Tuesday, July 29, 2014

Got Wrist Pain? How to Identify and Avoid Carpal Tunnel Syndrome

 
As an orthopedic hand and wrist surgeon, I have the opportunity to take care of a wide variety of athletes from various realms of competition. Recently, I have noticed a trend among my patients, primarily those who engage in heavy weightlifting and bodybuilding. These individuals, both men and women, appear to be developing carpal tunnel syndrome at an alarming rate. 
 

How to Identify Carpal Tunnel Syndrome

It is clear these athletes are committed to the sport of weight training; however, their bodies are rebelling in a not-so-subtle way with the development of carpal tunnel syndrome. Carpal tunnel syndrome itself is a compression of the median nerve of the wrist (pictured below) and unfortunately, this compression causes numbness, tingling, pain, and a debilitating lack of grip strength and dexterity. 

Monday, July 28, 2014

Cancer survivors who lift weights survive longer.

 http://www.ncbi.nlm.nih.gov/pubmed/24958698

 

The Effect of Resistance Exercise on All-Cause Mortality in Cancer Survivors.


Abstract

OBJECTIVE:

To examine the independent associations of leisure-time aerobic physical activity (PA) and resistance exercise (RE) on all-cause mortality in cancer survivors.

PATIENTS AND METHODS:

Patients included 2863 male and female cancer survivors, aged 18 to 81 years, who received a preventive medical examination between April 8, 1987, and December 27, 2002, while enrolled in the Aerobics Center Longitudinal Study in Dallas, Texas. Physical activity and RE were assessed by self-report at the baseline medical examination. Cox proportional hazards regression analysis was performed to determine the independent associations of PA and RE with all-cause mortality in participants who had a history of cancer.

RESULTS:

Physical activity in cancer survivors was not associated with a lower risk of all-cause mortality. In contrast, RE was associated with a 33% lower risk of all-cause mortality (95% CI, 0.45-0.99) after adjusting for potential confounders, including PA.

CONCLUSION:

Individuals who participated in RE during cancer survival had a lower risk for all-cause mortality. The present findings provide preliminary evidence for benefits of RE during cancer survival. Future randomized controlled trials examining RE and its effect on lean body mass, muscular strength, and all-cause mortality in cancer survivors are warranted.

Thursday, July 24, 2014

Muscle mass extends life expectancy

If you do heavy physical work or weight training, you'll not only make your body more muscled and stronger, but you'll also make it last longer. Muscle mass extends life expectancy write researchers at the David Geffen School of Medicine in the American Journal of Medicine. 

Read More at http://www.ergo-log.com/muscle-mass-extends-life-expectancy.html 

Wednesday, July 23, 2014

Training, Recovery, and Nutrition for the 40+ Runner

As a runner in my mid-forties, I’m beginning to notice a slight decline in my recovery ability and a more pronounced awareness of general muscle and joint pain. This time last year I felt as good as I did in my thirties (or at least I think I did), but now I feel that more visits to my massage therapist are in order.
The effects of aging on muscle function are different for each person, depending on other factors relative to your lifestyle, as well as genetics. But medical research has shown that in general a gradual loss of muscle function occurs, due to a decrease in both the number and size of muscle fibers. These changes may directly affect our ability to run by decreasing our endurance capacity and our overall strength and balance. The good news is that we can minimize the rate of decline by continuing to run (in a modified manner) and by giving our regular training routine and lifestyle a bit of an overhaul.

Switch to a Quality Over Quantity Mentality

Consider reducing the amount of time you spend running and then add value to your workouts by making each one purposeful. In other words, don’t just run to add miles to your weekly training log, but ascribe to each run a specific objective.  
For example, include in your weekly run schedule one HIIT (high intensity interval training) workout, one easy-paced mid-distance run, one tempo run, and one long run. You can also take advantage of the various pace calculators available online and use them to determine specific training paces for any upcoming race goals you might have. Here are a couple of pace calculators you can use:

Learn to Love Strength Training

One of the bonuses of reducing your overall mileage is that it opens up extra windows of time to dedicate toward strength training. Too few runners give credence to the value of strength training and then wonder why they repeatedly suffer from injuries.
Doing a few strength exercises two or three times a week will help to keep injuries at bay by avoiding imbalances in overall muscle strength. Furthermore, stronger muscles improve running efficiency by enabling you to maintain good form when the body starts to fatigue. And of course, greater muscle strength may help you to run faster and longer. A few strength-training resources you might find useful are:

Do Exercises in All Three Planes of Movement

There are three planes of movement: sagittal, frontal, and transverse. Movements in the sagittal plane are back and forth, while movements in the frontal plane are side to side, and movements in the transverse plane are rotational. Runners tend to spend a lot of time exercising in the sagittal plane but neglect to do any exercises in the other two planes. This often results in muscle imbalances that can weaken your ability to move and run.  
One of the best warm-up routines I’ve seen, which incorporates dynamic movements in all three planes, is Gary Gray’s lunge matrix. It is demonstrated in the following video clip by coach Jay Johnson:
  

Monday, July 21, 2014

from http://www.runnersworld.com

by Alex Hutchinson




There are lots of interesting theories out there about how to train better and race faster; I write about them on a regular basis. But it's important not to get so wound up in theoretical discussions that we forget to take a look at what the most successful athletes are actually doing in real life. There's been a push recently from sports scientists to get more field data from top athletes published and into the public domain, which is a great development. Along those lines, there's an interesting new study from Norwegian researchers in PLoS ONE that analyzes the training of 11 Olympic and World Championship gold medalists in XC skiing and biathlon. Specifically, they look at exactly one year of training for each athlete, culminating in that athlete's greatest triumph. In other words, it's a study of exactly what those athletes did when they got everything right.
There's a ton of interesting stuff in the paper, which is freely accessible to read – it's worth a look if you're interested in how to plan and periodize endurance training. Some of the details are specific to skiing – e.g. on average, the 11 athletes trained for 800 hours in 500 sessions in the year leading up to their championship race. That's a detail that can't be readily transferred to other sports with different muscular demands: as the study notes, top runners tend to train "only" ~500 to 600 hours per year. Interestingly, there was a trend over time suggesting that athletes are training harder (or at least more) than they used to. The subjects won their gold medals between 1985 and 2011; the more recent the championship year, the greater the training volume they were likely to do (but in the same number of sessions).
Another pattern: about 90% of the training time was below lactate threshold, while 10% was above. This is fairly consistent with previous studies of elite athletes, which tend to show around an 80/20 split.
The most interesting contrast between training theory and practice is in the taper. There have been lots of studies on how to taper, and several common pieces of advice emerge from those studies: taper for about two weeks; drop your volume by 40-60%; maintain training frequency and intensity; and so on. In practice, here's what the tapers looked like:

The key difference is that these athletes weren't able to focus all their attention on tapering for a single race. Instead, they had to bring down their volume by 24% (on average) six weeks before the championships in order to compete in key World Cup races. From there, in the final two weeks before the championship, they only dropped another 9%. This is the reality of competing on the circuit. Is it optimal? Who knows, but when coaches are planning training they have to take these scheduling issues into account.
There are some other interesting points that emerge when you look more closely at the taper (which you can see in Figure 7 of the original paper). For example, many athletes took a rest day between 12 and 6 days before the championship, but only 3 of the 11 athletes took a rest day in the last five days before the race. In contrast, 10 of the 11 athletes did a high-intensity interval session within 48 hours of the championship final. The picture that emerges (which, as it happens, is consistent with theoretical models of how to taper) is that you get maximally rested up a week or so before the competition, rather than right before the competition, then ramp your training back up in the final few days to make sure you're in the rhythm and not rusty.
Anyway, those are a few highlights – as I said, if you're interested in this stuff, it's worth checking out the original paper. After all, these are the people who got it right.