"ANCIENT MEDICINE FOR THE MODERN ATHLETE"
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Monday, February 13, 2012

"Cardio": What Does It Entail? What Is Too Much Of A Good Thing?

"If you feel bad at 10 miles, you're in trouble. If you feel bad at 20 miles, you're normal. If you don't feel bad at 26 miles, you're abnormal." ~ Rob de Castella, winner 1983 World Marathon Championships


CARDIO: The word itself is synonymous with fitness in our culture. I recall hearing it back in the 80's, as a child. I "filed" it away, mentally, with leg-warmers, step-aerobics, thong leotards and "Jazzercise."

A ritual began early in my life, in middle school. I would head to swim team practice after school, then head directly for the scale, after practice. Because if I swam hard, I might see some benefits on the scale, right? There would be a means to an end. All my "cardio" would pay off. Yet, from week-to-week, the scale swung wildly. I wasn't out to set records in the pool or anything. I wasn't set to be state champion in any stroke. I just wanted to reap the rewards of my "cardio." That would mean, for a teenage girl, that I would feel energy, fit into my jeans, and be able to go to the dances, in my pretty new red skirt, feeling confident.

Yet, I watched, dismayed, as my hours in the pool seemed to have intermittent effects. One week, I would be called "Skeletor" at school, denoting that I was getting too skinny. The next week, I would notice an increase in water weight, surrounding not only my abdomen, but upper thighs as well. "How could this be?" I wondered. I did a mental checklist: I swim everyday after school...check. I ride my bike everywhere, even to school and back sometimes...check. I took ballet class 2 days a week...check. I drank my electrolytes...check. I took a multi-vitamin...check. I ate salads...check. I didn't understand.



My first "big girl" bike. I was 6 yrs. old. :)


I remember one day, I was 14 years old. My mom asked me to bring 2 bags of groceries into the house from the car. I remember this like it was yesterday. I felt weak. It was a strange feeling in my body. One I was unaccustomed to, and startled by. My legs felt like "jelly." My head was spinning. I was seeing stars. I managed to bring the groceries into the house, without my mother being the wiser. I didn't understand the sensation, so therefore let it go, but it did trouble me that night. How could I be feeling weak? I do so much "cardio." I'm "fit." I dance, swim, bike, and play with my friends until dark.

Years later, as an adult, I know what that sensation of weakness is. Its one I've now identified within myself. Its when I've begun to lose muscle mass, and catabolize my muscles for fuel.


I've always been a bit of a "Nutrition Nazi," as my roommates in grad. school called me. I've always done everything in my power, to learn all I can about the human body, and how to healthfully, promote longevity. With the latest, and most cutting-edge information, that I've been exposed to, at any one given time, from nutrition to medicine to fitness, I've done my best to apply it. One thing I will give myself, is that I am disciplined. I am focused. I'm a self-motivator. If there's a theory that feels, and has proven to be accurate, in "bucking" the previous one I adopted, I will investigate it thoroughly. If I deem it worthy of "debunking" the last one, I will "bow" to the new knowledge, and let go of that which no longer serves me. I'm on a vigilant quest for health, and am always willing to let go of what we used to think is healthy, if the new theory has empirically proven itself.

With that being said, I've always enjoyed my "cardio." It clears my head. To run the beautiful trails of my home in Bend, OR. is nothing short of a delight for me. The smells, textures, seasons, dirt...I treasure it. My animals treasure their time with me on the trails. We all benefit in my household. I still enjoy riding my bike (both road and mtn.) and love the water too. Laps in the pool may be monotonous to some, but I find it soothing. It is quiet under water. No drama. No talking. I'm weightless. I'm by myself. A rare treat. A mermaid for a moment in time...gliding through the silkiness of it. Its dreamlike in its quality, and calming to my soul.



8 yrs. old, with my 2 dogs, "Sophie" & "Sugar." Being with my pups in nature was important to me when I was young.





It still is. Running and hiking the trails are my solace... (with "Sierra" & "Tallon" on "Tumalo Mtn.", 2009)


I get my love of the water from my father. He is a big lap swimmer. Always has been. Always will be. My father and I are a lot alike in some ways. Others different. But he made sure we were all in the pool at a very early age. It stuck. Now, as adults, we have few things in common. But the pool...the pool is our place, where we swim, side-by-side, in quiet. It bonds us, and after we hop out of the pool, its like we had a conversation.



My dad, Bill Barton, and I enjoying a lap swim :)


In no way, shape or form, is this month's blog post, advocating you do away with your "cardio." I want to emphasize that. However, I think its important to examine where benefits end/begin with it. This goes for lifting weights too. The same principle applies. However, because our culture is fairly "cardio. obsessed," I thought I would make an example of it.

"Cardio." is a word that insinuates endurance, and thereby ultimate fitness. There are new, emerging theories, that now challenge this notion. And rightly so. Is it "fit" to be able to run ultra-marathons, but tear your "Quadratus Lumborum" muscle in half, with the mere motion of lifting a 35 lb. backpack? That's what happened to my patient, we'll call him "Roger."

"Roger" is the human equivalent of a thoroughbred. He is an endurance horse. One of the world record ultra-runners, originally from the Sierras in California. "Roger" moved to Bend to enjoy the athletic community and beauty of the high-desert. Roger runs, and he runs a lot. Is this a "bad" thing? I don't want to get into "bad" or "good" with this post. That's not my intent. Its merely to get you thinking. "Roger" has repeatedly, over many years, trained his muscles to do 2 things: propel himself forward, and keep himself upright. That is it. He has not trained it to lift, push, pull or anything else of the sort. This is what tore the muscle in his back. Something as light as a 35 lb. backpack, was the "straw that (literally) broke the camel's back." Is that "fit?"

"Roger" is someone who could be deemed a "specialist." Is being a "specialist" a "bad" thing? Again, I want to emphasize a resounding "No." IF, and here's the IF: IF you KNOW that's what you are. If you think being a "specialist" denotes an overall example of "fitness," that is a different matter entirely.

To train your body to propel, horizontally, through space, while remaining upright is a feat. Yet, if you think about it, you do that all day, everyday anyway (except when you're sleeping). However, do you feel competent in moving loads across modal (various) domains of space and time? How is your body on the vertical plane? Are you able to push, pull, jump, and bend with ease? All of these things, in various combinations, could denote a solid picture of fitness.

Historically speaking (see "PALEO Fitness" blog post), there were very few "specialists" in a tribe. The tribe couldn't afford it. Work needed to get done: water hauled, logs for structures moved, the hunt skinned, etc. Now, with sports nutrition, sports-specific training and technology everyone can be a "specialist". It just takes the mental discipline and fortitude. Again, is this "bad?" No. However, we should examine what the benefits and drawbacks are.

You'll not find a bigger proponent of endorphins than me. I am a "junkie," no question about it. The topic of "endorphins" could be a blog post in and of itself. They're a "feel good" neuro-chemical that make us happy. This can only be good, in my book. I always loved the quote from the movie "Legally Blonde." When Elle (Reese Witherspoon) discusses a legal case with her fellow attorneys, regarding their client (whose on trial for murder) she reminds them: "I just don't think she did it. She's the 'spinning' queen. I took her spin class in 'Beverly Hills.' People who exercise are happy, and happy people just don't kill other people." Cute. Simplistic. Who could argue? People who are happy contribute to society. They radiate that happiness and enthusiasm out to others. The "Runner's High" has a "ripple" effect out to all who hang out with the runner. How could this be a "bad" thing? Its not.

What is troublesome, however, is that one of the world's top, most well-respected ultra-runners, is deemed a "pinnacle" of fitness by his comrades. In reality, he's hobbling into my office, because he doesn't have the strength to lift a 35 lb. backpack, and put it over his shoulder. Food for thought.

"Roger" has broken down so much muscle, at this point, through miles of running, that his body could not perform (at a very low weight) a simple functional movement. One that is necessary for daily activity: lifting objects (a.k.a. a "deadlift").

When I was doing my training, last year, for my first 2 half-marathons, I didn't like what I was seeing. As my miles increased, my strength decreased. The "holy grail" quest, for the majority of athletes is the perfect strength to weight ratio. How many of us accomplish it, though? This strength to weight ratio is different for everyone. Western science has categorized 3 primary body types: Mesomorph, Ectomorph, and Endomorph. The strength to weight ratio for each of these 3 body types will vary. There is no magic number or "bullet" formula to denote where mileage begins and strength ends. This will be pure trial and error for you to find on your own. This line is more "thin" than you think. Its a "razor's edge." There's a "cusp," and only you will know where that will be.

It will take some figuring out, and this will take place over time. Its not an overnight process. I'll give you an example: I found that when I did over 10+ mile runs that my strength decreased by 10 lbs. in each Olympic Lift I did in "CrossFit." I didn't like this. Not one bit. As a climber, that strength to weight ratio is crucial. To be "top heavy" is detrimental (its just more weight to "lug" up the wall). To be too light, is to potentially not have the strength to "pull" that difficult "crux" move. You need both. Like a gymnast. In fact, many pro. climbers, were once professional or collegiate gymnasts. There is a good deal of overlap with the two sports. With the type of climbing one does, however, it gets even more specific. If you carry a trad. rack up with you (because you're placing your own gear, not clipping into bolts, like sport climbing), the ability to "carry loads across various modal domains" becomes a necessity. Trad. racks are heavy. They get more heavy, too, with the length of route and difficulty of climb. As I began to run more, my (small) rack began to feel like the weight of the world, as I climbed up a standard 80 ft. route. This is not helpful to me.



My trad. rack weighs 15 lbs.  I hope to only make mine heavier, by getting more pieces, so that I may work different sizes of cracks. :) Get too skinny, and this will feel like a ton, half-way up a climb. You're legs will be trembling, and your forearms burning, panting to catch your breath. Maintain muscle mass, and it feels a lot better to lug up a route. :)

Certainly, whether you care or not about maintaining strength to weight ratio, depends on your athletic interests, right? Not necessarily. For "Roger," he didn't want to carry a trad. rack up a wall. He just wanted to lift a backpack with textbooks in it. An everyday activity. Are you a mother? Lifting your children (not to mention the groceries, etc.) could be important for you. Think because you can run an ultra that means you're strong? Mentally speaking, there's no question about it. That takes a mental focus, par none. Physically speaking, one of the world's best, struggled with a backpack full of books. I leave that for you to ponder.

Olympic lifts are a good barometer of whether your strength is being compromised, as you increase your mileage (whether it be by foot, bike or swim). It took me 2 weeks, after my last 1/2 marathon last year, to get my PR'd weight back for all my lifts. 2 weeks. That astonished me. All that hard work, I had built up over the 3.5 years I'd done diminished rapidly as I began "clocking" 10+ mile "long runs." Everything seemed harder. Carrying my climbing pack, helping my dogs into the car, carrying multiple bags of groceries at once. It was something I was acutely aware of.

Your mileage to strength diminishment distance may look different than mine. You will need to find out for yourself what this is. I will say this, though. Remember several months back, when I was doing running laps up "Pilot Butte," and came upon an injured woman? I posted on my "Facebook" page about it. I was able to do the "Partner Carry" (as we call it in "CrossFit"), and run her up the last 1/2 of the Butte, to where the ambulance met us. I thought in my mind, as I walked down after the incident, "Thank God, I'd gotten my lifts back to where they were in weight." If I had kept doing 1/2 marathon, after 1/2 marathon, I would've been too weak to carry her (while running!) up the Butte to medical care. Being strong has function. It has purpose. It can save lives. Its not just about feeling strong and looking fit (which is also a nice side benefit). Its about being useful in times of emergency, and no one knows when those times will be. I'm not saying it will never happen. I know better than to "never say never." It is highly unlikely, however, you will ever have to run 26+ miles in an emergency. It could happen. But, I'm doubting it.



2 women performing the "Partner Carry" in "CrossFit"


I believe nature is the truest picture of our essence. Chinese medicine states we are all governed by the same laws, man and animal alike. We are all governed by gravity. We all have the same bare necessities (sun, air, water, etc.). No being is immune. Nature is non-judgmental fair play. Its "survival of the fittest." Period. There are fast animals. There are strong animals. There are animals in between.

If you look at nature, however, the "specialists" are the outliers. The cheetah, being the fastest in the world, and the large elephant, with its massive body are far and few between. Both are not prolific species. The ones that can adapt to all things thrown at them are abundant. They have qualities of strength, flexibility, agility and speed. However, the "specialists" give us a rare glimpse into the extremes of what nature is capable of. They are a "lens" into the beings who move outside the "bell shaped curve."

Wildlife biologists agree (thank you, Dr. Jane Goodall :) that the species that is able to adapt to a survival situation best is...(drum roll)...the monkey. Why? Think about it. If you have a fast cheetah, at one of the spectrum (a "specialist") and a strong elephant at the other end of the spectrum (a "specialist"), you find the monkey right in the middle, as far as physical adaptability and skills are concerned: they can forage food on the ground, in the trees, they can keep up a consistent (and surprisingly! clipped) pace as a tribe, they are strong, they have four limbs, strong grip-strength, they can move loads (including carry several babies) across modal domains (climb with them, run with them, even "water jog" with them in some areas of the world). They are hunters. They are gatherers. They eat meat. They eat foliage. They eat fruit. They eat berries. They adapt quickly to the environment (even when the humans mess this up). Granted, all of the above qualities that monkeys exhibit will vary, depending on what part of the world they live in. The point? Human influence aside, the "specialist" will go extinct before the monkey does. Gauranteed.





A monkey's fitness stretch across varying distances and modal domains. This gives them the "survival of the fittest" advantage.


What does this tell us about ourselves, and the way we should train? Coach Greg Glassman, founder of "CrossFit," gives us a pretty good "PALEO" prescription for fitness: "Our prescription of functionality and intensity is constantly varied. We believe that preparation for random physical challenges- i.e., unknown and unknowable events-is at odds with fixed, predictable and routine regimens."

This past week, I sat down with Dr. Jason Kremer, D.C., C.S.C.S. I asked him, "Dr. K., if you were forced to make a decision on which workout you had to miss, a "cardio" workout, or a "strength" workout (including body-weight placement gymnastics and lifting), which would it be?" Without hesitation, Dr. Kremer said "I would miss the 'cardio' workout." "Why?" I asked (knowing full well what his reason was). "Because strength will promote speed, but it doesn't work the other way around. Speed will diminish strength."

This is precisely the echo of "CrossFit": Anaerobic work capacity benefits aerobic, but not necessarily the other way around. The fact that my lifting weight decreased by 10 lbs. in every Olympic lift, while I was doing 10+ mile runs was proof enough for me. Again, is this a "bad" thing? Not if you're willing to accept the everyday consequences of this: picking up objects, pulling things, pushing things, etc. becoming increasingly more difficult. That is an informed choice one has to make. The problem? Most endurance athletes aren't informed to the extent they should be about the topic.

A thought, however: if you were in an emergency or survival situation, who would you want to be "stuck on the island" with? Someone who has the equivalent skills of the monkey, or the cheetah or elephant?

My clinical specialty ranges in 2 areas: sports medicine and gastro-intestinal disorders/nutritional deficiencies. The two often go hand-in-hand. I have yet to see someone who (really) cross-trains (and this does not mean "cross-train" with "cardio" activities) come in with the following complaints as they increase their training: water retention, difficulty dropping weight (you'd be surprised how many endurance athletes I hear this from a week), insomnia, acid reflux, IBS, and amenorrhea. Drop weight? How can someone who runs ultras or does triathlons have problems dropping weight? I look at the vast majority of endurance athletes, and there are few I look at whose bodies I envy. Either too skinny ("but hey, Almine, being 'light' makes me so much faster), or bloated with water retention ("I have to sleep with my compression tights on at night, or it looks like I'm pregnant the next day"). There is something askew with that picture. Sure, subscribing to the "carb loading" nutrition theory of the "dark ages" (yeah, that would be the 80's) could be adding "fuel to the fire," but remember this: the more you increase your mileage, the more need your body has for strength and power.

Let's face it. If you're what I term a "Cardio-phile," you may "cross-train" on a "Bosu" ball or with resistance bands, or with isolated machines 1-2x per week, because well, "I'm a runner, & that's what I want to do." That's fine, but be aware of the effects this will have. Reality check: you probably wouldn't be able to do enough cross-training to maintain muscle mass, if you keep adding mileage. It will be a constant battle for you to "catch up" in the strength-to-weight ratio department.


A pinnacle of fitness? "Bicycling" magazine sure thought so.


Towards the end of my running season, last year, I got tired of, well, being tired. That meant to me, a loss in strength for what I needed to do for my daily activities and other sports. I decided to try it the "CrossFit Endurance" way. For a 1/2 marathon distance, I began running no more than 10k runs. No more 10-milers, 12-milers, etc. I decided to take the challenge. Decrease my "long" run mileage. Increase my 400m and 800m sprint-runs, and weight on my Olympic lifts. Why work on heavy weight? Because, if you're lifting correctly, you should be feeling it all in your abs, hamstrings, and quads. In the words of Coach Glassman, "Lifts strengthen your 'posterior chain' (the backside of your legs). What did that do? My legs got so strong, from deadlifting, doing squats with weight overhead, etc. that hills began to feel like flat road. They became a joy (and still are) to me. That is because of lifting, not because I'm necessarily "clocking" a lot of mileage.



My current PR for a deadlift? 195 lbs. I'm still working on it. :)


In other words: Work on speed vs. distance. Explosive power vs. distance. My next 1/2 marathon time? 2:12. The one I had done prior (using the "training method" given to me by my local running store)? 2:35.



Along the course for "Cycle OR.," 2011 (with BFF, Julie Neff) :)


I leave this post with you as food-for-thought. I'm not telling you not to go and do a long bike ride, swim, or run. I would never begrudge a person the gift of feeling the sun on their face, and the wind in their hair, on beautiful road or trails, as long as they desire. I'm telling you, like with alcohol, sugar, etc., be aware of intake, and how much. That is all. I'm wanting to get you thinking about your training differently, even if its for an endurance event. I've done a number of "Adventure Races" at this point. I understand what training for 6, 12 and 24 hr. races feels like. I want to introduce, however, new concepts to you. I want to invite you to consider throwing out the window old information as the new comes along. Be open to it. If we drag the outdated theories along with us, as we learn more everyday, about the miraculous nature of the human body, mind and spirit, and what its capable of, we will be like a 10 yr. old, still stuck in its crib.



Trail-Running Along My Favorite Trail, From "Benham Falls" To "Meadow Camp"


One of my favorite sayings is "A Zen Mind Is A Beginner's Mind." Be willing to have the mind of a "beginner" everyday: open, fresh, with new eyes. You might be surprised how little it takes to go very far.

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