I had a really interesting discussion/evaluation with a patient the other day. His primary interest was stem cells and TA-65 but we got to talking about some common symptoms he was experiencing that he had questions about.

“Doc first why do I need to stretch and do the tissue mobilization stuff every morning?  I wake up stiff as a board and then within an hour I am fine.  I go to bed limber but next morning it’s like I never stretched at all!  What is that all about?”

This is a pretty common problem for both men and women starting in their 40’s and 50’s.  Most people assume that it is the “beginnings of arthritis” and in some ways they may very well be right.

But what is actually happening is that when we sleep at night we do not move very much (even if you are one who rolls around all over the bed!). Compared to the daytime our muscles are lax and our movements very limited.  Lots of people sleep in one position for well over an hour with minimal movement.  Couple this with not drinking and not keeping up with hydration and you have a recipe for fascial binding.

The fascia is something I have talked about in the past. It’s a saran wrap like wrapping that covers most muscles joints and nerves.  In many ways it’s the glue that holds the body tissues together and gives them shape.  The problem is that just like glue it can get sticky especially when the water content of the body drops and we become immobile.

In the morning most people will drink at least some water and begin to move, thus unsticking the fascia.

If you practice Yoga, Pilates, or ball work for tissue mobilization in the morning you are unsticking the fascia.

So what can you do about morning stiffness? Well drink more during the day and during the night even if you have to get up to go to the bathroom more. Next unless there is a medical reason not to add some salt to your evening meal (gasp!)  Yeah I said salt!  You can spend a lifetime popping potassium and magnesium supplements and never fix stiffness or cramps if you are too salt restricted.

Just like it’s ok to eat butter now you mark my words. Salt will gradually be reintroduced into the mainstream diet unless you are in heart failure or have salt sensitive high blood pressure.

Next you can spend some time in the morning doing one of the forms of tissue mobilization I mentioned above.

The next question that came from this guy was why certain areas of his body were tighter and harder to mobilize every morning.  A good look at this guy revealed some significant muscle asymmetries (unevenness). His lower and upper leg on the right was bigger than the left and his left ab insertions were more prominent.

When I had him lunge with his right foot forward, his right hip and pelvic crest on the right were about 4 inches higher than the left.  When he went left foot forward his left foot barely touched the ground. As fate would have it he had in the past injured both his right hip and knee playing sports. The typical logic would be to say the injury should lead to a left sided dominance in order to protect the right injured side.

The truth is gravity was the culprit. For whatever reason this man decided to manage and control gravity with his right hip far more than his left. This is what his body decided was easier, probably for most of his life.  How this stuff happens is immaterial really, the fix is the important thing,

To fix both of the above problems I recommend large doses of Omega 3  to reduce fascial stickiness and inflamed muscles. Then you just start learning to use your non dominant side more. Start with awareness of how much more you use one side in weight bearing. From there start doing exercises in front of a mirror and work for equality and straight lines in your pelvis, hips knees and lower legs.

It will take a while to fix this and at first it will seem very unnatural. But fighting gravity is one of the most important things you can do to reduce and reverse the aging process. Catch this stuff soon enough and you may just avoid joint replacements.

And don’t forget the fish oil. It’s absolutely essential while fixing the effects of gravity and stiffness!

Doc

Ok taking a break from the nutrition and supplements to give you some free advice on your workouts.

I am not sure if you’ve noticed how the exercise prescription keeps evolving but it kinda parallels the drug recommendations e.g. more and more and more!

The current recommendation is for 50 minutes 5 X a week which effectively puts it out of the range of most of the population! Not to say that this recommendation is not to be followed if possible, but I can tell you that unless you are retired its not going to be easy for you to do this.

This recommendation also does not take into account recovery factors. If you are 80 and walking at 2 miles per hour for an hour is enough to get your heart rate to 70+ % of where it should be, the wear and tear on your body is going to be a lot less than if you are 35 and need to run 7 miles an hour for an hour.

While its safe to say at 80 your recovery demands are going to still be there its quite different from the joint trauma point of view.

What happens if you do 2 really hard workouts a week for strength and 2 for endurance- does that count?!

The answer is yes it does.

As a matter of fact rather than slavishly following the popular 10,000 steps a day rule, the arbitrary but popular recommendation of several internet gurus I would suggest you monitor your performance. If you are slowly but surely improving in your capacity to exercise- both in strength and endurance, you get “credit” and it counts!

Now, a lot of people ask about the so called “strength endurance” routines which often breaks down into some kind of circuit exercise ala PX 90, Ruthless etc etc.

I think these are great compromises and work well if weight loss is your main goal. I love the motion and movement based activities and the potential stretch benefits they give. Since we move as beings these strike me as a nice natural compromise.

But understand you will get neither as strong nor as cardiovascularly fit as with dedicated workouts.

In spite of what some of the still circulating literature suggests, you will not run faster 10K’s than 10 K runners who train in that distance by doing a circuit for 6 weeks.

You may look better and feel better than those very same runners but trust me you will not be running faster than they are or even than you would if you trained for this type of thing.

So once again it all boils down to my now famous “It Depends” answer to the what is the best form of exercise.

We should add “for you” at the end of the sentence. Train for what YOU want!

There is no question in my mind that strength and flexibility is the most useful thing for us as we age.

I cannot help but think of my friend and mentor Matt Furey.

Well into his 50’s Matt remains fast powerful and flexible and of course youthful. Combat Conditioning for instance is NOT yesterday’s news even though its over 10 years old now. This type of exercise will spank you if you are not prepared for it. If you haven’t seen what Matt is up to these days go have a look.

I will also mention to you that I am working on some specific programs with my friend and strength master Kyle Newell so stay tuned for a January launch date on that.

In the meantime remember: your body will adapt to what you give it in graduated routine fashion.

Lately I have been running longer and longer distances again with an eye towards another Canadian Death Race when I turn 60 soon. This time around I have given myself several years instead of a few months like I did when I turned 50!

That is the difference a decade can make and I respect and acknowledge the need for more recovery and better soft tissue management.

After all I want to be strong potent and still running at 90!

How about you?

Start with what you want from your body and if it’s a compromise, then that is fine. Just make a decision and stick to it until you feel your results are as good as you can get, then and only then should your change up your routine.

Doc

Ok we visited the dream world and the real world in Part 1. Now let’s get to some specifics.

If you are middle aged and American, or at least “Western” you probably are overweight.  I hope you are not but this is a statistical reality.  Another statistical reality is you probably sit too much.

When we were younger, you and me, we could exercise our way into an ideal body weight.  Somewhere after 35 the equation shifts and diet becomes more and more important in achieving weight goal Nirvana.  For me it was ketogenic calorie restricted diet that taught me what I needed to know. It will soon be time for me to update that experience and share it with you.

For you it may be different but my guess is very few people actually do this so give it a try if all else has failed.

Ok now you’ve got your weight under control, let’s look at muscle systems.

When we were younger, you and me we played more.  And we played for the sake of playing, not under some structured rules that were dedicated to scores and winning.

The other day a friend of mine and I celebrated our mutual birthdays by going out to a big playing field that had once been the property of an elementary school.  It was now “administrative” so the fields were public playing property.  We brought boomerangs and aerobe discs (a kind of long distance Frisbee).  For 90 minutes we engaged in what exercise physiologists would call High Intensity Interval Training.  I called it throwing a Frisbee!

And yet the next day when I went out for my obligatory medium distance run (these days that is 5 miles) I felt what we had done the day before big time. Since it was not painful I consider it “good”.

After one day of full rest I hit the gym for some weights. The next day body weight followed by another full day of rest.

At the beginning and sometimes at the end of each day I do stretching and mobility exercises.  Yoga works fine if you prefer the specific set of things that defines Yoga- I simply chose to focus on what I know my body needs.

And there my friend is the true definition of fitness in my opinion: what your body needs!

We are after all a mix of genetic and epigenetic tendencies and gifts. Life experiences and aging shapes those gifts in certain ways and we become what we are in this moment.

Are you strong?  Are you fast?  Do you have endurance.  Can you move freely? Are you pain free or at least relatively so?

If you can answer yes to all of those things, then you are truly fit by any reasonable definition.

If not, then you have the area you should focus on and the cure for any fitness lack.

Now some specifics for you and a conundrum.

The other day on one of my runs I heard the heavy foot strikes of another runner fast approaching.

Since running can admittedly be boring at times I often “analyze” my fellow runners out there.  There is no harm in it if I a wrong since they are not paying me or listening to me for that matter.

This person was a rarity.  They were a bit heavy on foot strikes because of the timing of where in the stride they hit and stayed in ground contact. But everything else was really pretty darn good.  The cadence was good, the posture was good, the heel lift was good, and other than landing a bit too far forward of their center of mass, the whole mechanics looked much better than most.  I can’t tell you how many people I see that should not be running and are heading for an injury if they continue. In most cases the resilience of youth is all that is saving them!

This person was indeed young.  So now for the consult: what would I change.  Runners, real distance runners have a prototypical ultra-lean build.  They lack muscle mass especially upper body mass. Without being too disparaging I call it a hollow look.  Cyclists on the other hand have a more muscular physique although still quite lean.

Each of these people consider themselves fit. So we can theoretically use body habitus as a guide.  What kind of athlete do you want to look like?

I would have told the guy who passed me to drop 10 to 15 pounds.  I am certain it would have skyrocketed his running performance.

So what kind of physique would I personally aspire to?

For me it’s a gymnast.  Viola! Integrate gymnastics into your routine and you will begin after a time to take on that body habitus.  But what is gymnastics lacking?  Well they do not seem to do long slow distance exercise which from the anti-aging standpoint is the most studies and currently the most important.  Now you have the prescription: combine the two!

Ok so endurance work and body weight stuff, pull ups pushups, parallete work and standing balance postures (again Yoga is great) spaced out with specific tissue mobilization (Yamuna ball work, MAT etc.) with some endurance work and you have the perfect “middle aged” fitness workout.

Now a few caveats:

• Most people have not done this kind of stuff in years if ever. Start slowly especially with the things that require hanging and supporting your body with shoulder strength (dips, bar hangs etc.)
• You can and should sub out one endurance workout with a speed workout or high intensity interval training. To benefit from this, you’ll need several weeks of one day a week.  You can do more but again if you are new to it be careful not to over train.
• Most people gravitate towards what they are good at. Skinny small muscled people tend to run; heavy boned thick muscled people tend to lift.  Before you are 40 it’s wonderful to make the most of your god given talents and body habitus as well as doing the sports you enjoy. But as you age, you should take a serious look at what you are lacking.  Skinny runners would do well to cut back their mileage and strength train 2 days a week.  Big muscular or more commonly these days fat, people should focus on endurance and cardiovascular fitness. So in a nutshell do what you are NOT good at and maybe don’t yet enjoy to develop the neglected aspects of your fitness.
• Mobility mobility mobility! I honestly think for every hour of other fitness activity you do you should spend half as much time at least on mobility.  Some exercises like running for me require a 1 to 1 ratio.  Now you know why I don’t do 30 mile runs anymore!
• As we age consistency becomes more and more important. The other day I had done my strength routine in the morning and a few hours later decided it was time expedient to go running.  About half way through the run I could tell the earlier effort and the unseasonable 85-degree weather were taking their toll so I cut the run short.  In doing this I probably avoided overtraining, possible injury, certain dehydration and skipping several days of running to recover.  Wisdom has taught me that showing up for the next workout is far more important than “getting my miles in” or hitting a certain weight lifted.  Show up!!!! Show up consistently so you can say it really is a habit!  Otherwise you’ll always be planning your personal fitness routine and not executing it.  You’ll always be planning and wishing you were fit instead of being it.

Experience has taught me!!!!

Now there are many things I did not cover such as changing your routines, sport specific stuff, periodization etc.  The info I have given you is an all-day everyday kind of approach.  If you want to develop specific attributes, then periodization may work better for you.

But I have found that such discussions become more and more the territory of personal trainers and exercise physiologists than aging athletes!

Your Health Secret for the Day is: Try spending the next 6 weeks doing the opposite of what you are good at!  If you are skinny and weak, do body weight, weight and band exercises. If you are strong in specific movements, try the bodyweight version of them and do some high intensity interval training on a Versa Climber or stationary bike.  Do what DOES NOT COME naturally to you for a month and a half while still doing less of what you are good at.  You may just discovery the missing link to your true fitness.

Live long, live well, have fun and share it!

Doc21