The Problem is a Verb

When it comes to muscle and joint aches and pain, patients and health care providers find it challenging to conceive of the problem as anything but a noun.

Herniated disc.
Tennis elbow (or lateral epicondylitis).
Torn meniscus.
Shoulder bursitis.

These are the type of labels we're familiar with. Everyone likes the idea of trying to deal with nouns. But it turns out that the noun is often inaccurate (1,2). At least initially, it's really not that important (3,4). Muscle and joint pain almost always has to do with dysfunctional movement. In other words, the problem is a verb.

Almost all-seeing, but not all-knowing.

Why, exactly, does your shoulder ache after volleyball practice? Is your Achilles tendon on fire because of poor foot structure or hip inflexibility? Will the headache and radiating pain down your arm require surgery or is it likely to respond to more conservative care?

It's more important to answer those kinds of questions than it is to identify exactly what hurts. And you'll need some verbs to find good answers.

Although X-rays and MRIs will give you an inside peek into potential causes of pain associated with injury or "wear and tear," the exact tissue at fault is often uncertain(5). Pictures of anatomical nouns in a rested state show how things look but not how they function. Form and function are obviously linked, but research has proven that looks are deceiving (6, 7, 8, 15).

You better take into account how they function.

The problem with noun diagnosis is that people who are in pain and those who have absolutely no pain often have disastrous looking structure. For example, the top dogs of orthopedic medicine and rehabilitating have knowingly skirted that mystery for decades by using the term"nonspecific low back pain," and have since given that diagnostic label to over 90% of patients with back pain (9,10).

I swear I'm not making this up.

It turns out that identifying the cause of pain is also tricky business elsewhere in the body. Is your partially torn rotator cuff tendon the reason why it hurts to buckle your seat belt? Maybe not. Many people without shoulder issues have partial and full thickness tears(11). I've treated people with full tears who are able to reach and lift overhead just fine after improving the mobility of their scapula and thoracic spine.

Experts agree that joint degeneration is a normal part of aging. Meniscal tears and osteoarthritis in the knee are almost universal (12), yet not everyone needs a knee replacement. Your MRI shows degenerative disc disease and herniations? Well, so do fifty percent of the MRIs of people in their early twenties (13)!

How much degeneration the body can accommodate varies from person to person. But something other than just a structural problem is responsible for causing misery for some people but not others.

The difference is in how they move.

So where are we left in our attempts to describe movement related problems with movement-related terminology? What do patients get when clinicians simply try to be honest about the limits of anatomical (noun) diagnoses?

Lumbar flexion dysfunction.
Scapula upward rotation dyskenesis.
Knee coordination impairment.

We get unsatisfactory professor words. Ugh. In order to be more technically correct, we've become more vague and silly. I've noun-diagnosed this phenomenon in healthcare providers as Well Duh Syndrome.

Imagine the scenarios at the office.

"Doctor it hurts when I bend forward, like, flexing my spine."
"Yeah, it seems to me that you have a pronounced case of lumbar flexion dysfunction."

"Doctor my knee hurts pretty bad. It often just gives out."
"Well I've determined that you have knee coordination impairment."

Before you laugh, remember that you've accepted terms like Restless Legs Syndrome and Halitosis as serious medical terminology. Besides, it's not so much a label, but a response to movement that we're after. That's hard to pin down in just a few words.

These poor (Ravens) fans have been
diagnosed with NFL Cheering Impairment.

The bottom line is that you should never be too intimidated when you hear arthritic this or torn that. Diagnostic imaging is one piece of the puzzle and it really is okay if your doctor didn't order expensive tests right off the bat.

The best thing you can do, at least initially, is to worry less about exactly what's causing the pain. I know that's asking a lot. Instead, seek to find out what, if any, movements and positions cause a change in pain and function.

A case for diagnostic imaging.


Nobody can "fix" arthritis. And I won't try to tell you that MRI and CT Scans are useless and that nobody should ever have surgery. But with the right intervention, changing the details of how your body does it's verbs quite often translates into less pain and more verbs.

- - - - -

1. Borenstein DG, O'Mara JW, Boden SD, Lauerman WC, Jacobson A, Platenberg C, Schellinger D, Wiesel SW. The value of magnetic resonance imaging of the lumbar spine to predict low-back pain in asymptomatic subjects: a seven-year follow-up study. J Bone Joint Surg Am. 2001 Sep;83(9):1306-11.

2. Saal JS. General principles of diagnostic testing as related to painful lumbar spine disorders: a critical appraisal of current diagnostic techniques. Spine. 2002 15;27(22):2538-45.

3. Cook C, Hegedus E, Ramey K. Physical therapy exercise intervention based on classification using the patent response method: a systematic review of the literature. JMPT 2005;13:152-62.

4. Donelson R, Aprill C, Medcalf R, Grant W. A prospective study of centralization of lumbar and referred pain. Spine. 1997; 22:1115-1122.

5. Chou R, Rongwei F, Carrino J, Deyo RA. Imaging strategies for low-back pain: systematic review and meta-analysis. The Lancet. 2009;373 (9662): 463-472.

6. Michael J. DeFranco, MD, and Bernard R. Bach, Jr, MD. A Comprehensive Review of Partial Anterior Cruciate Ligament Tears. In The Journal of Bone and Joint Surgery. January 2009. Vol. 91A. No. 1. Pp. 198-208.

7. Videman T, Battie MC, Gibbons LE, Maravilla K, Kaprio J. Association between back pain history and lumbar MRI findings. Spine 2003;28(6):582-8.

8. Young S, Aprill C, Laslett M. Correlation of clinical examination characteristics with three sources of chronic low back pain. Spine 2003;3(6):460-5.

9. Koes B. Clinical guidelines for the management of low back pain in primary care: an international comparison. Spine 2001;26:2504-2514.

10. Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 2006;4(2):S192-300.

11. Sher JS, Uribe JW, Posarda A. Abnormal findings on magnetic resonance images of asymptomatic shoulders. Journal of Bone and Joint Surgery 1995;77(A): 10-15.

12. Englund M, Guermazi A, Gale D. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med. 2008;359:1108-1115.

13. Takatalo J, Karppinnen J, Niinimaki J et al. Prevalence of disc degeneration and displacement, annular tears, and modic changes in lumbar MRI scans in young adults. Spine. 2009;34(16):1716-21.

14. Hoangmai H. Pham, Bruce E. Landon, James D. Reschovsky, Beny Wu, & Deborah Schrag. Rapidity and Modality of Imaging for Acute Low Back Pain in Elderly Patients. Archives of Internal Medicine 2009, 169 (10), 972-981

15. Connor PM, Banks DM, Tyson AB, Coumas JS and D’Alessandro DF (2003): Magnetic resonance imaging of the asymptomatic shoulder of overhead athletes. A five-year follow-up study. American Journal of Sports Medicine 31, 5, 724-727.

T-ball Recap

It is finished. The six of us at the Gorinski home suddenly have about 6 to 9 more hours per week of time on our hands.

When you sign up, they don't tell you that you're looking at roughly 90 minute "games," with a half-hour in the car and an hour or more of getting ready beforehand or going to the park afterwards, plus snack and peeing issues.

So below is a quick season highlight video. Well, it's not really a highlight, but rather a few pictures thrown together. I missed a lot of the games and when I did make it, I usually had my hands full settling Goldfish cracker/Gator-Aid fights between Maggie and Ben, helping Owen get his costumes on and off, and trying to coach.

Now don't let the video fool you. T-ball is 99% slow going, and that's no exaggeration. Lessons are learned alright, by players, coaches, and parents alike. Those lessons have little to do with baseball. I reflected on a few of my own lessons at the beginning of this season right here.

These gals and girls are just little. Learning to get your body to do what your brain wants it to do takes at least 18 or 20 years. The helmets are still way too big. Amy and I laughed during a recent 5:30 game, looking out and seeing a dozen five and six year olds tired from the day, all of them taking every opportunity to lay down in the grass when they can and trying to put off a potty break by grabbing their peepers.

In conclusion, Tball is worth it IF the kid wants to play.

So here's something to hopefully remember the season by. Remember this is fun for me:

______ League

- - - - -
Hours after coming into this world, mom dressed me in pinstripes, rested my head in a baseball mitt, and snapped a picture. A day or so later my height and weight was broadcast over Tacoma radio, presumably during small talk as dad stepped to the plate.

Mom competed in rodeos. Still does!

My earliest years overlapped temporally and geographically with a certain Steel City dynasty remembered unto the ages.

- - - - -

"You want to go where everybody knows your name." - Cheers Theme

I stride on the scene playing it cool. But who am I kidding? You had me at hello; even before that. It’s in my blood. I couldn't wait to be here today. I can't play alone. Well, at least not at my age. Without you, the physical activity turns into mundane and inconvenient exercise.

The 9 or 12 guys on the court right now are catalysts in the fuel I run on all week. That's how it works with everyday weekend warriors.

Alley-oops and deep post patterns are some of the best ways for men to connect. Helping a friend back onto the mountain bike he fell off in the pouring rain is intimacy. You want to talk about feelings? Pile-ups, blocks, and line checks during flag football are where five at a time gather over something they can feel.

- - - - -
A League of Extraordinary Gentlemen:
Bart Ben Brandon Brett Bret Bruce Chris Craig Dan Dave Doug Kyle Matt Max Mike Phil Rich Ryan Tim Tim
- - - - -

I love these guys.

They aren’t afraid to shut down the lane. In the fall they flatten me at the line of scrimmage and in the summer they make worn spots in the lawn that I interpret like an inkblot test. They pin me on the post, shove, and hit fade away jumpers in my eye. Their presence increases my physiological capacity and causes my bike to go places not meant for wheeled devices.

What could be better for men such as this? We plan, play, review, and share injuries together. It’s the best of high school glory days with only a fraction of the ego and false hope. The games are more fun and less edgy than official “rec” leagues. There is sweat and blood and a little cursing. There’s almost never anything malicious. In fact, I've found the court and trail and ball field to be some of the least contrived places.

Nobody owns or dominates the League. There’s not a cent on the line. Though many in the League were once pro or college-level athletes, all have paid their dues elsewhere. Now our weekly ceremony is a thing of beauty, like a tribal dance passed down from the ancients.

Mental and physical errors happen all the time. But the bursts of graceful, on-the-mark athleticism, when a man who sat at a desk all day or dealt with hours of tanbark or ill patients, shines in a moment of strength....

...That move you just pulled off?

Amen.

My brother, I stand in awe of that move.

When our meetings end there is laughter and grace. Everyone wins. We sit around sweaty and with poor posture, sometimes opening up our lives, always celebrating today's victory. Softness and frailty have been held at bay in todays battle, yet nobody wins that war.

I must deal with the fact that our gatherings are numbered. I hang my head and find comfort looking down at the three who blister onto the court/field ahead of me. The seeds are sown, as everyone in this League has been so kind to lend a hand in the next.

I think the point is to find your League. Call it a ministry because you need each other. If you have a functional body, fully receive your gift. Hurry, while there's still time. Your League offers sacred things that the sports page and ESPN can't even approach.

It's definitely not just a game.

- - - - -

Well People 2010

No - she - DIDN'T!!!" -K Shuman

"You told me there would be smoothies." A Gorinski

"Okay, but we're still on the clock for this?" -D Valdez

"Like a boss." -B Gorinski

- - - - -

Allegations of banned substances cut through the air like horsefeathers after Bob Gorinski's dominating performance at Health & Wellness Day 2010. At a post-game press conference, Gorinski admitted to a large group of reporters that he recieved treatments from the Kazakhstanian doctor charged with smuggling and supplying Strengthogen into the US.

When probed further, Gorinski attempted to fend off accusations by humming We Are The Champions a bit louder than he was previously. After another member of the press asked if his domination could be related to the fact that he created the events, Gorinski said "hello," putting his index finger in the air as he pretended to answer his cell phone.

"Let the beginning commenculate."

Otherwise, wellness day was pulled off in grand fashion. There were no injuries, blood doping, or any other kind of doping, unless you count water- and nectarine-hyperhydration overdose.

Heart rates and VO2 climbed, trash talk elevated, tomfoolery attended, and laughter reigned. Now that's some wellness right thar - I don't care who y'are.

Official NEHAWD standings:

Physioball Golf
Bob - 5 strokes, 44 seconds
Amy - 6 strokes, 0:56
Debbie - 6 strokes, 1:15
Kim - 11 strokes, 1:46

Treadmill Volleyball
1st - Bob
2nd - Kim
3rd - Debbie
4th - Amy

Physioball Water Slam
Bob - 32 ounces
Kim - 24 ounces
Debbie - 16 ounces
Amy - 8 ounces

Stool Hockey
Bob - 0
Kim - 0
Debbie - 0
Amy - 0
[Yes ladies and gentleman, a 4-way tie for first place here.]

Nectarine Eating Conest
Bob - 2.5
Kim - 1.5
Debbie - 1.0
Amy - .75

Bowmansdale Idol
Bob - 2.6 million votes

Kim - 2,599,999 million votes

Debbie - 1 million votes (pinky to lips)

Amy - .0000004 million votes

A good time was had by all. Yes ALL.

Spare the Arm 5: Choices

- - - - -

This 5-part series is about not missing the forest for the trees when it comes to injury prevention and training of pitchers. Focusing on the shoulder and elbow "trees" often causes neglect of the "forest" of relevant factors throughout the rest of the body. This installment explores some areas not directly related to anatomy and physiology at all.

Planning

I'm not going to give you a structured and straightforward evidence-based decision tree on not doing stupid things. The majority of shoulder and elbow injuries are due to the same thing that causes injuries in softball and judo and shuffle board and tight rope walking over Niagara Falls.

Whatever happens, it's not his fault.

The root of this multisport epidemic is non-organic (i.e. mental), and should be labeled Stupid Choices Syndrome (SCS). SCS is closely related to Common Sense Deficit Disorder (CSDD) and Too Much Too Soon Syndrome (TMTS), not to be confused with Teenage Mutant Ninja Turtles (TMNT).

These clinical diagnoses are especially prevalent in young men and may also be passed down genetically from overzealous parents. Whatever the case, shift the blame onto the syndrome and off the behavior of the athlete (and parents). Here's an actual clinical picture of a young man suffering with SCS:

Now of course all injuries are not due to taking on too much too soon or doing stupid things. But when they are, please don't feel bad. I've been stupid with you. The ulnar collateral ligament of my right elbow is an excellent case study in SCS.

During grad school I appeared to pitch in a Twilight League game after one whole week of preparation. I made it two innings. A few years later, without warming up, much less training my body to throw hard, I attempted to throw out a runner tagging for home plate. Last fall I tried to beat Bret Wagner in a walnut throwing contest in my backyard, and prior to that separated my right AC joint falling off my mountain bike.

All of these injuries and re-injuries resulted in elbow pain when throwing, and none of them were the "fault" of my UCL. My scapular stability and core rotational strength and hip range of motion were certainly not to blame. I've since self-diagnosed myself with a pretty cut and dry case of SCS, but many times the clinical picture is much less clear:

If you love baseball and try to pitch 11 months out of the year, you're diagnosed.

If you take a few months off like you should and then expect to gun the ball on a cold day in March, you're diagnosed.

If you're a player or coach who stretches the truth about pitch- and Ibuprofen counts, because it's the playoffs - you're diagnosed.

If you throw very hard and love to prove it at pitching "showcases" and especially at the local fair "Guess Your Velocity" game...

If you think you can get away with sitting 16 hours per day at school/work and in the car and on the X-box and not perform regular hip, scapula, and thoracic mobility work - you're diagnosed.

If you think it takes weeks and not months to condition your body to max out and withstand repeatedly throwing as hard as possible...

If your arm is sore and you always want to blame it on the curve balls you threw as a 12 year old, you're diagnosed.

As I wrote about here, curve balls don't injure developing arms. Pitching injures developing arms (1, 2). The factors strongest associated with injury in adolescents pitchers have nothing to do with pitch type or stretching routine or technical delivery technique. Instead, the primary risks include pitching more than eight months out of the year, often throwing more than 80 pitches per game, participating in "showcases", pitching with arm pain and fatigue, and frequently using anti-inflammatory drugs and ice (2).

- the.arm.is.not.a.robot -

And again I say prepare your entire body to throw. For example, my SCS resulted in tremendous strain to the UCL. Had I allowed sufficient time for the supportive elbow, wrist, shoulder, and scapular muscles to be conditioned for their role of significantly unloading the UCL, it likely would have been capable of handling the strain (3).

My advice to not do something stupid seems pretty obvious until you consider that SCS truly is a common diagnoses, and then it's very hard to steer out of a rut once you've been injured. As listed in part one of this series, the chance of the arm surviving to even get to the point of high level pitching (much less succeeding) is slim, even when you don't do something stupid (4, 5, 6).

So now that you're going to try not to catch SCS, I'm going to ask that you don't do something ignorant in your training. While the right conditioning can be extremely beneficial for pitchers, training sometimes gets a bad "rap" because many of us trainer type people have difficulty remembering that working out is not the end, but only a means to an end (lots of Ks and/or Ws).

We must take extra precaution to make sure the cost/benefit ratio is in check. Is it worth the time and risk involved for a high level pitcher to perform power cleans and heavy overhead presses? I don't think it is. Does the potential payoff justify the time and risk involved to perform some form of deadlifts and plyometrics? I think so. This type of cost/benefit analysis is critical for fitting the training to the individual athlete and not vice-versa.

And of course, when it comes to training, there is a ton of Misinformation Disorder and Just Plain Bad Idea Disease going around:

If you think muscle confusion, P90-X, and Cross Fit are good, pitching specific off season training programs - you're diagnosed. [Although the lower body plyo portion of P90-X does have merit.]

If you think that upright rows and dumbbell kickbacks are great exercises and needed for isolating the anterior deltiod and long head of the triceps...

If you think that pitchers must avoid all overhead exercise and yet persist in benching three times per week...

If you think that a handful of wimpy rubber tubing exercises are the key to safely decelerating an arm that the entire body has accelerated to over 7200 degrees per second...(7)

If you think jogging is a good way to condition your legs to repeatedly, explosively accelerate and decelerate the body and won't negatively effect peak power production...(8, 9).
David Wells errored a little too much on the safe side of overdoing cardio.



If you think you can pitch for a number of years without routinely revisiting corrective stretching and strengthening exercises...

Train like a baseball player for total body strength and power. Perform specific corrective stretches that will counter the asymmetries that pitching creates, and warm up well with rotational total body activities as outlined here.

In the spring, be patient and allow time to taper into throwing gradually. During the season, resist the urge to pitch the best players too frequently for too long, and to cover it up with Advil. Make sure the body gets an off season from actual throwing to focus on other sports or at least a period of hard cross training.

These are the things that spare the arm.

- - - - -

1. Fleisig GS, Kingsley DS, Loftice JW, Dinnen KP, Ranganathan R, Dun S, Escamilla RF, Andrews JR.Kinetic comparison among the fastball, curveball, change-up, and slider in collegiate baseball pitchers. Am J Sports Med 2006;34(3):423-30.

2. Olsen SJ, Fleisig GS, Dun S, Loftice J, Andrews JR. Risk factors for shoulder and elbow injuries in adolescent baseball pitchers. Am J Sports Med 2006;34(6):905-12.

3. Fleisig GS, Andrews JR, Dillman CJ, Escamilla RF. Kinetics of baseball pitching with implications about injury mechanisms. Am J Sports Med 1995;23(2):233-9.

4. Thigpen, CA, Gill, T, Schneider RE, DiStefano MJ, Reinold MM, and Seitz AL. Adaptations in 3D scapula position of professional baseball pitchers over one season. Presented at the 2009 Sports Physical Therapy Section Meeting.

5. Ouelette, H, Labis J, Bredella M, Palmer WE, Sheah K, Torriani M. Spectrum of shoulder injuries in the baseball pitcher. Skeletal Radiol 2007;10:3.

6. Conte S, Requa RK, Garrick JG. Disability days in major league baseball. Am J Sports Med 2001;29:431-6.

7. Fleisig GS, Barrentine SW, Zheng N, Escamilla RF, Andrews JR. Kinematic and kinetic comparison of baseball pitching among various levels of development. J Biomechanics 1999;32:1371-5.

8. McCarthy JP, Agre JC, Graf BK, Pozniak MA, Vailas AC. Compatability of adaptive responses with combining strength and endurance training. Med Sci Sports Exerc 1995;27:429-36.

9. Bell GJ, Syrotuik D, Martin TP, Burnham R, Quinney HA. Effect of concurrent strength and endurance training on skeletal muscle properties and hormone concentrations in humans. Eur J Appl Physiol 2000;81:418-27.

Come On Out to NEHAWD

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National Employee Health And Wellness Day is May 19th. We'll be partaking of it on the 25th, due to scheduling issues and Kim's training regimen.

I'll skip the part here where I wonder if a person can be healthy without being well. ...
...

Nonetheless, it's Health AND Wellness Day. Sooooo...

NEHAWD is one day out of the year when employers across the nation promote wellness by including lunch time walks and blood pressure screens and making mostly untasty snacks available. Over the last few years, we've decided to not do that. We've (mostly) gotten away with giving convention and liability and lameness the middle finger.

Well yeah, there's a message going on here, serious as a NOT heart attack. We bond and laugh a lot, scarcely noticing that our heart rates are well within the target zone. NEHAWD is an hour of sanctioned goofing off at work, so long as we're not sitting around on the internet eating Brusters Ice Cream.

This year's NEHAWD events have been meticulously structured to cover all 7 components of health and fitness:

1. Stool Floor Hockey - tests manual dexterity and shin whacking capacity

2. Physioball Golf (*no golf cart)- muscular power and awesomeness

3. Physioball Gulp - balance control and bladder fortitude

4. Asparagus eating contest - cardiovascular capacity of the jaw

5. Treadmill volleyball - tests social skills and analytic capabilities

Okay, so come out and compete with us next Tuesday. I dare you. Yes, there will be prizes and no gross "health" snacks.

- - - - -

The Theory of 11

- - - - -

"What we do is, if we need that extra push over the cliff, you know what we do? Eleven, exactly! One louder."

-Nigel Tufnel




- - - - - -

I never met a weight I could lift for 10 reps but couldn't do for 11.

I suppose that weight exists. In theory. It's really a matter of effort. Intensity. Will.

I DON'T DO 10.

Myself.

I don't force the madness on my poor clientele, but a long time ago, when I first "caught" resistance training, I decided to do one more. Because I could.

It's just that I always thought the whole decimal numeral system was way overrated, physiologically. While I'm glad that humans weren't made with six fingers to a hand, I highly doubt that after 10, muscle fibers suddenly become suspicious of your training goals.

"What? Wait! Forget fast and powerful, because now we're on 11 and that's just toning."

Blleeaacchh: toning. Hmmmph.

What if that eleventh rep is performed with a resistance that you would have loved to stop (or a more sane person would have stopped) at 7 or 9 with?

Eleven is not for beginners. I mean, sure, anyone can do an exercise for eleven reps, but that has nothing to do with Eleven. Eleven is for when you're willing and able to truly pay for results. It takes years, certainly not weeks or months, to perfect form and generate the kind of intensity that allows you to even approach Eleven.

You can't test the Theory of 11 too soon after a big meal.

A side note for less-than beginners: exercise is not boring! Yeah, it's boring when you look at exercise and functional performance like this:

Really, when you have only one machine to work with? Thankfully, most of us are given many opportunities to get things in order.

Is the economy uncertain? Are the kids learning the hard way? Another environmental disaster got you down? Need something you can feel? Well, how about treating it with some sets, reps, time, and other variables that you DO have some control over? Exercise doesn't fix everything, and it certainly can be taken too far. But it's way better than another 10 hours at the office or 3rd bowl/bag/drink over Golden Girls reruns.

Okay, where were we?

Eleven is for when you decide to quit screwing around with muscle confusion and fall head-over-heels in love with the idea of approaching your limits. What ever happened to the good old fashion value of devoting yourself to something? While muscle confusion can leave you tired and sore and maybe even regretful the next morning, doing one rep more with even just one pound more than what almost killed you last time - that's lasting, sacrificial love. Baby.

And to keep it simple, let's set just one ground rule. Bench press doesn't count. Do it with just about any other multijoint "big" movement, because applying the bench press to the Theory of 11 is like putting make-up on your butt.

Er, something like that. It's just not made to work that way, okay?

So forget your drop sets and supersets and trisets and complex high-threshold inverse periodized supercalifragilistic regimen and get down to freakin' business.

Eleven is done with 10 pounds more than your current "8-rep max," which you would really be able to do for 20 reps if you would only let go the umteen sets of whaa-whuu reps of "assistance" waste of time isolation exercises. Use those for specific corrective movements, if needed. Otherwise save the "chiseling" for the day when you have heaps and heaps of lean material for sculpting.

Because this one goes to 11.

- - - - - -

REFERENCES:

-References? What do you think this post is? Is it serious? Absolutely! Empirically PROVEN? Hell no.

-Talk to your MD and all that disclaimer stuff if you haven't started on your path to the Theory. Eleven can be modified to suit you, ya know?

-You're probably not over trained. You're just tired and have a lot going on. Short-term: no big deal. Long-term, make some adjustments to life.

-Other miscellaneous backpedaling:

-Even during your best, most consistent periods of training, not every day will hold a new personal record. It doesn't work like that. But getting some training in, at say, 80% of your best, when you're not feeling completely up to snuff, is paramount to getting those days where you create new limits.

-The more you truly realize the potential of 11 (i.e. the more intensely you train), the less margin of error you have with good form and missing workouts and such. The equation looks like: The Theory of 11 - Lots of Discipline = Injury. Yeah, I know about that too.