Cinnamon Toast Crunch

Is there anything better to "consume" after a workout that Cinnamon Toast Crunch?

[Or insert your favorite sugary/junk cereal.]

I really don't think there is. After years of trying out and studying up on expensive recovery supplements and fooling around with blenders and what not, I can tell you that none of those are any more (or less) effective than Cinnamon Toast Crunch.

I'm resisting the urge to write a parody, like I did here in an attempt to get across the proven effectiveness of chocolate milk.

Some may read this and judge me a dimwit. What about high fructose corn syrup? What about the ratio of protein to carbs and the milk, with it's supposed suboptimal amino acid profile?

What about the fact that after intense exercise, your body benefits greatly from a surge of insulin with some easily digested carbs and protein in store. How about worrying a little more about getting the rest of the week right, eating and drinking mostly non horse-sized portions of unprocessed foods, before ruminating the minutia of post workout recovery formulas.

Others may read this and go around telling people that Cinnamon Toast Crunch is the "secret" to fat loss, muscle gain, and many other great mysteries of the universe. But make no mistake, Cinnamon Toast crunch is primarily good for, above all else, cinnamon sugary goodness. And it happens to fit the bill for a moderate amount of high glycemic carbs and protein.

If you're regularly training hard for the purpose of weight loss, have a bowl of cinnamon toast crunch. Go ahead after a workout, because that's the time when eating a moderate amount of pretty much whatever you want will actually work for you.

If you're training hard for the purpose of gaining size and strength, have two bowls of cinnamon toast crunch and a normal dinner an hour or so later. The common themes here include regular, hard work and Cinnamon Toast Crunch. Hard work, not like the recumbent bike or a stroll through the mall. Hard work, like, there were at least a few points where you felt pretty miserable and would have loved to lay down and create a pool of sweat on the floor.

The timing is important. Total calories count, and you don't want to eat like that all the time, whatever your goals. But it can totally work for you. And since the window of optimal recovery is open for about 30 minutes immediately after exercise, better go get you some

cinnamon and sugar
we're baking up a bunch
baking homemade taste
in the Cinnamon Toast Crunch.

Testimonials. Do you really need to see a series of exaggerated and completely fictitious testimonials?


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Logo

This week I'll be speaking to pre-physical therapy students at Messiah College about interpersonal skills in the clinic. I'm certainly not the expert on this, but chose this topic because:

1) It's relevant for all health care providers and especially so for this profession. It applies on a daily basis whether you're a PT or intern or volunteer. I succeed and fail with this stuff every day.

2) It's not another academic fact binge. They're probably getting their fill during all the rest of the time they have to sit and listen to middle aged people talk.

3) Although things may have changed since I was in school, interpersonal skills don't get much coverage, at least not practical, realistic, honest attention.

So for 30 or so hopefully not too boring minutes, it's gonna go a little something like this...

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The American Physical Therapy Association attempts to summarize the essence of physical therapy with a little blurb under the APTA logo. Has anyone seen it?



"The science of healing. The art of caring."


I think it's great. I REALLY like that motto. What therapist (or any health care provider) wouldn’t do well to take it seriously and examine themselves by it? 


How do you feel about "art" and "caring" being put up there with equal status of "science" and "healing?" 


Things may have changed a lot since I was in school almost 10 years ago, but I would bet my gluteals that all of you can guess if it was "caring" or "science" that occupied 99 percent of training. We heard a lot about ethics and codes of conduct, but nobody even tried to teach us how to care. I can understand why it's that way, and I'm not so sure it could be any other way (especially at a state school). 



The assumption, I guess, is that you do care. You want to help people, right? But I can tell you that when you're put in any kind of competitive environment; when you're asked to walk the line between efficiency and quality of care; when you're up against a schedule full of folks with arthritis on a rainy day and everyone is achy, the caring isn't always foremost on your mind. 


Art, really? What professor or clinical expert confesses to art? Are you going to mention your artistic ability during entrance interviews? Maybe you should.


In defense of science


There's no substitute for clinical competence. All else being equal, what person with a miserably sore knee would pass on a top clinician with poor bedside manner in favor of a kind chap who uses the Magic 8 Ball in his clinical decision making? 





There’s a reason why much of our weight is planted on science while art barely gets a toe touch. We believe that PT can help many people function and that it makes sense economically. We believe that our methods are reliable and valid. But believing does not make these things true. After all, therapists have a vested interest in doing a good job, even if their “caring” only concerns themselves.


Art and caring are soft and non empirical. Neuroscientists may track electrical activity in the brain that are vague evidence of some thoughts, but who can calculate caring? You can quantify caring no more than you can see a ground reaction force. Employers and insurance companies don't reimburse you for caring.


The caring of science


Or do they?



The problem with the above scenario is that all else is not equal. The bridge between science and caring is the reality of two whole people. Go ahead over to Medline and search "bedside manner." Notice the number of studies that pop up, and the trouble they have with even defining, much less studying bedside manner in purely humanistic terms. 


Caring isn’t just the spoonful of sugar that makes the medicine go down. It's a vital ingredient in the medicine itself. It’s science that now confirms and helps us understand the complex interaction between the body and mind. Among many mysteries, we now have an inkling to how experience, expectation, stress, and other purely mental “events” have an effect on pain perception and other facets of healing.


So we're learning and practicing in terms of clinical pathways, prediction rules, and confidence intervals. And the patients...nobody cares. Really, nobody cares about how much you know until they know how much you care. In a decade of treating patients, I can tell you that people, whether they want to admit it or not, care far more about how you make them feel as a person and how you satisfy their personal needs than they do about how well written and effective your treatments are. Just watch. You don't need an MRI to see that.


So care, damn it

If healing and caring are a package deal that were never meant to be sold separately, what are some practical suggestions for caring?


1) Stand on evidence, yes. You have to. But stand at the edge, where you can still reach over and wrap both arms around a whole person in need of some caring (the hug may be metaphorical at times).


2) Our caring should have feet. External validity, if you will. Does your life generally validate your work? Do you highlight research journals on weekends and catch yourself analyzing the gait of strangers? Does your physical appearance affirm that you know something about body maintenance and repair? Do you offer your services to your closest friends and your own mom for no other reason than because you think you can help?


3) Maybe you need to seek or create an environment that leaves a little room for art. This may be difficult to do as a student, but again, watch and learn. I'm certainly aware of clinical models that have PTs "treating" four patients every hour, many of those patients going out and telling their friends that rehab doesn't work.


4) Do you care enough to look them in the eye and listen? Part of INTERACTING "in a confident yet respectful  manner" entails your mouth being shut. Wisdom knows how to pull off engaged listening without getting caught up hearing about a sisters sons cat for the third time. I could certainly use some help here. But I can say that if your caring is mostly just about your competitive drive and need to defend your chosen profession and pay the bills, the clients can tell. And sooner or later, so will your "outcomes."

5) It all counts-the type of person you are developing into along the way toward your PT license. Credentialing exams don't test you for caring, by the way. I think that seeing PT as a calling is the only route to this caring. Otherwise, it’s just a bunch of knees and backs and shoulders. I suppose it's possible to get by that way, but it can't be very easy and rewarding. Or fun. 


The logo captures far more than the academics of PT. I’m humbled and challenged.

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Respect Recovery

Most serious athletes and fitness fanatics are either training too much or not enough. I'm pretty sure it's one of those. "Optimal" improvement lies on a razor thin line somewhere between training and rest. Athletes can't know for sure if they are walking that line, but it's easy to tell if they stray far in either direction.

While it will always be easy to make excuses that result in laying around with a bag of chips and unreality TV, there are growing numbers of driven and devoted athletes who would benefit from nothing more than a day or three of rest.

On one hand, a certain amount of consistent training is needed to stimulate the body to adapt and reach new heights of performance. On the other hand, too much training and competition tears the body down before it has had time to recover, much less improve. Outside of technique, nobody gains or improves during training. The magic happens in all the other hours of the day; when the athlete is sitting in class, playing video games at home, and especially while sleeping.

Athletes, parents, trainers, and coaches would do well to remember that actual results are determined not simply by how much training is performed, but by how much training an athlete can recover from. Sorry coach, but an athletes recovery ability is determined by far more than what you can program. Age, gender, genetics, diet, stress, and the amount of sleep all play a large role.

So before you schedule those 5 a.m. workouts before class, please consider the 6 to 8 hours of classwork, hour of social time, minutes of family time, and hours of homework that will be wearing on the athlete until well past 11 p.m. If you want a thin 18-year old to gain 15 lbs of muscle before the spring season, don't have him or her running bleachers for 40 minutes 3 days per week on top of practice and weight training. Athletes who can tolerate, much less improve from, such a schedule are truly outliers.

I understand the value of extreme pre-season conditioning practices that build character and team unity and act as a self selection process for the final roster. There are certainly times for those lessons. There is certainly a time when an athlete must decide if he wants to work to get better or just have fun. But whoever signed up for getting worse while not having fun? The "more is better" approach, where athletes are chronically pushed on 5-, 6-, and even 7-day per week programs is worse than useless. Mental toughness may be worth the price of physical stagnation, up to the point where somebody gets injured.

All the glory and applause given to training, willpower, dedication, and hard-nosed coaching leaves little opportunity for us to hear the stories of drop-outs and injuries that are largely due to a lack of intelligent planning. They are stories of ibuprofin and arthroscopic debridement. They are stories of well-intentioned but unwell PEOPLE dragging themselves around day to day, beating their head against a wall, wondering why they're seeing such little return for all their efforts toward something they use to love.

Those stories do exist.

I see them most days in the clinic.

And I was one of them.

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It's Gotta Be The Shoes

I've had much to say about the limitations and (sometimes) foolishness of common fitness products these days. It's for good reason, because of all the claims for simple, easy, and comfortable substitutions for the "problem" of disciplined, patient, and thought-out effort. While I'm no big fan of programs, supplements, braces, supports, and splints that promise the world to aspiring athletes, I really don't want to be known as the Fitness Nazi.

No Reps For You!

So here's one on the other side of all the marketing hype and junk fitness products, based on legitimate biomechanical principles.A recent study published in the Journal of Strength and Conditioning Research looked at the effect of certain footwear on vertical leap.

Following the lead of a few other investigations, researchers measured the vertical jump while subjects wore (a repeated measures design) standard shoes and "experimental" shoes that place the foot into slight dorsiflexion. If you were standing in the experimental shoes, your heel would be about a half inch lower than the ball of your foot.

The vertical jump of the the group of "generally fit but not elite" women being tested was almost two inches higher when wearing the shoes. This is a pretty drastic improvement. What's more, the researchers also gathered data while the subjects ran. The jumping shoes had no adverse effects on running economy, pain, or perceived exertion. So there were no drawbacks in this population of people, at least for the time being tested.

It's ironic that most high falutin' high tops rest the foot in the opposite direction (about 4 degrees of plantar flexion), which has been suspected of contributing to the acquired ankle inflexibility and knee pain seen in basketball players. Isn't it cool to think that a little tweak of the ankle may produce an immediate increase in vertical jump without the body "paying" for it elsewhere?

As compared to typical hoops shoes, 

flat old school may be better for the health of your knees and vertical jump.

"Little" being the key word here. A little scientific evidence from a little tweak, without major complications, will get hundreds of thousands of people suddenly up and jumping  more, which tends to create an increase in vertical jump. At the same time, if the shoes catch on and are bought up in those numbers, there will be problems.

I mean, can you imagine these things being picked up by Reebok and a multi million dollar ad campaign? The average Joe looking white kid is suddenly throwing down in traffic.

The body almost always pays for any extreme additions or subtractions, and even a subtle tweak risks the chance of pushing underlying movement dysfunction (like say, those who are already restricted in dorsiflexion) over the threshold to injury and pain. Poorly conditioned (okay, fat) boys and girls will wonder why their heels are sore and they're not hitting their heads on the (basketball) rim. Some men and women who were just hungry for a little performance edge will get a big serving of tendinopathy from the increased load to the achilles.

And still, the concept is cool. The shoes hold promise as the first product of its kind, well beyond shoes, that may legitimately help you get more air.

Promise, with reservation.

Discomfort: Priceless

There's really nothing comfortable about our basement. This man cave is not equipped with a high-def TV or EZ chair, X-box or pool table. Walk upstairs and help yourself, because there's no bar or mini fridge.

The Green Room out back.

But there is a barbell. And a bench, a few adjustable dumbbells, several hundred pounds of weight plates, a 90's-era CD player, and gravity. The workouts often can't be contained, blowing out through the back door. The Green Room offers graded surfaces, rocks, obstacles (including kids) to accommodate plenty of running, jumping, hitting, and throwing. The "natural" climate control is just perfect, especially when the days are not sunny with a high of 75.

Attempting to make physical exercise soft and cushy misses the point. The body adapts to both comfort and discomfort. While discomfort deepens us, smoothie bars and cardio theaters and fancy chrome exercise gadgets are blood letting for the anemia of modern times. Discomfort grants us the opportunity to develop will and grit that's readily transferable to everyday life.

Time is a gift. So if you sit indoors for the majority of your work day, please don't drive (sitting) to a climate controlled gym to sit or recline back on some resistance exercise gadget, crunching your pelvis even further toward your rib cage. I don't care how well it isolates the lower obliques. Unless you're older than 70 or with a serious disability, swear that you'll never be seen reading a magazine while riding a recumbent bike, especially People Magazine.

[Sure, it was a cool down.]

If you're going to work out, for heavens sake, WORK out. Learning the joy of misery suddenly gives you time for a fitness program. Fitness doesn't even mandate an electrical outlet, much less your own TV and PlayStation (like the ridiculously equipped for a roster of 14 Dallas Mavericks training facility). If you have gravity and some ledges, rocks, or steps, you have plenty of gear for a solid level of fitness.

In general, the less fancy gear you need to exercise, the better. Therefore, yoga mats are probably a good return on investment. As is lifting barbells and other heavy things. And while I'm no fan of distance running, I have to hand it those who willingly engage prolonged periods of the most fundamental push against gravity. That's why they call the natural, exercise-induced rush of endorphins a "runner's high," and not a "Thighmaster's high" or even a "Cable Cross Overer's high."

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Mike has embraced this particular odd form of discovery and made the journey his own. I think it shows.

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How dare any fitness or infommercial person try to sale us on "quick and easy," stealing away what's priceless? Comfortable exercise never delivers the full dose. While we can't derive a mathematical relationship between discomfort and "benefit," such a formula is certainly worth considering in the context of an individuals abilities and goals.

K2

Of course this can be taken too far. I don't recommend Fight Clubs because the side effects are pretty awful. And not everyone should prepare for a solo climb of K2, or even deadlift 400 pounds, intentionally bloodying their shins with the knurling of a barbell (as I once witnessed at the now defunct Slippery Rock University Barbell Club).

But I am asking for a some middle ground here.

Speaking of bloody shins...

This is not the counterfeit discomfort of masochist ascetics. A recent accidental drop of a heavy dumbbell on my toes caused me to doubt that the purposeful infliction of pain holds much positive psychological value. Though the extreme saints, mystics, and barbell nut cases may disagree, I would argue that "gift" discomfort always comes riding on a productive act where pain is not the primary intent.



                THIS video: 300 framers per second, Kyle Wagner probes the limits of discomfort.


Embrace and deliberately manipulate discomfort as a controlled variable. Most of us should progress slowly and focus on the journey. As an alternative, you can ramp discomfort from practically 0 to 60 in mere seconds, like this:




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I'm all for the basement. It's ridiculous how much happens down there. I, personally, have never felt a place as comfortable as my basement floor.

Ahhhh...the floor!

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Thanks to those who got down(stairs) with discomfort:

Mike M, Mike S, Mike H, Dave T, Andrew C, Eric B, GG M, Amy G, Marie V, Ben C, Cort, Rose, Ryan H, Tim B.

The blogger, finding discomfort.

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Eat. Play. Love. (Part II)

The premise is that Ben probably BEGAN working on his hops a LONG time ago...

Shortly after moving to Harrisburg, Amy and I strolled purposefully through Sofas Unlimited. We stressed over color coordination and texture. Nobody needed a drink or had an emergency pee. In those days we cared, really cared, about our sofa, love seat, and over sized chair.

Now days, the precious furniture takes a beating at the hands and feet of four little ones. Especially on rainy days. Obedience is a top priority to us (no jumping on others sofas or on ours until we say). Furniture is not. And it's more convenient and less costly than 4 memberships to MiGym.

No furniture or bones have been broken yet. I'm just not up for the battle of going gently on the furniture, a relentless, thankless battle indeed. Perhaps we'll prioritize the sofa some day. But not right now. What a shame when furniture is outdated and demoted to the basement without having taken some hits.

Bear in mind that I'm a PT/trainer guy and not an interior decorator or furniture person. It's understandable if furniture is important to you. But for the kid's sake, have a horseplay couch in the basement. If you find it hard to let go of the whole furniture situation, go ahead and cheat by just starting with a 10-year old ugly couch. Think of your ugly old basement horseplay couch as an investment in their future.

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Side note, as ironically, I had to pause to address my 4-year old after he literally rolled out of his bed while asleep.

Risk is inherent in almost everything. Video games can become addictive. Kids ride in vehicles every day. I'm sure there are stories of kids getting horribly injured by falling from furniture. I don't know those stories, but there are many kids in close proximity to many couches, so I'm sure they exist. The key idea here is relative risk. 

Horse play on a couch has it's relative risks and rewards.

Encourage (OR discourage) it at your child's own risk. 

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What do couches have to do with athleticism? As stated in Part I (below), athletic potential in adolescence and adulthood has much more to do with acquiring an early love of physical activity than it does with genetics. The fundamental elements of athleticism are tied directly to natural sensitive periods in the development of the nervous system. The actual existence of these critical periods for motor development has been academically debated, but it makes sense and fits my personal observation.

Couches are the perfect gear for tuning little brains to spatial awareness, movement synchronization, and rapid acceleration and deceleration. Cushions awaken the smallest ones to the consequences of gravity.The process occurs conveniently and naturally, with far more stimulation than standing around waiting for a turn during "practice."

So leap. Chase. Hang. Lift. Throw with one and two hands. Any activity that your old aunt Edna yelled at you for doing in the sitting room is probably what kids should be doing. And often!

The best fuel for young athletes is frequent servings of a wide variety of physical activities. That's why starting them young does not have to mean soccer camp for toddlers and after school gymnastics. There are certainly worse things that 3- and 5-year olds can be doing with their time. But what I'm suggesting has little to do with organized anything. Quite the opposite, in fact.

Think couch.

I'm not saying that learning to cooperate and work as a team is without value. Those are needed lessons, but they are not lessons in motor control. Waiting your turn is probably a concept that should be introduced in the home and classroom before it's attempted during active times. We should expect a 12-year old to be patient and organized on the field during play time, but not a 6-year old.

Luke had to wait his turn.

So protect the kids, but don't hover. Let them learn about their body and gravity while the stakes are relatively low. Far more than any coach or trainer, you know how to challenge your little one in a way that also sets them up for success. And make it fun.

Mom and dad, be active yourself and look to praise their attempts at physical achievement. Encourage the horseplay, to some extent. Help them see their body as a performance machine good for more than sitting in front of electronics for 44 hours per week (the reported average for kids).

[Above] The author succeeds as an active model for the kids, but fails as a show boat.

On that note, send the kids outside. A lot. This link includes a referenced compilation of the benefits to being outside as well as many problems associated with the fundamental move of childhood to the indoors.

The brothers getting some fresh air.

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Lastly, point the little athletes toward the best finish line. You can train an athlete to run faster, but let's just go ahead and say that it probably won't make them a super star someday. Or content.

His Super Bowl ring is not what's making him happy right now.

Athletics truly helped keep me out of trouble and doing my homework. They still help me to get through long days, working as a father and a PT. The real value in training and competing is in the journey toward wellness of the body and mind. Lets set our children up for the love of physical activity without plastering them with commitments. Should they decide to pursue athletics, the foundation of higher level skill will be in place. '

The Promised Land is not some championship destination flowing with champaign and money. Anyone who is fed, loved, and given the opportunity to play is IN the promised land. And there, if you find that sweet spot between having fun and working hard...

....ooooh! You can let go of all the rest.

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From Over At The High Calling

www.highcallingblogs.com

This is the first of five legs in our Pilgrimage series. Today we’re led by physical therapist and High Calling member, Bob Gorinski.

It’s hard for me to imagine a pilgrimage or journey without movement. As a physical therapist and trainer of athletes, I help a wide variety of patients achieve new limits in movement. I play bio-mechanical detective, attempting to solve problems in the function of muscle, nerve, and bone.

Most of my clients are on a serious journey toward change in their physical form and function. And do they ever ask questions about health and fitness products, many of which guarantee results. Fast!

Why aren’t the orthotics fixing my heel pain? When can I pitch again? Will protein drinks help me lose weight?

I offer straightforward opinions and evidence-based answers. But often I simply don’t know. It’s challenging enough to keep pace with advances in rehabilitation and sports performance, much less the latest claims in homeopathic supplements and mattress technology.

“Optimal,” “comprehensive,” and “transformation” are permanent buzz words in the health and fitness industry. Transformation, really? Not even yoga is comprehensive. And sorry, Chuck Norris, but the Total Gym is still just a gym, and rarely do gyms help a person achieve peace.
Physical therapists pride themselves on treating causes of pain and dysfunction instead of symptoms, yet the root causes sometimes go quite deeper than we can dig.

Filling the hole

While there’s plenty that I don’t understand about the human condition, a decade in the clinic has shown me that even intelligent people buy into good and bad fitness products in order to fill a hole elsewhere.

Middle-aged moms imagine that getting into their college jeans is a realistic and worthwhile fitness goal. Couch potatoes think PTs and orthopedic surgeons can fully atone for years of bad decisions. Desk jockeys assume that simply being in a gym is equivalent to the inevitable discomfort of getting fit.

Similarly, fitness fanatics believe that glucosamine and more exercise is the solution to their repetitive overuse injuries. (Even PTs – ahem - take ibuprofen when the best prescription for aches and pains is a few days of rest.) And then there is greed, bitterness, and many other conditions less apparent yet more physically damaging than a soft midsection or flat feet.

In all seriousness, who has ever ab-crunched or low-carb-dieted their way to contentment?

Holistic means…

If (as the apostle Paul writes to Timothy in I Timothy 4:8) Godliness has value for all things – holding promise for this life and the life to come – then the body certainly stands to benefit from spiritual exercise. That makes a lot of sense, and I don’t think we have the capacity to will ourselves to any kind of transformation. Sooner or later, the body tells the truth.

But be careful now. If the body were always a testimony to the spirit, then we could identify spirit-filled people by their physique. Of course that’s not the case. The lives of my kindest, gentlest patients have taught me that an (apparently) strong spiritual life does not fix the genetic and life circumstances we’re dealt. By no means are injuries and the wear and tear of life always earned with laziness or neglect. I’m pretty sure that even the saints get arthritis.

The truth is that whole people are far beyond PTs, nutritionists, doctors, and the guy in the Facebook ad selling Acai Berry. While we can be helpful or even critical in handling the details, we know that a fit body requires more than diet and exercise. That’s why the “just” plans for health and fitness are always a lie: Just seven minutes of exercise per day. Just two pills before major meals. Just one spinal adjustment per month….

Even the oddest fitness products sell because they’re supported by an “expert” in a white lab coat (or a sports bra) and promise a “new you.” They look kind of fun and cost only three installments of $39.99. Yet being made new transcends the scope of physical medicine. It’s why I never make promises with my treatments. Besides, who is an impatient, chronically late, caffeine- and activity-addicted PT like me to guide anyone in mastery of life?

Health is a lifelong journey that demands daily attention; the kind of attention that costs more than the price of diets and exercise gadgets. Fit bodies are a worthwhile pursuit that can easily be forged into idols. At the same time, exercise and effort is a blessing from above that helps us manage the hard realities of our life and times.

As much as I’d like to prescribe what people need most, I’m fearful of writing Jesus into my medical plan of care. I wouldn’t want it to be another quick fix. What I can do is take the posture of washing feet. That just may be the best bio-mechanical and spiritual response toward wellness there is.

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