My First Marathon A-Ha

I've always been a vocal opponent of endurance training. I mention things about stress fractures, lowered testosterone in men, lowered thyroid function in women, blah blah blah.

Then I read a quote in a book from Brian MacKenzie when asked if endurance sports were good for you:


“Good for you physically? No. But you’ll recover. And I assure you: if you run 50K or 100 miles, when you finish, you won’t be the same person who started.”

That certainly made me stop and think.

Athletes at the competitive age aren't exactly the epitome and sanity and health. We push ourselves further than conventional wisdom or even science would say is smart.

However, irregardless of what direction your competitive spirit takes you, it will change you.

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If you're an endurance fan, save your joints, muscles and mobility by checking out Brian MacKenzie's new book Power Speed Endurance: A skill based approach to endurance training.

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Ferriss, Timothy (2010-12-14). The 4-Hour Body: An Uncommon Guide to Rapid Fat-Loss, Incredible Sex, and Becoming Superhuman (Kindle Locations 7978-7979). Random House, Inc.. Kindle Edition.

Physical Therapy Post Shoulder Scoping

My first session was pretty anti-climatic. The therapist was mostly getting an idea of what I had done in surgery, and what my goals for therapy would be plus sending me off with some rehab work to do while I was in Texas.

During my initial assessment, the PT noticed that I was a little more forward in the shoulders at rest than ideal, but more obvious, my shoulder blades "wing" out. That's usually indicative of being tight, but further movement analysis, he determined my problem is hyper mobility. I have A LOT of movement in my shoulders. Have I shown you how much my elbow bend backwards?

So my rehab apparently won't be focusing on creating mobility, but creating stability. And apparently, that's a lot harder.

And with a new ortho surgery, there aren't exactly a lot of weights I can do right now.

For my trip to Texas, my PT had me take a pulley system to work passive range of motion:

Not me. Too lazy to set up the camera. 

I do something like this working range of motion over head in front, to the side, and behind. I also use a pipe or stick of some sort to work rotation while laying down.

This time, I'm doing more activating work and stabilizing work:

So hard core. 

Apparently, the fact that I can do the above movement on my surgerized shoulder came as a surprise to him today, two weeks after surgery.

As for real training, nothing that puts weight or stress on the shoulder yet. No sprints, no hand weights, no barbells. Weight vests are okay, weight belts are okay. Running stairs/ stadium seats should be fine. I'll figure something out with that. Le sigh. 

He didn't really tell me what to expect or timeline it out for me. This is gonna be emotionally rough. 

More Kettlebell Swing Cues

Kettlebell swings are awesome! And you can bet your ass that once I'm cleared to start working with weights again, I'll be HIIT training with some kettlebells like a fool.

There are a lot of articles out there already talking about proper form and things to avoid when doing swings. I recently attended a kettlebell seminar at a NSCA coaching clinic and want to add my two cents for cues and drills that made a lot of sense to me and I started using immediately afterwards.

First though, I'd like you to read the following article and watch the embedded video:

5 tips for a better kettlebell swing

What I see most often is what you see as the first example in the Good/Bad Swinger video. Squatting means your hips only minimally move front and back, mostly up and down, and that isn't going to produce the momentum on the bell you want.

1) Keep your shins vertical. Any squatting movement will cause your knees to move forward and mess up this vertical shin position. Think more like you're about to do a box squat or a Romanian deadlift, where you sit back and simply unlock your knees.

2) Don't let the kettlebell swing below the knees. I see this a lot, too. A person who gets the knees back cue suddenly starts letting that kettlebell pull her over and the bell just skims the ground. You control the bell, not the other way around.

3) Keep the kettlebell close to your naughty bits. In addition to not letting it pull you over, the closer the bell is to the fulcrum, in this case your hips, and this will be the most powerful place to fire the bell from for the next swing.

4) Pull the kettlebell back down from the top of the swing. Don't just rely on gravity to do the work, get your lats and abs involved and bring that sucker back down to your naughty bits!


Side Note: The seminar also went over the Turkish get-up, but with my shoulder being jacked, I wasn't able to participate in that one.

WellnessFX: Second Test, 10 months later

ManFriend and I had our retest done by WellnessFX, about 10 months later. And I have to say, I was disappointed.

Not with the service, mind you, but with my results. After our last test (found here) you can see that there was a lot of work to be done. While my HDL and LDL ratios were great, and my glucose sensitivity was great, my total LDL and breakdown left something to be desired.

After that test, ManFriend and I went Paleo and cyclic keto. I went from having pancakes for breakfast 2-3 times a week, to maybe having pancakes once a month as a treat. I mean, we really cleaned up, but my second test LDL levels don't show that.

The ones where I don't have a mini-graph are newly tested this time around. So you can see that, with the exception of LP(a) everything stayed pretty much the same, within 2 point of the first test. Everything I've read, everyone I've talked to, other people who've had the tests, they go Paleo, or just lower carb, and these numbers get better like magic.

So it was onto the consult. The consulting MD did point out that my LP(a) went down significantly, and that's a really tough one to bring down. She thinks that the change in LP(a) is due to our change in diet. But she brought my attention to this other non-change:

This is my Thyroid Stimulating Hormone (TSH). Notice that from the first test to the second test, it got worse, as in further away from the ideal range. Before, the MD consultant told me that it was borderline enough that it could be chalked up to test variability, but this kind of precludes that.

My first order of business will be to get tested for antibodies against my thyroid and T3 and T4 hormones. If my thyroid is off, that would explain why when I change my diet, my LDL levels are basically untouched. And on another note, it would also explain why I tend to have a harder time losing body fat than I did as little as two years ago.

My mom is on thyroid medication, could be familial.

What s nice to see, though:

My white blood cells and neutrophils went from "high risk" to "low risk", which I was told last time was an indicator of adrenal fatigue. I've made a concerted effort to lower my caffeine intake, stress levels, and figure out ways to sleep better. It's good to see that something is paying off! Yay for better immune system!

I still have a few indicators that adrenal fatigue is an issue albeit a lesser one. This MD consult basically told me that she hasn't come across a competitive athlete that DIDN'T suffer from some level of adrenal overload. I suppose that also pulling back my focus on competition has helped a little in that regard.

Big take-aways from this consult:

0) Get thyroid follow up labs!!!1!1one
1) Eat. More. Veggies! Eat a GD salad! I love a good salad!
2) B12, fish oil, Vit C, Zinc, Vit D3 supplements
3) Suggestion to take up meditation or gentle yoga for adrenals. I wonder if the dance classes I want to do will count?

Things that ManFriend and I have discussed doing better:

- Cooking at home. Maybe we're falsely comforted by out eating out, and there is more sugar and gluten in sauces and curries than we think.
- More looking at techniques to help me sleep deeper and longer.
- Looking for ways for us to relax together outside of becoming zombies infront of our projector.

MY Spent Genetics: Part 2

Went to the doc on Monday, Dec. 17, five days after my bone spur was removed. He went through what they did, showed me the before and after images from the scope camera. He then talked about the tendon damage I had.

On the left is my jagged, nasty bone spur. On the right is the smoothed out, yet raw, bone. 

When he injected the enriched plasma, he could see the tendon puff up. A normal, healthy tendon would be too solid to puff up like that. This indicated that I had internal shearing damage to my tendon, in the back of the socket.

This is the tendon post injection. Notice how poofy it kinda looks?

He also showed on my MRI how my right and left tendons are basically symmetrical in location and extent of damage.

Left Shoulder: Notice how the tendon on top of the humerus is dark?
That means the tendon is solid. 

Left Shoulder: A more posterior image, and now the tendon is light?
That means water is in the tendon, indicating damage. 

This damage is indicative of over development of delts and pecs with a lack of support and control around the shoulder blades. This happens because (1) humans are never perfect or symmetrical and any sort of athletic endeavor will showcase these imperfections and (2) poor mechanical coaching and technique correction means the imbalances continue to build up and increase the resulting impingement.

That's my story. The bone spur, sure, could have been due to falling repeatedly on my shoulder as a judoka. But the tendon damage in BOTH shoulders is independent of the bone spur. Let's take another look at a snatch photo from about 1.5 years into my Olympic lifting training:

What to notice:
- internally rotated soulders
- huge delts
- relaxed upper back (and therefore, relaxed structures around the scapula)

Now take a look at this:

Can you tell how I'm also catching it "high" in my shoulders and delts, rather than supporting it through the skeleton. Active shoulders shouldn't mean pushing up through the delts, but supporting your shoulders in the back, around the scapula. No wonder I couldn't catch in a full squat. Everything about my lifts back in the day screamed "forward!"

Also notice my knees rolling in. But whatever.

So to sum it up, I spent my genetics on poor lifting form.

I lifted poorly. Got muscle strong faster than my tendons and ligaments could keep up with (that's some other damage my doc pointed out). And never took the time, even after correcting my lifting form, to back off and fix my muscular imbalances. These imbalances will continue to cause issues in the same fashion, irregardless of technique, because I've let it go so far.

So this physical therapy will definitely be part of the reset button for me. And hopefully a warning sign for the rest of you who have a "did I make the lift/ did I not make the lift" mentality.

Spending Your Genetics: What does that mean?

Kelly Starrett of MobilityWOD uses a phrase that I LOVE at the start of most seminars: Spending your genetics.

What on earth does that mean?

It's the old way of dealing with our top tier competitive and professional athletes. The process of becoming elite (however you define that) is usually a sieve that filters for people who have a high pain threshold, tough physicality and mentality, and are exceptionally strong, fast, and enduring.

Athletes have a short career length, typically when they come out the other end, they are all crooken, battered, and broken. It's said that a retired judoka has at least 5 joints that have chronic issues. (I guess I got out early since I only have two.) The mentality has been that, well, that's the cost of high level competition, and the training that goes into making the best ever better.

Dr. KStar whole heartedly disagrees.

The problem with athletics in general, and you see this a lot in CrossFit though it's not exclusive to it, is there is a focus on the end result. Did you make that goal? Did you make the lift? Did your opponent tap out? But what goes on with the mechanics of reaching those end results are often overlooked and that is where the dysfunction often leads to injury down the road.

So spending your genetics means that you're basically allowing your body to make adaptations to poor mechanics. Those adaptations always come as a cost which will present itself down the road. These genetic outliers are able to hold out for a bit longer than most, but they're still just "spending their genetics."

Let's say you're a basketball player. Basketball requires a lot of agility, toe turns and lateral shuffling. You also see quite a few knee and ankle injuries in basketball. When you're doing a quick pivot using either a toe or heel plant, it's pretty common for a person to let their knees roll in. Now, if you're also allowing the same basketball player to do plyometrics, squats, and lunges with a collapsed knee and ankle, you're only reinforcing bad mechanics and ignoring musculature and movement that would be protective on the court.

BAM! Knee blow out.

You see the same phenomenon in nutrition. The body has amazing ways to buffer and patch bad nutritional decisions. You don't get insulin resistant diabetes because you're older now. You got it because you made poor food choices for many years, your body had to continually make biochemical accommodations and now it's caught up with you. There are no more accommodations to make.

Think about that the next time you say "I can eat whatever I want and I don't put on weight." It's not always about weight. It's often about the biological adaptations your body has to make to allow you to continue on your way.

The same argument can be made for rheumatoid arthritis, psoriasis, heart disease and a number of other medical issues that are linked back to an over active immune system and high carbohydrate diets.

In fact, many things that are associate with old age can be attributed to this "spending your genetics" way of living that most of us do. Think about this next time your coach cues your technique and you want to "not hear" them...

Now the Rehab Begins: Surgery Story Part 2

Me with my anesthesiologist, Dr. ....

What a strange experience!

And just so you know, this post has been typed with my left hand, so all missed spelling errors can be attributed to that.

And I'm also taking percocet, so any confusion or in-congruencies can be attributed to that.

Prep, of course, starts the day before. And because I'm lucky enough to have a boss like KStar, I get some inside information on getting me healing process started off right. He gives me instructions on how to use the H-Wave machine, how to adjust my sling for better lymph circulation, and what to look forward to in the first week and after.

Also, his explicit instructions to eat super, low carb Paleo clean. "But I just bough two bags of Milano cookies for tomorrow!" I whine. I get an eye roll and am told to eat them now.

DAY OF!

You're STILL taking pictures of me??

I felt very taken care of going into surgery. You can see a pic of me with me my anesthesiologist above right before the nurse put my IV in. Once the IV is in, I get to walk to the surgery room, which has a cross shaped bed that I lay down on. They give me some medicine to calm me down as they test out the nerves they'll need to block. I feel my arms and muscles in my side and back twitching, then...

... I'm waking up in a chair in the patient recovery room.

Coming out of anesthesia for me was like waking up to a bad hangover, minus the pain. The foggy head, the exhaustion, the lethargy, feeling like my limbs were made of lead. There were nurses all around doing this and that, the anesthesiologist came by. I'm told my orthopedist came by. I was being given instructions, to which I would just close my eyes and try to defer their attention to ManFriend.

Eventually I was wheeled out and helped into our car to be taken home. It was still light outside.

For the first week, I have to keep it pretty chill. After all, it is raw bone in there. So no training (duh), no overhead (duh). What I found interesting is the insistence on using the prescribed pain medication. Reasoning being that when someone feels pain, the subconsciously tense up against it and will create all kinds of adhesions over time. And while when I wake up it's really not so much painful as just tender and sore, I guess I'm just going to take my percocet and be dizzy for a week or so.

And I have all these contraptions:

The top pic is of an H Wave machine that stimulates the muscles. This is helpful for two reasons: 1) muscel contraction is what drives the lymphatic system and will keep swelling down and 2) you want to start the muscles contracting as best as you can post surgery so that the scar tissue fibers align themselves in a way that won't cause mobility issues down the road. 

The bottom two pics are of a cold therapy machine that they brought to my house and set up on me while I was still pretty out of it on percocet. Just another way to keep inflammation down. 

Side note: In my current situation, where the trauma isn't that great, I'm with KStar on the movement and compression to keep swelling down. Just as a tell athletes to avoid ibuprofen, icing also blocks prostaglandin production and while there are "good" and "bad" prostaglandins in terms of muscle recovery, blocking all of them will only stunt your growth. I've been sleeping and napping in the H wave device, and using a compression sleeve and squishy therapy balls for my arms otherwise. 

Monday I see the surgeon and he'll check me for any infection and see when I can get my stitches taken out. I should also be having my first physical therapy session on Monday, so I can get the exercises that I can do while in Texas to start the path back to lifting again. 

I'm getting shoulder surgery! Part 1

I've had shoulder pain for a long, long time. I would say that it started about 8 months into my training as a competitive Olympic weightlifter. Now, I can't fully blame Oly lifting, as I've beaten my shoulders up pretty well between judo, capoeira, and rock climbing, but I suppose my training as a weightlifter was the final straw. Or probably the final bale of hay.

Notice the internally rotated shoulders? Pull internally rotated  = catch internally rotated.
Also, notice Diane in the back corner? Hi, Diane! 

When they first started hurting, my knees and back were hurting a lot, too. At that time, I was taking 12-16 ibuprofen a day so that I could train at the intensity my coach at the time demanded of me. When I switched coaches and had some technical issues cleaned up, my back and knees stopped hurting after a few months (not a miracle, just good coaching), but my shoulders never really got better.

By this time I had stopped taking all the ibuprofen, for fear I was either eating away at my stomach lining, muscles, or destroying my liver and/or kidneys. So every missed or off-perfect snatch sent stabs of pain through my shoulders. This is when it really started affecting my training. We pretty much start every practice with snatching, so if it was a "bad day" (and I don't know what snatching without any pain is like) then my morale would be so low that I just couldn't muster much gusto to go after the clean and jerk. My lifts suffered. My squat suffered. Maybe my deadlift was the only thing that didn't suffer since deadlifting is a sort of joy to me.

After over a year of my coach, teammates, and boyfriend imploring me to get my shoulder looked at by a professional, I finally did. This is what they saw:

Okay, so I suck at reading MRI images. Above is just my favorite picture of my right shoulder. That's my freakin' bone! How cool is that?? We're LIVING IN THE FUTURE!

So on Wednesday, Dec. 12, I go under to have my bone shaved down and a possible suture in my rotator cuff, plus some plasma enriched injections to assist with healing.

The reactions I get from people tend towards the "I'm so sorry to hear that!" I want to be like "NO! You don't get it! This is a relief!" I see this as a reset button. After scheduling the surgery I was taking stock of all the things I do to accomodate my discomfort and pain:

- I can only do push up with my arms and elbow right by my side.
- I have to set my shoulders and scapula back just to pick things up out of the back of my car.
- I do a little jerk prep to get clothes off over my head.
- I physically cannot muscle snatch a PVC pipe or do normal port de bras (ballet arm position exercises).
- I have to put on jackets or back packs carefully.
- The other day I couldn't even demo a bench press at 53 lbs.


There are very few things I can do without at least a modicum of forethought. I have slowly, as the discomfort finds it way into more movements, changed my routines and habits to avoid it.

This is a new start.

Me, after surgery. 

Pose Running vs. Sprinting

Yes, another post on "is sprinting Pose running?"

I think that some people say that, yes, sprinting is Pose running either due to the parallels during parts of the sprinting phases, or because they have a broader definition of what falls under Pose running than myself or other that disagree would say.

Pose Running

Pose running, to boil it down, is a technique that maximizes biomechanical efficiency to help a person run as far as they can as quickly as their conditioning will allow. Some technical aspects of Pose running include:

- a bod lean that draws a line through the head, hips, and ball of foot where the final push off the ground occurs.
- a forefoot landing under the runner's center of gravity
- no twisting at the waist or shoulders, and minimal bouncing of the head

Also occasionally called "Chi Running"

In endurance running, you're typically solving for distance first (have to finish!), then speed. Then there is sprinting...


Sprinting

Conversely, with sprinting, you're looking at going as fast as you can for as far as your can. While, no one needs to worry about finishing a 200 m run, if you can delay slowing down after hitting top speed as much as possible, well, that's where a sprinter's "endurance" comes into play. But that's neither here nor there.

Sprinting can be broken down in multiple different ways, but the way I like to break it down is the following: 1) Drive phase 2) Continued Acceleration 3) Maximal Speed 4) Delaying Deceleration

The drive phase is the most recognizable in a pose sense, you have the push off directly in line with the shoulders and hips. The athlete is in a dramatic lean that indicates the speed or acceleration. This typically lasts for 10 - 15 meters.

After that, the athlete continues to accelerate, but the angle of the torso begins to come more upright, and where we start to see the major differences between sprinting and typical Pose running. First, the angle of the torso is no longer indicative of the speed of the athlete. Second, rather than moving the recovering leg up in the typical figure 4 shape:

... you get a kick back after the push off, and long stride forward with the recovery leg towards the end of acceleration, and through maximal speed and deceleration:

The main similarities you can point to are: 1) They are both on the forefoot. 2) The landing catches under the athlete's center of gravity (though the sprinter is far more upright).

Therefore, depending on what main characteristics one takes into consideration when classifying something as pose or not-pose running will decide if you think sprinting is pose running. I, personally, am of the opinion that it is a different technique entirely.

Muscle Stimuli that CrossFit Misses

I need to be careful. Looking back, it seems that there are many posts that one could construe as me mocking, criticizing, or scoffing at CrossFit. That is entirely not the case.

CrossFit gets a lot of things right. High intensity sheds fat. Using progressively heavier weights builds muscle. Having lots of metrics to focus on so that you always see progress somewhere is what keeps people hooked and happy.

The problem arises when athletes start using CrossFit as the only source of training outside another sport. Or even using CrossFit as their only type of training for CrossFit competitions. CrossFit does have its limitations and not becoming more well rounded in athletic development can lead to not achieving your goals at best, and serious injury at worst.

Isometrics

CrossFit tends to focus almost completely on one form of muscle use: concentric or the contraction phase.

Isometrics are where you hold static muscle tension under load. This one is occasionally touched upon by CF boxes when you have L-sit holds and planks. We often see isolations in core work, like in the previous examples. They gyms I work at also have their athletes practice other holds like partial push-up positions and chin holds.

Using isometrics just gives your training another dimension to help your muscles get stronger. And using them on muscles other than the core would be helpful. If you train for gymnastics at all, you'll see a lot of this for the upper body. I'd recommend visiting GWOD to learn how to implement some into your training.

Eccentric

Eccentric, or the extension phase, is a very important part of athletic development that is almost wholly  ignored by CrossFit. There are a couple of reasons that eccentrics are very important. First, a muscle can actually create more force (in lbs/sq.in) during the eccentric phase. That means you can load more weight into a system, cause more of the muscle damage stimuli that increases growth.

This has to be used with caution. It can help with injury prevent, because your muscles and tendons get used to the extra load used in eccentrics (think of how often hamstrings and achilles get injured in various sports). But you can also injure yourself using this. Have you have done a lot of pull ups and had T-rex arms the next day (can't straighten them out)? You can easily and quickly cause enough damage that you can't recover and end up with localized rhabdomyolysis.

Overloads

When I talk about overload training here, I'm not talking about the go to exhaustion, then do a few more that a typical CF metcon has. Those are about endurance, cardiovascular and strength. I'm talking about methods that quickly allow the body to hit fatigue and do more. Or methods that allow more weight to be put on the system in advantageous strength positions.

For the first, using a combination of concentric and eccentric work, you can hit muscle fatigue in less than 10 reps. Ex: Have a partner push on your back while you do push-ups, and you have to resist on the way down, and push through on the way up. The partner pushes harder during the eccentric (down) phase, and just gives some resistance on the concentric (up). Done properly, the push-upper should reach muscle failure in 6 or 7 reps. Then the partner steps away, the push-upper goes to knees and reps out.

If you've ever dabbled in powerlifting and the Westside Barbell methods, you've probably played with bands, chains, and the Slingshot. These methods allow you to have more weight, either through band tension or Slingshot assistance, in positions where your levers are stronger, ie, past your "sticking points". This stimulus allows your connective tissues and central nervous system to experience heavier weights and can prep them for greater max lifts.

Isolations

Most CF "kool-aid" drinkers are adamantly against isolations, otherwise known as "body building." I tell people, you know, if you're down with being asymmetric and accruing injuries, that's cool. Sure, doing some isolations can give your appearance a nice well rounded look, but also let's be frank, no one is perfectly symmetrical and as such we are all going to move a little wonky because of it. For instance, I tend to hold weight overhead in my delts, and I need to do extra back work to balance myself out and make sure those muscles and structure keep firing and are there to support me when I need them.

Isolations can also help with injury prevention, particularly when combined with eccentrics. Doing calf raise negatives (hold weight, raise up on an edge with both legs, lower with only one) can helo prevent blown achilles. My elbows hyperextend, so I'm doing extra bicep curls to protect them in ballistic overhead moves. Plus, biceps are sweet.

Partial Reps

This is definitely more of a bodybuilding technique, but it can also just help build foundational size in places like the shoulders and back. CF emphasizes full range of motion in all movements, which in the case of 95% of work should absolutely be the case. However, during the "dessert" part of a person's workout, doing partial reps keeps your working muscles under tension through the entire set, and also gets extra use out of the stretch reflex (alternately knows as the Stretch Shorten Cycle, SSC), a stimulus that promotes hypertrophy.