When it comes to movement, we're missing the point (and it's getting ridiculous).

This morning on Instagram I shared a photo of my workout statistics as an experiment. The photo was a screenshot of the data collected by my WHOOP band and included: Calories burned, Average workout HR, Max HR, and Workout Duration. I indicated on the post that the only stats I cared about were the HR values, as these are true measures of fitness and health that I can use to track my individual performance. Unfortunately, I received more messages in the first 20 minutes of posting the image than any other image I’ve shared on my IG story to date. Here is a summary of some of the comments:

  • “Why don’t the calories matter”

  • “If you don’t care about the calorie count, how do you determine your macros?”

  • “Calories are important to roughly determine what your caloric intake should be”—> Please note that I agree with this comment in the case of athletes and those burning very high numbers of calories each day. More on this below.

Comments such as these shed light on a very serious issue that I believe is getting out of hand- people are moving, training, and working out solely to achieve a certain number on a calorie counter or a specified number of steps. No attention is paid to proper movement patterns, strength development, building the mind-body connection, decreasing body fat naturally, maintaining ambulation throughout life, increasing and/or maintaining bone density or optimizing one’s mental health, just to name a few. Physical activity, fitness and movement is a pillar of optimal health and longevity. Yes, physical activity burns calories (some forms more than others) and that is certainly an added benefit to your health, but when a specific calorie number becomes the sole focus and reason for your workout, it’s gone entirely too far.

I am not shaming wearable technology, in fact, I use data from WHOOP to track my sleep patterns, HR variability, and my HR trends across different workouts. This allows me to determine my body’s state of recovery and work to improve my overall fitness level and performance. I have workout buddies who video all of their workouts to examine movement patterns and use the footage to identify their weaknesses. Again, this data and information is helpful for athletes and fitness enthusiasts looking to improve their fitness, function, and ultimately their health.

With this said, I ask the question, what does “calories burned” do for you? Does it help you move better? No. Does it increase the efficiency and productivity of your heart and blood vessels? No. Does it provide you with real time data that relates to your performance, recovery or health? This is where things get a bit complicated and my answer would be “sort of”. Really the only situation in which I find any value at all in calorie counts is in the case of athletes or those that need to gauge caloric need. For example, if you are a marathon runner or high level athlete burning insane numbers of calories daily, you will need to account for that in your meals in order to maintain optimal health and biological function. This relates to one’s health, so it is a useful tool that when applied properly can improve performance and longevity.

However, looking at the general fitness population paints a much different picture-Individuals checking their wearables while running, spinning with their app’s open on their phones and worse, young people stressing so much about their daily calorie burn that they refuse to eat until the number is reached. The accumulated stress this causes is not healthy, it’s terrifying and most likely contributing to worse health through chronic stress. Perfectly good people are obsessing over the calorie number and refusing to stop until they achieve their “goal”. To this, I beg you to set new goals. Be thankful that you can move and work to improve how you do so. If you want to improve your fitness, work your ass off in the gym, on the bike, or on the road.

If aesthetics is what you’re after, work on improving your diet in conjunction with optimizing your exercise routine. Trust me, implementing some more HIIT training or heavy resistance training will prove much more beneficial than burning an additionally 12 calories on the treadmill. Yes, use the calorie number as a general guide, but don’t obsess over it and use the value to guide your workouts. Perhaps most importantly, make an effort to enjoy every last minute you have being able to move, lift, run, jump, swim, or whatever other type of training you engage in. Lastly, I want to make it clear that I am not completely against using the calorie value as a means for estimating caloric (albeit usually quite inaccurately) need but I am certainly against the neuroticism that often comes with it as an unintended consequence.

The Last Stretch

Wow, what a few weeks! With medical school right around the corner, I’ve made it a priority to spend less time working on medicine-related topics (research, prep courses, etc..) and more time on activities I simply enjoy (coaching group strength classes, working out, cooking, spending time outside, etc..). Some of you may be asking, “dude, why aren’t you making every last attempt to prepare for the future and make sure you’re ready?!” The simple answer to this question is I know I’m ready. I’ve wanted to be a doctor for a very long time and have invested a lot of time, effort, and money (YIKES) in preparing myself for the tough road ahead. So, rather than spend these next few weeks stressing and trying to teach myself every step of glycolysis and the kreb’s cycle, I’m focusing on enjoying every.single.second. of not being busy. Now, the more philosophical answer to the above question is that during the last few weeks and in the weeks to come, I will be preparing myself more than it may appear. Here’s some of the things I’ve been and will be involved in and why I feel they contribute greatly to my preparation for med school:

1) JoyUs Foundation Yoga/Kayaking Event- This Sunday, in collaboration with the JoyUS Foundation, Teslie and I are putting on a free event for Cancer Survivors at my parents home in NY. The event will feature a yoga flow taught by Teslie, followed by kayaking on the lake and finish up with a home-cooked meal prepared by yours truly. I’ve worked with JoyUs before and really love this organization for their commitment to restoring serenity and joy to Cancer survivors and their families. Experiences such as these make me realize why I went down this path to begin with- to help others find joy and live the happiest, healthiest lives possible. Further, it gives me a chance to interact with individuals who have experienced one of the most devastating diagnoses possible and hear stories and accounts of their journeys.

2) Group Strength and Conditioning Coaching at Anatomie- I have missed being an athlete since the day my career ended. Athletics, fitness, and performance have been a staple in my life for more than two decades, so when I had the chance to do some strength coaching at Anatomie, I was ecstatic. While I expected to love coaching, I didn’t expect to learn as much as I am about human interaction and the importance of empowering others to improve their health. Each time I coach, I have the opportunity to watch members leave the gym stronger than when they came, both physically and emotionally. Isn’t it the same with patients? As doctors, don’t we want our patients to leave the office feeling empowered, strong and motivated? I sure hope I do. Also, shout out to my 5 and 6am crews, y’all are some bad MF’s.

3) Learning to Manage Stress Appropriately- News flash- medical school will bring on some stress. To be honesty, I’m kind of over hearing this. Obviously medical school is stressful. However, one thing that I've learned over the course of my athletic, academic, and professional careers is that stress is only bad if you let it manifest. This is why over the next few weeks, I’m working on developing my habits for managing stress. For example, if I start worrying about if I’m ready for medical school, I go outside with Simba (my dog) and take a walk. Outside + Simba = Happy Albee, problem solved.

I know that medical school won’t be easy. I will be challenged academically, physically, and psychologically to adjust to the demands associated with becoming a physician. However, I know this is what I want to do, which brings on feelings of excitement and comfort rather than anxiety and fear. Sure, I’m a bit nervous but who wouldn't be? Over the next few weeks, I’ll continue to prepare my way because at the end of the day, this is my journey to own.

Have Bad Habits? Focus on Changing Your Enviroment

Today’s post is all about habit formation and the positive impact small changes to your environment can have on your health, productivity and overall happiness. A few months back, I read something that really stuck with me, it went something like this (paraphrasing a bit here):

Too often in life, we think that in order to change our behaviors, we need to change ourselves. For example, if one is overweight, they feel the need to be more like a lean individual. They place the emphasis on changing who they are rather than simply changing their environment. They start shaming certain food groups, hating the person they see in the mirror, and doing all they can to model those with bodies they feel they should have. They buy weight-loss pills in attempt to loose weight fast, yell at their peers for bringing cookies to work, and avoid going out to dinner with friends. Unfortunately, what usually happens to these individuals is not sustained behavior change leading to long-lasting results. Instead, these individuals often have decreased happiness scores as a result of the stress placed on trying to personify someone they are not. How much easier would it be if this individual could simply make some small changes in their environment to favor a healthier lifestyle rather than feeling the need to change who they are?
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I think the reason this quote really hits home is because I’d venture to say that almost everyone reading this post has made changes in their life to model that of someone else- an athlete, actor/actress, popular classmate, or anyone else possessing a highly desirable trait. This is evident in the field of health and wellness. We see an athlete, crossfitter, or popular blogger using a certain product, performing a certain exercise or following a particular diet, and we immediately adopt that change in an attempt to produce an identical result. Sure, sometimes these changes can be positive, but more often than not, they are short-lived, producing only a temporary dopamine surge. The reason they are so short-lived? I suppose I’m not completely qualified to answer that, but I can make the assumption that the reason is due to the fact that often times the changes we attempt to make often fail to align with our genetics, environment and individual needs, leading to limited results (if any). Further, we often try to make changes that will produce results overnight, which is simply unrealistic.

But what if instead of focusing on changing ourselves, we shifted our attention to our environment, as mentioned in the quote above. Using the above example of attempting to lose weight, wouldn’t it be less stressful to start your journey by simply removing poor food options from your home rather than shaming yourself into an extremely strict diet that you heard worked for someone else? I sure think so. You see, when it comes to living a healthy life, nothing impacts us more than our immediate environment. What’s more is that because we all carry different genes and have different needs, we simply can’t expect what works for others to work for us, this is why focusing on your environment is a great place to start when it comes to a wide variety of behavior changes.

Here are a few more examples of environmental changes as they relate to health and wellness goals:

**The key here is to make the environmental change obvious, as silly it may seem.

  1. To increase physical activity: place a set of dumbells, a kettlebell or a pair of sneakers in front of your door. This way, each time you enter the door, you have a reminder to exercise (put a hand-written sign if you need an additional push). Other examples would be replacing a chair with an exercise bike, or opting for the stairs instead of the elevator. You'd be surprised how much an impact this has.

  2. To avoid spending money- only carry cash. We don’t like spending cash. The act of handing someone else your hard earned money is painful, so try ditching your cards for a few months and sticking to just cash.

  3. To decrease stress- set a reminder to meditate for 5 minutes every morning before you start your day. To make it even more of a commitment, set a yoga mat up in your room beside your bed to remind yourself upon waking.

  4. To increase work productivity- get a jar and fill it with marbles equal to the number of tasks you’d like to complete. After completion of every task, move one marble to an adjacent jar, until the first jar is empty. (courtesy of Atomic Habits by James Clear)

While I know these changes may seem obvious, if you’re struggling to achieve a certain goal, try changing your environment. Give yourself some credit and realize that you don’t need to live someone else’s life, you need to optimize your own.

Stress: The Good and The Bad

The more I read about human disease (in particular diseases linked with chronic inflammation like diabetes, obesity, metabolic syndrome and even depression and anxiety), the more I blame stress for the surge in numbers of chronic diseases seen today. The overwhelming majority of the studies examining the stress response over time show very clearly that individuals who live in a chronically stressed state consistently have worse health outcomes. However, while it is certainly beneficial to reduce and avoid chronic exposure to stress, there are some short-term benefits of acute stress that can serve to increase performance, focus and even motivation. In today’s post, I want to try and simplify this topic by introducing the stress response from an evolutionary perspective and discussing some of the short-term benefits before moving on to the negative outcomes brought on by chronic stress.

**As usual, note that entire textbooks and research collections are designated to this topic. I have only chosen to cover some of these topics broadly for your benefit.

The Stress Response from an Evolutionary Perspective

I hear people everyday complaining of stress. In a world where it always seems like there’s something that “needs” to be done, rarely do we find a time to relax and repair. But what is stress from a physiological perspective? Why does it make us feel anxious, tired, and overworked? Stress is actually a protective response for humans in which hormones such as cortisol and epinephrine are produced to provide us with the ability to adapt to certain conditions. You can think of this as a coping mechanism for the body in times of danger to increase arousal through activation of what’s called the sympathetic branch of the nervous system. Sympathetic activation leads to increases in bodily functions such as endogenous glucose production, blood pressure through vasodilation, heart rate elevation, arousal, and increased respiration. This makes sense because in the past, if we wanted to flee from danger such as attack from prey, we needed to develop the ability to allocate as many resources as possible (glucose, oxygen, attention span) to the task at hand. Then, once the attack was over, our bodies could return to the resting stage, also know as parasympathetic activation.

To briefly summarize, stress is an adaptive response that primes the body for attack. In short-bouts, our bodies handle stress quite well. However, long-term exposure to stress is a different story, as a heightened activation of these systems is very expensive for the body and it eventually begins to wear down. I’m sure all of you reading this have felt tired and worn down after a stressful day. Well, if your heartrate is elevated, blood pressure high, and liver is working overtime to increase blood glucose, your body (through the feeling of fatigue) is most likely sending you a message with instructions to rest, relax, and repair. In my opinion, it’s not about avoiding stress completely, that’s impossible and unnecessary. I believe it is more important strike a balance with stress that allows you to both perform at a high level (acute stress) and avoid getting worn down (chronic stress).

When Stress Helps Us

As I mentioned above, I don’t believe all stress in bad. In fact, in my own life, the stress response has probably helped me perform in a variety of situations. A perfect example of this would be in preparing for a hockey game. Prior to big games, I could literally feel my heart rate elevate and would often sweat at a ramped pace. This makes sense- my body was preparing for battle. However, would it be good for me to live my life in this state? Probably not. Anyway, here’s a few additional benefits of short-term stress exposure:

**Before reading the examples, look at this graph. Notice that there is an optimal amount of stress that leads to peak performance. Beyond this optimum level of arousal, the body begins to fatigue and the negative effects of stress set in.

http://www.haleo.co.uk/wordpress/whats-stress-got-to-do-with-it/

http://www.haleo.co.uk/wordpress/whats-stress-got-to-do-with-it/

  1. It aids us in preparing and performing in events that require performance such as athletic events, workouts, presentations, and exams.

  2. Short-term stress helps us build up resilience, allowing us to cope and handle future stressors.

  3. In times of danger, the short-term stress response provides us with the resources such as oxygen and glucose to respond. It does this through shutting down bodily functions such as digestion, ovulation, and immunity.

So, in summary. In times of danger or times requiring peak performance, the stress response (adrenaline and cortisol) is beneficial. Now let’s look at what happens with chronic stress.

Chronic Stress- A Major Threat to Human Health and Longevity

One of the most interesting aspects of the stress response is how dramatic the differences are between short-term and long-term exposure. What in the acute phase can provide us with energy, focus, and strength can lead to fatigue, weakness, and disease if it persists in the long-term. But why? This is where we must look at the systems in play, in particular what happens with glucose homeostasis, the immune system, and the body tissues:

1) Glucose Homeostasis- During the stress response, both adrenaline and cortisol are released into the bloodstream. Cortisol is a glucocorticoid hormone that is catabolic in nature. Catabolism means to break down, so cortisol acts to breakdown stored carbohydrates (glycogen) and proteins to glucose. This glucose then enters the bloodstream to be used for energy production.

Why long-term cortisol surges are bad: Long-term cortisol elevations will lead to long-term elevations in blood sugar levels. To counteract this, the pancreas secretes insulin to remove the sugar from the blood. However, if blood sugar is constantly high, insulin remains elevated. Elevated insulin levels are a major driver of fat storage and obesity. Further, cortisol signals the body to store fat rather than burn it, further contributing to weight gain (in particular around the abdominal region).

2) Immune Function- Cortisol halts the division of immune cells such as lymphocytes. Think of it this way- your body isn't concerned with bacteria or viruses when a tiger is chasing you. However, chronic immune suppression is dangerous, as it opens up the opportunity for all sorts of infections to occur (including bacteria and viruses). This is why we often get sick after long, stressful weeks! See more here- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/?utm_source=Global+Healing+Center&utm_campaign=87899af75f-Natural_Health_Blog_RSS_Feed&utm_medium=email&utm_term=0_7950820145-87899af75f-107880133&_escaped_fragment_=po=29.3860

3) Tissue Breakdown- Cortisol elevation leads to decreased protein synthesis. This leads to less opportunity for repair of muscles, bones, and connective tissues. For active individuals, this can predispose you to injury as the body isn't given the optimal environment for repair.

I hope I have made it clear that you should take measures to control the stress response. However, I realize this is easier said than done, so I have come up with a broad list of actions that you can take to counteract the more stressful times in your lives.

Counteracting Stress- Striking a Healthy Balance

As I mentioned above, you will not avoid stress completely in the modern world. However, you can take some steps to limit the stress and avoid the negative health consequences associated with chronic elevations:

  1. Eat a diet rich in vitamins, minerals, and antioxidants: Avoiding nutrient depleted food sources such as packaged and refined goods will only exacerbate the stress response. By providing your body with whole, nutrient dense foods, you can ensure that you’re providing the raw materials for a healthy stress response, while limiting inflammation.

  2. Exercise: This is obvious to me, but exercise in any form is beneficial. Endorphin release, insulin-independent glucose uptake, and much more. Stay moving!

  3. Meditate: It’s hard, I know. However, just 5-minutes a day can provide some serious benefit. If you really can’t do it, try yoga.

  4. Don’t let your brain talk you out of relaxing: too often we tell ourselves we aren't good enough, don’t work hard enough, and don’t have the things we want in life. This leads to increased feelings of stress and anxiety to be constantly doing something. Trust me- all of the stress is counterproductive. Give yourself some credit, take a few breaths, and learn to relax throughout your day.

I know this post is a bit longer than most, but I feel that is warranted given the importance of this issue. Stress-management is key to living a happy, healthy, and productive life and I hope this post helps you in adopting a lifestyle that allows you to do so.

The Impact of Exercise on Mental Health

Frozen Fenway, 2017. @Brandon88Photo

Frozen Fenway, 2017. @Brandon88Photo

For those of you who know me, I’ve long viewed exercise as an essential part of my day. You could certainly classify it as an obsession of mine. From a young age, I have always used physical activity and athletics as a safe space to escape any negativity and focus my attention on activities I enjoyed most such as ice hockey, weight lifting, running, and swimming. As a youth hockey player, I remember the freedom I felt when I could put down my bookbag after a long day of school and simply focus my mind on hockey for a few hours.

Today, it’s very easy to tell when I haven't exercised; I feel tired, my productivity suffers and I’m simply not as fun to be around- just ask my girlfriend! However, on the days I have time to train, there is no better feeling than completing a hard met-con, spin class, or even just a long run. When I leave these workouts, I get more done, smile more, and sleep better.

While the impact of exercise on mental health and wellbeing is obvious to me, there are many people out there who struggle to start exercising or simply don’t see the point. For these reasons, I decided to write this article after taking a semi-deep dive into the research regarding the many benefits of different forms of exercise. While I certainly have left some things out (as I merely don’t have the time to list every single known benefit), I have tried my best to highlight some of the more interesting findings. I hope you find this article beneficial in adopting a sustainable exercise program that works best for you.


The Muscle-Brain Endocrine Loop-Exercise Helps Me Learn?

I’ll start with this finding, as it is the fascinating to me. We all know that exercise is beneficial for things such as maintaining muscle mass, burning through fat, and improving cardiorespiratory fitness, but did you know that the muscles communicate with the brain in a direct manner that can both improve memory and learning mechanisms AND decrease risk of depression? It’s true. During exercise, your muscles release small proteins called myokines. While there are many different forms of myokines, studies have shown that exercise-induced release of these factors may lead to:

1) Increased production of Brain-Deriver Neurotropic Factor (BDNF) in the hippocampus- BDNF plays a role in the growth, repair, and maintenance of our neurons (cells in our brain) and is important in the maintenance of neuroplasticity (the ability to learn novel things).

2) Increased formation of new blood vessels- In studies in rodents (often used to test hypothesis), exercise increased the production of VEGF (Vascular Endothelial Growth Factor). This increased production of VEGF led to increased production of new neurons and blood vessels.

3) Skeletal muscle activity may help regulate the sleep-wake cycle- Research has shown that a muscle-derived protein may be useful in regulating our circadian rhythms. So, if you’re having sleep trouble, perhaps some exercise is all you need!

*Note there are many more benefits listed here.

EXERCISE, SSRI’s, and BEHAVIORAL THERAPY- Which is best?!

If you’re someone who has ever suffered from a mental health disorder, you know that it’s very easy to turn to drugs, supplements, or even alcohol for relief. I told you how therapeutic exercise is for me, but does it compare to conventional treatments for mental health disorders such as depression? Let’s look at the research to confirm:

Review of the research on exercise and depression:

Summary:

  • This paper is a comprehensive review of the treatment available for depression and the current research of exercise as a treatment for depression. It is not a research study, rather it is a comprehensive review of the available research.

  • It started by introducing the pharmacological approach (usually SSRI’s) and mentioning that these treatments work for roughly half of the population, usually those suffering from more severe forms.

  • The paper then goes on to describe psychotherapies, such as cognitive behavioral therapy, which are shown to be fairly effective, especially when combined with other treatment modalities.

  • The paper then presents the case for exercise. The majority of the studies reviewed involved participants performing aerobic exercise, with a few resistance training studies mixed in.

Findings

  • One review of 850 individuals participating in randomized controlled trials showed aerobic exercise to reduce depressive scores by 7.5 points. However, the authors did not feel this was significant enough to confirm the benefits of exercise as a treatment modality.

  • In a separate review, researchers compared exercise to standard line of treatment (SSRI’s), placebo, or no treatment. In studies comparing exercise with no treatment or modalities such as cognitive behavioral therapy or pharmacotherapy, it was found that exercise leads to moderate clinical improvements in depressive symptoms.

  • The Duke Smile Studies- This is where things get a bit more interesting. This randomized controlled trial compared exercise, exercise + pharmacotherapy, and pharmacotherapy alone. I like this study because now we can work to really isolate exercise vs. pharmacotherapy. After 16 weeks of treatment, the groups showed no significant clinical difference in symptoms. HOWEVER, at 10-months follow up, those in the exercise group exhibited lower rates of relapse than both other groups and were 50% less likely to be depressed than the non-exercising groups!

Summing It All Up

After going through some of the research, there’s a few things I’ve learned:

1) Exercise is certainly beneficial to learning and memory (via BDNF and VEGF). The most studied modality is aerobic exercise, but there is evidence that HIIT and resistance training induce similar benefits.

2) For those suffering from clinical symptoms of major depression, the best treatment seems to be a mixture of pharmacological therapy, behavioral therapy and exercise prescription.

3) While exercise may not outperform other modalities to a significant degree when examined during randomized controlled trials, it certainly appears that it is the single most effective modality for treating the long-term symptoms associated with depression.

4) Adhering to an exercise program is the best way to prevent relapse of symptoms.

I tried my best to look over the data with as little bias as possible (which is difficult since I just wanted to confirm the benefits of exercise). After doing so, I am convinced that exercise of all forms is protective over our mental health. My reasoning for this (in addition to the points outlined above) is there are also social and behavioral factors at play. Some of my closest friends, mentors, and competitors are those I’ve met through athletics and there is something to be said about the social connection that comes with exercise. I hope you find this information interesting and helpful in optimizing your health and wellbeing!

The Importance of Fascial Health in Optimzing Performance and Avoiding Injury

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Recently, I’ve been getting more into reading about the interconnectedness of the human body. It’s fascinating to me that weakness in one area can so juristically impact function of another area. With my interest in sports medicine, I’m doing my best to get an early grasp on how “it (the body) all fits together.” Luckily, I recently picked up a new book that goes into detail into a fascinating, yet underappreciated structure of the human body that’s answered many of my questions, the fascial system.


What is Fascia and How Does it Work?

First off, this topic is very new to me, but I think it’s important. I’ll do my best to simplify what I’ve learned, but please correct me if anything I say seems incorrect or misunderstood. While the formal definition of fascia is still under debate within the scientific community, I think the best way for me to define it is as a interconnected, continuous connective tissue (mostly collagen but some elastin and reticulin) that lines each of the major organs of the body (muscle, bone, internal organs, vasculature). A good example of how the fascial system works is what occurs when one ignores a small, seemingly minor injury, let’s say in the shoulder. All of a sudden, months or years down the road, they find that they wake up with neck pain, then pain in the forearm. How could this be?

How Injured Fascia Can Cause Pain

There is much more to this than I will attempt to explain. However, I think it’s worth emphasizing to you that fascia health is important in both the prevention and treatment of injuries. In the above example, an injury to the fascia in the shoulder most likely led to some local overcompensation to avoid the pain. Over time, through a variety of different mechanisms (poor posture, overuse injuries, etc..), this pain-avoidance strategy in the shoulder can lead stiffening of the fascia due to increased collagen production. While you may just shake this off as “a tight shoulder,” eventually this will lead to pain developing in nearby fascial regions (in this example- the neck) due to the interconnectedness of the fascial networks of the body.

This now leads to a larger issue- where is the source of the pain? That’s where a deeper understanding of fascia comes in handy and this is probably what interests me the most. I’ll plan to do a future post on this, but for now, here are a few other ways fascia can cause pain.

Other examples of triggers for fascial-related pain:

  • Overuse injuries- Moving in the same plane of motion over and over again (sitting at a desk) can lead to tightened and strained fascia.

  • Trauma- direct blows to certain areas of the body will upregulate collagen production. This can lead to the fascia becoming fibrotic in nature, posing risk for disfunction along the entire fascial chain.

How to Protect Your Fascia

Based on my general understanding, my biggest takeaway from learning about the fascia is that lack of movement in one area of the fascia leads to that area becoming “sticky” due to the lack of lubrication and hydration. This is a real issue, because as I mentioned above, fibrotic fascia can disrupt entire lines of fascial continuities. This is why those with very tight fascia under the foot (plantar fasciitis) often also suffer from knee pain and even hip pain as the dysfunction travels up that fascial line. So, here are some of the methods I suggest for protecting your fascia and avoiding injury:

1) Move in different movement planes- avoid staying in the same position for more than an hour at a time. If you sit most of the day, try to take breaks and move in ways that oppose sitting. Examples would be standing, taking a brisk walk and doing some back bending exercises.

2) Use self-fascial release therapies- You don’t need a massage to move protect your fascia (nothing against massage!). Methods such as foam rolling, tennis ball work, and self-massage are great tools to for recovery, maintenance, and injury avoidance.

3) Allow your body to rest- One really interesting thing I read is that exercise dehydrates your fascia. Dehydrated fascia is not healthy fascia. The fascia becomes brittle and less elastic, which can severely impair both function and performance. However, with adequate rest, the fascia re-hydrates and grows stronger. Further, the fascial system actually follow Wolf’s Law, which describes the idea that progressive overload with adequate rest will lead to a stronger system over time.

4) Stretch often- This goes with the points above, but stretching fascia is vital to maintaining hydration and health. However, note that static stretching is best done after any type of weight training.

I think this stuff is pretty cool and look forward to learning more. If you have any suggested resources, feel free to send them my way!

5-Tips For Staying Fit When Your Schedule Gets Busy

Simba and dad hockey.jpg

For me, getting in a good daily sweat is always a priority. First off, it’s in my DNA at this point (this is not the case for everyone, and that’s okay!). Further, after competing as an athlete for so long, I know that I simply don’t function as well without giving myself 1-2 hours a day to lift some heavy things or run around like an animal. During undergrad, I used my hockey practice and lifting sessions as “me-time” and focused only on improving as an athlete, leaving all of my other obligations off of the ice and out of the gym. I feel this made me a better athlete because I focused solely on my craft during practice but also decreased my overall stress levels off the ice so when it came time to focus on organic chemistry or physics after practice, my mind was clear and I could focus on my academics.

When my career ended, the last thing I wanted to do was lower the intensity of my workout sessions, especially since life has gotten more stressful during the medical school application process. However, as I’m sure is the case for many of you, I simply don’t have the time now that I used to have and can’t devote 2 hours a day to the gym. Between research, meetings, clinical involvement, and other obligations, I have needed to modify my workouts to maximize the effectiveness and efficiency of my time spent exercising.

So, how do you maximize your time in the gym to accommodate your busy schedule, while ensuring you’re still getting high quality workouts? First off, let’s make one thing clear- making progress towards your fitness goals takes hard work and time, there’s no way around this. With this said, there are some steps you can take to make your workouts more time-efficient and effective, and that’s what today’s post is about.


METHODS FOR INCREASING THE EFFICIENCY OF YOUR WORKOUTS:

1) Utilize Complexes- If you’re someone who is experienced with lifting of any kind (barbell, dumbbell, kettlebell) complexes can be a tremendous time savor. Complexes involve choosing 5-10 different movements and performing them with the same load in series, without dropping said load. For example, you may choose the following:

A. DB Deadlift

B. DB Clean

C. DB Push Press

D. DB Front Squat

E. DB Alternating Row

You would complete each exercise for 5-10 reps before moving onto the next exercise without dropping the weight. 3-4 sets is all you need here, TRUST ME.

Benefits of complexes- Increased calorie burn post-exercise (epoc), works both anaerobic and aerobic systems, is very easy to progress and/or modify.

2) Implement Full-Body Workouts- If you’re pressed for time and can’t make it to the gym everyday, don’t stress! You’re not an athlete and you have other obligations. Instead, program your workouts to include full-body splits. This is best for someone looking to put on some strength, but only has time for 2-3 workouts per week. The only caveat here is that you’ll likely have to spend a little more time in the gym on these 2-3 days to see any significant results. However, if you make those 2-3 days high-intensity full body lifts, that’s all you’ll need!

3) Too busy for the gym? Use bodyweight exercises in complex, Tabata or MetCon form- This one’s huge. I get so angry when people say things like “well I’d really like to get a workout in but I can’t make it to the gym.” I have a friend who is an ER Doc, on call at all hours of the night, works 80 hours a week and still manages to workout 4-5 times per week. If you don’t have time to get to the gym, choose some bodyweight exercises and get after it. Some of my favorites are burpees, mountain climbers, pushups, jump squats, and hand stand push-ups. Try implementing your favorites into a Tabata (20 sec on, 10 sec off), or set a timer and do as many reps as possible in the time you have available.

4) Go to a cycling class (if you have the guts)- Don’t you dare laugh at this. If you’re reading this thinking “man, Albee has lost it, he’s gone soft,” you’re wrong. If you find a good, well-run, intense cycling class, you will benefit from 30-60 minutes of pure torture. Your HR will elevate, you will burn calories very efficiently, and most importantly, you will have a blast. I try to cycle 1-2 times per week and feel that it’s helped me get into the best shape of my life ( I also cycle at a top notch cycling gym where the instructors take no prisoners).

5) LEAVE YOUR CELLPHONE ELSEWHERE- Can you tell this is a pet-peeve of mine? Obviously, if you’re on call or need access to your phone, bring it with you. My point is, we need time to ourselves and often times the gym, road, field or wherever you exercise can serve as the best space for you to forget about the world and focus on you. Further, the more you focus on your workouts, the greater the benefits will be and the less time you’ll have to spend in the gym.

I’m sure I missed a ton of other obvious tips, so feel free to comment on your own experiences below!

Set Daily Intentions and Own Them

Happy Monday Friends!

Brain Food.JPG

If you’ve been following my first few posts, you’ll know by now that athletics, fitness, and performance are big passions of mine. Since I first stepped on a hockey rink at age 4, I loved everything that came with performing, competing, and growing as an individual and as an athlete. While I am no longer a competitive athlete, I have continued to push myself athletically through involvement with crossfit, yoga, cycling, and even some long distance running. Staying active is important to me, and I plan to remain active throughout medical school and beyond. I’ve always felt that the 1-2 hours of movement per day increases my focus and improves my overall mood.

Recently, as part of my quest to get out of my comfort zone physically and not just simply throw weights around (which is still fun), I took my first hot yoga class since probably 2014. In the beginning of the class, the instructor provided a very simple que to each of us, “Right now, I want you to set your intention for the next 45 minutes, and every time you sense your mind wandering, return to this intention, own this intention and accept nothing less.” Seems fairly simple right? Not so much.

In today’s world, we are constantly bombarded with texts, emails, requests, demands and a variety of other distractions to process amidst our already important priorities (health, family, work, etc..). I myself constantly feel as if I “need to” be doing something. If I’m not reading, I should be at work. If I’m not at work, I should be at the gym. If I’m not at the gym, I should be reading research. It wasn’t until I heard this simple message from my yoga instructor that I realized that sometimes we need to just allow ourselves to be in the moment. No phones, no responsibilities, just you and your intention.

Since the day I heard this message, I have been setting daily intentions for all of my tasks (workouts, reading, blogging, cooking, etc..). For example, if I’m reading a research paper on cardiovascular disease, my intention may be to focus solely on my reading and make three key points in that article. If I’m preparing for an interview, my intention may be to do my best to stay stress-free, show the application committee my strengths as an applicant, and support my peer interviewees.

I have found this strategy to be extremely helpful in helping me live in the moment and avoiding losing perspective. At the end of the day, we control our thoughts and we have the power to set and stick to our intentions. Regardless of how busy, stressed, or successful we may be, I think it’s important to always return to these intentions, even if this means modifying as we go.

The Boys Are Back!

I’ve been reading a lot about the positive effects of training with a partner. Harder workouts, more camaraderie, and healthy competition. Since my career ended, I’ve missed competing and pushing my limits with elite athletes. Luckily for me, this week I had the chance to connect with one of my old buddies Justin who plays baseball overseas. The kid is a terrific athlete who has had one hell of a career. So, rather than waste time, we got after it pretty good. Here’s what we hit today:

Strength Work:

  1. Barbell Bulgarian Splits- 1 x 8, 5 x 6 each leg (Pre-WOD)

  2. Sledge Hammers- 5 x 10 each arm (Pre-WOD)

  3. Chained Front Squats- 4 x 8 (Post-WOD)

WOD (workout of the day) :

Death by 10 meters-

Every minute, sprint 10 additional meters. Continue to add 10 meters each minute until you reach exertion or can’t finish the reps in one minute. JB and I both got up to 190 meters, can you beat it?

Summary-

  • Work out with friends who motivate you. The same goes for studying, eating, and enjoying life.

  • If you’re circle of friends doesn't motivate you to get better and accomplish your goals, find a new circle.

  • Push yourself to do things you struggle with (I’m not a great runner, so the death by 10 meters was no joke).

  • Don’t do front squats after 20 minutes of sprinting, seriously.

Methods For Delaying Fatigue and Increasing Endurance During Strength Training

Training with my man Stefon, captain of the Stride Wounded Warriors Sled Hockey Team.

Training with my man Stefon, captain of the Stride Wounded Warriors Sled Hockey Team.

If you’re an athlete, chances are you’ve had the crippling feeling of soreness that develops after an extreme bout (or bouts) of resistance training. It’s a feeling that makes you want to avoid the gym, ice, court, or field for a few days to let your body play catch up. A few years back, during the summer before my junior year competing on the men’s ice hockey team at Umass-Boston, I upped my training intensity in attempt to put on some mass, increase my overall power output, and get faster for my senior year. Unfortunately, what I found was that I needed more time to recover after each lift, fatigued more easily and failed to make the strength and power gains that I expected. I was still conditioning 2-3 times per week, so I couldn't figure out why this would be. So, rather than get discouraged, I put on my pre-med hat and turned to the best book I could find, “Essentials of Strength and Conditioning” by Thomas Baechle and Roger Earle (if you’re interested in anything in the sports performance world, this book is a must-have!).

What I found was simple, but is a technique that I think many serious athletes, crossfitters, and the general population fail to benefit from. As I mentioned above, I was conditioning 2-3 times per week. HOWEVER, most of these conditioning bouts were short, rapid sprints that I was very comfortable doing (I had been training for 8 years at this point, so I had become comfortable with certain training modalities). To put it in more scientific terms, I wasn’t challenging my anaerobic capacity and as such, I was failing to improve the buffering capacity of my muscles, resulting in more soreness and greater fatigue. The famous “lactic acid” was staying elevated in my blood and preventing me from making the gains I had hoped for.

So, I worked with our trainer to come up with a more comprehensive approach to build up my buffering capacity, increase my time to fatigue, and decrease muscle soreness. Rather than just doing sprints, I started doing longer high-intensity bouts of exercise on the Air Assault Bike and Row Ergometer. While brutal, I saw DRAMATIC increases in my anaerobic strength, power, and overall fitness. Now, it’s important to know that using intervals and sprints aren't beneficial for improving buffering capacity unless you get into a certain HR zone or % of your VO2 max. The moral of the story is our bodies need to be pushed in order to get stronger, faster and more resilient. This can be a bit difficult to figure out and get started, so I’ve attached some suggestions below.

  1. Easy HR MAX calculation- 220-age.

  2. Determine what 80-85% of your HR MAX is.

  3. Choose your method of punishment (treadmill, rower, bike, ropes)

  4. Set interval times that are consistent with your level of fitness.

I use this technique even now to maximize my workouts. Currently, I’m doing fairly heavy strength work 3-4 days per week, usually MWTF. On the other days, I will either do a cycling class (which implements this concept of high intensity intervals, or hit the Row Ergometer for a battle session. Here’s one of my favorites:

  • Row for 45 seconds

  • Rest for 30 seconds

  • Row for 30 seconds

  • Rest for 45 seconds

  • Row for 1 min

  • Rest for 1 min

  • Row for 30 seconds

  • Rest for 1 min

  • Row for 1 min

  • Rest for 30 seconds

Hope this technique works for you! Let me know!

Albee