Some researchers say that America has “sitting disease” because (on average) we spend 56 hours a week in a seated position. I had the chance to talk to the ABC news team in Washington, DC, about the importance of daily activity to keep our bodies from losing muscle mass. I encouraged us to think of activity not just as going to the gym, but as the daily commitment to NEAT (non-exercise activity thermogenesis, described by Dr. James Levine at the Mayo Clinic). And yes, I confessed to having sitting disease myself… and have made a clear New Year’s resolution to address this problem!
This week’s CBS Doc Dot Com features 42-year-old Dara Torres, who has been in five Olympics and won every kind of medal a swimmer can win. She juggles motherhood (her 3-year-old daughter, Tessa, is a gold medalist in being cute), a career, and philanthropy. And to top it off, as she proudly displayed during my interview with her, she has serious abs – world class.
But it wasn’t her abs that impressed me the most. Not nearly. It was the pride she took in her work. She understands that there’s no free lunch, that every one of her achievements has been paved by hard work and attention to detail.
I am always moved by a person who rolls up their sleeves, committed to doing a good job – whatever that job is. When I first started dating my wife, Kate, I took her to one of my favorite Italian restaurants. As we sat at our table, I suddenly saw her eyes well up with tears. She explained that she had been observing a bus boy carefully set a large, round table across from us. Seconds from finishing, he had noticed a small stain on the tablecloth. Rather than hide the spot by covering it up, he had painstakingly removed everything, replaced the tablecloth, and begun setting the table again. She was touched by his work ethic and I by her sensitivity and powers of observation.
Ponzi schemers may hog the headlines but I’ll bet most people still believe in the value of an honest day’s work.
Which brings us back to Dara Torres’ abdominal muscles. They didn’t just appear. She swims for two hours every morning and then does about seventy five minutes of core exercises. The take-home lesson from Dara Torres isn’t about her abs; it’s about the work ethic that lies beneath them.
For this week’s CBS Doc Dot Com segment, I thought I’d cover something completely non-controversial: what can weekend warriors learn from elite athletes? But I’m starting to believe that in this era of evidence-based medicine, nothing may be truly knowable. I went to the studios of the world famous Ballet Hispanico in New York City and spoke to athletic trainer Megan Richardson. She took me through the motions, emphasizing the importance of warming up and stretching in preventing injury. It sounded good and it felt good. But proving in the medical literature that it’s effective is another thing. An online search quickly produced multiple conflicting reports and advice: stretching definitely works, stretching definitely doesn’t work; stretching only works if you do it my way. Click here for a sampling:
My friend and CBS colleague, Richard Schlesinger, offered his solution. ”I get around it by neither stretching nor exercising.” Had I listened to Richard, my blog post would have ended right here. But I figured I needed at least one more paragraph so I contacted a true expert on the subject, Ian Shrier MD, PhD, a specialist in sports medicine and Associate Professor at McGill University. He has a PhD in physiology and is Past-President, Canadian Academy of Sport Medicine. He’s not a huge fan of stretching right before exercise.
“First, the stretching, whether with or without warmup, does not improve performance. It makes you run slower, jump not as high, and makes you weaker.” And “stretching definitely can hurt people if you overstretch; people do it all the time if they force the stretch.”
He added, “I don’t think it hurts you in general if you do it properly but it doesn’t prevent injury.” He’s more supportive of stretching at other times, including after exercise, saying, “Regular stretching at other times is beneficial. It makes you stronger, jump higher, etc, and there are three studies suggesting it reduces injuries as well, although the results were only significant in one.” He adds that “stretching is analgesic; it allows you to put your muscle through a wider range of motion without feeling tension. And that may be why ballerinas say that stretching helps them.” Dr. Shrier spells out his take on the subject in detail in a chapter called
“Does stretching help prevent injuries?”
For me, Dr. Shrier’s most interesting advice, especially for weekend warriors, was about the importance of warming up. He explained that muscles need energy to function properly. Energy is mainly produced inside of cells in structures called mitochondria. When you are resting, your mitochondria power down. During exercise, it takes awhile for the cell to rev up the enzymes needed for breaking down fat and carbohydrates for fuel and for using oxygen to make energy from that fuel. If you start running at full speed without warming up, your body will produce lactic acid. Lactic acid can impair muscle function for awhile, preventing you from sprinting efficiently at the end of the race.
So Dr. Shrier suggests gradually warming up. He estimated it takes about 3 to 5 minutes to efficiently go from one level of exercise to the next – for example, going from rest to a ten minute mile or going from a ten minute mile to a seven minute mile. If you go for a jog, “you walk, then jog slowly, and then pick it up. Elite marathoners might go for a fifteen to twenty minute jog before they run a marathon. That allows them to run faster at the beginning of the race. They run the second half of the marathon faster than the first.”
In summary – and I suspect that I am the first person today to tell you this – don’t outpace your mitochondria.
Midway through the third quarter of an April 2 NBA game between the Cleveland Cavaliers and Washington Wizards, a Cleveland guard tossed a lob pass toward the rim. Most of us sitting in the Verizon Center, in downtown Washington, D.C., had an idea what was about to happen.
Lebron James, the 24-year-old heir apparent to the NBA’s Best Ever moniker, elevated from the left baseline, caught the pass and, as he floated through the lane like a bird on wing, dunked the ball behind his head. The crowd roared its appreciation and even some of the Wizards’ players nodded in approval.
But the theatrical dunk, which came at a point when Cleveland was trailing by double digits, was one of only a small handful of highlights James – the leading candidate for league MVP for the 2008-2009 NBA season – had produced to that point in the contest.
He spent a good portion of his on-court minutes on the periphery, loping up and down the court with little urgency, distributing passes and setting an occasional pick but otherwise leaving the driving and scoring burden to his teammates.
The Wizards held on to win, despite a late flourish by James that left him with 31 “quiet” points.
The outcome hardly mattered: The Wizards were nearing a merciful end to a season that tied the franchise’s worst-ever record. The Cavaliers had all but wrapped up the top seed in the Eastern Conference for the playoffs.
Loafing or saving energy?
But from a health perspective, the on/off performance of James raised a question: How is it that NBA players – and many other professional athletes – are able to switch gears so readily and (seemingly) with few physical repercussions? How can someone go “half speed” without risking injury and still appear competitive on a court with some of the world’s best athletes?
DeNubile made an important distinction between going half-speed and being tentative. If you’re tentative – in any sport at any time – that’s when you risk injury.
“You need to be relaxed,” DeNubile said, to ensure that all of your faculties are there when you need them (for example, to leap to the rafters of an arena and throw down a reverse dunk). But “relaxed” doesn’t mean you’re not ready to go full speed on a moment’s notice. It’s similar to the difference between a cat stalking prey (relaxed but alert and focused, ready to strike) and a skier standing atop a cliff, doubting that he can navigate the leap (frightened and tense, and becoming increasingly less focused). Skilled athletes can go partial speed and still stay relaxed, DeNubile notes.
But this doesn’t apply to all sports. Diving, for example, or pitching a baseball require a focused anaerobic punch that would be very difficult to perform lackadaisically.
Why players hold back
For NBA players, the decision to occasionally temper their effort is not always bad.
“Recovery is so important for the players [and] metabolic recovery can vary from athlete to athlete,” DeNubile said.
“A lot of players come into the season three-quarters fit and use the season to get in shape for the playoffs. You’re better off if you come into the season fit,” but in an 82-game season even some of the fittest players have low-intensity nights. They may do it for selfish reasons – a contract dispute, for example. But in most cases they do it because they have to keep some reserves in the tank to stay competitive throughout a season that, for playoff teams, can span almost three-quarters of the year.
DeNubile recalled the 2001 NBA Finals, when his 76ers faced the Los Angeles Lakers.
“When we went to finals some players were dangerously over-trained,” he explained. “We did blood work [on the team] and you could see the guys who were on the brink. When you push too hard the body can start to break down. It’s the reverse effect” of training well.
DeNubile didn’t name players who were over-trained but he did cite Allen Iverson as one player who rarely gives reduced effort. “Every game of the year he’s giving 100 percent, 150 percent, diving for loose balls, playing as hard as he can,” DeNubile said. “That guy is incredible. He just doesn’t have an off switch.”
Somehow Iverson has stayed competitive for 12 (and counting) NBA seasons, defying predictions from many analysts that his all-out, physical style of play would result in a truncated career.
Are you over training?
Most of us will never play professional sports. But that doesn’t mean we can’t learn from those who do.
While the great majority of Americans is in no danger of over training (see: obesity epidemic, 21st century), some of us become addicted to strenuous exercise and tend to push ourselves harder than we should. One easy marker to check for over-training is your resting heart rate. Check it in the morning, right after you wake up, DeNubile says. (If you fear you are already over-trained, take a week off and see if that morning heart rate drops by 10 to 15 percent; if yes, you were likely over-training.)
Most are NBA players are incredibly fit and have resting heart rates around 60 beats-per-minute.
“When you see it start to bump up 10 beats per minute, that’s one of the signs over overtraining,” he says. “Or if a player says he’s getting a good night’s sleep but is still feeling tired.”
This made me wonder how much fuel NBA players burn during a game.
Interestingly, they’re burning about the same number of calories – 10 to 12 calories per minute – as you or I would during vigorous exercise. But because they are so fit their bodies use available energy stores much more efficiently than would a less-fit body, and thus they can accomplish more physically with less energy.
But DeNubile says that doesn’t make NBA players immune to basic exercise risks. “It can get dangerous when you’re tank starts to get low. People who sweat big can get dehydrated. You’ll see a player come off [the court] and he’s not happy about how he was playing or whatever and the trainer will offer him water or Gatorade and he’ll wave it off. That always worries me.”
These guys need to replenish lost fluid just like the rest of us. It’s nice to know we have at least that in common.
Davis Phinney has won more cycling races than any other American. He is charming, articulate, handsome, and requires a deep brain stimulator to keep him from experiencing incapacitating tremors. Davis was diagnosed with Parkinson’s Disease at age 40.
I attended the Parkinson’s Action Network 15th Annual Morris K. Udall Awards Dinner in Washington DC last week. Davis was interviewed by Diane Rehm and I recorded the conversation for my blog readers. It was an exceptional interview.
Davis explained how he was initially diagnosed – he felt tired, slow, experienced foot cramps and began tripping more frequently. As a young, seemingly invincible athlete who worked long hours, he assumed that he was just tired and in need of a massage. Eventually his symptoms became so persistent that he went to see a physician. After many tests and many different doctors examined him, a retired neurologist made the diagnosis. Davis says that it was a tough blow to his family. He felt as if he were Superman, now saddled with a permanent kryptonite necklace. Read more »
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