Safety First?

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My financial adviser interrupted our meeting last week.

"Had my first session at CrossFit yesterday. They say CrossFit doesn't injure you so much as reveal where you're prone to injury."

I agreed, told him that was an interesting word choice. We discussed some of his concerns, but the fact of the matter is that anything can injure you. While risk is a given in our four dimensional world, two issues that deserve some thought are relative risk and risk/benefit ratio.

 Relative risk is more important than risk.

You are far more likely to be seriously injured driving to the gym or athletic field than you are while exercising. Parents worry about their teenager injuring growth plates while lifting weights, when those injuries are far more likely incurred during a soccer game or bike ride.

All that sitting we do while in class or at work is risky behavior when it comes to neck and back health. I laugh when experts with chronic forward head posture, thoracic kyphosis, and reduced lumbar lordosis vilify some specific exercise.

To say that the risk of an exercise outweighs the benefits for a certain person or population is one thing. But I don't want a blanket opinion on dead lifts from someone who can barely reach the ground without contorting their spine or almost falling over.

Likewise, every activity has a risk to benefit ratio. For example, the risk of injury from walking three miles on a treadmill is less than running 10 miles or sprinting down hill. Wimpy thera-band movements carry little risk but also little benefit outside of a rehabilitation setting. Those elliptical trainers have less risk than plyometric jump training. Resistance training on machines is usually less risky than trying to move free weights.

The down side to safety is that most of us with life in our bones are not content with safety. We want to improve, compete, and push ourselves. Longer runs, faster sprints, higher jumps, and heavier weights (all relative) offer real mental and physical benefits that their less risky counterparts can't touch.

Sorry all you "I just want to stay healthy" people, I'm just not buying it. 

While doing a seated hamstring curl is fine, dead lifts will cause the entire posterior chain (scapula, back, hip, and leg muscles) to perform enormous feats of controlled mobility. Your weak points are exposed and you can work on what matters. Nobody ever said you have to load a tank on the bar and yank it like a power lifter.

Risk:benefit ratio is definitely a sliding scale. A pitching prodigy shouldn't risk his throwing shoulder with heavy overhead barbell presses. But a similar football player who wants to add some lean muscle mass may benefit greatly from that same exercise. A middle aged man without health insurance may want to skip weekend flag football games, even if he trains for it. He might focus on running 5K faster and with less knee pain rather than bumping up to 10k.

Any good story involves risk. While we can't afford to ignore safety, we also can't afford to write boring stories. We should remember that everything under the sun has some degrees of risk, and consider the risk:benefit ratio. While activities that involve high risk and little skill are plain stupid, we should seek to be calculated and willing to live with the benefits and risks rather than minimize risk at all expense.

*Mathmatically: Awesomeness = 1/Safety


reverse lunges are the bomb

I often joke with my patients about how much I love reverse lunges.

Knee, hip, or back pain? You need some reverse lunges.

Headache? Malaise? Dry mouth? Okay, maybe not...

But if I had to pick one resistance exercise to cover a host of orthopedic issues, it would be lunges done backwards.

Here's why:

They're a single leg movement that inherently work the stabilizing muscles of the entire lower extremity while "teaching" the brain to balance.

They fight back against chairs! All of us are droop shouldered, flex hipped, chronic over-sitters. Proper reverse lunges give a nice stretch to the hip flexors while making you pull your thoracic spine and shoulder blades back into good posture.

They're knee friendly. This is critical! Reverse lunges cause far less tibiofemoral shear and patellofemoral joint reaction force than squats and forward lunges. This is a fancy way of saying they allow you to work the hip and thigh muscles brutally hard while minimizing strain to the areas that commonly take a beating.

If you try squatting or lunging with weak trunk or hips, inflexible hips, or tight ankles, your knees will certainly moan, often because they are forced into a knee dominant movement pattern.

They facilitate a hip dominant movement patterns. As ground zero to the most powerful muscles and longest levers in the entire body, knees lend themselves to numerous wear and tear issues.

"They train the core."
It's easier to see the entire lower extremity and correct any abberant movements in the entire kinetic chain (foot, ankle, knee, and hip working together).

They train the core. The core and hip muscles must work to stabilize the spine while the hips moves, especially when you add a little resistance. This is far more functional, effective, efficient, and safe than thousands of cycles of crunching your ribs toward your pelvis or that ridiculous thing where you hold a dumbbell in one hand and do standing side bends.

No gear! It's just you and gravity, baby. Effective hard work never came so easy. To add resistance at home, hold on to some dumbbells, that ab crunch machine you never use, gallons of water, your pet, kid, house plant, or your choice of random object. Yes, your shoulder muscles will burn if they're weak.

With all this for the price of...that, what are you waiting for?

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the hell with body transformation

Tomorrow, while some of the little ones are napping, I plan to journey to my basement for yet another adventure. On the agenda is a handful of big, basic weight training movements. But what I'm thinking about tonight is squats.

I'm going to squat a ridiculous amount of weight for an obscene number of reps. I'm not listing specifics because it will seem like bragging and that's really not my intent. I'm pretty sure that I can do it, but not certain. The total workload scares me. Which is how I like it.

Why? I don't know. Why do some people trick-out their cars or golf or play video games on a Saturday afternoon? The strength and conditioning aspects of heavy weight for high reps are mere side effects. It makes my body and mind resilient. I feel awesome with minimal repercussion, which is saying a lot for a middle aged father of five.

Don't get me wrong. I'll have to hold tight to the wall when I finish my sets, until the dizzy nausea passes. I'll have delayed onset muscle soreness for a couple of days. My knees will probably ache a bit. Which brings me back to the questions.

How do you age gracefully and yet still push the limits of what defines aging? Arthritis and dementia are not at all the same, and this is no crossword puzzle. I could care less about wrinkle lines that show I've spent some years under the sun, so why should a normal decline of speed and strength bother me so much?

I'm sure time will answer these questions, but I haven't figured them out yet.

What I do know is that I still get excited about this. I'll repeatedly tell my kids when their turn to "lift weights" is over and they have to get out of the way. A friend or two will be joining me again. We'll talk for a while before the music blasts and the suffering really begins.

And we'll walk up the basement steps as different people.

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