A GOOD YEAR: 97 days strong!

I want to wave a "That's Pretty Awesome Flag!" for Cathy. Cathy worked out for three months before missing a workout.  Almost a hundred days, without a miss!  Cathy had ONE rough week and called feeling a little melancholy.  I pointed out some things that can be helpful when you feel off your game.

She has successfully modified her life and is working out consistently for 150 minutes or more doing cardiovascular exercise.  This karate chops her risk of cancer, heart disease, stroke, and diabetes!

She is strength training two times a week, also decreasing her risk of disease!  

She is also stretching and performing yoga, addressing her flexibility! 

What got in the way?  She has some foot pain cooking up.  Her left foot has been as issue, and I recommended taking one week off of kickboxing and we subbed in a 30 minute circuit style workout with low impact moves. 

I want to point out to all that if injury comes your way, baring fractures and things where usage would make things worse, there is a way to get around it, keep getting fit, while you figure out the source.

Here is a note from Cathy!  Next week we will reflect on her progress and lay out her next week of working out.  In the next month, I would like to add one more day of strength training, to keep helping Cathy build muscles!

My challenge this month is for her to find a practitioner to help her mitigate the ouch.  I have suggested a rolfer or a really great injury recovery masseuse!  

Be Well,

Beth

I have to be honest, the last few weeks have been challenging emotionally.  I have been dealing with some tough things and it's really thrown me for a loop.  A lot of times my workout routine will lift me up or at least give me some good adventures to write about on this blog.  But I've haven't really been inspired to share much.

Part of the problem is that I have been in pain.  The pain was partly because I was so sore from aerial yoga and partly because my feet have been giving me a lot of problems. And with me feeling so blah on top of that I've had a hard time focusing on the positive.

Fortunately I have Beth.  And Beth dropped a huge accomplishment bomb on me when, after missing a workout on Sunday, she pointed out that for the past 97 days I haven't missed a single workout. Not one.  

• Legal frustrations with the divorce? I still worked out. 
• Days where I was overwhelmed with feelings? I still worked out. 
• Crazy work schedule? I still worked out. 
• Feet hurting constantly? Yeah, okay I need a time out. 

Ninety-seven days not missing a single workout is pretty amazing.  I've never come close to that before.  Although, I've never been this organized in my workouts before so it has been a huge eye opener to see how powerful it is to plan my workouts ahead each month.

But when pain sets in you need to rethink what you're doing and allow your body to heal.  Beth pointed that out.  And as frustrating it is to change up a routine that you like and is working, she's right.   

All of this started a few weeks ago when I went to that aerial yoga class.  Watching the instructor move through poses on each on a hanging silk, a trapeze, and a silk fabric hammock was amazing. I tried each apparatus and really gave it my all.  But it was crazy hard.  Do you remember the rope climb in middle school?  Um, yeah.  If you see someone who does aerial dance regularly do not mess with them. They are insanely strong and could probably crush you with their thumb. 

At the end of the class the instructor told me that I would be sore the next few days.  But I didn't have the ability to wrap my mind around the ridiculousness that would be the next week of my life.  I could barely move and I was not able to straighten my arms.  I looked like a t-rex with my tiny, folded-up arms that couldn't reach anything. 

Exhibit A: Me trying to reach things

The pain lasted until the following Sunday when yoga finally loosened me up.  But, when I went to my kickboxing class Monday night I had a ton of trouble keeping up. Even though I wasn't sore, my muscles were still really tired and it slowed me down.  That was really discouraging.  I really don't like to be the guy who can't keep up in a class setting.  Normally that's been kind of a good thing because I push myself harder.  Monday night it really left me feeling super insecure.

On top of everything else, I noticed that I was icing my feet multiple times per day because they hurt pretty much all the time. I've had problems with my feet since high school. I've tried seeing a podiatrist. I've tried using orthodics. I've tried physical therapy. I've tried sucking it up and pushing through the pain.  Eventually I just stopped trying.  Since not trying is not an option this time, I need to figure out another plan.

I talked to Beth and about it and we decided to change some of the workout plan for the next few weeks. For one, I skipped kickboxing on Monday. It pains me to not go. I worry if I miss even one class I won't go back to it (I'm still working on the black and white thinking). Instead, I did a great online workout with Beth that still kicked my butt. We are also adding more weight training to improve strength. I've read that is better for weight loss so I'm curious about what kind of changes I see.

Next weekend Beth has suggested I take my measurements again so I can see the changes.  If there are changes I think it will really help with feeling discouraged about my feet.  If there aren't changes... well, I'll deal with that when it comes.  Either way I promise to share my progress.  

A GOOD YEAR: Kapow! Bap! Thwack!

I just got back from Portland and it was an AH-MAZING trip. I got to go on beautiful hikes in Forest Park, take a couple of yoga class (including aerial - more about that next week,) try out a new workout video, go to a kickboxing class with Beth, drink skim lattes with fancy designs in the foam, meet goats living in a field designated just for them in the middle of the city, drive to the coast, and eat amazing food. There are so many other things I got to do and every day was super fun. Honestly, between my cozy room, the great workouts, and Beth's wonderful massages I really felt like I was at a health spa. The difference was that I was hosted my kind and caring brother and sister-in-law who are truly the best. I'm sure my stories from the trip will continue to show up in my blog posts as time goes on so I'll stop gushing for now. 

So in the week leading up to my trip I tried my first kickboxing class here in the Detroit area. I've had an on and off relationship with kickboxing over the last 10 years - I'll go for a while, get super into it, and then stop going for no good reason. Through it all kickboxing has proven to be my favorite fitness activity. I love my gloves, I love the way my body feels hitting the bag, I love the way the music syncs up with the timing of your feet as you bounce from one foot to another. 

But it's been a long time and a lot of pounds since I went to a class and I know this is an intense workout. I wasn't sure if I was at a weight or level of conditioning where I could make it through an entire hour. I mean I've been doing awesome with the program so far but I have always loved kickboxing so it would be heartbreaking if I got myself to class and couldn't finish. But Beth was great. She really encouraged me to just show up and try and do the best that I can.  

So how did it go? First of all, it was hard. Crazy hard. The class started with a 25 minute intense cardio session where you hop from foot to foot in a sparring stance while you deliver jabs, crosses, hooks, uppercuts and front and side kicks at a quick pace, just not on the bag. Jumping is hard. Have you done any plyometrics? (Yeah, I'm using technical jargon now.) It's one hell of a workout. So even with just the hopping foot to foot, the back of my legs immediately cramped, locking up from my ankle to my hip. I pushed myself to keep up but had to step touch my feet instead of hopping around. That was discouraging because when I "used to" go to classes, years ago, I was able to keep up without a problem. Why I expect that to be the case three years and 50 pounds later is, well, something I should probably talk to my therapist about. 

With me struggling to keep up, unhealthy thinking found an opening and took over my head. I could see in the mirror how my weight hindered my movement. It made it hard for me to just execute the moves let alone keep up. With mirrors on every wall in the gym, I watched myself struggle and then proceeded to size up everyone in the class only to decide I was the heaviest person there. 

Fortunately I'm stubborn. And I'm competitive. And I was not walking out of that class having quit after the first ten minutes. So I just kept trying, continued to just step-touch instead of hopping and I got through the pure cardio portion which lasted about 20 minutes.

After we finished cardio we moved to the bags. That was when it all came rushing back - why I love this sport, how good hitting something can feel, and the strength I often forget I have. I began with jabs, then moved to hooks (my favorite) and then to combos (jab, cross, hook, hook, uppercut, uppercut). I hit that bag over and over again and each time I could feel the painful emotions that had taken up residence within me over several years just pour out. Sorrow, anger, frustration, guilt, and pain all went into that bag with every hit and kick. It was freedom and I remembered why I loved it.

We finished the class with an intense core and butt workout (fire hydrants, row boats, kneeling leg lifts) and I walked out of that building feeling like I was ten feet tall. I was proud of what I accomplished, I was proud that I still had good form all these years later, I was proud that I kept pushing even when everything in me wanted to stop.  I was also pretty sure my muscles had liquified. 

In spite of how great it felt to hit that bag, I'd be lying if I didn't admit that I felt like 11 year old fat Cathy for a few days. Watching my body struggle with the first part of class was a big blow to my self esteem. Additionally, for the rest of the week my body was so sore that it was challenging to do basic things, like stand up and sit down, which are important to be able to do it turns out. I also had trouble with my feet for a few days from the impact (most kickboxing classes are barefoot) which made my walks a lot harder and required a lot of ice packs. 

But all of that passed. When I went with Beth to a class in Portland it was still a really hard workout. But having Beth there helped push me to keep up and motivate me to try harder. I pushed my heart rate to the max. And you know what? I kept up the entire time. 

I'm really glad I procrastinated on writing this post because on Wednesday I went back to the class here in Michigan. I was nervous about how making it through the hour because the last two classes were such a huge challenge. But right away I saw a difference in my mentality. I didn't feel like the fat girl in class. I didn't mind being surrounded by mirrors. I was proud of what my body could do and excited to try again. When class started I immediately noticed a huge difference in my ability to keep up. I was able to bounce from foot to foot most of the class and pretty much kept up the entire time. And as my first jab landed on the bag, joy crashed over me like a wave. 

So here is my advice to anyone trying a really challenging class based purely on my experience (I am not a professional):

1. Go in with the goal of finishing - Don't worry about getting every move right or keeping up. You won't. Do the best you can so that when you go back you will know better what to expect. 
2. Go to at least three classes - Give your body time to get comfortable working new muscles before you decide it's too hard. I know class three was a game changer for me in terms of what I was able to do. 
3. Just showing up the first time is the hardest part - But being the new guy is not fun to me. I hate feeling like I don't know what I'm doing. But if you'd never done this before how can expect yourself to be perfect the first, second or third time you try something? I made a whole bunch of excuses of why I shouldn't go on the day I went to my first class. Fortunately Beth saw right through them and pushed me to try. Just trust that it will get easier. 

I have not traditionally made the best decisions when it comes to releasing stress. I usually tried to stifle my emotions and distract myself from what was bothering me by drinking too much or going on an online shopping bender. Facing this realization has helped me rethink how I deal with the things that bother me. The best way to release stress for me is to hit things. Fortunately, there is a healthy way to do that without getting arrested for property destruction or assault. Kickboxing needs to be a part of my life and I am so grateful to Beth and Go Training for helping me find my way back to it. 

Cathy takes Portland!

Cathy came to visit Portland! And she kinda tore it up! Fearless is this lady!

Here is Cathy's story from the beginning, if you would like to read her insights from day one, and where we started her journey.

1. A GOOD YEAR: Getting Started
2. A GOOD YEAR: Let's Get Moving
3. A GOOD YEAR: Fitness Challenge: Yoga
4. A GOOD YEAR: Month One...Check!
5. A GOOD YEAR: Olive the Dog
6. A GOOD YEAR: Taco Bell Fiasco

She is my sister-in-law, friend and this past week, my exercise partner.  She is well on her journey to making healthy choices.  She will be blogging her journey with GO Training for the next year.  She is 2.5 months down already! As a physical therapist and personal trainer, I get to be part and parcel of this sweet transformation.  It also shows my style of training and my perspective on getting people started.  And I am so happy she agreed to blog about it; her voice is relatable and honest and funny.

Here are months 1and 2 of Cathy's workout plans.  She has done every workout thus far!

Month One Challenge: Yoga!

Month Two Challenge: Kickboxing! Done week 9!

Then there was a couple in between weeks before Cathy came here and during her visit.  We decided to use this time to discuss what is working, readiness for resistance exercise.  And work out together!

Exercising side by side was great.  Cathy loves the walking portion of her program, and is READY for resistance exercise!  She is also committed to attending kick boxing weekly.  Going to a kick boxing class together here in Portland we problem solved modifications for some plyometric moves.  Plyometrics is a type of jump training which definitely can help in the future but right now Cathy has some issues with lower leg muscles and feet, so I am recommending she modify, or do just one or two moves a class that way until performing those moves is not pain provoking.

We also did a resistance training video together and she followed along great!  I am making a video for Cathy and will post it here for her base resistance program tomorrow.

Big change for month three is rolling in resistance training, which I am going to start out with basic moves and one or two dynamic moves, and lots of core training. Once Cathy does a month of this, we can discuss how she is feeling and progress from there!

Hill Walk: same all month!

Hill repeats:

5 minute warm up,Find a small to medium hill, 4 X up and down, 5 minute cool down

Intervals:

Week 11 and 12: 20 minute
5 min warm up
2 min on, 30 seconds off X 4 repeats Effort: 10 point Berg 6-7
5 min cool down

Week 13: 25 minute

5 min warm up
3 on, 2 off X 3 repeats Effort  10 point Berg 6-7
5 min cool down

Week 14: 30 minutes

5 min warm up
3 on, 2 off X 4 repeats Effort: Effort: 10 point Berg 6-7
5 min cool down

Month 3.5 is on!

BY the hair of your Shinny Shin Shin!

Shin splintz! That's the 90's way to spell it...I started this post a while ago, when Cathy started her program and wanted to make sure it was informative but not too long, I am not sure I have achieved either...BUT I do feel super proud chest and confident you WILL possess solid knowledge about shin splints after this post.

Also known as Medial Tibial Stress Syndrome (MTSS), shin splints is a catch all term, it is the universal "my shin hurts" term.  But the pain could be lots of things, muscular irritation, compartment syndrome, stress fracture, or sometimes the actual periosteum of the (perisoteum is a thin connective tissue that is the most outside covering of a bone) of the tibia.  How do you know what's contributing?  Read on my friend!

The number one reason for shin splints to arise from the musculoskeletal abyss is usually/always too much, too fast.

I also want to say that shin splints are pretty normal, and manageable.  Easing into walking, aerobics, running, whatever your flavor of exercise is, will mitigate the ouch.

Reasons why shin splints arise:

• A too large increase in mileage, speed, or terrain change for walkers/runners.
• Any scenario where you are increasing the demand of shock absorbing and work in foreleg muscles, will stir up this super unpleasant sensation. 

First, I just want to remind all of us, myself included, that the body likes a little prep.  The body will respond to stress and get stronger.  The smart way to train is to gradually increase that stress over time to let your body get a little inflammation, rebuild tissues, and get back at it!

On the front end of my weight loss journey (30 down, 20 pounds to go), I weighed 183 pounds, at 5'2".  And one day, after a stirring talk with my buddy Angie, I jumped on my weight loss train with gusto, toot toot!  I remember my first run after being pretty patchy with exercise for about 7-8 months.  It was intense/terrible/uncomfy. Shins a'fire!  My caveman crazy brain over rode my physical therapist brain, and a walk with intervals, or just a walk the first time out would have been a great call.

Please ease into your program! But if you got a little wild and crazy read below, and we will talk about bone structure, anatomy, and some strategy to make shins go right!

Let's get all sciencey about shins.

Boney anatomy and bone irritation:

Shins have two boney maroneys. Then tibia on the inside, and the fibula on the outside.  They articulate at the foot with the talus.

How does the bone get irritated?  The tibia flexes back just a wee bit as we strike the ground with our foot.  When we train too much, too fast the bone tissue gets broken down faster than it can be rebuilt.  It's akin to you cleaning up after one 2 year old pretty good.  But if you had to keep up with a room full of  2 year olds and they had popsicles and several bins of toys, you could clean up a bit but you would never clear the room, and every person in the room would have sticky hands.  Same idea with bone stimulation, and bone building.

Weight bearing,  cyclical,  repetitive exercise stimulates bone growth, but the growth needs time to happen.  You pull the trigger on bone building when you do more than your normal level of activity. That tells your bone to start building up that area of bone, and it triggers bone building cells called osteoblasts to make stronger bone.  This tissue turn around usually takes about 6 weeks.  Longer in those with healing issues, and maybe even shorter for others.  This process of rebuilding tissues after stress is called Wolff's law, a link is provided if you want to delve another layer deep into the theory and physiology.  If the stress of the new activity is too great, the bone cannot remodel fast enough to recover from the stimulating inflammation, and irritation of the outer layer of bone (called the periosteum) occurs.  If you keep training hard, this inflamed periosteum may start to fail and a stress fracture may happen.

http://www.atlantaequine.com/pages/client_lib_sequestrum.html

It would be rare to have JUST boney inflammation without a mad tendon or muscle too.  And why is that muscle mad?  Usually a weakness or tightness SOMEWHERES in the biomechanical chain.  Or maybe you kept going when you were pretty fatigued.

Muscular anatomy:

Many muscles that attached to the lower leg are also movers and shakers of the foot.  They contract to decelerate and accelerate your body and maintain your balance as your foot strikes the ground while walking or running.  Dorsiflexors live on the front outside of your shins, and pull your toes up and plantarflexors point your toes, and live on the back side of your calf.

Academics divide the bottom of foot into four layers of foot muscles, ligaments and tendons because there is so many important structures there. Lots of tiny muscles here flexing, extending toes, spreading toes!

Most dorsiflexors and plantorflexors also do other jobs, like pulling the foot in or out, flex or extend toes! Muscles work in concert with each other during the running cycle, turning on and off as needed.   Also rotation happens at the foot causing pronation and supination of the foot.  Just throwing out this info to illustrate how complicated the anatomy and function of our glorious lower legs and feet really is, and why getting shin pain if your go out to hard is so easy to bake up.

I found great images of muscles on a massage therapy sight, and encourage you to visit this link http://medicfrom.com/publicpress/Massage/Basic_Clinical_Massage_15.html.  Scroll like a champ down to the foreleg pics and just 'preciate all the LAYERS of muscles and tendons that surround the leg and foot!

Overuse and irritation in these muscles may be the source of your shin pain. And treating the muscles will aid your recovery.   If your foot is slapping the ground as you walk or run it could mean weakness and tightness in the calf is making it hard for you to pull up your toes.  MAYBE an old ankle sprain may have left you with decreased range of motion into pointing or flexing that wasn't really called out as a problem until you started walking or running.  All of these issues may not be part of your story but even a mild asymmetry in core, hips, knees, or ankles can cause big problems if your are progressing into running.  Even mild injuries from the past, if not addressed or rehabbed may have left a small mark in your symmetry.

Most of these issues are totally addressable and the comments above are not a full list of causal reasons for shin splits, just keep in mind asymmetries and weaknesses even from years and years ago CAN be improved.  I am talking to you "I have always had weak ankles" people.  Your body is strong and if you have never TRIED to strengthen a weakness, please don't assign yourself a label!  (Last two sentences....a physical therapy rant!)

What to do?

So with front of the shin pain, most likely caused by a jump up in training, here are some recommendations.

1. Just be aware of other shin ouch sources and make sure this isn't your kind of pain:

• Stress fracture: stress fractures require the attention of a physician and imaging to rule it in, and will require rest from running to recover and heal it.  Women typically are more vulnerable to this injury, and it may be characterized by pain lasting after a run, an ache along the tibia or fibula, painful to touch along the bone.  It is a weakened spot of bone that cracks a bit from repetitive stress.  A stress fracture can also happen in the bones of the foot.

• Compartment syndrome: so think of your leg as a container.  When you exercise blood flow increases to your legs as the muscles demand fuel.  Sometimes the swelling or flow of blood causes pain because the container fills up and is not relieved of this fluid shift fast enough. The lower leg is divided by fascial compartments, and a compartment may get too full pressing on blood vessels and nerves and due to it not being real stretchy.  Muscle groups are covered in connective tissue that can trap the blood flow and cause pain, pins and needles, redness, and can be serious.  If the pressure in the compartment is high, tissues actually cannot get blood flow and tissue death can occur.  Totally not fear mongering here! It is rare but possible source of shin pain with exercise.  Compartment syndrome in the lower leg is much more common in trauma situations (fracture, crushing type injury, gun shot wound)  where there is a lot of damage and the swelling response is significant in a short amount of time. 

• Check out the links for the above issues to allow you to explore the above issues deeper.

• WHEN EVER IN DOUBT, stop, collaborate and listen, but also see a physician.

2. Self Massage and stretch:  Roll out the affected muscles with a can, tennis ball,  golf ball, or foam roller.  And do some good stretches!  Never stretch cold by the way!  Check out this video I made for Cathy, the author behind the Good Year series, who went out too hard at the beginning of her program and has had some shin splint issues.  Always remember, when addressing a really mad muscle, you may get more muscular relaxation or tissue softening with a gentle approach.

VIDEO!  Disclaimer:  It's long! 13 minutes worth, and I am talking to Cathy, and I was going to remake it for public use cause I don't LOVE my outfit, but as this is my Portland launch month who knows when free time will arise again!

3. Ice: the magic elixir!  10-15 minutes at a time with a towel or other barrier to protect the skin several times (4-6) will help reduce pain and swelling.  Always check your sensation and skin make sure that you are not "burning" your self with the ice.  A good safe way to ice is to let the tissue come back to normal temp before reapplying more ice.

4. Rest: Definitely give the running or walking a rest.  Bike, swim, and let the inflammation go down. When walking no longer reproduces pain, start back with a gentle walk, and reassess before you jump right back into running.

5. Elevate: elevating your feet above your heart will help to mechanically tilt the swelling away from your shins and back towards your heart.

6.  Address muscular imbalances:  Is one of your gastrocnemius (calf) muscles tighter than the other?  Is one hip stronger than the other?  Is your core getting tired out as you walk or run and then your form degrades?  There may be something in your biomechanical chain (pelvis, core,  hip, knee, ankle, and any of the stuff that attaches to these arts) breaking down a bit for you, and seeing a medical or fitness professional might help you get there!  Or sign up with me and we will figure out your imbalances!

7. Give yourself time to build up.  SO remember all the muscles that just make up your foreleg and foot?  And how your core, hips and all kinds of other factors affect your walking and running gait?

The study listed below followed collegiate athletes and monitored those who got the MTSS.  Those with less than 5 years of athletic experience, orthotics, and a prior history of stress fracture or MTSS were most likely to get  MTSS.  Through my therapy eyes, I would say anyone with orthotics is already predisposed due to someone in there course of life saw a motion that needed to be controlled by an orthotic.   And I also want to highlight the years of experience and maybe throw out that the larger base of strength in hips, pelvis, buns, calfs, quads the less likely you will have glaring asymmetries or weaknesses.  This month we are kicking off a strengthening program for Cathy, so check it out if you are interested in a nice base strengthening program.

Med Sci Sports Exerc. 2009 Mar;41(3):490-6. doi: 10.1249/MSS.0b013e31818b98e6.

8.  TLC.    Establishing a relationship with any of the take-care-of-your-body professionals. Rolfers, massage therapist, acupuncturist, etc may be necessary to help you stay as fit a s a fiddle!  Maybe even a physical therapist?

Summary:

• Start slow!  Slower than you think.  
  
  
• Address tight and sore and weak muscles! 

• REST, ICE, ELEVATE!

• Make sure it's not something else that needs the help of a medical professional! (Pain that does not go away when you stop exercising, numbness, tingling, loss of feeling or strength in the shin muscles)