pure distilled H2O and nothing will happen. However, the water we drink has electrolytes dissolved in it (sodium, magnesium, etc). If you take regular water that has electrolytes in it something will happen when you put that same electrical wire into it (we do not recommend doing this).
Not only can we get electrolytes from your everyday run of the mill bottled water, we get it from our food as well. Not to mention we get sufficient carbohydrate to replenish glycogen stores that we use during exercise too. As a coach of youth sports I can promise you that MOST kids are not training hard enough in their practices or games to justify 140 calories of rapidly dissolving sugar water (I say most kids because there are programs out there that train puberty age and high school age kids very hard).
What do I recommend for the kids that are training at a higher level with more intensity or competing numerous times on a very hot day like the previous weekend we just had? NUUN. NUUN is a company that makes electrolyte replacement tablets and powders for endurance and high level athletes competing in intense sports. I take NUUN after long runs on hot days, I bring them with me to the field in the Army, and I share bottles of them with the other soldiers on my team. These have worked for me numerous times when I am in the field doing training missions carrying 40-50 pounds of equipment and wearing an additional 15 pounds on my body on a 90 plus degree day. I promise they will help your kid get through the doubleheader baseball and softball games on a hot day. On the front page of the NUUN website I linked above, their slogan reads: "that much sugar belongs in your ice cream, not your sports drink."
Makes you think.
Everything "Works" (But Nothing "Works" Forever)]]>Matt Hartenburg D.C., 04 Jun 2018 13:58:35 +0000
CrossFit, running, Orange Theory, yoga, spin, paleo, intermittent fasting, keto, vegan, vegetarian, atkins, Les Mills, and the list goes on. Did I miss anything?
Maybe you have done one or more of these in the past. Maybe you saw results? Maybe you (or a friend) became convinced that because you (or they) saw immediate results that it was the best thing in the history of fitness and nutrition. Trust me, we have all been there at one point.
Here's the thing: when it comes to fitness and nutrition, "everything works, but nothing works forever."
Back in the days when we ran CrossFit Mokena we worked with hundreds of people who were just beginning CrossFit. In general, when someone tries CrossFit for the first time, many of them are picking up a barbell and following a strength training program for the first time. In the first several weeks to months there progress and weights rapidly improved in a linear progression. Each time they repeated a lift like the deadlift or squat, their numbers improved. After a course of several months of training they would begin to plateau and we would have to introduce a different type of training stimulus to continue seeing improvements.
When I went to basic training one of the first things the drill sergeants put into our heads was that the people who needed to lose weight would lose weight and the people who needed to gain weight and strength would gain weight and strength. It's just how the program is set up. After putting thousands of kids through basic training, the Army can pretty well predict what types of responses individuals will have to basic training. Sure enough, people like me who came in around 215 pounds quickly dropped to 200, and the underweight kids who came in ended up looking like they had just been training for the NFL combine. By the time basic training was over, regardless of what you looked like when you first arrived at Ft. Leonard-wood we all looked the same when we left. Each morning consisted of physical training followed by a full day's worth activity and three meals a day. Despite the fact that we ate three times each day, I found myself to be in a constant state of caloric restriction which is why I lost a considerable amount of weight. Many kids who went their had never really done anything physical prior to basic so they put muscle on as if they were training in a gym 3-4 hours a day. I went to basic weighing 215 pounds and years of training had given me a pretty high metabolic rate. Therefore, I needed to consume considerably more calories than most of the younger kids there.
So, when I left basic training it should have been easy to stay lean, right? Just continue working out in the morning and do my best to remain in a restricted caloric state, right? Wrong.
Everything "works," but nothing "works" forever. I put works in quotes because defining what works depends on individual goals. Someone who begins a training program to get stronger for the first time can follow a very simple program that prescribes 5 sets of 5 reps for months and continue to see results. Eventually though, they will begin to notice it getting more difficult to continually improve.
Someone looking to lose weight and get in better cardiovascular shape may toss on the running shoes in the spring and run one mile a day. During the first month or two, this person will likely lose weight and improve their ability to run one mile. But guess what, eventually these results will slow and they will also reach that point of "diminishing returns."
Another example is a person who visits the doctor and receives the news that their cholesterol, BP, blood sugar, etc is out of order (high, low, whatever). The doctor recommends the person go on a diet and the person finds dietary advice on the internet (paleo, vegan, keto, intermittent fasting, etc). Almost immediately, this person will see results related to weight loss and general health. Once again however, these results will only go so far before they also experience the point of diminishing returns.
Why does this happen?
Any time you make a substantial change to your current fitness and nutrition protocol (if you have one) your body goes through an initial adaptation period. During basic training, when I was in a perpetual caloric restriction my body acclimated by initially losing a great deal of weight, but eventually my metabolism slowed to deal with the stress of not getting enough calories. This is why, upon returning, I could no longer rely on staying in a restricted state and maintaining a high level of activity and hope to continue to see the same results. My body made the initial adaptations (which can happen quite rapidly) but eventually progress slowed because my body had adapted to the stress and had become resistant towards that stress.
Our fictitious person who started a strength training program saw results quickly because of the initial adaptations that occur when beginning a new program. Strength and endurance training is a stress which forces your body to adapt. After the initial adaptations occur, the same stimulus (stress) will cease to produce the same level of results.
Our fictitious person who started a new diet per their doctor's advice made a substantial shift in their nutrition which likely resulted in quick adaptations. For example, a week of limiting carbohydrates can often result in losing 5-10 pounds of water weight IN THE FIRST WEEK (especially if the person has only followed the Standard American Diet up until that point). However, continuing down the same path for 6 months to a year will once again lead to your body and physiology adapting to the new stimulus. A personal example of that was in 2016 when I was experimenting with the ketogenic diet. After one year of being strict on keto I noticed that the weight I had lost had come back. My body adapted to the lack of carbohydrates and calories.
Compare your body to the temperature setting on your household thermostat. Let's say you have your thermostat set for 70 degrees in the winter, but in the excitement of going to school one of the kids leaves the door open and the cold air gets in the house and knocks the temp down to 50 degrees. Eventually the thermostat will turn the heater on and attempt to bring the temperature of the house back to 70 degrees. Your body works much the same way. You have metabolic and homeostatic set points in your body. By applying a systematic stress to your body, you can alter that metabolic and homeostatic set point. For example, someone who just begins running can take a high resting heart rate and get it to come down closer to 60 beats per minute or lower. Without getting too deep into the science of these processes, just understand the concept that your physiology is constantly making adaptations to each stimulus. Eventually, your body creates a new set point. At this point you will likely need to adapt and alter the training or dietary protocol.
How do you get past this point?
It comes down to a three different things: 1) long term goals 2) metabolic flexibility and 3) variations in fitness protocols.
1) Long term goals. In the long run, what are you training for? If you only have goals that go to the end of summer (looking good at the beach) this will be a continual issue for you. A yo-yo effect if you will. Start to look down the road beyond the 5K you signed up for in August (or whenever). How strong or fast do you want to be at 70 years old? Ever think about what you want your "beach body" to look like in 30 years? Begin to think of fitness and health goals that extend beyond the immediate, and you will begin to make fitness and nutrition a lifestyle instead of an inconvenience.
2) Metabolic flexibility. I do well on a low carb diet. Very well,
in fact. However, 1-2 days a week I will eat between 200-300 grams of carbohydrates. If I do so well on a low carb diet, why would I introduce so many carbs a couple times a week? Because I know that metabolic flexibility is very important. Once again, your physiology will ultimately adapt to whatever stress you place on it. High intensity training on a low carb diet for long periods of time is a stress and the adaptations that the body makes are not always advantageous. I see this all the time. "Dr. Matt, I don't understand. I've been eating 1500 calories a day for 6 months. At first, I lost a lot of weight but now I'm gaining weight again." Once again, without dipping into the geeky science of what happened, your body adapted to the stress of calorie restriction by slowing your metabolic rate and now it is essentially storing calories to keep you from going into a chronically starved state. Yes, that is an oversimplification, but is a short version of what happens. The way to avoid this is by learning how to vary the nutrition. For example, someone on a ketogenic diet could follow a cyclical approach by adding carbohydrates 1-2 days a week.
3) Vary your approach to fitness. If you are training for a marathon, you need to run. If you are training for a powerlifting competition, you need to lift. Specific performance goals require specific training. Period. However, if your goal is fitness and overall health you need to train in multiple modalities. Vary your training between aerobic endurance, anaerobic endurance, and strength. Adopt a program that regularly varies the training stimulus to include cardio, strength, short sprints, etc. Yes, 1 hour of cardio each day every day will result in weight loss in the short term. 2 Years from now if you are following the same program you will cease to improve.
There are a lot of fads out there right now, but the interesting thing is that many of these "fads" have a great deal of applicability if they are integrated into a comprehensive lifestyle. There is no ONE BEST WAY. The best approach is a varied approach with the understanding that your body needs to be introduced to different dietary and training stimuli to continue to see results.
Adventures in (Sort of) "Mountaineering" Part one]]>Matt Hartenburg D.C., 01 Jun 2018 15:37:31 +0000
This Fourth of July Dr. Anna will be relaxing on a warm sunny beach on a tropical island in Florida; I, however, will be high atop a mountain in California. A beautiful beach provides solitude and relaxation, a mountain can provide solitude and a formidable challenge. Both are a profound means of renewal of the mind. Dr. Anna loves the ocean, I love the mountain!
My cousin and I have been seeking a challenging mountain scramble, hike, cross country back pack trip for several years, but have been unable to get one together. He is a Captain in the Air Force and has the fortune of having been stationed in very mountainous locales thus far in his career. First, in Colorado Springs and now in California.
In 2015, myself, Dr. Anna, my cousin, and his wife trekked up to the top of Pike’s Peak in Colorado Springs, but that was the last time the group of us was able to get up a mountain together. In the time since, Dr. Anna and I have completed numerous hikes together but nothing about 7,000 feet in altitude.
I have a history of not handling altitude very well. I’m not afraid of heights, but my lungs seem to be. One trip that stands out in my mind is a seminar in Westminster, CO. Dr. Anna and I landed at Denver International Airport, rented a car, went to Boulder and drove up into the foothills and trekked around a little bit. Afterwards we went to a local Crossfit gym, did a quick workout, went to bed, woke up the next day and went for a 5K run. That was the extent of my activity for the remainder of the weekend. I found myself laid up in the hotel bed with Acute Mountain Sickness. Yes, I was only at 6,000-7,000 feet in altitude, but the (stupid) physical exertion I placed on myself without acclimatization after flying in from Chicago (altitude around 600 feet above sea level) proved to be too much for this low lander. A previous rugby trip to steamboat springs in college resulted in a similar outcome.
Since then, I have learned that when I’m attempting any type of physical exertion at altitude, I have to allow myself adequate time to acclimate.
Altitude is the ultimate equalizer. It is a fantastic way of testing your mental and physical fortitude. The physical challenge of a mountain coupled with the lack of oxygen as you ascend provides a unique challenge to your physiology. I am enthralled by the humans that are able to ascend to the top of such daunting peaks as Mount Everest (29,029 feet above sea level), Kangchenjunga (28,169 feet above sea level), or K2 (28,251 feet above sea level). I’m continually inspired by those who are willing to subject themselves to that extreme, especially considering the amount of people who don’t return from such trips. Though Everest and K2 aren’t anywhere to be found on my bucket list (as of now), Denali is on my radar…..Maybe someday.
Prior to attempting a Mt. Everest summit, George Mallory was asked why he was doing it, he famously replied, “because it’s there.” (*Note* that quote is often attributed to Sir Edmund Hillary who became the first to summit and return from Everest. This is actually not true. Mallory was the one who said it prior to his unsuccessful Everest attempt). Regardless of who said it, I love the quote. When asked why I crave these types of “vacations” my answer is “because I can, and someday I won’t be able to.”
So what are we doing? In comparison to the peaks I mentioned above, our trek will not be daunting at all. In fact, people who live at altitude regularly make treks like this on any given day. For a low lander from Chicago, it’s a little unnerving. Especially in the manner we will be doing it.
We are setting out to hike/scramble to the top of Deerhorn Mountain in the Sierra Nevada. Deerhorn Mountain is a 13,281 foot peak which consists of class 3, 4, and some 5 sections to get to the top. The trailhead starts around 9,000 feet and the total out and back trip will take several days and will total close to thirty miles. Here’s the kicker. There will be very little acclimation time. I will be landing at the airport near sea level, jumping in the car and heading to the trail head. There will be very little time to acclimate which means my preparation needs to be on point.
I’m not concerned about putting some weight on my back and walking. Dr. Anna and I have already completed some challenging hikes this year.
And I just returned from Air Assault school for the Army which consisted of two rucks with 35 pounds and a rifle. One six miler completed in less than 1.5 hours, and a twelve miler which had to be completed in less than three hours. These were pretty easy.
What I will not have access to will be exposure to altitude. Until I get to the trailhead that is.
Since I will not be exposed to altitude prior, I will need to be in great shape prior to leaving. Here is what I am doing.
Aerobic training
For aerobic conditioning I am following Chris Hinshaw’s programming through his aerobic capacity website. Specifically, I am following his running program “Running: developing engine and stamina.” I’ve followed his programs before and have found them to be very comprehensive in terms of general aerobic conditioning. He designs his programs for Crossfit athletes to establish an aerobic base. More research is showing the benefits of aerobic training and improving recovery both at sea level and altitude.
Anaerobic Training/Strength and Conditioning
Strength and anaerobic conditioning is essential for any type of trek. I am continuing to use the program put out by“Power Athlete” called “Johnnie WOD.” This program was developed by 11 year NFL veteran John Welbourn. Following his NFL career, Welbourn developed the CrossFit Football program, but has since departed from the CrossFit ranks and developed his own strength and conditioning program. I have used this program extensively in the past. I gain a great deal of benefit from his systematic approach to strength and conditioning and the dynamic movements they program.
Body Weight
I generally walk around at 215 pounds. I will bring that down to 205 for conditioning purposes. Right now I am at 209. Less body weight equals less stress on the body. Simple enough.
Additional measures
One means of improving the body’s ability to acclimate is strengthening the inspiratory muscles of breathing. Exercise is one way to do that. Another way is through practicing hyperventilatory breathing. Deep breaths with a shallow exhale for several 2-3 minute cycles. I practice this each morning.
Another means of training the body to acclimate to low oxygen environments is through forcing your body to acclimate to cold. I wrote a blog post several weeks back about contrast showers. I do a contrast shower each day, and once to twice a week I practice cold water immersion in an ice bath. Several studies have shown that cold water immersion can improve the physiological recovery from exercise as well as altitude acclimation. Will all this stuff work? We shall see.
Part 2 of this article will be completed when I return and will be a journal entry of our trip.
Part 3 may or may not be a blog post. I am currently trying to put together means of data collection during the trip. I intend to measure heart rate variability during our acclimation and trek. I will also be collecting pulse oximetry data, blood pressure, pulse rate, and subjective data will be gathered by utilizing the “Lake Louise Score” survey which measures symptoms of Acute Mountain Sickness (AMS).
If you’re interested (which if you’ve read this far, I’m assuming you are), stay tuned!
Wear a Stop Watch in the Shower]]>Matthew Hartenburg D.C., 22 May 2018 14:06:50 +0000
Yes, the title is clickbait, but you really should wear a (water resistant) stopwatch in the shower. Here’s why.
If you have ever spent any time reading and studying training methodologies of high level athletes in what I refer to as “performance sports,” such as weightlifting, track and field, or endurance sports, you would understand the value those athletes place on recovery. If athletes only focused on training and ignored recovery efforts they would likely find themselves in an overtrained state. Recovery modalities allow the body’s physiology to make the needed adaptations to the stress of training in order to enhance performance, strength, and endurance.
One of the critical factors of recovery is improving circulation and vascularity to allow the body to eliminate inflammatory markers which accompany the damage inflicted upon the musculoskeletal system following training. A time tested means of manipulating circulation in this manner that has been tested scientifically and anecdotally is contrast therapy.
Contrast therapy is a means of exposing the body to bouts of extreme temperatures in a systematic way. Athletes, weightlifters in particular (because that is a sport I’m very familiar with), would often times sit in a sauna then follow it immediately with a cold shower or ice bath, then get back in the sauna and repeat the cycle. There are even stories of soviet athletes sitting in a sauna and heading outside to roll in the snow (often times naked) then head back to the sauna. In addition to the hot/cold extremes, some athletes would actually whip each other with a switch off of a pine tree to further stimulate the autonomic nervous system. I’m not advocating this.
I am however advocating contrast therapy regardless of your athletic prowess.
Modern humans in western society are pretty coddled when it comes to temperature. We live in relative year round comfort of 70 degrees thanks to heating and air conditioning in our houses, cars, and workplaces. Living here in the midwest, we love to complain about the weather, but lets face it, unless your job keeps you outside much of the day, we are really only exposed to weather extremes for the short amount of time it takes us to get from house to car and car to office. This is vastly opposite to how humans evolved.
The human body evolved under austere conditions. Modern comforts are just that; modern. In the grand scheme of human history the ability to exist at 70 degrees year round is a relatively recent phenomena. Prior to central heating and A/C humans had to adapt to extremes in temps (which is probably why so many early humans settled near the equator). Ever notice how your appetite increases in the fall and early winter? This is likely an evolutionary instinct that our bodies undergo in order to retain calories and body fat to deal with the upcoming cold months. Ever get goose bumps? This is the body’s attempt to retain heat in the core. Ever sweat? That is the body’s attempt at cooling off. These are all simple adaptations that we take for granted.
By now, you may be thinking, “so what, technology has allowed us to remain safe in extreme temps, why are these adaptive mechanisms so important anymore?” Great question.
Just because we have modern conveniences doesn’t mean we can ignore the conditions under which humans evolved. The ability to adapt to hot and cold was not only a survival benefit; research suggests that it can still confer physiological benefits for us today. Exposure to heat and cold alters metabolism and improves physiology. Think of it this way. Stress is good. Otherwise, why would we exercise? Exercise is a stress. Stress on your physiology allows your body to make an adaptation which improves fitness. Think about a first time marathon runner. The first time they set out to do ten miles it was likely incredibly difficult. By the end of 16-18 weeks, ten miles feels like a walk in the park because they have been exposed to as much as 22-26 miles. This is a positive adaptation.
Hot and cold are also stressors. The first time you (willingly) expose yourself to temperature extremes in a shower, it will take your breath away and you will feel like you can not do it much longer than a few seconds. However, repeated exposures will allow your body to acclimate and 2-3 minutes in a freezing cold shower will seem like child’s play. Dare I say, you will even come to enjoy it.
So why wear a stop watch in the shower?
Next time you take a shower, stand under hot water for two minutes (obviously not scalding, but hot enough to make the skin a little red). Then turn the water cold for 1 minute. After your 1 minute (you can do it) turn the water back to hot for 2 minutes and repeat the cycle and be sure to end on cold. Try to repeat this cycle for 10-15 minutes then note how your body feels afterwards.
Contrast showers have shown many anecdotal and scientifically measured benefits. Will it work for you? Try it. You have very little to lose except for maybe a slightly higher water bill.
Can Spinal Health Dictate Your Future?]]>Matthew Hartenburg D.C., 27 Apr 2018 15:52:49 +0000
Chances are, you are reading this on a tablet or smart phone type of device. How is your posture? Are you looking down? Are your shoulders rounded forward?
How many times during the day are you in this posture? How many hours a day do you spend in this position? Have you ever considered the implications this poor posture may have on your future health?
How does posture affect overall health in older populations?
A study published in 2013 examined 804 participants aged 65-94 years old and looked at the relationship between spinal posture and future dependence on activities of daily living over a 4.5 year follow up.
Researchers found a strong correlation between the distance of forward head posture (how far forward the subject's head was in front of the sacrum) and dependency on activities of daily living. In summary, the more defective your posture is, the more likely you are to have to rely on others to do simple things such as bathing, putting shoes on, and other daily activities.
Pay attention to your posture and continue taking care of your spine. In the coming months we will be launching some more posture specific protocols designed to improve posture health, but none are as important as making a conscious effort at controlling posture during the day!
When Can My Child Begin Weightlifting?]]>Matthew Hartenburg D.C., 22 Jan 2018 23:22:19 +0000
I get asked this question a lot, both in the office and with the wrestling team that I coach. The question is usually brought on by a concerned parent who is looking for answers because their adolescent athlete is looking to begin training, or often times the parent asking the question is hoping to start prepping their 7 year old superstar for the NFL combine. Either way, I will address my (humble) views and opinions on the issue.
First, YES it is safe (if done right). The American Academy of Pediatrics agrees with me here.
Second, NO it will not harm growth plates or stunt growth (again, if done correctly).
Third, weight training is incredibly beneficial for kids in the class room as well as the competition field.
Fourth, yes I have seen many many kids compete in the sport of weightlifting. No, this article is not talking about them. This article is geared towards the average person with the average adolescent athlete. For the weightlifters out there reading this, know that this article is geared towards the person who cant differentiate a bicep curl from a clean and jerk. I know from having spent enough time around strength sports that the kids who compete in them are coached very very well and many of them have far better technique and progression than their adult counter parts. If you leave a comment on this article of a video of a kid from another country squatting 200 KG, I will simply cut and paste this last paragraph under your comment.
I will not address the safety and growth plate issues any further in this post because both topics have been written on ad nauseam and there is nothing I can add to that particular conversation. I will emphasize on the "done correctly" part in a moment.
Rather than looking for some magical age where it is all the sudden safe and effective for a child or adolescent to begin strength training, my personal opinion is that we ought to determine relevance of strength training based on relevance of other strength and developmental baselines.
Here is an example. Back when I was involved in CrossFit Mokena, we routinely had high school aged kids come in to try CrossFit out. Many of these kids were athletes, and while it may seem like I am poking fun at these kids, I assure you I am not. I highlight these kids as examples because they remind me of myself at that age. Eager to train, eager to learn, eager to get stronger and faster. The vast majority of times the kids would come into the gym and tout the numbers they put up in their high school weight rooms. I can't tell you how many times I would hear from sophomores or juniors that they were back squatting 400+ pounds (read: quarter squatting), or bench pressing near 300 pounds. When we would introduce them to simple bodyweight movements, however, such as an air squat or a pushup or even a simple plank, their form would break down within a matter of only a few repetitions. I recall one particular encounter with a father who insisted his kid (15 years old) could bench press 270 pounds and that I should allow him to get into the advanced classes with the advanced crossfitters. I informed the father that would not be happening until I witnessed the young man string together 20 consecutive push ups with good form, something I hadn't seen him to thus far. In fact, if memory serves, he could not string more than 8-10 pushups together, and the ones he did complete were not a full range of motion and had excessive sagging in the middle of his body demonstrating a very weak core.
They left and found another gym that was less responsible.
Again, it may sound like I'm poking a little fun, but I assure you I'm not. Stories like this highlight where my opinion on this topic stems from. I personally believe that adolescents should begin adding resistance training AFTER AND ONLY AFTER they have demonstrated core competency in basic body weight movements. Athletes should be spending their early developmental years mastering simple unloaded body weight movements such as:
-Air Squats
-Bulgarian split squats
-Step ups
-Push ups
-Push ups
-Push ups
-Pull up and chin up progressions
-Dead bugs
-Bird dogs
-Did I mention push ups?
-Many more
These movements not only require muscular strength and endurance to do correctly, they also instill proficiency in different movement patterns. That proficiency and coordination is just as much neurological as anything else. It involves the nerves and muscles working together in synchronicity (neuromuscular junctions). Let's imagine a 10-13 year old athlete in our heads. Picture them playing their sport. Do you see a lot of kids in that age group displaying a particularly high amount of coordination yet? (mind you, the ones who have achieved high levels of coordination are typically the better athletes in middle school, but often times the rest of the kids catch up to them by senior year of high school and level the playing field a little bit). If an athlete is unable to demonstrate adequate levels of coordination in a body weight squat movement, why would we add a load to the movement and stress the athlete in an inefficient means?
Sadly, this is what happens all too often in middle school and high school. Kids start doing some relatively high levels of weight training before they are proficient with their own body weight which leads to form errors and inefficiencies that some day need to be corrected. (Don't get me started on the high schools that encourage kids to load the bar up only to do improper bench presses, squats etc, or even the high school sport coaches that allow that to happen). I personally believe that every middle school and high school that have sports which utilize the weight room, should have an assigned strength coach who works with all sports, teaching all athletes how to properly train and programming for them as such.
So what is the answer to the title of this article? When can kids start to lift? When your kid can string numerous pushups together going through a full range of motion without excessive sagging in the core then they are likely getting closer to being able to lift. When your kid can do body weight squats without coming up on their toes, letting the knees bow in, rounding their mid and low back out, and generally maintain a solid athletic posture, they are likely able to start squatting with a load. When the kid can lift a relatively heavy object off the ground without looking like a camel, they are likely ready to begin deadlifting. When the kid can hold a solid plank position for a minute (arbitrary number, but you get my point) they have developed good enough core strength to start lifting. Last but not least, when the kid has developed the maturity to maintain focus in a training environment, and the maturity to understand proper progression (the second one will likely require a good coach or trainer) then they are ready.
Was this answer not scientific enough? Is it too open to individual interpretation? Good. Thats what I wanted. There is no magic age and there is no magic "voila" moment to decide when the kid can start training heavy. The actual answer is very subjective. Kids mature physically and mentally at different rates. In the meantime, get your kid doing the body weight movements. They can practice the deadlift, squat, bench, and power clean with a PVC pipe but in the meantime, they should be able to show you the movements listed above. Don't put the cart before the horse.
What Is Your Movement Baseline?]]>Dr. Matthew Hartenburg D.C., 03 Jan 2018 22:29:05 +0000
Are you an active individual? Are you a serious athlete or even a recreational weekend warrior? Does your occupation require you to perform strenuous and often times repetitive tasks (occupational athlete)? Are you a parent of a youth or high school level athlete?
If you answered yes to any of those questions, the next question is; have you ever had a functional movement screening performed?
What Is a Functional Movement Screening?
The functional movement screening is pre-participation tool used to identify faulty or compensatory movement patterns in individuals and athletes. Poor movement patterns can lead to increased risk of injury and decreased performance.
The Functional Movement Screen tests seven fundamental movement patterns that evaluate quality and efficiency of movement, thus providing a baseline and an objective measure of areas to improve to increase performance and decrease injury risk.
The test movements are the deep squat, inline lunge, hurdle step, shoulder mobility, rotational stability, trunk stability push up, and active straight leg raise.
The screen allows us to begin to build a platform in which we can improve each movement pattern leading to better performance on the field, track, or job site.
Contact the office today at 815-464-1414 to set up your screening with Dr. Hartenburg.
-Initial screening lasts an hour (wear workout clothes) and costs $65.
-Follow up session including report and exercise prescription lasts 30 minutes and costs $35
Following the screening and report you will be given a series of exercises to do to improve the movement pattern most needing improvement. These exercises can be done one on one with Dr. Hartenburg or done at home depending on your preference.
We look forward to helping you in your journey to peak performance
Improve How You Move]]>Dr. Matt Hartenburg, D.C., 11 Dec 2017 16:26:47 +0000
Biomechanics: the study of the action of external and internal forces on the living body, especially on the skeletal system.
Biomechanics is the study of human movement. You may not realize it, but the efficiency of how you move carries a great deal of importance beyond just the gym. Movement of our physical body and our musculoskeletal system is related to many other health factors such as; joint health, proper circulation, respiration and lung capacity, brain and nervous system health, and learning in kids and adults.
First, lets talk about movement and the physical health of the body. Injuries occur because of one of two reasons; macro traumas and micro traumas. The word “macro” implies that the cause is of a larger origin. Examples of macro traumas would be a considerable fall, auto accident, or significant sports injury. Despite the obvious nature of a macro trauma, micro traumas are actually more commonly the cause of peoples pain. Micro traumas are the little bio-mechanically and ergonomically incorrect movements or repetitive activities which we do each day that build up and over time lead to injury and fatigue. Micro traumas are the number one reason why people present to our office in pain. Micro traumas are most commonly the result of poor biomechanics (poor movement) which can place excessive strain and stress on tissues and joints leading to overuse injuries. Poor biomechanics in everyday life lead to movement mistakes which ultimately results in compensation in the body, uneven and suboptimal joint alignment, poor posture, poor muscle coordination, eventually leading to injury and pain.
But is it just adults who run the potential for poor biomechanics? Sadly, no. With the abundance of on screen activity and lack of physical activity for children, more and more children are showing deficits in movement ability. A study in 2012 found that children who were unable to perform simple activities such as crawling or balance on one leg were more likely to underperform academically. Researchers pointed to the fact that children are less likely to be active in youth, spend more time in front of screens, and were less likely to engage in play.
Improving movement has been shown to decrease injury likelihood (for everyday people, not just athletes), improve cardiovascular function, improve respiratory function, improve focus, and improve learning ability in children.
In January we will be introducing our “Move Well” program at Be Well Chiropractic. The program will consist of Functional Movement Screening and corrective exercise prescription to improve movement patterns. Who this program is for? Anyone and everyone. This is not a therapy or treatment for any injury or illness, this program is designed to improve movement capability and coordination for all age groups. Whether you are a college bound scholar athlete or a corporate desk jockey, chances are you lack the ability for functional movement. Improving movement will change your life.
It's time to end the cycle of pain, poor posture, and poor movement.
For more information on how to get started contact Dr. Matt Hartenburg at Be Well Chiropractic
Make Time for Exercise This Year With Tabata Intervals]]>Dr. Matthew Hartenburg D.C., 29 Nov 2017 00:48:17 +0000
Are you strapped for time this holiday season?
When life gets hectic and busy during the holidays, do you typically let health and fitness fall to the wayside, only to promise yourself that you will get back to it in January? This year, keep fitness a top priority and learn to squeeze in 3-4 tabata interval workouts each week.
Tabata intervals are named after Dr. Izumi Tabata, the researcher who first experimented with the unique work/rest intervals and published his results back in 1996. Here is a link to an abstract of the original article.
Tabata and his team of researchers had two groups of athletes perform two different types of exercise for a period of 5 days. One group of participants spent 60 minutes exercising at a moderate intensity while the other group performed 4 minutes of incredibly high intensity exercise by doing 8 sets of 20 seconds of work and 10 seconds of rest.
The researchers discovered that while both groups improved aerobic capacity, only the high intensity group improved both aerobic and anaerobic despite the workouts only being 4 minutes in length compared to the other group which performed 60 minutes of exercise during each session.
Since the original study on the tabata interval in 1996 more research has been published validating the interval methodology and other high intensity interval training methods (HIIT) as a means of not only improving fitness levels but also accelerating fat burning and muscle building efforts. Here is one such study and here is another which looked at using tabata intervals with kids.
A sample tabata routine would be (following a 5-10 minute warm up):
20 seconds of all out effort
10 seconds rest
20 seconds all out effort
10 seconds rest
20 seconds work
10 seconds rest
20 work
10 rest
20 work
10 rest
20 work
10 rest
20 work
10 rest
20 work
done. That’s it. Seriously.
The key to the success of the tabata intervals is selecting exercises that allow you to work at a high output rate for all 8 intervals without failing. While body weight exercises like squats, pushups, and situps may provide a good session and will cause failure of the muscle groups worked, they don’t raise the intensity relative to VO2 Max.
I’m not saying don’t do exercises like pushups and squats in a tabata interval at all, but in order to get the fat burning effects that tabata intervals are often touted for, it’s best to do pure cardio exercises like sprints, stationary cycling, rowing, or swimming.
Download a free tabata timer app on your smart phone, do a short 5-10 minute warmup, and get started with some tamara sprints!
"Better For You" Pumpkin Coffee Cake]]>, 20 Nov 2017 15:22:18 +0000
What you will need:
1/4 Cup Melted coconut oil
1/4 Cup Maple Syrup
1/4 Cup coconut sugar
1/4 Cup Canned Pumpkin
4 Eggs
1 Cup Almond Flour
1/4 Cup Coconut Flour
1/2 Teaspoon Baking Soda
1-1/2 TSP Pumpkin pie spice
1/2 TSP Cinnamon
1/2 TSP Salt
1/4 Cup Coconut Flour
1/2 Cup Almond Flour
2 Tablespoons Coconut Sugar1/2 TSP Cinnamon
2 Tablespoons Maple Syrup
2 Tablespoons Coconut Oil
-Preheat Oven to 325 and line 9X9 pan with parchment paper
-Make Crumb topping first in a small bowl.
-In a large bowl, combine coconut oil, maple syrup, coconut sugar, and pumpkin. Mix well.
-Add eggs and mix well.
-Add almond flour, coconut flour, baking soda, pumpkin spice, cinnamon, and salt. Mix well. Pour into pan and top with crumb topping.
-Bake for 45-50 minutes
-Refrigerate after first day.
More great recipes at:
Simple Wellness in Two MinutesDr. Matt Hartenburg, D.C., 08 Nov 2017 21:37:53 +0000
Wellness is not something you can buy off a TV commercial or in a store. I’m familiar with many supplements and products available on the market and none of them will provide you with wellness if you’re not improving other areas of your lifestyle.
Think of “wellness” as a large mason jar. You are going to fill the jar with three large rocks (diet, exercise, healthy interventions such as chiropractic), many smaller rocks (fasting, meditation, sleep hygiene), and sand will fill in the cracks (supplements etc).
If you wanted to fill the jar efficiently you would prioritize placing the large rocks into the jar first because they will take up the most space but will also leave some open areas. These larger rocks represent the things you do every day or every week and serve as the cornerstone. Eating well, exercising, chiropractic, massage, care for your physical body, and I could also put sleeping well in there too. Once the big rocks are in place you will fill in the spaces with smaller rocks like pea gravel. This gravel represents things that are beneficial but non-essential to life such as fasting, meditation, being a part of clubs and organizations that boost mental health. These things all have a great deal of benefit but are not necessary to survival despite the positives to them (obviously, I still strongly recommend doing them). The last thing to go into the jar are what I call the gimmicks. Supplements, products, ab rollers, and other informercial products. Many of these have benefits and are valuable products to have and use but if the big rocks and the pea gravel aren’t in place FIRST then the sand will be of little use. If the rocks and gravel are in the jar already, then the sand will fill the remaining volume and create a tight fit.
Wellness in 371 words
Prioritize sleep. Numerous studies have shown the importance of a good night’s sleep and it’s effects on not only energy but HEALTH AND LONGEVITY. If you do not sleep enough you, develop more chronic illness…..PERIOD.
Take care of the physical structure and frame of your body. Your body should move, bend, and twist with relative ease, and picking something up off the floor should not have high risk of injury. Take care of your spine. The intimate relationship of your spine and nervous system shows the importance of a healthy functioning spine.
Prioritize nutrition. There are thousands of diets out there. None of them are better than the other. I am very well versed in nutrition research and I can tell you from reading as much of the body of evidence that is available that NONE of them is the PERFECT diet for all. However, nearly all of them are better than the standard American diet. My suggestion? Experiment. See what works for you. See how your energy levels are affected, how sustainable the diet is for you, and whether or not you can make it a part of your life forever rather than another temporary fling. However you eat, your diet should not force you into having to supplement something. If you have to supplement, it is not a complete diet. Last, a diet should promote cultivation of lean muscle and loss of body and visceral fat. There are enough studies out there showing the benefit of his amounts of lean muscle mass in your body to justify saying this.
Last, find a physical goal and crush it. Just starting to exercise? Good, go out and do 10,000 steps a day for 4 months. Run a 5K, break your 5K personal record, run a marathon, set a goal in the squat or bench press, just pick a goal that will challenge you physically and mentally. Everyone is in awe of people like Jack Lalanne and fitness celebs that look great and function well into their 90’s. The reason they look forever young is because they continued to challenge their body long into their prime years. Continually moving towards physical goals will keep you young at heart and body.
Do you have some loved ones you want to get into the Chiropractic lifestyle?
For a donation of 10 non-perishable food items, each new patient will receive a first visit exam and adjustment for only $55!
For existing patients, a donation of 10 non-perishable food items enters you for a chance to win a $20 gift card to energy nutrition!
Chiropractic, HRV, Sports Performance, and Recovery]]>Matthew Hartenburg D.C., 02 May 2017 15:54:16 +0000
Chiropractors talk a great deal about sports performance, but we tend to leave the autonomic nervous system out of this discussion. We need to correct this.
This post was inspired by reading through Dr. Andrew Flatt’s blog This website is a treasure trove of information on the topic of the autonomic nervous system, heart rate variability, adaptation, and exercise physiology. Every paper and abstract I have written on this topic has referenced at least one of Dr. Flatt’s papers.
This quick post will be somewhat of a commentary about Chiropractic and sports performance while highlighting a few gems I pulled from two articles on his blog. The first article is one I shared on our Facebook page on May 1 titled: “If you’re not assessing (the ANS) you’re guessing,” and the second one is “HRV Explained Part 2: the Research.”
As a side note, the title of the first paper applies to Chiropractors in a big way. I can’t remember where I read it, but I remember coming across a line in a text book several years back that told Chiropractors that if we are going to stake our claim on the nervous system, that we need to own it by understanding the anatomy, physiology and how to evaluate it. I don’t think I can overstate this enough. Heart rate variability is at the forefront of assessing function of the ANS (especially when it comes to athletes), yet very few chiropractors are utilizing it as an objective measure.
I want to use this post to put a little more context into how HRV is being used to assess performance. Before I begin, let me declare that this type of research is in it’s infancy, and consensus is a long ways off. Most exercise physiologists in the field are saying that HRV is a good means of assessing adaptation to training stress but must be considered in the context of subjective outcomes including psychometric variables and, of course, performance. Don't take this blog post to mean that HRV is the end all be all. It is a great tool, but not the panacea of sports performance (more on that later). I’m going to scratch the surface on this topic in this post, but if you want more info head over to the hyperlinks I posted above and spend a few hours (or days) perusing Dr. Flatt’s website.
HRV Used to Assess Recovery Status
Chen et al in 2011 utilized Heart rate variability to assess recovery status in a small sample of olympic weightlifters, and found that a return to baseline was correlated with baseline performance (1)
Pichot et al used HRV to assess fatigue and found a decrease in parasympathetic tone and an increase in sympathetic tone in response to overload training (2).
HRV to Predict Performance
Cipryan studied hockey players and noted a correlation between HRV scores and a coaches assessment of performance. Athletes who had higher HRV scores (parasympathetic) were more likely to have performed better according to coaches.
Buchheit et al utilized HRV to assess endurance performance and concluded that it was useful in assessing training response and possible a predictor of performance (4).
These are only a few studies of hundred potential studies out there that discuss this topic. Again if you want more info and insight from someone I consider to be the leader in this field of exercise physiology check out and get lost in that blog for a few days. He has done some fantastic work and does a great job of compiling his thoughts in one place.
As I stated before, this field of work is in it’s relative infancy, and the use of HRV in predicting performance has a long way to go. A review of the literature in 2008 stated that HRV is a useful tool but must be used in the context of further subjective markers as well (5).
HRV in physiology and pathology research
Aside from the interest in heart rate variability in the exercise physiology arena, HRV is being investigated in terms of its applications in pathology and physiology. I refer to one of the great researchers in this field, whom I have had the pleasure of listening to and meeting on several occasions, Yori Gidron PhD.
In 2006, Gidron wrote about the role the Vagus nerve plays in potentially modulating an anti-inflammatory response as well as an afferent function of “informing” the brain about peripheral inflammation (6). Keep in mind that heart rate variability is utilized to assess vagal function as it relates to the cardiovagal autonomic relationship.
In 2013, Gidron investigated data on 5 different cancers (n=657) and found prognostic value in assessing HRV and vagal function (7).
These studies and many more lend to the context in which HRV is being investigated for diagnostic, prognostic, and overall physiologic means. Perform a search of Yori Gidron in google scholar or
and just start reading. The research that is being conducted and published is fantastic.
Comments About Sports Chiropractic
The role of Chiropractic and sports is largely a injury diagnosis and rehabilitative role. While many Chiropractors excel in this field, I believe we need to shift our focus at the very least to utilizing HRV as an means of assessing autonomic response in our athlete patient population. We have begun using heart rate variability in our office this past year, and I have been experimenting with it in our athlete patients for quite some time. While I feel the data I have collected has more clinical relevance than it does scientific relevance (small sample size, lots of variables), I have seen some very interesting correlates.
In order for us to effectively investigate autonomic responses to Chiropractic care and athletes, I believe we need to start by investigating an acute response to the adjustment in athletes. Simple pre and post HRV readings in athletes. Interestingly, there have been several studies that have done that in non-athlete patient populations (8,9,10). Once we have established a body of evidence related to acute responses to the Chiropractic adjustment, the next step would be to follow a population of TRAINED athletes undergoing a training program. We should assess HRV in a group of athletes under Chiropractic care compared to a control group, and correlate with measures of performance and psychometric questionnaires such as the REST-Q. I emphasize a population of trained athletes for a couple reasons. 1) Untrained athletes will improve performance no matter what. An untrained athlete will undergo short term adaptations and improve performance in an almost linear fashion. An athlete who has been undergoing training for several years will have reached a point where performance improvements become far more difficult. 2) an untrained athlete will have far more erratic changes in subjective outcomes (pain, fatigue, etc) and will likely have far less clinically significant shifts in HRV readings day to day, due to the fact that a training stimulus will be a novel stress to their body and they have not undergone the typical adaptations a trained athlete has.
Where do we go from here?
First, we have to explore the ANS and it’s relationship to not only Chiropractic but also to performance. As this field continues to grow (at a very rapid pace) our profession can not be left behind. As I said before, if you head over to and browse articles and studies that are continually coming out, you will see how vast this body of evidence is becoming. Second, it is very simple to utilize HRV in our offices. Ultra short HRV readings are becoming increasingly validated and accepted in the sports physiology arena. In our practice, we have been utilizing 2 minute readings looking at rMSSD and HR in the first week a patient is under care, and the week leading up to their final re-exam. So far this data has given us some great clinical value, but until we refine our methodologies we haven’t produced much statistical significance (yet). In order to develop this as a common practice protocol, we need our profession, it’s governing bodies, and it’s educational institutions to recognize the value of HRV and begin to teach it to every Chiropractic student as we continue to develop our collective understanding of it.
When it comes to sports performance and Chiropractic, I don’t believe we need to change the conversation, however, we should introduce a new side bar to the conversation. As exercise physiology and strength and conditioning continue to evolve their paradigm to understanding adaptation, our profession should be paying very close attention to the evidence looking at the nervous system and performance. Chiropractors view the spine and it’s intimate relationship to the nervous system as central to our professional identity. The anatomic and physiologic foundation has been laid for us to begin investigating HRV as an outcome measure and the relevance it would have to performance and athletes is coming to the forefront.
1) Chen, J., Yeh, D., Lee, J., Chen, C., Huang, C., Lee, S., Chen, C., Kuo, T., Kao, C., & Kuo, C. (2011) Parasympathetic nervous activity mirrors recovery status in weightlifting performance after training. Journal of Strength and Conditioning Research, 25(6): 1546-1552
2) Pichot, V., Busso, T., Roche, F., Gartet, M., Costes, F., Duverney, D., Lacour, J., & Barthelemy, J. (2002) Autonomic adaptations to intensive overload training periods: a laboratory study. Medicine & Science in Sports & Exercise, 34(10), 1660-1666.
3) Cipryan, L., Stejskal, P., Bartakova, O., Botek, M., Cipryanova, H., Jakubec, A., Petr, M., & Řehova, I. (2007) Autonomic nervous system observation through the use of spectral analysis of heart rate variability in ice hockey players. Acta Universitatis Palackianae Olomucensis. Gymnica, 37(4): 17-21.
4) Buchheit, M. et al (2009) Monitoring endurance running performance using cardiac parasympathetic function. European Journal of Applied Physiology, DOI 10.1007/s00421-009-1317-x
5) Bosquet, L. A. U. R. E. N. T., et al. "Is heart rate a convenient tool to monitor over-reaching? A systematic review of the literature." British journal of sports medicine 42.9 (2008): 709-714.
6) Gidron, Yori, et al. "Vagus–brain communication in atherosclerosis-related inflammation: A neuroimmunomodulation perspective of CAD." Atherosclerosis 195.2 (2007): e1-e9.
7) De Couck, Marijke, and Yori Gidron. "Norms of vagal nerve activity, indexed by Heart Rate Variability, in cancer patients." Cancer Epidemiology 37.5 (2013): 737-741.
8) Welch, Arlene, and Ralph Boone. "Sympathetic and parasympathetic responses to specific diversified adjustments to chiropractic vertebral subluxations of the cervical and thoracic spine." Journal of chiropractic medicine 7.3 (2008): 86-93
9) Budgell, Brian, and Barbara Polus. "The effects of thoracic manipulation on heart rate variability: a controlled crossover trial." Journal of manipulative and physiological therapeutics 29.8 (2006): 603-610.
10) Zhang, John, et al. "Effect of chiropractic care on heart rate variability and pain in a multisite clinical study." Journal of manipulative and physiological therapeutics 29.4 (2006): 267-274.
Implementing HRV with Athlete patients]]>Matt Hartenburg D.C., 19 Apr 2017 15:34:34 +0000
I've been getting a lot of questions about implementing heart rate variability monitoring with patients, so I wanted to write a quick post about it. Figuring out best practices is still a work in progress, but there are some simple, accessible means of tracking HRV in our athlete-patients.
We have a long way to go as far as understanding how to best utilize heart rate variability as an objective measurement in clinical practice. However, a great deal of research has been dedicated to monitoring athlete's training response using heart rate variability, and it seems that the field is nearing closer to a consensus on best practice. In this post I will explore a couple different means of utilizing HRV with patients who are training (runners, triathletes, cross fitters, body builders etc).
First, let's look at some of the literature surrounding measuring athlete HRV. The most common recommendation we see when it comes to measuring HRV is CONSISTENT METHODOLOGY. Above all else, consistency in measuring appears to be the most important aspect of checking HRV (1). Many of the studies that have been done, and much of the literature on the topic has athletes measuring their heart rate variability first thing in the morning within 5 minutes of waking up to get as close to an at rest measurement as is possible (1,2,3).
Given that there are many individual variations in HRV it is also very important to note that subjective measures must be taken into account including the athlete’s mental state (are they apathetic towards training), energy levels (are they experiencing lethargy), and, most important to the athlete, are they performing well (has their performance declined recently)? Correlating weekly variations in HRV with subjective changes as mentioned above is paramount to interpreting an athlete’s physiological response to their training stress (4).
For those of us in practice this poses significant challenges to monitoring a patient’s HRV. If the patient is presenting to your office at different times of the day, the challenge becomes interpreting HRV changes done at inconsistent times. This creates significant reliability issues when trying to interpret physiologic changes week to week. HRV is likely going to become a great tool for pre/post adjustment checks and re-examination tests as well, but like I said before, there is a long way to go in figuring out best practices.
Due to the need for consistency in methodologies, I have been advising patients to use HRV4Training. This is a smart phone app that does 60 second rMSSD readings in the morning using nothing more than the phone’s camera. This easy to use app makes daily HRV monitoring incredibly accessible to patients without the need for a chest strap heart rate monitor. Numerous studies have investigated whether or not rMSSD could be accurately measured using a smart phone camera and found it to be a valid measurement that tend to agree with readings obtained from a chest strap or ECG (5,6,7). The patients who have been regularly monitoring simply send me an email from the app and I’m able to view what their readings have been (as well as whether or not they have been consistent in checking).
Despite it’s ease of use, the issue we have been having is developing patient compliance. Patients tend to forget to do the reading each morning. That probably doesn’t surprise anyone reading this. These compliance issues tend to be resolved after we communicate to the patient the importance of monitoring HRV.
I have found it effective (and very necessary) to explain to patients initially, that exercise is a stress on the body. In fact, exercise itself is actually BAD for the body. Think about it. Exercise and intense training is actually a fight or flight stress. It is the subsequent adaptation to exercise that has health benefits. If the athlete (patient) is not adequately adapting to the stress, or worse, maladapting, then exercise can actually pose a threat to the physiology and result in sometimes pathologic symptoms.
adapting and not recovering from workouts is how patients end up in a non-functional overreach or overtraining situation. Explain to the patient that measuring HRV gives us a direct measurement of how their autonomic nervous system and physiology is responding to training. High HRV is good, low HRV is bad. If your HRV is low, you are not adapting well to the training load you are under. Period.
Obviously this is a very simplified explanation of HRV. The purpose of this blog post is not to go into a deep exploration of HRV, but I strongly encourage each of you reading this to start looking into the role of measuring HRV not only for athletes but for general population as well.
To sum this post up, here is a brief explanation of what I have been doing with my athlete patients. The first thing I have them do is get the HRV4training app and begin tracking their HRV and emailing the readings to me on a weekly basis so I can assess their weekly trends. When the patients come to the office I talk with them about what type of training load they are under, as well as how they seem to be responding (are they improving performance, do they feel beat down, etc). Last, we examine how they do the day after they are adjusted and what changes they are noticing after getting adjusted in the office. I am seeing some excellent changes in HRV readings and subjective measures following Chiropractic adjustments, however it is way to early and too small of a sample size to begin to draw any inferences from it.
I encourage any DC with a large athlete population in their practice to begin utilizing simple measures to track HRV. Keep in mind that consistency is the most important factor!
1) Buchheit, Martin. "Monitoring training status with HR measures: do all roads lead to Rome?." Frontiers in physiology 5 (2014): 73.
2) Morales, José, et al. "Use of heart rate variability in monitoring stress and recovery in judo athletes." The Journal of Strength & Conditioning Research 28.7 (2014): 1896-1905.
3) Flatt, Andrew A., and Michael R. Esco. "Evaluating individual training adaptation with Smartphone-derived heart rate variability in a collegiate female soccer team." The Journal of Strength & Conditioning Research 30.2 (2016): 378-385.
4) Le Meur, Yann, et al. "Evidence of parasympathetic hyperactivity in functionally overreached athletes." Med Sci Sports Exerc 45.11 (2013): 2061-71.
5) Plews, Daniel J., et al. "Comparison of Heart Rate Variability Recording With Smart Phone Photoplethysmographic, Polar H7 Chest Strap and Electrocardiogram Methods." International Journal of Sports Physiology and Performance (2017): 1-17.
6) Bolkhovsky, Jeffrey B., Christopher G. Scully, and Ki H. Chon. "Statistical analysis of heart rate and heart rate variability monitoring through the use of smart phone cameras." Engineering in Medicine and Biology Society (EMBC), 2012 Annual International Conference of the IEEE. IEEE, 2012.
7) Jonathan, E., and Martin Leahy. "Investigating a smartphone imaging unit for photoplethysmography." Physiological measurement 31.11 (2010): N79.
The 23rd Chiropractic Principle and Resistance TrainingMatt Hartenburg D.C., 19 Jan 2017 16:15:31 +0000
Principle 23: The function of Innate Intelligence is to adapt universal forces and matter for use in the body, so that all parts of the body will have co-ordinated action for mutual benefit.
Next month marks 8 years that I have been out of school. I was taught that Chiropractic is a philosophy, science, and art; and that the philosophy was the lens in which we view our scientific inquiries as well as our practical clinical applications. Towards the end of my schooling I remember coming across many fellow students who had already dismissed our philosophy as being an outdated, historical construct. When I speak to students now, the topic of philosophy isn't met with disdain so to speak, but rather a general misunderstanding (or no understanding whatsoever). Our philosophy is not only a guiding light for our scientific and clinical practice, but also serves as a technical "jargon" within the profession. I wouldn't expect a dentist to recite the 33 principles for me anymore than an engineer would expect a lawyer to understand tensile strength of certain materials. Different professions=different jargon.
Putting contemporary science in the context of our philosophical constructs can be one of the most fascinating endeavors a chiropractor can undertake. When teaching the topic of adaptability, chiropractic philosophy, and strength and conditioning, I like to use the example of a body builder undergoing resistance training for purposes of hypertrophy, and relate it to the 23rd Chiropractic principle.
Let's use a hypothetical example of a body builder who is training biceps for an upcoming competition. The bodybuilder's goal is to gain appreciable size on their biceps. In order to do so the athlete will train the biceps 1-2 times per week to a point of complete fatigue and exhaustion. The training period will impose damage to the muscle fibers and create tiny micro traumas. As a result of these traumas the body will take peptides from the small intestine, break them down into individual amino acids, transport them from the liver to the muscle via the blood stream to the damaged muscle fibers, where the amino acids will be reconstructed into protein fibers to repair the torn myofibrils. This process will not only repair the damaged fibers but it will actually repair them and build them stronger. Keep in mind that this process is not only local to the damaged areas that were trained, but system wide adaptations are occurring as well. Changes in heart rate, bone density, lung capacity, and blood circulation are all occurring simultaneously.
As a Chiropractor we should be able to look at this hypothetical scenario in the context of the 23rd principle. Training is a universal stress (force) that is placed on the body which causes adaptation in biochemical and physical means via the adaptive functions of innate intelligence, which leads to a stronger physiology over all (not just strong biceps).
Lessons Learned From Teaching 5 CE's]]>Matt Hartenburg D.C., 16 Jan 2017 16:43:14 +0000
This past weekend I taught 5 CE's for the Illinois Prairie State Chiropractic Association down in Champaign, IL, and I picked up a couple lessons for myself along the way.
The first lesson I learned is that 5 hours is a lot more difficult to teach than 2 hours! I had done 2 hour versions of the class on several occasions, but this was the first time I had to prepare much longer than that. It was difficult to have all my info sorted in a manner that flowed well and made sense, and even more difficult to keep people's attention for that amount of time.
It still went well, but definitely learned a couple lessons along the way.
The second lesson I learned was in regards to the topic I was teaching. The science behind adaptability and heart rate variability is a very exciting field that is gaining a lot of notoriety and attention. I have been looking at adaptability from the standpoint of an athlete undergoing a periodized strength and conditioning cycle, as exercise physiologists are investigating autonomic responses to training and recovery bouts. Admittedly, I have put myself into an adaptability bubble, so to speak, and regularly converse with other Chiropractors who are investigating the same field. I have conversations with DC's and other health professionals about heart rate variability so often that I forget that the average Chiropractor does not really grasp the concepts or the basic underlying principles of autonomic adaptability and heart rate variability. This post will serve as a very elementary introduction to those topics.
Before I continue I want to put out a shameless plug for my friend and fellow Chiropractor (whose office is less than a mile from my own) Dr. Rob Sinnott. Dr. Sinnott authored a text on Adaptability that puts the topic together beautifully. I had been spending countless hours over the past few years trying to piece together my understanding of the topic of Heart Rate variability and adaptability, and Dr. Sinnott put it all together in a clear and concise text that should be a part of every Chiropractor's library (and taught in schools). You can click on the hyperlink above and get a copy for yourself.
Back in the 1950's, Canadian physiologist Hans Selye wrote a book titled "The Stress of Life," and published a paper in the British Medical Journal called "Stress and The General Adaptation Syndrome"(full text PDF available at the hyperlink I provided). Dr. Selye described the human stress response and how it related in the context of modern life. When humans encounter a stress, we exhibit a fight or flight response, or as he referred to it as "the alarm phase." Most of you reading this are likely aware of the symptomatology of the fight or flight response, so I won't dedicate much time to the specifics of it. Historically, the initial phase of the fight or flight response evolved as a survival mechanism. Think of it this way; several hundred (or thousand) years ago, the likelihood of running into a life threatening situation was considerably higher than it was today. In a life threatening situation survival instincts were necessary to avoid the stressor (lion, tiger, bear, etc). Once the stressor was no longer present, the activity of the sympathetic nervous system would return to baseline, and normal physiology would resume. The body attempting to return to a lowered degree of readiness and normal physiology was referred to as the resistance phase.
Selye put the stress response into a more contemporary context and wrote about the stresses of everyday life. While we rarely encounter life threatening situations, most people in the western world deal with varying degrees of stressful situations in everyday life. These stressful events and situations often times leads to a more constant activation of the very same stress response, to a lesser degree however. Selye referred to this chronic low grade stress activation as the exhaustion phase. He noted that in the exhaustion phase, people would develop a maladaptative response to the chronic stressor, which would put people into a chronic state of low grade fight or flight response. Therefore, the general adaptation syndrome was noted as being a complexity of neuroendocrine symptoms related to heightened sympathetic nervous system activity through constant activation of the hypothalamic-pituitary-adrenal axis.
Increased sympathetic activation coupled with little resistance from the parasympathetic system (rest and digest) was hypothesized to be a contributing factor to many chronic illnesses and disorders of the day (and I would go so far to say that is VERY prevalent in today's society, more so than 60 years ago). Fast forward to today. The activity of the autonomic nervous system is gaining far more attention than ever before in popular media and scientific literature. Vagus nerve stimulation has become a popular method of treating seizure disorder and is being investigated in other disorders such as gastric ulcers. Articles about "hacking" the autonomic nervous system are popping up all over the internet, some of which are claiming that it will be the greatest thing since sliced bread when it comes to overall health and wellness....
Function of the autonomic nervous system has gained a lot of attention in the strength and conditioning world as well. Training is a stress. Period. Training your body is a stress which is designed to elicit physiologic adaptations as well as localized adaptations specific to the area which is being trained. The body's ability to adapt to the stress and recover and become stronger is the key to improving performance during a macrocycle of training. If the body is unable to adapt to a training load, the stress which continues to compound on the athlete leads to a maladaptation similar to what Selye hypothesized nearly 60 years ago.
To combat this and to monitor the effects of the body's physiology during training cycles, more coaches and athletes are turning to simple means of measuring the autonomic nervous system, primarily through heart rate variability. Heart rate variability is an non-invasive tool to measure vagal control of the heart. The vagus nerve exerts a parasympathetic effect on the heart which can be understood through measuring HRV. There are two different basic domains which HRV measures: frequency domain such as high frequency (generally thought to be indicative of parasympathetic activity), low frequency, and high to low frequency ratio. The other domain (which is far more accessible, because you don't need ECG equipment) is time domain. The two most common time domain measures we see in research and application (though these are not the only time domain measures) rMSSD and SDNN. Both of these measure fluctuations and variations in the R-R interval (think QRS complex). Under resting conditions your heart rate should not beat like a metronome, meaning that it should not be a rhythmic one beat per second. There should be variation in time between each beat. Even in a "healthy" heart rate of 60 beats per minute, there should be a fluctuation between each successive heart beat. For example, 4 different heart beats in a row may have four different time measures between them (1.003 sec, 1.006, 1.002, 1.007 would be a better reading than 1.000, 1.000, 1.000, 1.000). The more variation in time between resting heart beat indicates more parasympathetic control. This is a direct method of measuring your body's adaptive capability, and a very simple means of quantifying autonomic function in an individual.
Obviously, I'm not trying to write an exhaustive review of HRV and the ANS, but i found it necessary to at least give background information before moving forward. Again, go up to the hyperlink I provided earlier and pick up Dr. Sinnott's text on adaptability. It was a very clear and easy read which furthered my ow understanding of the topic beyond what I had already learned.
A Quick Note About Studying Sports Performance.]]>, 05 Jan 2017 14:30:57 +0000
Im sitting here preparing my powerpoint for 5 CE's I'm teaching in Champaign, IL on January 14 and an idea for a quick post came to mind. One of my slides I will use for my powerpoint can cause some pretty incendiary conversation among Chiropractors, and as I was editing the slide this morning I thought this would be a good time to elaborate on it.
The slide is an abstract from a study I found titled: "Chiropractic Treatment and the Enhancement of Sports Performance"The literature review was published in the Journal of the Canadian Chiropractic Association in 2010 by Andrew Miners BPHE CSCS.
The paper was a fantastic review of the literature that reviewed studies related to different hypothetical mechanisms as to how Chiropractic could indirectly affect different aspects of functional performance. The author reviewed studies related to several different mechanisms including:
-reduction of muscle inhibition
-Altered muscular EMG activity
-Muscle strength modulation
-and Cognitive motor reaction time and motor control
Despite the author sharing some excellent foundational studies that may elucidate methods that need further study, his conclusion stated: "Although many studies, ideas and theoretical frameworks have been postulated and discussed, it seems that at this time there is insufficient evidence to convincingly support the notion that treatment provided by chiropractors can directly and significantly improve athlete sport performance."
Even though this may sound like a damning conclusion, the author noted that the studies he cited were outstanding foundational work, but that little has been done and published to show direct impact on sports performance.
A couple notes on that. 1) Of course we need more studies. Every profession does. Human performance research would go a long way in chiropractic, and would break up the monotony of much of the allopathic, pain related research that seems to be coming out. 2) Aside from defining "treatment methodologies" in Chiropractic studies, we need to be less reductionist when it comes to studying sports performance. Allow me to explain.......
Anyone who has trained seriously for any type of sport knows that performance is a result of a long period of train up. The average training period for a marathon (for an average level competitor) is 16 weeks. Nearly every weightlifting cycle I have ever used to train for competition was periodized over 8-12 weeks at minimum. Improving performance and reaching peak performance is NEVER the result of a single day or single event.
Let's use creatine as example. Creatine is one of the most time tested supplements on the market. It has been making headlines since the 1990's. Strength and endurance athletes have been utilizing creatine with much anecdotal success and it is also one of the most studied supplements out there. If I were to design a study to evaluate the effects of creatine on sports performance, here is what I would NOT DO. I would not have an athlete perform a "pre-test" feat of strength or performance (let's say 40 yard dash), then ingest 3 MG of creatine and re-test the forty. That is too short sighted of a study design. Creatine boosts recovery and supplies more phosphagen for ATP synthesis for increased work output during training sessions. Taking it once would not improve performance, however regular consumption over the course of an entire training mesocycle or macrocycle would be a more applicable means of understanding how it could improve recovery and training during train up periods, rather than a single use improving performance.
Performance comes from a well balanced training program that allows for sufficient rest and recovery to adapt to increasing training loads, frequency, and intensity. Sport science seems to have established the best ways to train. The contemporary view of performance surrounds recovery. Adequate recovery following a training session allows for increased training intensity during the following session.
One of the biggest taboo topics in sports right now is the use of performance enhancing drugs (PED). While we always here the term "performance enhancing," the reality is that most of the drugs on the anti-doping list of banned substances are recovery enhancers. Generally, an athlete that utilizes PED's does so during the training period and then does their best to rid them from their system prior to competition when they are most likely to be tested. Remember Lance Armstrong and Marion Jones? At one time they were the two most tested athletes in the world, and despite it being uncovered that they had been using PED's during training, neither of them had EVER had a positive drug test in competition.
I am not condoning the use of PED's, but let's face it, they are a reality in sports. Any time there is money, sponsorships, and olympic medals at stake athletes will utilize whatever means they have to gain an edge. That edge typically comes in the form of anything that will boost recovery. Items that increase performance on the day of competition are heavily tested for and often times banned (EPO, Caffeine, and other stimulants are examples). One final example of this would be human growth hormone (HGH). Taking HGH once, prior to competition likely won't improve performance, which is why athletes take it off season to improve their training.
Where should Chiropractic put their research efforts in sports performance (or at least one area we should emphasize)? The effects of Chiropractic need to be studied in a population of athletes during their training period when training intensity is of the utmost concern. Take a population of athletes training for competition and compare them to a control group that does not get adjusted, for a four week period at minimum. Why four weeks? Because four weeks is an average mesocycle within a quarterly macrocycle. This means that during those four weeks the intensity, volume, and frequency of training will spike followed by a de-load or taper period, followed by some sort of assessment of performance. We should direct our outcome measures towards autonomic markers such as heart rate variability, inflammatory markers, cytokines, and other measures of recovery that the exercise physiology research world is putting a great deal of effort into studying.
If you are a Chiropractor in private practice, this may seem like a great deal of work. The best thing that we can do is continue to document our patients progress incredibly well and utilize HRV (which is the most simple and non invasive tool we can use in practice). Let's start getting more case studies like that published and correlate it with subjective outcome measures such as the rest-q QuestionnaireIn the meantime, I believe that this is the type of research that we can begin to create a demand for in the profession (and since this is a blog and not a formal means of scientific communication, I can state my opinion!).
A Brief Explanation of Periodization and the Autonomic Responses to Training.Matt Hartenburg D.C., 30 Dec 2016 14:30:27 +0000
Welcome back to another exciting edition of "Learning Out Loud" on our blog. 17 Readers of our last article can't be wrong! If you are new to this blog, welcome. I have been using this platform as a way to dissect the information I have been taking in for the past three years on the topic of strength and conditioning, the autonomic nervous system, and heart rate variability. Writing and publishing is helping me to keep my thoughts on the topic organized, as well to disseminate some of the stuff I'm learning as I prepare to develop a more formal means of publishing.
My wife and I are on vacation in the beautiful city of Savannah, Georgia this week and I have been spending time each morning preparing for my January 14 talk for theIllinois Prairie State Chiropractic Association in Champaign, IL. If you live in Illinois and need some more CE hours for license renewal come on down to Champaign, as there will be 5 hours available on the topic of training physiology, chiropractic, and the autonomic nervous system.
In the past two blog posts I began to introduce terms related to different phases of training, and I thought I would expand on some of those terms today.
First, it is important to understand program design. I always start my classes off teaching Chiropractors typic design features of training programs. I always give a hypothetical example of a patient in their 40's with a new years resolution of running a marathon, with very little prior training experience of any kind. That example is very relevant considering how often it happens and that tomorrow is NYE. If you are a practicing Chiropractor and you have never run a marathon or competed in any type of event that requires significant train up, it is important to understand how a simple program is developed and the goals of each program for the purposes of communicating the different phases with a patient who is undergoing training as well as understanding the changes the athlete's body will undergo as a result of a new training program.
In this example I will be referring to someone training for a marathon, as that is a pretty typical experience in a Chiropractic office this time of year. Understand that even though I'm referring to someone training for a marathon, this type of program design is relevant to nearly all forms of strength and conditioning training.
Program design is typically broken down into several different time frames referred to as periodization. The purpose of periodization in a well designed program is to gradually increase the physical stress to generate a response in the body known as super compensation. Super compensation is the period at the end of a training period where the athletes performance has improved beyond that of where they began.
The different time frames of a well periodized program are as follows: macrocycle, mesocycle, and microcycle. A macrocycle is the longest period of time in a training program. Usually a macrocycle takes into account the entire competition schedule. In our example of a patient running a marathon, the macrocycle will be the time period that they are training for one marathon, which is usually a 16 week period. For an elite level athlete, a macrocycle could be an an entire calendar year or more, and may include several different competitions that they will be attempting to "peak" for.
Macrocycles are made up of several different mesocycles. A mesocycle is a 3-6 week period where training load will be increased and then allow for a rest or "de-load" or "taper" period at the end.
Mesoocycles consist of several different microcycles. A microcycle is generally viewed as an individual week or sometimes individual training sessions. For our example we will view the microcycle as a week. Let's say our hypothetical patient who is training for their first marathon trains four times a week. That means that this person has four individual sessions which make up a microcycle (week). Many marathon programs consist of 16 weeks of training (16 week macrocycle), broken down into 4 mesocycles (4 week mesocycles), and those mesocycles will consist of 4 microcycles. Each week the athlete's training load (allostatic load) will increase gradually over the first three weeks of a mesocycle, then on the fourth week of the mesocycle they will typically have a "taper" or "de-load" week designed with less mileage and intensity to allow the body to recover. Each mesocycle will build upon the intensity of the previous one until the end of the 16 week macrocycle when the load has been increased to the point where the previously untrained athlete is now ready for a 26.2 mile race.
Each of the aforementioned training cycles is designed to elicit a physiologic response in the athlete. Microcycles are designed to elicit a response known as reaching. Reaching is the fatigue that is caused by short term training bouts. A simple example is when the patient goes for the first long run of 10 miles or so. For the 24-48 hours following the training session they will experience fatigue and soreness and decreased performance. Adequate rest and recovery allows the athlete to return to training within the next few days.
Reaching is the goal of microcycles and individual training sessions, but overreaching is the goal of longer cycles such as the mesocycle. Overreaching is a period of time where the athlete is adapting to the increase training load and is generally characterized by seemingly harmful symptoms such as lethargy, soreness, apathy towards training, soreness, etc. While these symptoms may sound disadvantageous they are part of the normal training response. A well developed training program is designed to elicit overreach. With adequate rest, the athlete will overcome this period and performance will improve as a result, because their body has adapted to the stress. A rudimentary example of this is the athletes resting heart rate. During a period of overreach it is not uncommon for an athlete to have an elevated resting heart rate. If the athlete's program allows for adequate taper and rest periods we generally see the resting HR drop below their previous resting HR. This is an autonomic adaptation to training load.
If the athlete is not allowed adequate recovery period, they run the risk of leading into a period of non-functional overreach, characterized by the symptoms of overreach persisting for long periods of time without a performance improvement. Or overtraining syndrome which is persistence and increased severity of the same symptoms for 4-6 weeks. I won't spend much time talking about overtraining because the simple fact is that in our offices we don't typically see a truly overtrained athlete. What we generally see is an under recovered athlete. Training loads that lead to overtraining are generally seen in high level athletes or people that have been pushing the envelope for a long time. Even though the new athlete in our example may experience some seemingly sever symptoms, chances are they are just acclimating to the training program. They are not overtrained necessarily, they are under recovered and simply not used to the type of stress they are placing on their body.
I first learned about the different cycles and responses from Bob Takano's book Weightlifting Programming: A Winning Coaches Guide ,even though the book was written geared towards the sport of weightlifting, the principles apply to nearly all forms of strength and conditioning.
Of most interest to Chiropractors is the means of tracking reach and over reach during training periods. I will expand on these more in later posts but these are some interesting articles for further study, Training response is being measured in regards to the autonomic nervous system (which is why this is such an important topic to chiropractors). More on that later, but here are some links to additional reading on the topic:
1) Evidence of parasympathetic hyperactivity in functionally overreached athletes.
2) Training adaptation and heart rate variability in elite endurance athletes: opening the door to effective monitoring.
3) Monitoring Athletic Training Status Through Autonomic Heart Rate Regulation: A Systematic Review and Meta-Analysis.
These are only three examples of possible hundreds, but the examples I picked are articles I have recently read. I encourage chiropractors to begin to explore and understand the role of heart rate variability and the autonomic nervous system in training! More to come later........
Chiropractic: Investigating the Role of the ANS in Training and RecoveryMatt Hartenburg D.C., 21 Dec 2016 13:19:52 +0000
Despite the many complexities of training in the sport of weightlifting (and pretty much every other strength or endurance sport), the main premise is pretty simple. Gradually increase the training stress and training load over a period of time, allow the body adequate means to recover and ADAPT to the stress, introduce taper and de-load periods, and at the end of the program or cycle and the athlete enters competition they should be set up for improved performance. Despite this relative simplicity, there are numerous variables to account for including stress of life, what percentages (intensity) to program, how often the athlete trains (frequency), and how long the individual training sessions are (volume).
Programming for the athlete can be incredibly complex and open to a lot of individual interpretation and application, but one aspect persists, in order for ultimate success in sport the athlete must be allowed to adapt and recover following individual training loads. If the athlete fails to adapt, or maladapts, to training stress performance will suffer as the result.
Several years back when I first began looking into the topic of recovery, my sole interest was related to the role of the nervous system. Physiologic adaptation occurs through the autonomic nervous system, and is at the center of much research in the field of pathology and salutogenesis. Being that I am a Chiropractor first and foremost, I tried to approach this topic through a Chiropractic lens. After numerous searches using keywords like “recovery and nervous system,” I came across a study that examined the role of the autonomic nervous system and recovery geared towards a population of weightlifters.
The study was titled “Parasympathetic Nervous System Activity Mirrors Recovery Status in Weightlifting Performance After Training,” and was published in the “Journal of Strength and Conditioning Research” in 2011.
The researchers put 7 male weightlifters with national or international competition experience through a 2 hour training protocol of back squat, shoulder press, deadlift, and front squats. Athletes then rested under “sedentary conditions” for 72 hours. Heart rate variability measurements and blood marker measurements were taken at 3, 24, 48, and 72 hours post training session. Blood markers measured were creatine kinase levels and DHEA-s. DHEA-s is a hormone produced in the adrenal glands which the body converts into testosterone, and creatine kinase is used as a marker of muscle damage.
CK levels were elevated post workout and didn't return to baseline by the end of the 72 hour period, and DHEA-s levels dropped below baseline and remained low, and subjectively reported levels of muscle pain were elevated 72 hours post training.
HRV high frequency values (generally considered to be indicative of parasympathetic nervous system activity) dropped below baseline within the first 24 hours but returned to baseline by the 48 and 72 hour mark. Weightlifting performance was tested again at regular intervals and was found to return to baseline by the 72 hour mark.
Despite the biochemical markers not returning to baseline, the performance improvements correlated with a plateau in the HRV reading indicating the parasympathetic NS activity marked recovery status and performance.
A few notes of relevance to Chiropractors:
-“In contrast to the endocrine system, the autonomic nervous system is a fast component of signaling system controlling the whole-body metabolic homeostasis by coordinating different organs and tissues, aimed to precisely match oxygen demand and supply in response to external challenges.”
Chiropractic principle 32: The Principle of Coordination: “Coordination is the principle of harmonious action of all the parts of an organism, in fulfilling their offices and purposes.” I’m always thrilled when I come across contemporary science that supports the Chiropractic principles first espoused in Stephenson’s text from the 1920’s. Chiropractors recognized the importance of the nervous system and it’s role in homeostasis dating back to the turn of the last century. Homeostasis is incredibly important to athletes (as well as the general population obviously, but this article is in the context of athletes). Training stress leads to a disruption in homeostasis, recovery from an individual training stress marks a return to a homeostasis. Are you seeing the trend? The authors of this paper note the importance of the ANS and measuring the ANS for determining how the body responds to external challenges……sound familiar?
-“Increasing resting sympathetic nervous activity with reciprocally de- creasing resting parasympathetic nervous activity reflects an elevated oxygen demand for ATP generation in the periphery, which typically occurs during and after external challenge.”
Again, note the importance the authors place on the roles of the sympathetic and parasympathetic nervous system in the context of markers that are important to athletes such as ATP generation and oxygen demand.
-“Furthermore, the strength recovery and parasympathetic nervous activity appear to be unrelated to pain and circulating muscle CK levels.”
This is the first time I’ve seen something like this in a study but I think it can have some very important clinical applications. Often times, health care practitioners in many different fields tell people to listen to their body and soreness levels etc. In this study, they showed that pain and CK levels appeared to be unrelated to subsequent performance. Very interesting, but we should also keep in mind that the 7 people in this study were high level weightlifters.
-“Our data provide evidence that parasympathetic power mirrors recovery status in weightlifting performance after training.”
Very simple: activity of the nervous system mirrored recovery. Sure we can point out that this study was N=7, but keep in mind that this is one study in a sea of many that have come out since. I will expand on more of these papers in future posts.
-“In conclusion, HRV is a noninvasive tool that can be used by coaches to monitor recovery status from fatigue for a weightlifter during the training period and before competition.”
Just like I said in the last post, it’s time that HRV becomes a standard in Chiropractic schools and practice. A paper published in 1999 laid out the rationale for assessing HRV as an objective way to monitor autonomic response to care, and several smaller studies have come out in the past decade substantiating that notion.
This is an incredibly broad topic, and I’ve only just begun to scratch the surface.
1) Chen, Jui-Lien, et al. "Parasympathetic nervous activity mirrors recovery status in weightlifting performance after training." The Journal of Strength & Conditioning Research 25.6 (2011): 1546-1552.APA
2) Eingorn, Alex M., and George J. Muhs. "Rationale for assessing the effects of manipulative therapy on autonomic tone by analysis of heart rate variability." Journal of manipulative and physiological therapeutics 22.3 (1999): 161-165.APA
Chiropractic, Sports Performance, and the Autonomic Nervous SystemMatthew Hartenburg D.C., 18 Dec 2016 22:20:30 +0000
For the past 4 years I have been merging two my passions in life: Chiropractic and the exciting world of sports performance. Remember the line from "Talladega Nights" where Ricky's dad said: "I am a semi professional race car driver and an amateur tattoo artist?" Well, I am a professional Chiropractor, a semi-mediocre weightlifter, and am amateur research reader.....
In studying Chiropractic and sports performance, I recognized that there is one overlying topic that seems to continually transcend both fields, and that is the role of the autonomic nervous system and adaptability. This blog will serve as a means of me "learning out loud" as I continue to study both of these topics and expand my own knowledge on the topic. I will review articles on here, share some ideas I have for research agenda, and talk about my two favorite things: Chiropractic and training.
In my quest to develop as a coach in the sport of Olympic Weightlifting, I began reading every book I could get my hands on in regards to coaching. I was reading books written by famous American coaches, online articles, even books translated from Russian to English that shared some of the methodology that the former Soviet lifters used to follow. One aspect of training that I hadn't really considered (I should emphasize that I never placed a conscious emphasis on it) was how much recovery was involved in the sport of weightlifting (or any strength/endurance sport for that matter). Nearly every book I got my hands on that talked about strength training dedicated a significant amount of text to the physiology of recovery. The best coaches in the sport viewed training in the context of how it would affect homeostasis in each individual athlete. Simply put, training is a physical stress which causes a departure from homeostasis, and recovery in between training sessions must allow the athlete to return to the previous state of homeostasis.
Chiropractors in practice often view recovery in the context of athletes purely in a musculoskeletal manner. We view biomechanics, range of motion, and subjective measurements of pain as the predominant means of how effective Chiropractic is for athletes. Don't get me wrong, anyone who has ever trained endurance sports or strength sports understands the importance of efficiency of movement and pain free range of motion, and I'm not taking anything away from that aspect of care; but I believe that as Chiropractors, our bread and butter needs to be in our understanding of the role of the autonomic nervous system. Wayne Gretzky was quoted as saying (I'm paraphrasing) that he was so good because "he always knew where the puck was going." Where is the puck going in terms of sports physiology and sports performance? Right where Chiropractors should want it to go, to the autonomic nervous system.
As I stated before, training for performance in any sport is a culmination of effort in the gym or track coupled with rest and recovery. If insufficient time, effort, and energy goes into the gym, it will be reflected in the results in competition. Likewise, if intense training is not matched by adequate recovery, then the athlete will experience maladaptation and performance will suffer and risk of injury, overuse, or overtraining becomes imminent. Match a sufficient training program which adequately stresses the athlete's physiology with recovery, and the athlete performs better in competition.
As much emphasis is being placed on recovery as the training program itself. More than ever, athletes are seeking out different recovery modalities to assist recovery, reduce inflammation, and to promote as much healing as they can in between training efforts. Recovery is JUST AS IMPORTANT as training. PERIOD.
Sort of interesting so far? It gets better. Any Chiropractor who has attended the Adaptability symposium in Chicago in the last few years, or anyone who has been paying attention to adaptability should pay close attention to what exercise physiologists are directing much of their research efforts to.
Athletic performance comes down to how well the athlete is able to adapt to a training load. Adequate adaptation=improved performance, inadequate adaptation=decreased performance. Balancing the two is key. The window to understanding adaptation? HEART RATE VARIABILITY and the AUTONOMIC NERVOUS SYSTEM. Coaches, athletes, and researchers are investigating the autonomic nervous system and it's role in recovery, and they are utilizing heart rate variability as the most accessible means of quantifying the recovery status of individual athletes.
A paper I recently came across was titled: "The Role of Heart Rate Variability in Sports Physiology," which was published in the journal "Experimental and Therapeutic Medicine" in Feb of 2016. The paper was a review of the literature which evaluated the role of HRV in assessing training adaptation/maladaptation of athletes and the relation of the HRV and ANS. Here are a few highlights which (I believe) are very relevant to Chiropractors:
-HRV is "an important method for assessing the cardiovascular autonomic parameters that are partially under the control of innervations from the sympathetic and parasympathetic systems."
HRV should be taught in Chiropractic school as an objective outcome measure. Every Chiropractor in practice has seen improvements in non-musculoskeletal conditions and HRV would be a fantastic way for us to quantify changes in the ANS as a result of a Chiropractic adjustment. There is a growing body of evidence inside and outside of Chiropractic looking at the effects of the adjustment (and spinal manipulation) on HRV. It's time we put more effort and energy into this field of study. Chiropractors recognize that the body is a self healing, self regulating organism, and that the nervous system is the "master control system in charge." HRV may be the best available tool we have to quantify that (which is exciting considering that sports physiology research seems to recognize the nervous system's self regulating capabilities as well). It is philosophically and scientifically congruent.
-"Additionally, in athletes, HRV monitoring is frequently applied to prevent and diagnose overtraining syndrome, which is associated with numerous syndromes such as ANS dysfunction and imbalance."
Note that the authors are looking solely at how the physiology the Autonomic Nervous System responds to training. I have seen a lot of papers which look at the role of the ANS in overtraining. Some have even gone so far as to say that overtraining and non-functional overreach (topics for future posts) are neurological disorders with endocrine repercussions due to the relationship between the ANS and the endocrine system. In endurance type sports like running and triathlon, athletes often exhibit signs of parasympathetic dominance (i.e. low resting HR, chronic fatigue, apathy towards training etc), where as in strength and fitness sports like weightlifting, powerlifting, and CrossFit athletes often exhibit signs of sympathetic dominance (ie. sleeplessness, high resting HR, increased respiration rate etc). Overtraining and non functional overreach are signs of maladaptation. Inability to recover and adapt to training load will decrease performance.
-"Findings resulting from multiple studies suggest that HRV parameters are relevant in the analysis of stress that the body experiences during training and to increase insight into physiological recovery after training."
Once again, the authors are focused on physiological recovery after training. A simple example that I use is a bodybuilder who is trying to increase the size of his or her bicep muscle. He/she will train the biceps incredibly hard on monday. We know that resistance training creates micro tears in the muscle being trained. With that in mind, it would be silly for the athlete to go back into the gym and train the biceps hard again the following day. The muscle must rebuild and recover or else it will not adapt and grow stronger. Obviously, in this example much of the recovery will occur localized to the bicep muscle and will be related to tissue repair, waste reduction, inflammation reduction, and protein synthesis. However, the athlete's physiology at large must recover as well. That is the role of HRV. In a sport such as olympic weightlifting or marathon running, it is the athlete's physiology that must recover in order to reach a point of super compensation and improved performance. We know that the spine and the autonomic nervous system are closely related anatomically and functionally. Some smaller studies have evaluated the effects of the adjustment on HRV and they have been promising thus far. We need studies with populations of athletes looking at how subsequent HRV changes post adjustment affect their recovery. Recovery is the realm that Chiropractic can make a large impact and gain even more inroads into sports and human performance, if we can just back off the pain train for awhile and focus some energy on the ANS and HRV.
In future posts I will explore more of the research related to this topic as well as some of the more exciting studies that we have in Chiropractic which have evaluated the response of HRV to the adjustment as well as other CNS/ANS related outcomes. In this post, I wanted to plant the seed of where I have been directing a lot of my energy over the past three years in studying this topic. Someday I hope to see studies with a large sample size of athletes undergoing intense training measuring HRV to see their responsiveness to Chiropractic and how that affects their recovery efforts. Until that day comes, I will continue to beat this drum and put these pieces together. There is a great deal of overlap in research related to sports performance and adaptability. As a profession, Chiropractic needs to begin to direct more resources to understanding how the adjustment (and subluxation for that matter) affect adaptability as measured through HRV.
1) Dong, Jin‑Guo. "The role of heart rate variability in sports physiology (Review)." Experimental and therapeutic medicine 11.5 (2016): 1531-1536.APA
Stay in the Fat Burning Zone for up to 48 Hours with this “One Weird Trick”]]>Dr. Matt Hartenburg, D.C., 18 Jan 2016 21:28:29 +0000
Don’t you hate titles like that? I do. Yes, I realize the irony that I have such disdain for click bait titles like that and I am using one, but I am using it to make a point. I can’t stand fitness marketing. Especially the fitness marketing geared towards women. There is a constant myth being touted that in order to get in shape one must exercise for hours in the mythical “fat burning zone,” eat 1000 calories a day (that’s my breakfast), and firm/tone their thighs. I hate it mainly because that type of marketing is usually accompanied with a picture of a lean, airbrushed, bikini model, who, in reality, probably does none of the things that her image is selling in that particular ad.
There is a prevalent mythology that in order to “tone and firm” we must do cardio non-stop. Don’t get me wrong, cardio is important, very important. But to obsess over calories burned, keeping your heart rate in the “fat burning zone,” trying to stay on the elliptical for hours on end will lead you in circles. Quick weight loss from calorie deprivation always comes with consequences, and those consequences are usually putting the weight right back on.
Do you want to learn how to tone and firm and burn fat? It really isn’t a secret. Lift weights and sprint. No, not those 5 pound dumbbells in the gym, actual weight. I refer back to a study I came across last week titled “Intensity of Resistance Exercise Determines Adipokine and Resting Energy Expenditure Responses in Overweight Elderly Individuals.” The link is too long to post here, but it was shared on Be Well Chiropractic’s facebook page last week if you want to read it. The study was published in the journal “Diabetes Care,” and the authors found that Resting Energy Expenditure (REE) was increased up to 48 hours following resistance exercise, and that the length of time REE was elevated was directly related to the level of intensity of the workout. So, what does that mean? Resting Energy Expenditure is similar to your basal metabolic rate, but it refers specifically to the amount of energy (calories) you burn while resting in the hours following a workout. If you workout with a high intensity level, you will have a higher REE. In other words, you will burn more calories during your recovery than if you were to go for a walk, or lift weights that are far below your maximum. Muscle is a very metabolically active tissue. When you exercise at a high intensity, you will break muscle down to a greater degree than if you were to workout at a lower intensity. For example, running 5-10 sprints instead of walking for an hour or performing deadlifts at 50% of your maximum versus doing curls with a 5 pound dumbbell. These higher intensity activities will break down muscle fibers to a far greater degree, and as a result they must be built back up. Building muscle back up is a process that utilizes a great deal of energy, hence a higher REE. You burn more calories in response to higher intensity exercises, which equals a leaner HEALTHIER body.
This is why it is so important to quit avoiding the area in your gym where the barbells and weights live! The single most efficient means of transforming your physical health and body is with the functional, dynamic, compound exercises like the squat, press, and deadlift. Most people avoid these exercises out of intimidation or a fear of getting “bulky.” Folks, getting bulky and looking like a bodybuilder is hard. Very hard. People who look that way, or who pack on tons of muscle have a level of dedication that very few will ever know. Their life revolves around building muscle. Typically, it requires trips to the gym 5-7 times per week, for several hours at a time, and a diet that is zeroed in on the exact number of carbohydrates, protein, and fat that their bodies require. Someone who says you will get bulky from lifting weights doesn't know what they are talking about, and are very patronizing to those who have dedicated countless hours to training and eating to develop muscle like that. Believe me, I know from personal experience. Back when I still competed in weightlifting, I trained 2 hours a day and ate like it was a part time job. I would even drink protein shakes in the middle of the night to keep my metabolism going while I was sleeping. If you are not willing to do those things, you will not get bulky, I promise.
The other reason people avoid these movements is a fear of getting hurt. That is very understandable. They do appear intimidating, and many trainers (unfortunately) don’t know how to teach them correctly, and as a result, don’t teach them at all. That is why we are hosting our free workshop Monday, January 25 at Be Well Chiropractic at 6 PM. Dr. Anna and I will be teaching you how to safely lift weights to get the most out of your workouts. We will cover high intensity interval cardio, weightlifting form, and how to set up a week of workouts from beginner to advanced. Don’t miss this workshop!
No excuses this year……
Science and research long ago proved Chiropractic to be best at reducing or eliminating pain when compared with other forms of medical treatment. However, the purpose of Chiropractic care is not to simply remove or reduce pain. A great side effect of an adjustment is that pain can be reduced or eliminated entirely. Pain dissipates when the intelligence and power in the brain no longer perceives an adverse condition. Pain is felt in the brain, not the body, and understanding how pain originates becomes a key element in its elimination.
Alleviating pain begins with finding the cause. Although simple in principle, millions of people every day seek to treat and mask symptoms of pain rather than the origin. Chiropractors seek to find and address causes rather than effects. The Journal of Spine serves as one of the greatest medical reference publications available. The research compared three different forms of treatment for chronic spinal pain sufferers. They compared Non-Steroidal Anti-Inflammatories (NSAIDs Vioxx and Celebrex), Acupuncture, and Chiropractic. The results surprised the medical community and brought clarity to the mission of Chiropractors seeking to help people understand the benefits of regular adjustments.
The results of this particular study revealed that Chiropractic adjustments alleviated pain five times better than medications and three times better than acupuncture. The patients assigned to the group receiving Chiropractic care had experienced chronic pain for almost twice the amount of time as the subjects in the other two groups. Therefore, Chiropractic helped the people with the worst pain get better quicker than medications or acupuncture. Another important point of the study reported that 47% of the subjects receiving Chiropractic care had an improvement in their overall health while just 15% reported the same in the acupuncture group and 18% in the drug therapy group. Chiropractic long ago advocated many more benefits than simple pain relief. Improvement of the nervous system translates into a body empowered to improve overall health.
Chiropractors specialize in locating and correcting small misalignments in the spine that interfere with the central nervous system. Adjusting subluxations produces the wonderful side effect of pain alleviation and removed. The Journal of the Spine study serves as one of many professional health studies that prove the powerful benefits of a well-functioning nervous system through Chiropractic care. Unfortunately, much of the public remains unaware of the amazing benefits that Chiropractic adjustments deliver to all aspects of human performance. Despite the statistics, the majority of people take drugs for pain relief because they are marketed and sold as the solutions. A change must take place and it starts with education. The best decisions are rooted in sound research and an informed public. That philosophy drives the Chiropractor’s initiative to educate and lead communities into a better healthcare philosophy and approach.
Health or Disease, It’s Your Choice.]]>Dr. Anna Denton, D.C., 26 Oct 2015 15:35:53 +0000
“A quality life demands quality questions.” -Dr. Demartini
Each day I am asked many questions about my own lifestyle: what I eat, how I workout, who adjusts me and if I get adjusted. I’m always encouraged when these conversations are initiated because I know that person is beginning to question their current and past health beliefs. This week, I want to discuss how the type of questions we ask determine the quality of our outcome.
In our culture, we are trained to ask about the details of sickness and disease. We ask and research everything in regard to the disease, diagnosis, and symptoms we have. This brings us comfort in knowing we have defined our health problem. In this model, we study sickness. We spend all our time, focus, and energy learning about the details of the illness. We ask questions like:
What is the sickness called?
What symptoms does it include?
What treatment does it need?
Which doctor treats it?
Does my insurance cover?
When we are ill, we are desperate for answers, relief and want to be well again to resume our lives. It’s obvious that the goal of the ill person is to become “healthy.” Do any of the questions above bring up health? In a way, it's like a person in search of wealth. Let me explain: if you wanted to become wealthy, would you study impoverished cultures, low income populations, and bankruptcy in hopes of avoiding these things. Or, would you learn about people who made it and became successful, managed their money, and were actually wealthy? I think we would all agree in that we would study the wealthy! If we studied the poor we would know nothing about how to gain riches and reach our goal. Consequently, we would know everything about a lack of wealth, the very thing we are trying to avoid. This is just like health. Instead of asking “How do I become healthy?” We ask, “How do I avoid sickness?” As a result, we get more of what we do not want.
I want to encourage you to start thinking differently. Instead of asking about a diagnosis or labeling yourself with an illness, start thinking of questions in the context of health.
What CAUSED this?
How did this happen?
What is missing in my health? (nutrients, exercise, nerve supply, positive thinking)
Has anyone healed from the “illness?” What did they do?
What do “healthy” people do in their daily routine?
See the glass half full. If your body created the disease/pain/disfunction, do you believe it can take it away? Want a better life? Start asking better questions. One of the things that drew me to Chiropractic is that it's a different model of health care. Instead of asking about sickness and disease, we ask about health. When I understood this, I knew I couldn't live in the sickness model any longer. You have the power to choose which model of health to believe in: sickness or health. It’s up to you!
Medicine: The study of disease and what causes man to die.
Chiropractic: The study of health and what causes man to live.
Why You Need To Be Proactive With Your Health]]>Dr. Anna Denton, D.C., 19 Oct 2015 13:42:01 +0000
Many of us watch the news, follow social media, and keep up with current affairs. Everywhere we go we are bombarded with subliminal messages about health care. With all of these messages, marketing, increased insurance policies, has our health care really gotten better? I think we all know the answer to this, NO! In fact, we are overweight, under nourished, over prescribed, stressed out, disease ridden population. How is this possible with knowledge at our fingertips, doctors on every corner, and health advice all over the media?
The answer is simple. WE REACT. WE FOLLOW. WE FAIL.
Let me elaborate.
Yes, if we feel good, have minimal symptoms, we assume we are healthy. Is this true? Well, how does cancer, heart disease, and diabetes feel? No feeling, symptomless. In fact, the top 10 list of killers in our country have little or no symptoms of pain or discomfort. Did you know less than 10% of your bodies entire function is dedicated with sensory function (pain, temperature, pleasure)? That leaves over 90% of our body to perform feelingless autonomic function. And, we base 100% of our healthcare decision on 10%. Now we know why these top 10 disease killers have no symptoms.
When we do have pain we react to it, we think we are sick and go to the doctor. What happens there? DRUGS, tons of them. SURGERY, many times before conservative measures were exhausted. Do drugs and surgery make you healthy? Have you ever seen someone completely regain their health by taking drugs or losing body parts? Neither have I. This explains why we spend the most money on health care, and we are ranked 37th in healthcare according to the WHO. Terrible investment.
Solution, Be PROACTIVE.
Feeling good, awesome. Why not stay that way. Be at your best ALL THE TIME. So many people live life on the edge; health crisis to health crisis. Did you know Chiropractic care is the BEST way to prevent ill health? You brain runs your body, your spinal cord and nerves communicate messages to your cells ,tissues, and organs SO YOU CAN FUNCTION (this is the 90%). An adjustment removes any nerve interference; which blocks full communication to your cells. Thus allowing your body to get healthy and stay healthy. Eating organic fruits, vegetables, and meats also support your body along with exercise. Be proactive by creating new healthy habits.
Ever taken advice from TV doctors, magazines, or food commercials? This advice is ever changing and is always biased. For example, many food companies purchase labeling rights from the American Heart Association in effort to advertise their foods as "healthy." Some of these foods include Cherrios and Pop Tarts. Yes, eat your Pop Tarts everyday to support the BEST cardiovascular health. Great advice. Health advice from the media is usually bought, and the advice is ever changing.
Solution, ASK and RESEARCH.
My general rule for myself is that if I start noticing myself doing what most people are doing, I better start paying attention and go a different direction. This is when I know I am off track. It is not easy exercising, eating right, and going to the chiropractor weekly over your lifetime. BUT, know what's harder??? Getting sick and losing EVERYTHING you have and love. Research your health care decisions. Making educated decisions takes away fear. The key to success is following the plan; it's not exciting or dramatic, but the plan works when it is followed.
Eat Well. Move Well. Think Well. Get Adjusted.
Not much to say here. This is exactly where we are. We are failing because of our health care beliefs and the choices we make based on those beliefs.
My hope for each of you is that you never have to experience the American health care nightmare. Instead, you choose to feel energized, connected, and healthy and continue to do so over your lifetime. I hope you can sense the urgency to take action today; do not wait any longer. This is YOUR life. True success is the long game, not the short game.
“Now, I Can Finally Go Back To My Doctor and Get Healthy Again…..”]]>Dr. Matt Hartenburg, D.C., 02 May 2014 09:00:00 +0000
During the Cub’s game last night a commercial came on that ignited the inspiration for this newsletter. The commercial was for Humana, and the premise of it was that after Obamacare went into action there were 36 counties in the state of Mississippi that had no insurance coverage; that is until Humana came to the rescue and offered coverage in those areas. One of the actresses in the commercial said in the final seconds of the commercial “now, I can finally go back to my doctor and get healthy again.” Think about that for a second. This commercial implied that it is impossible to be healthy without health insurance, and that somehow having access to insurance will somehow magically make you healthier.
What does insurance actually do for you? Think about it. All insurance does is give you access to more doctors, more drugs, and more medical procedures. Does more access to these services necessarily make you healthier? Absolutely not. Sure it can help you if you run into health crisis, but it does not guarantee you health. Health is determined by your day to day lifestyle, not the insurance card in your wallet.
Let’s use blood pressure as an example. It is commonly understood that blood pressure is in large part a result of your lifestyle, regardless of your genetic predisposition. This point was made clear in the past few months by the comedian Penn Gillete from Penn and Teller fame. Penn was diagnosed with high blood pressure, and despite his family history of high blood pressure, his doctor informed him that if he was able to get his body weight down to 205 he likely wouldn't require medication at all. Penn took this to heart and set out to lose some weight and change his lifestyle. After dropping near 100 pounds, Penn’s BP was low enough that he was able to get off all medications. Let’s be clear, his insurance did not pay for his gym membership, it did not pay for his healthier food, and it likely did not pay for his personal trainer or nutritionist. It did, however, pay for his blood pressure medications.
Do blood pressure medications make you healthier? You may be thinking right now that it will lower your blood pressure, but is that making you healthier or just covering a symptom? If you answered that it is merely covering a symptom, you are correct. If Penn merely took a blood pressure medication to lower his BP, his pressure would have rose again simply if he stopped taking the medication. Since he instead took control of his health and lowered his BP through lifestyle changes, his BP will stay low for as long as he maintains his current lifestyle. Which option sounds better?
The commercial I spoke about above missed the mark. Insurance does not make you healthier, it just gives you access to more medications and more hospitals. That is not the mark of health. Do you really think another drug will make our country healthier? Do you really think that another procedure entered into the medical framework will provide our country true HEALTH? According to the World Health Organization, the United States takes more medications than any other nation, and spends more of its GDP on “health care” than any other nation in the industrialized first world, yet we rank nearly dead last in most major categories.
Your health is not the responsibility of your insurance carrier, your doctor, or your pharmacist. It is your responsibility.