Training: Health vs Performance.- Perception vs Reality and KISS

There is a false perception regarding exercise, many believe that you need to feel like Rocky after rounds 10 with Drago.  This is not reality, however, it hinders progress of the majority.  It feeds into a vicious cycle.  People who don't exercise say I don't have the time to do ALL OF THAT (whatever that is) or I don't want to subject myself to that torture, and therefore they do nothing, as they think fitness is this all or nothing, Drago pounding.  On the other side of the spectrum, there are people who do exercise who feel they NEED to feel like this in order to get any results, the attitude of "if I did not come close to puking and am not sore the next three days, I must not have worked our hard enough."  BUT, is this effective training?

Does somebody day in day out need to put their bodies through intense, mind numbing, body bludgeoning exercise in order to attain a healthy lifestyle?  The short answer is NO.  

Before we get carried away, yes, there are many variables to health.  Proper nutrition and sleep are far more important than exercise, so I am examining the exercise piece with the assumption that proper nutrition and 8 hours of sleep a night is the reality, although I do have the perception many of you are lying to yourself if you assume you fall into this group. ;)

If someone is looking for general health related goals, do they need grueling half-hour or hour long workouts, day in and day out, utilizing countless exercises or pieces of equipment, racking up hundreds of reps at a given weight? Once again, NO.  It is unfortunate that the incorrect mindset has become established that this is what is needed.   

Where does KISS come in to this? Well the legendary rock band who wore makeup to cover up the reality they were a bunch of funny looking rockers who were not as bad ass as they were perceived to be has nothing to do with this article.  

The KISS I am referring to is something which I feel gets lost in many of today's strength and conditioning centers, especially when we are looking at training in regards to health.  What is KISS?  Keep It Simple Stupid.  Even if you are training for performance, KISS may be the way to go 80-90% of the time.  It is easy to see how we forget about KISS.  We like bright and shiny toys, we like performing new movements, we like long workouts with lots of reps and lots of different movements, a la "CrossFit" style chippers, all day every day.  We like having to lie down on the floor in a puddle of our own bodily fluids which have creeped out or several different orifices to feel like we got a good workout in (well maybe not that far).

My belief is that too many people, trainers AND trainees, get caught up in the complexities, bells and whistles, and these all interfere with them or their clients attaining their desired outcomes.  In most instances, you do not need workouts to last more than 30 minutes or longer, day in and day out.  You do not need to spend hours on the treadmill or elliptical machine, or bike.  Chances are, the more you do, the less your results will be.   In regards to generalized training for health, even with specific goals within that framework, it does not take "much" to accomplish many of the goals.

I am a scientist at heart.  In the world of pharmacology there are two phenomenon. One is the Tolerable Upper Limit (TUL), what is the maximum dose of something before toxicity occurs, and the other is the minimum effective dose (MED), the smallest amount needed to elicit a response.  These principles apply to all types of training.  You need to ensure  your training falls between these two levels, and a majority of your training, really only needs to fall in the minimum effective dose range.  Every now and again if you want to test the limits of your upper dose, do so, but it should be an exception, not the norm.

First off, in any strength and conditioning program, strength should come first.  Why?  It makes life easier, because you are stronger.    Physically, you are capable of picking up heavier things or lighter things more often.  Physically, as the more lean body mass you have, the stronger you are going to be at meeting the demands of life, whether that is due to sickness, or some of those other things that life throws at you.  Muscle is a highly metabolic and healthy tissue.  The more lean body mass you have, the healthier you are, and the longer you will stay alive if you even happen to get really sick.

How do you get strong?  A dedicated strength program, ie lifting weights that are heavy for you.  Not lifting light weights or your body weight, over and over and over.  I am not saying to lift the most you can every day all day, because that's extreme, but weights challenging to your bodies current strength.  Personally I like variations in the 2-8 rep ranges.  It may fluctuate depending on the exercise, however, for most this is what I go with.  Now lifting weights may be something you do, and done right, this may be all you need for health.  A simple balanced strength program of pushing, pulling, squatting, hinging is enough. This along with a long walk a few times a week, and some gymnastics balancing/mobility work and many should be are at their MED.

You want a little more?  You want to get your heart rate up?  Sure, but once again, there is a limit.  Don't be Rocky.  Since many of you who follow do some form or another of "CrossFit", and it is a methodology I enjoy when done effectively.  In the old days of CrossFit the norm was KISS.  Simple workouts in design.  Nothing fancy.  The beauty in many of the workouts, and the health benefit, were in the few simple movements, and the short duration or intensity.  The dosage was within the TUL and the MED.  Looking at a typical WOD, lets look at MED.  Round 1 takes 3 minutes, Round 2, takes 3 minutes, and Round 3 takes 3:30.  Basically you are spent after three rounds, as going hard for 9 minutes is a difficult endeavor, and enough really.  Let's say you did Round 4.  Round 4 takes 4:30 to complete.  Lets do one more round which takes 5 minutes.  Is there any benefit gained in those last rounds, as your intensity dropped.  Your MED was attained after round 2, and you were on your way to the TUL and passed it during round 4. Why not just stop after 3 rounds?

Yes, there are people who push themselves to the brink of performance.  Those "Pros" are probably taking years off their life to perform at the level they are now.  We see this in most major sports, guys (and gals) dying young, not too many years after being at the height of their game.  Too much exercise ramps up your body's stress hormones, and long term, overwhelms the system.  The body becomes weak and breaks down.  Injuries can take a hold, and progress halts.  This is even more true if sleep and nutrition suck.  If the latter is true, stress hormones are already jacked up, and doing anything outside of some simple strength and long walks is detrimental and could have you heading straight to adrenal fatigue city via cortisol highway!

If you want to get your heart rate up and a good sweat going, KISS is still where its at.  You don't need a lot of movements for good conditioning.  You don't need a lot of reps. You don't need a lot of complex movements, or any for that matter.  Good coaches know and implement this.  Too many get caught up in more is better, and feed into or eat off of clients perceptions, instead of steering the course of reality.  Smartly programmed workouts have you wanting no more after 5-10 minutes without you having gone 100%.

Here is one of my favorite KISS conditioning workouts.  It is 5 minutes long.  This was done after 18 sets of 2 squats and some handstand holds.  From start to finish my entire training day lasted 25 minutes.  Every minute on the minute 5 DOuble KB Clean and Front Squats with a challenging but doable weight.  With the remainder of each minute hold a push up plank. Try it.  Tell me if you wanted more.

More is not always better, and perception is deceitful especially when it comes to health!

Carbohydrates: performance AND health

The new year brings with it many goals to “lose weight”, well, normally people do mean fat mass but I digress. This has resulted in many gyms/PT’s offering “nutrition challenges” to their clients which tend to promote their own adaptation (miscomprehension) of the paleo diet. Many of these challenges suggest reducing carbohydrate (CHO) intake to extremely low levels and this then affects both health and performance. With this in mind, I want to take some time to discuss the effect that CHO has on health, namely, on immune function. I believe this is timely not just because of the “new years resolutions” but because at this time of the year many of us get ill which affects our training and probably just pisses you off full stop.

1.1 Exercise and Immune Function

The relationship between the risk of infection from a pathogen and exercise has been modeled as a “J” shaped curve. This model suggests that periods of prolonged and strenuous exercise may impair immune function. This exercise-induced immune dysfunction appears to be linked to the immunosuppressive action of stress hormones such as cortisol. It has been suggested that a decrease in blood plasma glucose during exercise leads to an increase in the stress hormone cortisol which leads to a decrease in T-lymphocyte function.

1.1.1 Carbohydrate, Exercise and Immune Function

It is clear that an adequate amount of carbohydrate (CHO) availability is a key factor for maintenance of heavy training schedules and successful athletic performance. Glucose is an important substrate for immune cells because metabolic rates of immune cells are extremely high. High levels of stress hormones such as cortisol and catecholamines (epinephrine, norepinephrine) not only occur during high intensity exercise but also depend on glucose availability. Low levels of blood glucose concentration during prolonged exertion are associated with higher levels of cortisol and epinephrine. The immunosuppressive effects of acute and chronic stress and high levels of stress hormones are well established. Thus, the underlying rationale is that adequate CHO availability and stable blood glucose concentration may limit stress hormone responses, provide glucose as energy substrate for immune cells and help to maintain immunity.

1.1.2. Availability of Dietary Carbohydrate

It has been shown that exercising on a high-CHO diet vs a low-CHO diet leads to an increase or stable blood glucose level. Plasma cortisol levels may be decreased and the post-exercise glutamine level may rise or stays unaffected. A high-CHO diet during times of intensified training for six days may have a favorable effect on immunity.

Training on low levels of CHO availability may raise the magnitude of exercise-induced immune alterations, such as higher plasma and salivary cortisol levels which ultimately leads to impaired performance.

Although limited evidence exists, it should be highlighted that exercising in a carbohydrate-depleted state, results in higher levels of circulating stress hormones, greater perturbations of immune cell subsets and an impaired immune function. Putting this in to context, if you begin to train in a CHO-depleted state you will experience an increased heart rate, you will fail to increase muscle mass as your body will be in a catabolic state and you will have a much greater chance of becoming ill which is detrimental to both health and performance. Keeping the muscle and liver glycogen stores full is therefore a crucial factor.

So, if you want to be able to optimise your training and remain healthy for as long as possible this year then do not exclude CHO from your diet. CHO is the fuel for athletic performance and immune system health.

References

Gillis, S., Crabtree, G., & Smith, K. (1979) Glucocorticoid-induced inhibition of T cell growth factor production. Journal of Immunology 123: 1624-1631.

Krzywkowski, K., Petersen, E., Ostrowski, K., Kristensen, J., Boza, J., Pedersen, B. (2001). American Journal of Physiology and Cell Physiology. 281(4): 1259-65.

Nieman, D. (1998) Influence of carbohydrate on the immune response to intensive, prolonged exercise. Exercise Immunology Review 4: 64-76.

Parrillo, J., & Fauci, A. (1979). Mechanisms of glucocorticoid action on immune processes. Annual Review of Pharmacological Toxicology 19: 179-201.

Jeukendrup A.E., Gleeson M. Sport Nutrition: An Introduction to Energy Production and Performance. 2nd. Human Kinetics; Champaign, IL, USA: 2010.

Walsh N.P. Exercise, Nutrition and Immune Function. I. Macronutrients and Amino Acids. In: Gleeson M., editor. Immune Function in Sport and Exercise. Advances in Sport and Exercise Science Series. Churchill Livingstone Elsevier; Edinburgh, UK: 2006. pp. 161–181.

Nieman D.C. Exercise Testing and Prescription: A Health-Related Approach. 7th. McGraw-Hill; New York, NY, USA: 2011.

Burke L.M. Fueling strategies to optimize performance: Training high or training low? Scand. J. Med. Sci. Sports. 2010;20:48–58. doi: 10.1111/j.1600-0838.2010.01185.x.

Nieman D.C. Immunonutrition support for athletes. Nutr. Rev. 2008;66:310–320. doi: 10.1111/j.1753-4887.2008.00038.x.

Nieman D.C., Pedersen B.K. Exercise and immune function. Recent developments. Sports Med. 1999;27:73–80. doi: 10.2165/00007256-199927020-00001.

Walsh N.P., Gleeson M., Pyne D.B., Nieman D.C., Dhabhar F.S., Shephard R.J., Oliver S.J., Bermon S., Kajeniene A. Position statement. Part two: Maintaining immune health. Exerc. Immunol. Rev. 2011;17:64–103.

Nieman D.C., Henson D.A., Smith L.L., Utter A.C., Vinci D.M., Davis J.M., Kaminsky D.E., Shute M. Cytokine changes after a marathon race. J. Appl. Physiol. 2001;91:109–114.

Calder P.C. Immunodepression and Exercise: The Evidence & an Evaluation of Preventive Nutritional Strategies; Exercise and Immunity in Athletic Performance and a Healthy Life, Proceedings of the 10th ISEI Symposium; Oxford, UK. 11–13 July 2011; Invited Speaker Presentation #7

Mitchell J.B., Pizza F.X., Paquet A., Davis B.J., Forrest M.B., Braun W.A. Influence of carbohydrate status on immune responses before and after endurance exercise. J. Appl. Physiol. 1998;84:1917–1925

Gleeson M., Blannin A.K., Walsh N.P., Bishop N.C., Clark A.M. Effect of low- and high-carbohydrate diets on the plasma glutamine and circulating leukocyte responses to exercise. Int. J. Sport Nutr. 1998;8:49–59

Bishop N.C., Walsh N.P., Haines D.L., Richards E.E., Gleeson M. Pre-Exercise carbohydrate status and immune responses to prolonged cycling: I. Effect on neutrophil degranulation. Int. J. Sport Nutr. Exerc. Metab. 2001;11:490–502.

Bishop N.C., Walsh N.P., Haines D.L., Richards E.E., Gleeson M. Pre-Exercise carbohydrate status and immune responses to prolonged cycling: II. Effect on plasma cytokine concentration. Int. J. Sport Nutr. Exerc. Metab. 2001;11:503–512

Costa R.J., Jones G.E., Lamb K.L., Coleman R., Williams J.H. The effects of a high carbohydrate diet on cortisol and salivary immunoglobulin A (s-IgA) during a period of increase exercise workload amongst Olympic and Ironman triathletes. Int. J. Sports Med. 2005;26:880–885. doi: 10.1055/s-2005-837467

Training: Health vs Performance and Optimal Oly's

With there being a clear distinction between training for health and training for performance, it is necessary to examine some of the types of lifts, especially some of the lifts which carry a greater risk to benefit ratio, in light of this distinction.  The Olympic lifts are fascinating, fun and exciting movements, to watch being executed eloquently.  They also are fascinating, fun and exciting to perform, eloquently. they require tremendous strength, power, coordination, body awareness, and mobility.  But are they, or should they be, a necessary component of a training regimen for health, and/or performance.

Let's tackle the performance issue first.
Your goal is to compete in the American Open in Weightlifting. Yes.  You need to train the Olympic Lifts, in all varieties and all facets.  You should work on drills to enhance mobility in the shoulders and hips, you should work technique, the whole gamut.  For a person whose performance related goal is the American Open, or any weightlifting tournament, an Olympic Lifting regimen is necessary.  Benefit > Risk

Your Goal is to Compete in a "CrossFit" type event. Yes.  You need to train the Olympic Lifts, in all varieties and all facets.  Whether I personally agree with High Rep Oly lifting is another blog post, however, there are certain precautions and necessities one should take before performing high rep Olympic weightlifting.  You should work on drills to enhance mobility in the shoulders and hips, you should work technique, the whole gamut.  You need to ensure you have technical proficiency of the lifts and full mobility to complete the lists before any volume and/or "going for time" is added to the equation.  If these are not ensured, there is an huge increase in the risk.  Personally, for any CrossFit Athlete, I would tend to make sure that technique is solid during all Olympic lift strength work before adding Olympic Lifts to a WOD, and even then the volume needs to be monitored, along with the weights used and the two balanced (i.e. Prilipen's Chart).  Total reps more than 10-15 should be based on percentages of Max.  I would tend to lean on the side of re-setting fully on consecutive reps, as you want to make sure you build solid motor mechanics of every facet of the lift as well as minimize risk.  The issue when you bring volume and time into the equation, and is typical for a Crossfit Athlete, as you fatigue and as you try to go faster, proper form and technique slide, and the muscle memory that is built around this sloppy form takes longer to correct, when you slow the tempo and the volume down.  This is why making sure technique is flawless is the foremost priority.  Olympic lifts appear in all levels of CrossFit competition.  If you are set on being a CrossFit Competitor, you need to train these lifts, however, you need to ensure proper technique before you try to go as fast as you can.  Benefit>Risk

Your Goal is to compete in some other sporting endeavor. Not Necessarily.  Most sports require you to be forceful and powerful.  Do you need to train the Olympic Lifts for other sporting endeavors like Hockey, Soccer, Basketball, Rugby or Football?  Yes, but not the full Olympic lifts.  I think the power varieties, work just as well, and even more so, the Hang/Mid Thigh Varieties if explosive power through the hips is wanted.  First off the power varieties carry less risk than the full Olympic movements, and this is important as you do not want to lose an athlete from playing on the field due to an injury in the weight room. Paul Comfort authored a few papers the past year in the Journal of Strength and Conditioning Research where he showed that if you are training to maximize power, that mid thigh power cleans and mid thigh clean pulls were the most advantageous versus the full movement, and even the hang movement.  The other benefit of these movements, are that mid thigh clean pulls and mid thigh power cleans also have an easier learning curve. You also do not need to worry about any other issues, like lack of mobility in selected joints.   Comfort also showed that as you increased weight, you reduced the peak power and velocity of the lifts, however, you increased the amount of force generated.  To maximize both force and power, training at 60-80% of 1RM loads is the most advantageous. Benefit>Risk when dealing with Power Varieties, Risk>Benefit for full movements

Non-Performance Based Goals
Your goal is to be healthier, stronger, fitter, more powerful in your everyday life. No.  In a person training for general health is it necessary to perform full Olympic movements?  I tend to believe not.  Is the mobility that an Olympic Lifter good for general populations, yes, it is good to have full range of motion in all planes, but mobility is required for Olympic lifting, but Olympic Lifting is not required for mobility. Mobility means your joints are healthy.  As mentioned previously, there is risk associated with Olympic Lifting. In a person training for health, the idea is to minimize risk, as they are coming to "the gym" to be healthier, and if they get laid up with an injury, they all of a sudden are not as healthy as they were, and are also unable to come to the gym.  Power generation is important in all populations however.  The ability to generate power and force through the hips allows daily tasks to be easier.  As mentioned above, Comfort's studies showed that utilizing easier lifts from the mid thigh and hang positions, generate substantial amounts of power.  These lifts also have the benefit that they require less instruction, have a faster learning curve, and are relatively safer compared to the full Olympic movements.  If having the ability of generating power is what is needed for health, why then risk health, by adding in highly complex technical movements that require precision and coordination? I don't feel it is necessary.  I don't even want to discuss adding high volumes of reps, going for as fast a time into the equation. Risk>Benefit for full Olympic movements

You Can't Handle the Truth, or Can you?

I like using case studies when I can to illustrate points, as it helps to give people some perspective as many look at ways they can relate to others, and others goals.  In the previous post, Dan discussed the importance of goal setting.  Goal setting is important whether training for health and longevity or for performance.  I think it is equally important for a coach to not only impose concrete, tangible goals for their athletes, but to also discuss the implications of those goals.  Normally I am posed questions from athletes, well whenever I am posed a question from anybody for that matter, I unfortunately give them a truthful answer.  A flaw of mine is I tend to be blunt, and don't sugarcoat much, but science tends to do that, and besides sugar is toxic!  Many times, the answer is not necessarily the response wanted. (sidenote: if you cannot handle a potential answer to a question, don't ask the question!)

Now many people associate positive health with running.  Many tend to think the more they can run, the better, or the healthier I am.  For the record, I am not opposed to running, however, the running like all exercise needs to be properly dosed for the person, and based on recent evidence, within 5-19 miles a week for a distance runner for optimal health, over this window, leads to increased morbidity.  Personally, and in terms of taking a anabolic vs catabolic look at building lean muscle mass, and building a badonkadonk, sprinting is a much better alternative than distance.

Since many people like to run, and not just from the police, I am going to discuss two similar but different cases.  Ryan is a 30 year old single male, former collegiate runner, who works full time, and who for the past few years has taken to running longer distances, yes, hold your breath, wait for it, wait for it, the marathon.  Ryan has a performance related goal of trying to qualify for the Boston Marathon.  First things first, I acknowledge Ryan's goal, and discuss with him the fact that this is a performance related goal, and discuss that training for performance is not necessarily going to expand his lifespan or enhance health.  I go over how running long distances is extremely catabolic to the body, it raises cortisol levels, and studies show that the longer distances people run does not equate to longer longivity, actually the opposite.  I want to make sure he understands fully.  I also acknowledge the fact that this is a "short" term goal, as he will know in four years if he has attained this goal.  The other thing is that Ryan does not see this goal as a  lifelong goal, and that after the next few years the need to want to run long distances will probably wean.

From a health and longevity standpoint, he is still young, and after the next couple of years there should be plenty of time for any damage to his heart to repair itself (hopefully), as the heart is a dynamic and resilient organ.  Now that we have a performance related goal, we can assess his starting point, and start a strength program designed to supplement his running, and other desires.  We can also start discussing lifestyle modifications to enhance his health, as well as his performance, in the pursuit of this goal.

The second case is one of Amanda.  Amanda is a 32 year old, married mom, who also has a full time job, and is looking for overall fitness and well-being.  Luckily she does not work third shift, and most nights gets 8 hours of sleep.  Within her goal for overall fitness she also has a performance related goal which she wants to work towards.  That goal is to run a sub 20 minute 5K withing the next 6 months.  Now is this goal feasible in terms of health and longevity? Yes.  The amount of mileage necessary  to be an efficient 5K runner, is generally within the 5-19 mile weekly range mentioned above.  A proper strength and conditioning program should fall well within this range and closer to the lower end as more interval work at lower distances can be utilized.  In terms of intensity of the work needed to meet this goal, that brings about another issue in terms of health.  To meet this goal, Amanda probably needs along with strength training, four to five bouts of high intensity metabolic conditioning a week, whether in the form of interval running, Interval work with weights, a la "CrossFit" style, etc.  Being in her 30's, this amount of work I would think is okay.  If she was 10 years older, or did not get adequate sleep, or worked an overnight job, the amount and type of work needed for her performance related goal may need to be re-worked, as it might not be something that was within the confines of training for health and longevity.  Now that her goals are determined, we can now assess her starting point, and start a strength and conditioning program to help her meet those goals.

While having goals is important, it is also important that no matter what the goal is, don't let the goal be the end all, and the only focus.  Enjoy the journey along the way to the realization of your goals.  Take time to stop, and enjoy the view.  Regardless if the goal is attained or not, if you look back from where you started, to where you end, progress will have been made, if you made a concentrated effort at meeting what you had set forth in front of you.