Monday, January 17, 2022

The Four Components of Metabolism

 


The Four Components of Metabolism

Metabolism is defined as the bodily processes needed to maintain life. But when you hear the word “metabolism” used today, it’s usually in reference to weight issues. You may hear someone say, “I can’t lose weight because I have a slow metabolism.”

While there’s some truth to this, other factors — such as how much you eat and exercise — play a much bigger role in your weight than your metabolism does. And while it’s true that how much lean body mass you have can affect how many calories you burn at rest, its effect is limited — in part, because you can build only so much lean muscle by strength training.

There are four main components of metabolism which you should be aware. They include:

  1. RMR (Resting Metabolic Rate)
  2. Activity Level
  3. The Thermic Effect Of Food
  4.  NEAT (Non-Exercise Activity Thermogenesis)

Let’s look at each of these individually.

1. RMR (Resting Metabolic Rate)

Resting Metabolic Rate has been discussed earlier. Of importance to remember is that RMR accounts for about 60-75% of total daily energy burn depending upon how active an individual is. Being such a huge component of metabolism, it pays to devote time and energy to keep it optimized.

The higher the RMR, the easier to lose weight and maintain weight in the future. Those who are very active and have a high degree of lean muscle mass will always have a higher RMR value than those who are less active with less muscle. Lean muscle mass determines 74-80% of the RMR value.

2. Activity Level

The daily activity level of an individual also is instrumental in establishing their RMR. Burning calories is the key. This is achieved by exercising at the gym or playing a game of soccer. All of these activities contribute to the daily calorie burn. The more intense an exercise, the more calories it will burn. (Additionally, the higher it may boost the RMR, as noted earlier)

This is the part of the daily energy burn that can fluctuate the most between individuals, and as well as on a day-to-day basis with the same individual. For example, if one day an individual is highly active and the next day they are not, a significant difference in total daily burn rate is seen. Usually, this will account for up to 15-30% of the total energy expenditure for the day.

3. The Thermic Effect of Food (TEF)

The thermic effect of food (TEF) refers to how much energy is used during the process of digestion (the breaking down of the foods eaten).  An average mixed diet consisting of a balanced ratio of carbs, proteins, and fats will account for about 10% of the total calorie burn.  If a higher protein diet is eaten, it can be assumed the TEF is a little higher. This is because protein-rich food is the most energy-costly to break down and digest. Therefore they will spike the metabolic rate the most.

One reason referring a client to use a high protein diet as a weight-loss strategy results in fewer net calories overall, thus favoring fat loss. It should also be noted that some research does suggest that the thermic effect of food may be higher in those who are already lean compared to those who are overweight. Therefore if an individual is already lean, this may make it easier to stay lean.

4. NEAT

The last component of metabolism to be discussed is referred to as NEAT (non-exercise activity thermogenesis). Essentially, these are movements that individuals make that are not planned but are done spontaneously, often without realizing.

Ever notice how some people cannot stop moving? They have to constantly be pacing, jiggling their foot, tapping their fingers, or so on? This is all classified under NEAT. This element of metabolism is heavily based on genetics. Some people naturally move more, and thus but more calories over the course of the day.  Others move less, and as such, burn fewer calories.

Remember, every little bit of activity will add up, so any little movement counts. This generally accounts for about 5% of one’s total daily expenditure, so not very high. In those frequent movers, however, it can be higher, accounting for 10% or more in some instances.

One additional interesting thing to note is that for many people, dieting impacts this. When an individual is on a very low-calorie diet, they naturally tend to move less as their body is trying to conserve fuel.  Likewise, when they are eating more food, such as in the case of overconsumption, they will ramp up their NEAT activity, trying to burn off that extra energy.

Those who are the high movers typically ramp up NEAT so much, this may offset some of the excess calories they consume and making it unlikely they experience weight gain. This is a factor that many people overlook, but one that can have a significant influence over body weight.

Monday, January 10, 2022

Treating Ankle Injuries and Shin Splints



Ankle injuries and shin splints are fairly common in various outdoor activities. They are usually minor and can heal quickly when properly addressed.

Ankle Injuries

Ankle soft tissue injuries are divided into three grades, I, II, and III.

  • Grade I describes a stretching of the ankle ligaments without tearing of the collagen fibers that provide the bulk of the structure.
  • Grade II describes a partial tearing of the fibers without a complete rupture.
  • Grade III is a complete rupture.

A careful physical exam of the ankle joint by an experienced examiner can accurately grade the injury. X-rays can determine if a bone fracture has occurred with the ligament rupture.

Fortunately, surgery is rarely required initially because if specific treatments are instituted early, the results of non-operative treatment can often match the operative treatment; conversely, the results of late surgical treatment of unstable ankles can be excellent in experienced hands.



When an ankle is injured from twisting in towards the other foot, called an inversion injury, most commonly the anterior talofibular ligament is stretched or torn. If the two other primary ligaments on the outside of the ankle (the posterior talofibular ligament and the calcaneofibular ligament) are also injured the primary bone of the ankle, the talus, can be displaced from beneath the tibia, and the ankle “shucks” out of joint.

A physician or trainer examining the ankle soon after an injury can compare the amount of “shuck” to the opposite ankle and develop a grade for the amount of injury suffered. Usually, if the injury is limited to one ligament, the instability is less. If all three are involved, the ankle is more unstable.

The nerve supply to injured ligaments can also be injured. The nerves provide “proprioception” or position sense, in effect telling the brain where the foot is in space. In the healing process, it is critical to re-train the healing ligaments to regain the neural connections required for a stable ankle. Specific exercises can effectively do this.

Ankle injuries, in the past, were often treated with cast immobilization for six weeks or more. We have found that this is detrimental to the healing tissues. When injured collagen tissues are immobilized, the collagen heals in a disorganized fashion, producing scar tissue. The tissues are weakened by the lack of normal motion and stress required for tissue nutrition and organization. The injured nerve fibers have difficulty reestablishing the proprioceptive sense for the ankle.

Treating Ankle Injuries

A freshly injured ankle usually swells and hurts at the site of the ligament damage. The principles of treatment are icing, stabilization, early motion, and proprioceptive and strength training.

Immediate icing diminishes the swelling and actually speeds healing by decreasing the subsequent swelling-induced limitation of motion. Icing three to four times a day for the first 24 to 48 hours is required, as the maximal tissue swelling occurs during this period.

Heat is only used in fresh injuries after the initial swelling period has resolved. In general, heat is used to warm up before exercise, and icing after exercise to diminish swelling.

Stabilization of the injured ankle is best provided by an Aircast splint which provides both compression and protection, but simultaneously permits motion in the safe range for the injured ligaments. If such a splint is not available, ace wrapping and taping the ankle can help.

Early motion exercises of the injured ankle are required in order to diminish the swelling and prevent ankle stiffness. By carefully identifying which ligaments are injured, the safe range of motion that gently stresses the ligament while avoiding harmful deformation can be prescribed. The stimulation of new collagen formation along the lines of maximal stress is critical to achieving a strong healed ligament. The first day after an ankle injury, proprioceptive and strengthening exercises can be commenced if within the safe range of motion. For proprioception, “stork stances”, which are single-leg standing with the eyes closed for one minute, provide excellent rapid small muscle training for the foot stabilizers.

Since ankle injuries occur by rolling the ankle over to the inside, any motion in the same direction or opposite should be avoided. Therefore straight pointing and flexing of the ankle in a pain-free range of motion is recommended 7-10 times daily. If any of these exercises cause pain, don’t do them!



The gastrocnemius and soleus muscles of the calf are the prime movers that point the foot away from the body. To exercise these muscles, place the uninjured foot beneath the ball of the injured foot. Gently apply tension and push the foot straight away from the body.

To strengthen the main muscle in the front of your ankle, the anterior tibialis, place the uninjured foot on the top of the injured ankle and slowly flex the ankle toward the knees, hold and slowly return to the starting position. Do both exercises for 3 sets of 10-20 repetitions.

Additional exercises may be performed if pain-free.

A very simple exercise is the two-legged one-third knee dip. Stand with equal weight on each leg in a partially bent-knee position, slowly bend both knees to a 90-degree angle and slowly return to the start position. Progression into a single stance one-third knee dip is started when the athlete is able to perform the exercise without pain. Do 3 sets of 2-3 minutes. All exercises should be performed in the ankle brace to help give support, control motion, and most importantly to protect the ankle from rolling over again.

At 2-3 weeks, activity can be resumed if the ankle is pain-free in athletic footwear. At 4-6 weeks, upon physician approval, gentle straightforward running, inversion, and eversion exercises may be started. Before actually running, two-legged stationary bicycling and running in place should be tested. If performance is pain-free then outside bicycling and running is allowed.

The goal of early motion and strengthening exercises is to return the athlete to sports with a stable strong ankle, which should be able to be accomplished in most ankle ligament injuries.

Surgery is highly successful for chronically unstable ankles that have not adequately responded to an exercise program. Newly designed techniques that isolate the repair only to the ligaments and joints involved and careful rehabilitation exercises designed to be compatible with the surgical procedure immediately thereafter have resulted in excellent success rates.

Prevention of ankle ligament injuries is accomplished by conditioning the lower extremities prior to playing sports, and by wearing supportive shoe wear. The exercises described above are best performed prior to injury.

Ankle injuries can be diminished by preseason training and supportive shoe wear. They should be aggressively treated to provide the most stable result and the earliest return to sports. For chronically unstable ankles, a careful exercise program can improve performance and if necessary, a carefully designed surgical procedure can correct the most difficult of chronic instabilities.

Shin Splints

Symptoms include pain in the calf or shin area (usually along the medial, lower half of the tibia, anywhere from a few inches above the ankle to halfway up the shin) that is sometimes accompanied by swelling or bumps over the bone.  The repeated running cycle of pounding and push-off results in muscle fatigue, which may then lead to higher forces being applied to the fascia, the attachment of the fascia to the bone, and finally the bone itself. Respectively, this represents a spectrum from mild to severe. On the relatively more severe end of the scale, the injury may progress from a stress reaction within the bone to an actual stress fracture.

In the early stage of shin splints, a runner will describe a pain that is present when the run first begins, but then may disappear as running continues. This disappearance of the injury may be due to the warming of the muscle and added adrenalin.  The pain will most likely return after exercise or later in the day. As the severeness of the shin splints progresses the runner will experience more and more pain, especially every time their foot meets the ground. This tender area caused by the shin splints can be felt by pressing with the fingertips along the bone.  If ignored, or if the area of pain is sharp and focused on a small area along the tibia, a stress fracture may be considered.

Causes include overuse, imbalance between gastrocnemius, soleus, and tibialis anterior, old shoes, improperly fitted shoes, heavy foot strike, an extended period of down-hill running, improper gait, too much weight being carried while running.

Preventing Shin Splints

Prevention includes proper stretching and strengthening of the muscles of the calf to prevent any imbalance in that area. Be certain the landing of the foot is soft…especially when running downhill. Vary the runs, and increase the volume of intensity and distance slowly.  Be certain the running shoes that are worn are fitted properly. In some cases, orthotics may be needed. In some cases, weight loss may be needed.

Treating Shin Splints

Treatment is rest. For a period of time, running may have to completely stop, all depending on the severity of this injury.

P.R.I.C.E. (Protection, Rest, Ice, Compression, and Elevation) is a treatment as is massage. However, the most important treatment and preventive strategy is to remedy the cause that leads to the injury. Understanding the circumstances that lead to the shin-splints is key to preventing them from recurring.

Monday, January 3, 2022

Types of Cardiovascular Activity



Everyone has an opinion about the best form of cardiovascular exercise. Just like resistance training, there is no one best cardiovascular exercise. Sometimes the best exercise is the one the client will do, as long as the risks or drawbacks do not outweigh the benefits. For this reason, it is important for each individual to understand the demands, limitations, benefits, and drawbacks of each of the major forms of cardiovascular exercise inside and outside of the gym.

The various types/modes of cardiovascular activity may include:

Walking

Each individual must demonstrate the ability to perform prolonged walking without fatigue before engaging in other more strenuous exercises such as jogging, running or sports that require more intense activity.

Here the emphasis is not a training heart rate (THR) but on the continuous activity of longer duration to build up endurance levels and increase circulation and the efficiency of various hormonal processes.

Walking is an ideal activity for both therapeutic and health benefits due to the mental relaxation it offers with the opportunity to reflect on feelings and thoughts of the day. It is not uncommon to perform more efficient thinking and thought processes while venturing outdoors or walking indoors on a treadmill than while sitting at a desk or computer.

Jogging

Walking becomes jogging when the individual moves at a speed and form that requires “flight” between foot strikes. This could be as low as 3 or 4 mph or closer to 6 or 7 mph, depending on the individual. It has been determined that the net energy cost of jogging is about twice that of walking and requires a greater cardiovascular response.

There is much greater stress on joints, muscle and connective tissue as speeds increase due to increased impact forces on the body. However, it must be noted that the body was made to be able to tolerate such forces as long as the individual is able to jog with the appropriate form and on variable surfaces with appropriate shoes. Jogging may not be advisable for individuals with specific physical muscular or joint dysfunctions or injuries or who are particularly overweight.

Shoes tend to wear down internally long before external wear can be observed. For this reason, any shoes worn regularly with high activity should be replaced every 3-6 months, every 6-12 months with regular moderate activity and at least once a year for regular light activity. Any individual who jogs or runs regularly should be encouraged to purchase running shoes from an establishment with qualified professionals who will watch the individual jog/run to help determine the appropriate shoes to be worn.

Running

Jogging becomes running when the activity is performed at a sufficiently high level that the intensity can only be performed for between a few seconds or several minutes for the average person. Running is one of the highest energy-consuming forms of activity. An individual must cycle at least twice as long as running to obtain a similar cardiovascular effect.

Competitive athletes are able to sustain high running speeds for significantly longer periods than the average fitness enthusiast. Running requires speed of movement where both feet are off the ground in between foot strikes. This requires a very high level of exertion and requires that the ability of the individual be high enough to not only accelerate under control but to stabilize and decelerate appropriately and safely, while maintaining control as well. Natural muscular shock absorption reduces with fatigue and the impact is increased dramatically.

Much like jogging or any other activity, if the individual cannot land softly to re- duce the forces created from their own momentum and be able to maintain satisfactory form then the intensity level or speed should be significantly reduced until coordination and control can be established. It should not be expected that everyone will run the same and there is no perfect technique. However, it is important for the individual to:

1) Lean slightly forward to allow gravity to help pull the body forward during gait

2) Look forward about 10 yards to help maintain appropriate running posture and vision forward

3) Stride naturally to avoid overstriding and putting excessive stress on the body (uphill running at a 10% or greater grade can help increase stride length naturally)

4) Perform a natural arm action with wrists and elbows gently brushing the side/shirt with elbows flexed at approximately 90-110 degrees (depending on speed of movement and stride length) and the hands closed around an “egg” to emphasize a slightly closed but relaxed grip (all-out sprinting may advocate an open palm with wrist/forearm in neutral position)

5) Perform slight downhill running (10-15% or lesser grade) to naturally increase stride rate or frequency of strides (lunges will not help with stride length or stride rate but will provide functional strength)

6) Work on overall body strength with a well-designed resistance training program (lower body, core, and upper body) to help the individual increase strength and coordination to find their own running form more efficiently (teaching efficient running form in an individual lacking sufficient overall strength will merely complicate problems for the individual over time)

Swimming

Gravitational forces are reduced in water to reduce the impact of exercise. Swimming can be a very useful tool for recovery from land exercise to help joints, connective tissue and muscles recover adequately. The high resistance of water can help increase strength in the many muscles that are not used with typical cardiovascular activity. Like recumbent biking, swimming may be a very suitable starting activity for an overweight or obese individual. Some HR monitors can also be used underwater for measuring intensity and body response to training.

Cycling

Cycling indoors (on an exercise bike of course) or outdoors can provide beginners with an easy to perform activity with little coordination or skill demand. Cycling can also be used as a tool to get off one’s feet from moderate to high-intensity walking, jogging or running.

A recumbent bike requires leg extension toward a forward position, while seated in a reclined position (as opposed to a normal seat position on a bike), and can be a very useful cardiovascular tool for individuals who are particularly overweight or who may have difficulty with other pieces of equipment. It should be noted, however, that the recumbent bike can be very “hamstring dominant” due to the flexed hip position with the legs extended.

The upright bike (normal seated position) utilizes more quadriceps involvement and can involve the glutes significantly when riding out of the saddle (seat). The seat height should be positioned so that the individual has a slightly flexed knee at the bottom of the cycle stroke with the foot on the pedal. The ankle should plantarflex on the upswing and dorsiflex on the downward swing phase of the cycling motion. An overly flexed knee can result in lesser force production and an overly extended knee can result in injury.

Cycling shoes are not necessary unless desired or the client engages in intense outdoor cycling. Using a heart rate monitor while biking can provide feedback on speed and distance in addition to caloric expenditure and heart rate response to training.

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Elliptical Trainer

The elliptical trainer is a favorite of many at the gym. The elliptical trainer is easy to use and reduces the impact forces of the body at landing due to gravity during walking, jogging or running activities. However, the elliptical trainer should be used as an alternative and not a primary activity if possible.

Many elliptical trainers (although not all) shorten the stride range of motion with each stroke. It is important that the client not “bounce” and maintain feet firmly on the plates. This may increase the intensity of the exercise and the tension or elevation levels may need to be reduced.

Like any exercise, if it is enjoyable for the client, he or she should be encouraged to use it properly. But, barring injury or physical disability, the client should seek to utilize some form of impact training as well in order to maintain or increase functional strength and bone density.

Rowing

Rowing can be a great alternative cardiovascular exercise as it includes a healthy proportion of upper and lower body muscular endurance. Technique is key with this motion. Consulting with a rower is advisable to learn efficient rowing technique, in order to optimize this exercise.

Sports

Sports activities require greater levels of energy expenditure, coordination, conditioning, and skill. It is imperative that individuals have the necessary base of conditioning before playing sports that require multiple changes of direction played at high speeds or more complex movements and joint range of motion/overall mobility. It is much more difficult to maintain a consistent heart rate or exertion level while playing sports or other game activities. While this is true in most life situations, the activity often goes for several minutes or hours and can be very stressful to beginners or even to average-level fitness enthusiasts.

Whichever form(s) of cardiovascular exercise is(are) used it is imperative that a reasonably healthy individual either walk, jog or run combined with at least one or two other forms of cardiovascular exercise to provide different stimuli, avoid overuse of specific muscles and provide a psychologically different venue for purposes of motivation and maintaining interest in the activity.