Strong Medicine

Exploring the Science, Art and Practice of Sustainable Health and Strength

Folding Inner Space: Part I – Iron Zen: Exercise-Induced Altered States

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Iron Zen

Tibetan Lama Dungse Jampol is the son of a Tibetan meditation master. At a young age he asked his father to explain to him, “What is the nature of the mind?” and “What is ‘pure existence” and what is the meaning of “enlightenment?” His father sat down and said to the boy, “Come closer.” The boy came within arms length of the father who gestured him even closer by wagging his finger. When the boy’s forehead was within six inches of the father, the elder lama unleashed a blood-curdling scream that literally sent the youngster reeling. Dungse recalled, “That scream was so loud and so intense and so unexpected that I was paralyzed; shocked, my mind was completely cleared of everything – instantly. My father excitedly said, “See! There it is! There it is!”

It is my contention that intense physical effort, the kind of effort generated during limit-exceeding weight training sessions, offers an entranceway into higher realms of consciousness. My Zen master friend, Ken O’Neil, and I have talked frequently about this phenomenon at length and in depth. I have long sought out others that have experienced this Iron Satori in my ongoing effort to bring attention to this rarified and refined quality of consciousness attained during “Iron Zazen.”

Exercise-induced altered consciousness, or, alternatively and more poetically, The Zen of Pure Physical Effort, is a higher awareness induced by intense physical exercise. Superhuman effort opens the “heavy door with rusted hinges.”

I have been a hardcore weight trainer for 54 years and a meditator for 43 years. Nietzsche once noted “true greatness requires long obedience in the same direction.” To which I would add, over time and with continual repetition the ability to enter into exercise-induced altered states of consciousness becomes easier. The longer and more often the athlete enters these zones of heightened sensory awareness, the deeper the experience becomes and the easier it is accessed: vividness and clarity magnify with repeated visitations.

The exercise-induced altered mindset offers a “shortcut” method, a meditational way in which to fold inner space.

We can jump the beginning meditator ahead; throw them into the deep end of the pool, metaphorically speaking, through the precise application of Iron Zen. Intense physical effort shortens the meditation learning curve, depositing the Iron Zen adherent into an advanced state-of-being. Entry is dependent on the quality of the individual workout: if the effort is deep enough, sincere enough, intense enough, Huxley’s Doors of Perception swing open and the exerciser is predictably enveloped in blissful state of exercise-induced nirvana.

Conscious thought is the enemy, the destroyer of optimal human performance. The elite athlete understands this fact: they embrace and inhabit a wordless state that characterizes optimal human performance. Intense physical effort attacks the human body on a variety of fronts in a variety of ways: we self-inflict body trauma in order to induce beneficial stresses. The optimal workout creates stress. The poison is in the dose.

Our subtle task is to create sufficient stress to invoke the adaptive response–this in order to reap all the considerable benefit associated with expertly applied progressive resistance training. Too little self-induced stress and nothing of any physical or psychological consequence occur. What are the stress categories?

  • Mental stress
  • Hormonal stress
  • Central nervous system stress
  • Muscular stress
  • Internal organ stress

How do we create beneficial stresses and not overdo or under-do the dose?

The requisite stress dose appears when we approach, equal or exceed some measure, some current performance benchmark. Hypertrophy, strength, power and exercise-induced satori do not and cannot appear or occur in response to sub-maximal effort. Pushing up to or past capacity–in some way, shape or form–is what triggers all the good stuff.

The elite athlete is able to will his body to perform past its realistic capacity. This ability is one of the contributing factors to why the elite are the elite. At the highest levels of athletics, regardless the sport, everyone has the genetics and everyone has the work ethic, everyone is fast, everyone is strong and agile–so what separates 1st form 5th place?

In most cases superior or inferior placing correlates to the mental attributes (or lack there of) of the athlete. Some athletes are natural competitors and rise to the competitive occasion while others shrink and fall apart at the actual competition.

Human Nervous System

The elite athlete is willfully able to invoke the primordial fight-or-flight response, the necessary precursor to extraordinary effort. Successfully triggering the flight-or-flight response sets in motion everything of benefit that follows. How does one “artificially” invoke fight-or-flight? They create a system of psych.

Successful superhuman effort requires a singularity of mind. A person does not casually exert superhuman effort.

Elite athletes develop individualized mental methods by which they psych themselves up in order to achieve superhuman levels of performance.  Athletes do not care one wit about attaining higher levels of consciousness; elite athletes only care about improved performance.  An experienced, mature, seasoned athlete uses a highly developed psych designed to elevate the quality of the individual workout and elevate performance in actual competitions.

Recalibrating the mind is the necessary precursor to elevating performance. The “Psych” is a conscious, willful act. The athlete executes a mental checklist that they have developed over time. They recalibrate their mindset to prepare for the training session. Once the actual training session is underway, a highly individualized psych-up routine is used repeatedly in each exercise, drill or protocol.

By consciously focusing, concentrating and using tunnel-vision focus, the seasoned athlete optimizes their capacities and abilities. This singularity of purpose improves the quality of, and results derived from, the workout. The key to continual improvement is being able to string together long series of quality workouts, like pearls strung together on a necklace strand.

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Marty Gallagher is the author of Strong Medicine, The Purposeful Primitive and Coan: The Man, The Myth, The Method.  Gallagher coached the United States team that won the IPF powerlifting world team title in 1991. He is a 6-time national masters champion and national record holder.  He was the IFF world master powerlifting champion in 1992.  He currently works with elite athletes, spec ops military and governmental agencies.

Quieting the Mind-Monkeys

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Quieting the Mind-Monkeys

“This restless monkey, which is thought, has broken up this world and has made a frightful mess of this world, it has brought such misery, such agony. And, thought cannot solve this, however intelligent, however clever, however erudite, however capable of efficient thinking, it cannot, thought cannot possibly bring order out of this chaos. There must be a way out of it, which is not thought.”

J. Krishnamurti

This quote from the brilliant Indian philosopher Krishnamurti references the Buddhist concept of “mind monkeys” or what is sometimes known as the “monkey-mind.” These monkeys are the thoughts comprising an incessant internal dialogue driven by worry, fear, anxiety, and rumination. They are constantly chattering and screeching, creating a cacophony in our mind that pulls us away from the present moment. They create imaginary scenarios, reliving recent past events and anxiety-producing worry about potential future problems.

How many times have you arrived at a destination in your car and can’t remember exactly how you got there because you were so immersed in an internal dialogue? For many of us, the monkeys are chattering all day in the background without our full awareness of their presence. The monkeys are not just distractions, but have real health consequences.

Strong Medicine discussed in detail how the mind-monkeys of worry and rumination put us into a constant low-level flight or fight response (sympathetic nervous system) and activate the stress response with real physiological consequences, contributing over time to chronic diseases such as diabetes, heart disease, high blood pressure, and even cancer.

I knew I had a mind-monkey problem, but did not realize the magnitude until I removed all outside stimulus from my environment. I found myself in this almost unimaginable situation during my first experience with a sensory deprivation float tank. The float tank is a futuristic looking pod filled to a depth of only ten inches of water. The water is super-saturated with epsom salt (magnesium sulfate) and warmed to skin temperature. The high concentration of salt allows you to float effortlessly almost on top of the water, and because the water and surrounding air is kept at skin temperature, it is difficult to tell that you are even in water. When the pod door is closed, all light and sound disappear and you feel like you are floating in a void with minimal sensations coming from outside your body.

Floatation Tank

Inside the float tank, the call of my mind monkeys was deafening. There were no outside sounds or sensations to compete with the monkeys in my brain and they made their presence known in an alarming way. I have had training in mindfulness meditation practices, but it still took me almost 30 minutes of floating to quiet these chaotic creatures of thought. I use mindfulness practices often at home and usually feel that I can get to a quiet state, but this experience has led me to question how effective I really am in silencing the monkeys. At home, there are still background noises and bodily sensations that may dull my perception of the monkeys still likely whispering in my head.

After the first 30 minutes in the float tank I was able to start tuning in to the state of my body’s internal workings. I could feel and hear my heartbeat stronger and start to barely detect my intestines rhythmic machinations.   I was finally able to strengthen my sense of interoception, sensations from within my body. I used the sound and feel of my heartbeat to get into a deep meditative state. The sound of New Age music drew me out of this sustained mindfulness, gentle notes hitting with startling force as I had been without external sensation for close to an hour.

The short time I spent in this deep state of meditation, tuned to the interoceptive sensations from within my body was the most profoundly relaxing experience I have had with mindfulness. This was the benefit of the sensory deprivation tank for me. It was nothing mystical or transcendental; it recalibrated my ability to detect the mind monkeys. Now I know how loud they really are behind the distraction of the modern environment, with products of industry and technology resulting in sensory pollution, obscuring the howl of the monkeys.

Knowledge is half the battle when confronting a problem. I have a new standard for my mindfulness practice, and re-tuning with periodic floats in the sensory deprivation tank will be integrated into my self care. Remember that the health benefits of reducing the chattering monkeys are real, with a foundation in modern neuroscience and wellness practice. This is a part of how we rebuild a brain physically and functionally changed by chronic stress (see more in Strong Medicine).

The availability of sensory deprivation float tanks is increasing. A one hour float is usually less expensive than a massage session. The experience of floating without external sensations has been invaluable to me personally. I was given a reality check; my monkeys were (and still are to some extent) running wild.

The Stress Cup and Training

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Paul Britt, RKC Team Leader with Dynamometer

How full is your stress cup? For those that have not read the incredible book, Strong Medicine, the stress cup is a great way to view your overall stress levels. The cup can only hold so much before it overfills and starts to spill. If your cup is running over then you are not able to train effectively and other areas of your life will suffer also.

As Dr. Hardy writes, there are a lot of ways to check on your stress and oxidative inflammation levels. You need to know what your cholesterol is, the levels of associated lipid profiles, and markers of inflammation. If you do not know your levels, you do not know where to go and what your end goal should be. But, you cannot check these numbers on a daily basis. I personally chose to have lab work done about every 4 months or so. That time frame corresponds with the 120 day life cycle of the typical red blood cell. I have found that any changes I have made will be detected and quantifiable in that time frame.

But, you also need to use something that will allow a daily check of your stress cup. A little background before I go any further. My stress cup is pretty full most days. I have three kids, run my gym and training business and I am a full time student in Parker University’s Doctor of Chiropractic program. I leave my house at 5:15am and often return home at 7pm. My days are long, and at 47, tend to be pretty stressful. My school goal is to maintain a 3.2GPA and my current training goal has me training for the Beast Tamer, 48kg kettlebell pistol, press and pullup. I had to find something that would allow me to check my stress level on a daily basis to maximize my training and not add any extra stress or lengthy procedures.

Dr. Hardy spoke about Heart Rate Variability at the Dragon Door Health and Strength Conference as an indicator of the health of our autonomic nervous system. To live the Strong Medicine way we want the parasympathetic nervous system (PNS) to be the main operating system in our daily life. It is the “rest and digest” system. However, in today’s society, the sympathetic nervous system (SNS) is often running at a low volume in the background. The everyday stresses that we allow to affect us keep the SNS pump primed and stress hormones continually trickling into the body. The SNS keeps the stress cup filling all day long and that affects training.

I looked into Heart Rate Variability (HRV) as a method to measure my stress levels for training. A quick, easy explanation of Heart Rate Variability looks at the spacing between heart beats. The more regular the space is between beats, the more the sympathetic nervous system is piloting the ship. You want there to be some variability between beats as that means the parasympathetic nervous system is in charge of everything. The drawback for me was the need to wear a chest strap to measure pulse rate during sleep as HRV is measured upon waking and prior to getting out of bed. It added a little to my stress cup as I did not sleep well with the monitor strap around my chest at night. Sleep is one of my cup fillers that I am working on as it is, but that is for another article.

Dr. Hardy mentioned grip strength as a possible tool to measure the stress cup on a daily basis. There are studies that have shown that a decrease in grip strength is correlated with strokes, heart attacks and overall longevity—it made sense that it would also be an indicator of Central Nervous System health. I also liked the fact that it was a quick and easy check that I could do daily before I trained.

I did some research on the subject and found some others had used grip strength for the same purpose with pretty good results. What I did not find was a consensus on numbers. Everything I read indicated that you need your baseline number, but everything else was across the board in regards to what constituted having a full stress cup. Dynamometers are pretty cheap online, so I bought one and began to play with it.

My initial baseline was an average of three different readings after two days of rest. I measured, waited five minutes, measured and repeated one more time to develop my numbers. The first training session using the dynamometer was the next day. My grip strength was dead-on my baseline and it was a great session, my press and pistol were really strong that day. I monitored my grip strength on a daily basis while using a program based on Easy Strength to train. My testing procedure is the same every time, I perform it in the same position and close to the same time that I initially tested. I try to keep the outside variables at a minimum. I feel that this is the best way to get an accurate reading.

I found on days that grip strength was at baseline or higher, I had incredible training sessions. In fact on days that it was higher, I was using a 44kg kettlebell for my lifts. But what about those days below the baseline? I tried to push through a few of those days to see what the result would be. The days that I tried to push hard, even though my grip strength was not at baseline, were rough. I did not make my numbers and I would lose a few days of training.

I looked at my daily numbers and came up with a guide that works pretty well.

  • Baseline: Green light to train heavy
  • 3-5% decrease: Yellow light, medium day
  • 6-8% decrease: Light or recovery day
  • 10% or more decrease: Take a break and rest

Remember, this is a quick test to determine how full your stress cup is—it is just a piece of the puzzle. You need to know your numbers on blood work, body composition, and determine as many other numbers as possible (such as amount of sleep) to help you maximize your health and avoid overfilling your stress cup.

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RKC Team Leader Paul Britt has been an RKC kettlebell instructor since 2006. He is currently earning his Doctor of Chiropractic, while still training clients at Britt’s Training Systems, his award-winning Hardstyle Kettlebell Training Facility in Rockwall, Texas. Paul is a Certified Kettlebell Functional Movement Specialist (CK-FMS) and PCC Instructor and has worked with  the top Chiropractors in North Texas. Please visit his website brittstrainingsystems.com or Britt’s Training Systems on Facebook for more information.

East Meets West

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East Meets West

I’ve been waiting a very long time to write this blog post. Something near and dear to me, the state of the medical situation not only in the United States but everywhere in the world should create concern for all of this planet’s inhabitants. The answers are out there. We have them all. Unfortunately, money and egos have kept all of our citizens under the thumb of their illnesses and the medicine conversation feels more like an intentional tap-dance.

The good news is, this will not become some sort of political rant. It won’t become a push to convince people that all western doctors are corrupt and are only out to make a buck. I enjoy a good conspiracy theory as much as the next guy, but this is not going to be one of those either. Very much on the contrary. We live in an age where our doctors are developing technology, perfecting techniques and blazing trails like we have never seen before. And I can say with confidence that 99% of our doctors are true healers whose intentions are to eradicate disease and cure their patients.

I spent the weekend of August 15/16 at Dragon Door’s inaugural Health and Strength Conference. A gathering of some of the most forward thinking health, strength and fitness experts in the country, our intention for the weekend was to inform and celebrate the ideas of these exemplary people. I traveled alone, and looked forward to meeting the presenters and make some connections to continue my own growth as a coach and doctor. First up on Saturday morning, Dr. Chris Hardy. Within 20 minutes of his 90 minute presentation, I couldn’t sit still. The information he was sharing was so on point, his approach to health was so progressive and his delivery of the information was presented in a digestible way where even a high school sophomore could understand the value. By the end my head was spinning and my level of anxiousness and excitement to speak with Dr. Hardy was tangible. My good friend Mike Krivka introduced us, we saw the value of partnering, and now we are here.

My name is Chris Holder and I am the head of strength and conditioning at Cal Poly in San Luis Obispo, CA. I am a Senior RKC for Dragon Door but what makes me more useful for the Strong Medicine family is, I’m also a Doctor of Medical Qigong. One of the four major pillars in Traditional Chinese Medicine, my expertise lies in the study and manipulation of the bioenergetics of the patient to create healing. My training specialized in oncology and energetic psychology but my doctoral thesis was directed at athletic performance and how exposure to Qigong will give a competitive athlete an unfair advantage come game time.

Cal Poly Qigong

Since graduating in 2012, I have been on a self-imposed island testing some of my theories on my athletes with stunning success. We’ve been testing Qigong’s impact on flow state induction, concentration and focus during competition, accelerated healing in athletic injury and increased recovery as it relates to training. In the winter of 2015, I embarked on a formal study with my assistant and RKC Team Leader, Chris White, to investigate the potential benefits of a daily Qigong practice and its effects on strength gains. After 8 weeks of training, we found significance in nearly every single factor studied- and we had over 10,000 pieces of individual data at the conclusion. Years from now, I’m hoping, that this one specific study will be one of the propelling factors of moving mindful practices like Qigong into every locker room in America.

Enough about athletics and let’s talk about health. If you are reading this, you are likely an American or European born person whose health care system is firmly planted in western ideas. Great. You are the people who will benefit the most from reading this. Besides perhaps acupuncture, I will assume your familiarity with Eastern Medicine of any kind, but particularly Chinese Medicine, is limited at best. Awesome, you will extract the most from this article.

The differences between the western medical paradigm and the eastern medical set of ideas couldn’t be more different. When I was in medical school, I quickly realized I had to forfeit any notion of understanding what I was learning if passed through a western lens. They don’t match up in any way. Perhaps my greatest asset going into this study was an agreement I made with myself sitting out in front of the school building on night one. I made the deal that I was going to accept whatever I was being taught with no resistance whatsoever. A true “child’s mind” approach. This became enormously valuable from the onset because many of the ideas eastern medicine has challenge and even conflict with how a western trained doctor conducts business. I put up no fight whatsoever which helped expedite my understanding and quickly enhanced my abilities. I encourage you to do the same as you read.

Eastern medicine has been around for approximately 5,000 years. Compared to our western medical practices, which in contrast is a toddler in total years (around 150-200 years old), eastern philosophy is claimed to have been dated back before the written word. Medicine men, shamans and priests were credited for some of the fundamental practices that are still used in modern times.

Susan MeditatingTraditional Chinese Medicine (TCM) is broken into four primary practices: Qigong (where my expertise resides); herbal medicine; acupuncture; and massage. Due to some feathers I have ruffled, I will qualify all of my medical knowledge to be isolated to the Qigong perspective only. I have done the herbs and the medical massage, and since I am not licensed to needle anyone, I have no experience with acupuncture from the provider’s vantage point. Lucky for you, the Qigong is not only the most interesting of the four, but also considered to be the mother of the other three, philosophically.

Please place your Eastern cap on now. All things in the universe are comprised of energy. The sun, your coffee cup, your dog, the water in your tub, the rocks in your backyard, your cell phone and your physical body are all-energy. Quantum physics supports this. At its fundamental roots, TCM is trying to restore the human body into perfect balance of Yin and Yang. Everyone is born with a special recipe of both (for the purposes of this blog we will say an even 50/50). When your balance has been established and all that is YOU is in harmony, the human machine thrives. Digestion, sleep, cellular regeneration, respiration, circulation, hormone balance, cognitive function, sexual performance, immune function… the list goes on and on. Imagine your body is a car that is not running well. You take it to the mechanic and he returns it to you tuned up and ready to go another 5,000 miles. When the Yin and Yang of your being is in balance, you are ready for another 5,000 miles.

Where the great divide between east and west begins (in my mind) is the way we approach health care and healing. Please let me explain. Here in the west we like to use the term “holistic”. It’s that all-encompassing word that implies there is an attempt to heal the body, the mind and in some cases, the spirit. Unfortunately, we have compartmentalized each component to the point where a true healing, under the above definition of holistic, would take around 8 different doctors, nutritionists, psychologists and ministers to achieve the desired effect.

In an eastern framework, the three (body/mind/spirit) are one. We’ve never separated the three. They are one system that work in rhythm to complete the human experience, to live a long, healthy abundant life. When a patient comes to me for my services, they are usually in fairly deep trouble. Because of the inherent obscurity of my practice, many of my patients are at the end of the road and at a stage where considering getting their affairs in order is recommended. Their team of doctors have performed the appropriate surgeries, prescribed all of the best drugs known and given this patient the most cutting edge care fathomable and yet, they are still declining. What gives?

What if I told you that in the current system of practice here in America, in many cases, is looking in the wrong place when it comes to healing? Let’s put together a hypothetical. Susan has just been diagnosed with breast cancer for a second time. She endured a lumpectomy, radiation and chemotherapy four years ago but is facing the same problem again. On paper, Susan has lived a very healthy charmed life. She’s happily married with three fantastic children. She has her dream job and is very successful within her thriving company. She’s not a smoker, her stress levels are as low as they can be, she eats a very healthy diet and exercises four times a week. Her support system is strong, she has a tight nucleus of loyal friends and has an incredible relationship with her family who all live nearby. She was surrounded by amazing doctors who followed protocol and now she and her medical team are considering a full mastectomy. Everyone is very hopeful for a full recovery this time but the entire team is mystified by the reoccurrence due to Susan’s lifestyle, demeanor and overall positive approach to life.

Five years ago Susan lost a pregnancy. It was hard on everyone, especially Susan. Her husband John was a rock and that amazing support system we mentioned above came to her side and helped her pick up the pieces. Susan is the posterchild of poise and perseverance and after a very short time away after losing the baby, she jumped back into life feet first. I mean let’s face it, she’s got three other children to take care of, a husband who couldn’t live without her and a company that needs her presence as much as possible. In doing so, she never gave herself a chance to fully grieve, if that is at all possible in this type of tragedy.

Unfortunately, her doctors will go more aggressive this time with both the surgeries and the drugs and Susan will be in a bigger fight than she ever imagined. In this case, her medical protocols are like taking a fishing pole and trying to catch the evenings dinner in a swimming pool. Yes, fish live in water… just not that water.

Chris Holder QigongFrom my perspective (the Qigong approach), we begin with the timeline in which the original diagnosis was made. We understand that the doctors have determined we are stage two. The mass has returned. But we are not interested in the mass itself… we are more concerned with its fuel source and origin or root cause. Where the disconnect resides with her current care is in the lack of understanding by her medical team of the emotional/spiritual versions that make up Susan (the entire person). When I’m treating a patient, I’m not just looking at their physical body or managing their physical symptoms. We are looking at the emotional and spiritual bodies as well (think of a holographic copy of that person that represents one of the three aspects of their being). In many cases (more than you might understand) the illness is in the emotional or spiritual body and simply manifesting in the physical body. The emotion of grief/sadness is assigned to the lungs from this perspective. Each of what we call the five Yin organs (Liver, Lungs, Kidneys, Spleen and Heart) are responsible for setting the energetic stage for the entire body. The motion and fluidity of the energy moving in the body keeps everything functioning normally. But, when Susan lost the baby, the overwhelming grief that accompanies an event like that created a thunderstorm of sorts of dank, stagnant energy within the lungs. Since Susan didn’t get to take the time to care for herself emotionally and chose to dive back into life, her grief was never resolved. Over time, or in this case, the following year, that storm sat into the lungs until on a nuclear level, gave birth to a flower. That flower manifested into her breast and this is where our original story began.

Even though her doctors jumped on things in time and were able to remove the tumor, the root system (that grief which energetically becomes prime soil for regrowth) is intact and will bear fruit once again… unless she sorts out her grief. With the help of a savvy psychotherapist and some high end energy work, her chances at beating this disease once and for all goes up exponentially. It’s the grief, the emotion that is the fuel for the illness. Think of Qigong and other mindful practices as the grand gardener of all chronic illnesses.

See, the primary problem with our healthcare system isn’t that one side is right and one side is wrong. I’ve said for years now that if the greatest minds of both sides could meet somewhere and sort out philosophy, fill gaps in one another’s approach, we would have a complete system of care. Even the side I am most aligned with, the eastern side, is saturated with ego, stubbornness and an unrelenting need to be right… so much so that they regularly stifle the information to contain the power of the medicine. I was fortunate to study with a person (Dr. Jerry Alan Johnson) who was willing to put everything on the table for us. He was retiring at the conclusion of my doctoral work and closing the school, so we ended up getting the gold. Because my work is so heavily entrenched in the esoteric and what most would consider supernatural, many of the religious fundamentalists would rather suffer, and some willing to die, because of misled fear tactics their leaders have imposed on them. I’ve seen it over and over.

Listen, I understand that some of this information can be overwhelming. And I know that health care can be expensive, especially when most of the “alternative” services are not covered by conventional insurances. The purpose of this blog post is to open your mind. I want to expose you to a new way of looking at health and wellness. Along with the rest of the Strong Medicine team, I want to educate and create dialogue about healing and vitality.

In the months to come, I will be contributing extensively to the Strong Medicine blog about all things Qigong related. I look forward to answering questions and encourage all of you to keep an open mind and do a little research of your own. I’m excited about partnering with Dr. Hardy and Marty Gallagher and hope to become a valuable ally in helping you achieve lifelong wellness and longevity.

Editor’s Comment:

I have been trying to find a person with the requisite expertise for applying Eastern concepts to Western Medicine, and was fortunate to have crossed paths with Dr. Chris Holder. This article may raise some eyebrows for some of you, but I encourage you to open your minds to some of the concepts Chris has introduced above. “Mind-Body” techniques such as Medical Qigong are the missing link in contemporary medical care. They have been developed empirically for thousands of years with modern science recently starting to uncover the molecular mechanisms behind the observed benefits. Mechanistically, most of the mind-body practices work by reducing the stress response and inflammation, the primary driver behind many chronic diseases, including cancer.

Medical Qigong and other mind-body practices reduce the stress response (see Strong Medicine for more). Chronic stress response can dramatically influence the progression and growth of cancers (no convincing data for initiation of cancer at this point). Thus it is no surprise that these practices have shown to have a significant favorable impact of quality of life and even long term outcomes in cancer patients. I have put some links below to some recent research with Medical Qigong and cancer treatment for those interested in more information. Chris will be a regular contributor to the Strong Medicine blog.

http://www.ncbi.nlm.nih.gov/pubmed/18543381

http://www.ncbi.nlm.nih.gov/pubmed/21715370

http://www.ncbi.nlm.nih.gov/pubmed/19880433

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Coach Chris HolderChris Holder comes to the Strong Medicine Blog with over thirty years as an athlete and coach. A football player first and then spending his entire professional coaching career at the college level, Holder has been in love with everything weight lifting since he was a little boy.

Holder, a Senior RKC with Dragon Door, has an incredibly diversified training background that brings a unique product to his athletes. Known in many circles as a pioneer of kettlebell training at the college level, Chris opened the door in the early 2000s to break the mold and monotony of the traditional methods of training college student-athletes. Additionally, his preparation of football players for the NFL Combine has gained recognition from the NFL for years.

In his “other” life, Chris is a Doctor of Medical Qigong with an emphasis in oncology. Under the tutelage of legendary Kung Fu and Qigong Grand Master Dr. Jerry Alan Johnson, Dr. Holder has developed protocols to enhance every aspect of an athlete’s competitive life. Blending disciplines of both East and West, Holder has created a holistic training environment for his athletes and is at the forefront of Qigong research at Cal Poly in San Luis Obispo, California.

Rekindling the Fire: The Dragon Door Health and Strength Conference

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RekindledFire

I must admit to feeling burned out of late. Strong Medicine was released several months ago and I have just completed the final requirements of a two year fellowship in Integrative Medicine. Both of these have been monumental personal achievements for me following my passion and mission to improve the dismal state of public health, specifically the seemingly unstoppable spread of preventable chronic disease. Despite these recent achievements, I have felt very alone and isolated within the conventional medical system. My Integrative Medicine classmates are like-minded, but many are struggling to find a way to earn a living putting a holistic model of medicine that emphasizes prevention into practice within the mainstream. I have been disheartened to say the least, but this last weekend was a game changer for me.

Dragon Door’s first Health and Strength Conference was an incredible experience as both a speaker and participant. I have never seen so many incredibly talented people under one roof who were all freely sharing their experiences and diverse approaches to the betterment of our collective health and wellness. I am posting this on the Strong Medicine blog, because the conference presenters and participants exemplified the Strong Medicine mission statement found on the home page of this blog in their own unique way.

Health and Strength Conference Group Photo

Rolando Garcia gave an insightful presentation on the business of fitness, but made a key point that left a lasting impression on me. He rightly pointed out that a trainer will potentially see a client 100-200 times per year (as opposed to a handful of 15 minute doctors visits) placing the trainer in a unique position with an opportunity to have a tremendous impact on a person’s health, potentially far more than their health care provider.

Danny and Al Kavadlo gave informative and entertaining talks, reminding us again that your clients don’t need gym memberships or fancy equipment to effectively rebuild bodies ravaged by the inactivity rampant in modern society. Their amazing bodyweight progressions make strength training truly accessible to all.

Max Shank knocked it out of the park sharing his stripped down approach to training. While I gave a theoretical talk about using the concepts of allostatic load in training, Max showed us how he is already doing it with his clients and getting fantastic results and keeping them injury free.

Zach Even-Esh is truly a warrior for public health. He is training our kids, a group many are predicting to be the first generation not to outlive their parents. Zach’s life story, work ethic, and commitment to improving the sorry state of fitness in our adolescents and teenagers was inspirational for me.

Andrea Du Cane put the spotlight brightly on the importance of training our aging population. She gave a fantastic talk that emphasized not only why we should be actively seeking this demographic as clients, but safe and effective ways to implement real strength training and reverse the scourges of sarcopenia and osteoporosis.

Steve Holiner filled in brilliantly for Josh Henkin. His presentation of the DVRT system was outstanding, filling in the gaps many of us have with our movement. The potential applications to rehabilitation and “prehabilitation” are very exciting for me. I was also blown away be his brief offline discussion with me on his biopsychosocial approach to training.

Phil Ross gave a barnstorming presentation on training and combatives that peaked my interest as a fledgling BJJ practitioner. Jon Bruney and Logan Christopher gave fascinating lectures on harnessing the brain and nervous system to improve performance.   Mike Gillette showed us how to save our joints while building incredible strength and resilience with his masterful presentation on ring training. Mike Krivka showed his passion and expertise anchoring our introduction to CrossCore HardCore.

And finally my co-author Marty Gallagher gave one of the most poignant and inspiration talks that I have ever seen. I am truly honored to call that man a friend.

The participants were out of this world as well. My discussions throughout the two days with so many of them were just as educational for me as the formal presentations. There were so many trainers and even some other health care professionals sharing their knowledge freely. This was the most collegial environment that I have ever experienced.

I have come away from the Dragon Door Health and Strength Conference with my fire burning again. The epiphany for me was that I need to spend my energy bringing groups like this together to better our collective craft, rather than wringing my hands over my frustrations with our current health care system.   If we can keep building our collective and synergize our efforts, we can truly have an impact on public health. My sincere thanks to everyone involved for making this experience one of the best in my professional career, and especially to John Du Cane for having the vision to make it happen.

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Chris Hardy, D.O., M.P.H., CSCS, is the author of Strong Medicine: How to Conquer Chronic Disease and Achieve Your Full Genetic Potential. He is a public-health physician, personal trainer, mountain biker, rock climber and guitarist. His passion is communicating science-based lifestyle information and recommendations in an easy-to-understand manner to empower the public in the fight against preventable chronic disease.

Back in the Coaching Saddle… After a Twenty Year Hiatus

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Marty Gallagher and Cristi Bartlett

I stopped coaching at the national and international level when my superstar powerlifter, Kirk Karwoski, retired in 1996. After a ten-year rocket ride with the Kirk, the undisputed King of powerlifting, anything subsequent would have been anticlimactic. Kirk crushed the best with yawning nonchalance: he won seven straight national titles in three different weight divisions. He steamrolled to six straight world titles and set 20 + world records, including an all-time squat record of 1,003 pounds that remains unsurpassed to this day, 18 years after being set. He was widely considered to have had the strongest legs in the history of powerlifting and he built his unprecedented leg power using a strength system I introduced him to. He and I, coach and athlete, refined and fine-tuned this simplistic approach over the next decade. With each succeeding year he got substantially better.

We called our power approach “The Modified Cassidy” because this unique strength strategy was based on an approach first devised by world champion Hugh Cassidy. Hugh’s template was brutal yet effective, a minimalistic approach towards strength training (and eating) that we customized for Kirk. We were heavily influenced by innovative modifications made to the same system we used by power immortals Ed Coan and Doug Furnas. I talked to Coan weekly for years; we were like two lab scientists discussing a mutual science project—which happened to be Kirk. He was the baby gorilla we were raising in captivity: each week I would tell Coan what Karwoski had done in training and listen to Ed’s feedback. We had this ongoing three-way conversation and eventually settled on a system that caused Kirk to skyrocket. It took five years of dues paying before Kirk won his first national title. That same year he took second place at the world championships when Kristo Vilmi of Finland, edged him by 5-pounds. After that, Karwoski went on a rampage: Vilmi was the last man to beat Kirk, ever.

Kirk and I were a coach/athlete partnership: we thought long and hard each successive competitive year about what new wrinkles we would add, what modifications we would apply, how would we hone and refine our core strength system to make it better. We had a viewpoint, a philosophic strength strategy and our report card was how we did at the national and world championships. For seven years he was the best in the world—by a country mile. He didn’t defeat the competition; he annihilated the competition. He was our champion and we campaigned a specific method, a defined strength philosophy. Kirk was the best in the world for a long, long time and he could have won five more world titles had he not become bored with it all.

I did a lot of coaching at nosebleed levels, including coaching the United States to the IPF world team title at the 1991 world championships in Orebro, Sweden. Like Kirk, I too got burnt out. Truth be known, I didn’t miss coaching. I did so much of it for so long and with such a high caliber of athlete that the idea of coaching again held zero appeal. That all changed when I got a load of Cristi Bartlett. Naturally I heard about her before I met her. She was a protégé of Jim Steel, the no-nonsense, Old School, hardcore strength coach at University of Pennsylvania. Jimmy has been at Penn going on 15 years and oversees a 20-million dollar facility with responsibilities for twenty + collegiate sport teams. He needs help and Cristi worked for Jim as an assistant coach. He began telling me about her years ago and a few years back I met her.

I was really impressed with how she looked and how she moved. She was a muscled-up 190-pounds, which sounds huge, but on her it looked quite normal. She moved like a panther and had “elite athlete” stamped all over her. I was hardly surprised when told she’d been a collegiate basketball player and held a Masters degree in exercise science. Cream rises to the top and genetics, brains and youth are always a good combination in an athlete. While I was not surprised at her athletic pedigree or academic degree, I was quite surprised (shocked, actually) at how “spot-on” her deadlift technique was: she deadlifted as if she’d come straight out of the same Hugh Cassidy technical deadlift boot camp that world champions Mark Dimiduk, Mark Chaillet, Marty Gallagher, Kirk Karwoski and Don Mills were schooled in.

She had intuitively taught herself how to pull using the same technique we were taught: narrow stance, upright torso, bust it from the floor using leg power, finish off the pull with a steel-coil hip hinge held in reserve until that special instant. “Where’d you learn to pull like that?” It was the first question I ever asked her. “Oh, I sort of figured it out on my own. It seemed logical.” Now that was the right answer. She had excellent body proportions; a positive indicator for future balanced lifting. Most good female powerlifters are short and squat; they usually have good squats and good bench presses and are piss-poor deadlifters. Cristi is the rare breed: world level bench presser and deadlifter. She is also a 100% lifetime drug-free athlete.

I asked around a bit about the national and world records in the newly minted USAPL and IPF “raw” divisions. Raw powerlifting is done without any supportive gear, other than a weightlifting belt. The explosion of CrossFit has been a shot in the arm for raw powerlifting competitions. Nowadays the raw national championships might attract 400 + lifters. The USAPL and IPF are strictly judged; squats have to be below parallel; and they practice out-of-competition drug testing. Strict judging and strict drug testing work in Ms. Bartlett’s favor. Her training lifts were at or above world record level. For the first time in decades I sensed that here was an athlete capable of going all the way: become the best in the world. Few knew those “all the way” ropes better than me.

She was receptive to the idea of going to the USAPL national powerlifting championships. That competition would be held close by, in Scranton, and would occur in October, a long time off. We agreed in principle to “go for it.” She needed to compete in a qualifying meet in order to be eligible to compete at the nationals. We found a USAPL competition in suburban Baltimore on July 12th and worked together for eight weeks leading up to the Baltimore competition. The web is a wonderful training tool: each week she would video tape her “top set” in the squat or deadlift and e-mail it to me. I would review it, critique it and then, based on all the combined factors, we would make the poundage/rep call for the subsequent workout. It was agreed that the key to her ultimate powerlifting success would be lie in increasing her leg strength.

She was already world level in both bench pressing and deadlifting but she was 100 pounds off the pace in the squat. Champions don’t continually play to their strengths; instead they attack their weakness. That is where the dramatic improvement lies. Ergo, it only stood to reason that she would concentrate on bringing up her squat: to do so would make her invincible. Rome would not be built in a day and we would treat the Baltimore meet as a mere workout, she would lift conservatively: no close misses.

Cristi Bartlett Deadlift

The actual competition turned out to be a madhouse as 100 lifters were lifting. The 28-year old exhibited coolness in her competitive demeanor; she was aggressive yet upbeat, engaged but unfazed, she was alternately in one of two states: totally relaxed sitting in the audience with her dad and Tracey, her training partner, or prior to a lift, concentrated and focused. In her squats, her first attempt was with 295-pounds and she buried the lift a full three inches below parallel. It was a “three-white-light” success. Her 315-pound second attempt squat was easier than the first. She roared out and methodically dispatched a perfect 3rd attempt with 330. Each squat was a cookie-cutter replication of the previous perfect squat.

In the bench press she was nursing a shoulder injury, a serious injury that caused her to train light. She was not at her benching best. The competitive bench press has to be paused on the chest and then pressed evenly and perfectly: she perfectly pressed 205, 231 and finally a very easy 248. We were unaware that the national record was 252-pounds, or we would have taken 256 on her 3rd attempt. Six lifts, three squats, three bench presses, eighteen white lights; she was perfection in motion.

In the deadlift, she hit her first (and only) snag of the day when on her 1st attempt deadlift with 440-pounds she drew a lone red light; the side judge said she did not have her shoulders all the way back at lockout. Two judges passed the lift. She asked for 485 pounds on her second attempt deadlift. The current national record was 473 pounds. After seeing the slump-shouldered 440 opening deadlift, I secretly thought 45 pounds might be a bridge to far. Plus the competition was dragging on and on and cumulative fatigue was a real factor; Cristi had taken her first squat warm-up at 9:30 am and now it was 2:30 pm. That is a long time to maintain an edge.

To my surprise and delight, she strode out and after a long, hard pull locked out 485 pounds to set the new national record. What a GRIP! Mark Chaillet had the strongest set of hands I’ve ever seen and he could just tug and tug and tug on an 850 + pound deadlift all day long—Cristi has that same powerhouse type of “kung fu grip.”

After she locked the weight out and accepted the thunderous applause, she came off stage and I congratulated her. “That’s it—right? You don’t want a 3rd do you?” After seeing how tough the 485 was, after seeing the adrenaline dump and the excitation of that national record, I was convinced she was done. “Whoa!” she said, “How about a 3rd attempt?” I was puzzled, “Really?” I looked deep in her eyes; she was smiling but serious. I didn’t say it but thought; if you worked that hard with 485, what are we going for on the 3rd, 486??? “Sure!” I said, “What’s the number?” She didn’t hesitate. “500!”

She would need to find a deeper well somewhere. To make a long story short, it was as if everything in the competition leading up to this point was the preliminary stuff. By now it was apparent to everyone in the oversized, stuffed to capacity gym, that this woman, pound for pound, was the best lifter in the entire competition, female or male. This deadlift would be more than the male class winner in the 184-pound class and it would exceed her just-set national record. It would also exceed the current 496-pound IPF world record in the deadlift.

https://youtu.be/V3eGtpDQaW4

She crushed 500. 485 was light years better than 440 and 500 was light years easier than 485. She had racked up nine perfect lifts and made 26 out of a possible 27 white lights. She ended with a world record-exceeding lift in her second-ever powerlifting competition. It was exciting as hell. It triggered a feeling in me I hadn’t felt since Kirk hung it up. As my old boss at the Washington Post, Vic Sussman used to say, “Let the facts speak for themselves.” Here is a fact: Cristi Bartlett got me back into coaching…and I am excited to see how far she can go. If she caught fire she could become the female Ed Coan, she’s that talented.

 

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Marty Gallagher is the author of Strong Medicine, The Purposeful Primitive and Coan: The Man, The Myth, The Method.  Gallagher coached the United States team that won the IPF powerlifting world team title in 1991. He is a 6-time national masters champion and national record holder.  He was the IFF world master powerlifting champion in 1992.  He currently works with elite athletes, spec ops military and governmental agencies.

Finding a Balance Between Building and Repair: Part 2 Intermittent Fasting

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Finding a Balance between Building and Repair part 2

Prolonged calorie restriction seen in many fad diets is not a sustainable practice. Weight will be lost for sure, but a significant amount of the disappearing pounds will be from valuable muscle mass. Loss of muscle mass with prolonged caloric restriction has a huge health cost in the long term, especially for those with metabolic diseases such as diabetes and the aging population. Adequate muscle mass is vital to maintain metabolic health and prevent frailty as we age. It is also impossible to work out at high enough intensities to achieve the beneficial adaptive responses to exercise while undergoing long term calorie restricted diets. Our engines need adequate fuel to perform optimally.

Prolonged caloric restriction has been shown to extend the life span of rodents, worms, and fruit flies, but longer life spans have not been seen from fasting in higher primates and humans. What is clear is that periodic fasting has been shown to improve the health span in humans and can be highly effective in reversing chronic diseases if done properly.

The issues with prolonged calorically restricted diets for weight loss and the proven benefits with periodic fasting have led many of us to experiment with intermittent fasting (IF).  Intermittent fasting is the practice of scheduling short term periods of calorie restriction, followed by normal caloric intake. Recent science has shown that many of the metabolic benefits of fasting can be achieved with IF without the loss of our prized muscle mass. For this reason, IF has gained popularity in recent years. For some IF works fantastically to achieve a lean physique and metabolic health, while others have not been so successful with their experiments with short scheduled fasting. What gives? Why do some people see great results with IF and others crash and burn?   Much of the variability with results likely is from the “environmental” context IF is used. Let’s go back to first principles to establish a framework for successfully using intermittent fasting.

Intermittent fasting is an environmental stress (remember that our environment includes all aspects of our lifestyle) on the body and brain. The short-term stress of IF activates the repair and recycling system of autophagy we covered in Part I. Intermittent fasting will temporarily shut off the mTOR building pathway in favor of repair. The autophagy system improves the health and metabolic efficiency of our cells which translates into beneficial effects for our entire body. “Dosed” correctly, IF can be the missing link in your quest for optimum health, body composition, and prevention of chronic disease. The important point to remember is that although potentially beneficial, intermittent fasting like all caloric restriction contributes to your daily “stress cup” (aka allostatic load discussed in Strong Medicine).

Calorie restriction with IF contributes to your daily Stress Cup
Calorie restriction with IF contributes to your daily Stress Cup

The proper dose of IF is a moving target, as the other contributors to your daily stress cup determines how much caloric restrictions you can handle (if any) on any given day. If you have had a night of bad sleep and significant work or social stress, there will be very little room for the added stress of intermittent fasting. If you don’t take into account a nearly full stress cup and press ahead anyway with a significant fasting period that day, your stress cup will overflow (allostatic overload). This will create a substantial response from the HPA axis (stress system) and increase your cortisol levels. Your brain is protecting itself utilizing increased HPA axis activation and resulting high cortisol levels during allostatic overload situations. This response ensures the brain has adequate glucose, even if it has to get it from your precious muscle mass (from amino acids using gluconeogenesis- see Strong Medicine for more).

Not a good day for intermittent fasting
Not a good day for intermittent fasting

We can frame the “dosing” of IF using the concept of hormesis. From Strong Medicine, we know that hormesis is the phenomenon of something that is potentially bad for us can be beneficial at the proper dose. Calorie restriction certainly follows the concept of hormesis- small amounts produce a beneficial response while large amounts lead to a starvation state. A crucial concept to understand is that the same dose of fasting can be beneficial one day detrimental the next day depending on the state of your stress cup. This is how hormesis and allostasis are intertwined.

Area “B” represents the optimal dose of calorie restriction this day. The level of your stress cup is relatively low allowing a longer period of fasting resulting in a beneficial autophagy (repair and recycling) response.
Area “B” represents the optimal dose of calorie restriction this day. The level of your stress cup is relatively low allowing a longer period of fasting resulting in a beneficial autophagy (repair and recycling) response.
This is a day when your stress cup is filled with other sources of stress such as poor sleep, social stress, or high levels of exercise. The length of your fasting this day has to be reduced (to the area of the green”B”). If you did the same length of fasting you did in the first example (yellow “B”) you would “overdose” fasting and overfill your stress cup. On especially high stress cup days, fasting periods should not be attempted.
This is a day when your stress cup is filled with other sources of stress such as poor sleep, social stress, or high levels of exercise. The length of your fasting this day has to be reduced (to the area of the green”B”). If you did the same length of fasting you did in the first example (yellow “B”) you would “overdose” fasting and overfill your stress cup. On especially high stress cup days, fasting periods should not be attempted.

The benefits of IF-induced autophagy will not be realized if you overdose your fasting period. This point deserves repeating- intermittent fasting is a stress on your body and has to be balanced with the other stresses in your life to do it successfully.

Exercise and Intermittent Fasting

Finding the right mix of high intensity exercise and fasting can be a very tough to consistently pull off. High intensity resistance training and interval training stimulates the mTOR building pathway, increasing/maintaining our muscle mass and promoting fat loss through the actions of growth hormone. High intensity exercise is also a significant stress (which is why it works) on the body and needs to be figured into your daily stress cup evaluation. This type of training directly after a period of fasting can be especially stressful and should be approached with caution and careful assessment of your stress cup.

General guidelines

For the lucky few that live idyllic lives (my Strong Medicine co-author, Marty Gallagher, comes to mind) and have relatively empty stress cups, you can get away reckless forays into fasting experimentation and be just fine. Most of us are not that lucky and need a few guidelines to keep us out of trouble:

  • Assess your stress cup daily. Fasting is never a good idea with an already-full stress cup.
  • Start with brief fasting periods when beginning IF. The most popular is fasting from dinner the night before until lunch time the following day.
  • Avoid fasting when planning high intensity exercise sessions that day (“feed your activity” concept from Strong Medicine). Fueling your post-workout time periods will help maximize mTOR and muscle building. If you are getting good results starting your work out in a fasted state, make sure you feed yourself adequately post-workout.
  • Avoid fasting after a night of poor sleep. Poor sleep is one of the biggest contributors to the stress cup.
  • Plan fasting on your non-exercise recovery days. This can help maximize effectiveness of the repair/recycling autophagy system.
  • If you can’t handle complete fasting try a reduced protein day. Recall that amino acids from protein are potent triggers of the mTOR building system and reduced protein intake will trigger autophagy without abstaining completely from food. Meals consisting of high fiber vegetables with additional fats from olive oil/coconut oil or avocados will work well for this reduced protein strategy.
  • For those of us pushing middle age it is important that we give potent stimulation of the mTOR pathway to slow the muscle wasting of aging (sarcopenia). It is harder for the aging trainee to stimulate mTOR compared to the younger person. If this applies to you, consider a weekly schedule with less overall fasting and more attention to resistance training with increased protein intake to find your optimal balance between building and repair.

Conclusion

Intermittent fasting practice that is informed by daily monitoring of your stress cup can be hugely beneficial. The key is to be flexible and not overly rigid with planning your fasting. If you are having a high stress cup day, don’t be afraid to ditch your fasting plans. Failing to take allostatic load (stress cup) into account will just hurt you in the long run and slow progress to attaining your fitness and health goals. Start slowly with short fasting periods and increase with small increments. Using the conceptual framework we have created with intermittent fasting and the stress cup you can find your optimal individual balance between building and repair.

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Chris Hardy, D.O., M.P.H., CSCS, is the author of Strong Medicine: How to Conquer Chronic Disease and Achieve Your Full Genetic Potential. He is a public-health physician, personal trainer, mountain biker, rock climber and guitarist. His passion is communicating science-based lifestyle information and recommendations in an easy-to-understand manner to empower the public in the fight against preventable chronic disease.

Breaking Down the Barriers to Exercise

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Carrie Hardy Breaking Barriers for Exercise

Another day and another pep talk. I know that exercise is good for me but some days I find myself making excuses and rationalizing why I can’t exercise today. As a former scientist and current physician-in-training, I am well aware of the research that shows the benefits of exercise for health and wellness. I know that in addition to the physical benefits, daily exercise can facilitate protective, adaptive and regenerative responses in the brain. I am even married to the guy who co-wrote Strong Medicine, arguably the most important health and wellness book out there (I am in no way biased!), with pages filled with the reasons I need to exercise. So why do I have such a hard time sustaining a schedule that includes regular exercise?

From looking at the poor state of fitness in the majority of us, I know that I am not an anomaly. Most of us have similar struggles prioritizing exercise. Starting and maintaining a regular exercise routine obviously has many barriers in modern society. There are entire industries built around finding the latest “revolutionary” gadget or program to inspire us to exercise. The marketing gurus of the sporting goods and technology companies have tried to assist us (and take our money) by selling handy gadgets such as the Fitbit, heart rate monitors, and activity trackers all created to help motivate us to just move. Despite of all the latest technology at hand we still struggle.

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Those who study this subject have looked closely at barriers to exercise (and lifestyle change in general). These barriers can be broken down into three general categories:

  1. Intrapersonal: time, knowledge, motivation, personal appearance, and overall health to initiate an exercise program.
  2. Interpersonal: commitment to self versus others, lack of support, and lack of workout partner
  3. Environmental: lack of equipment and lack of realistic role models.

Personal appearance! Who doesn’t want to look better naked? Some days it is really tough to face the mirror and many feel this way (whether they admit it or not). What can even be more taxing on self esteem is how we perceive we look both in our workout attire and while we are performing the exercises.   Before you launch into a rant about exercise not being a beauty contest, let’s take a closer look at these very real barriers (especially for women) to getting someone to start and maintain an exercise program. I came across a very interesting research article published by Bourn and colleagues that evaluated the effects of viewing “reality” weight loss television shows on body satisfaction, mood and snack food consumption. We assume that these reality TV shows are motivating for those watching, however Bourn’s published results show that “larger women experienced less body satisfaction and less positive mood in response to weight loss program” than a control group that watched a program on home renovations (the control group). Additionally, it was reported that a “greater percentage of women with higher dietary restraint ate food whilst watching the weight loss program.” In this study, not only was watching overweight people exercise not helpful for the viewers own body image, people whom normally have more restraint with snacking ate food while watching the reality weight loss show!

I know you are saying to yourself that this is a research group and perhaps they were almost expected to feel this way. But, let’s look at a snapshot in reality. Negative thoughts about your appearance can create a rabbit hole into which we chase our self-esteem. I want to share a story about appearance during exercise. A friend of mine and I were talking about exercise and clothing. The weather is getting warmer, but not quite warm enough for just shorts and t-shirts. I freely admit that I have moments where I am concerned about appearance while in workout attire. I expressed this to my friend, who has been an athlete since she was a teenager and has the lean body composition that one would expect with a life long athlete. I was shocked to hear her express similar insecurities with her own appearance in workout clothing. Logical or not, perceived self image and appearance is a river that runs deep!

Lack of time and conflicting responsibilities seem to be partners in crime for creating barriers to exercise. There never seems to be enough time and it seems that we have to make a choice to do something good for ourselves or take care of our family first. I know I think about this often!   I am a full time medical student and I feel that I need to carve out time for everything from studying, spending quality time with my family, and personal time for myself (mostly to workout).

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I scrutinize my schedule to see where I can fit in time for a 20-minute burst protocol (see Strong Medicine) or a 4-minute Tabata routine. It doesn’t seem like a lot of time but when you factor everything in, but even this amount of time can seem prohibitive. I have become creative and workout. When there is a short break in between classes or before I get dinner started (if I am home before Chris), I will pop into the garage to get some sort of workout in. Having a space set aside in your home to work out can really make a difference. Strong Medicine provided us with a look at some efficient exercises that can be done using either the burst or HIIT protocols, helping to eliminate the concerns of time being barrier while still getting in an effective workout. Using these two methods can certainly help overcome the barrier of time.

While engaging in regular exercise can help increase energy, improve mood and improve your physical appearance, make sure you start at your ability level. You may have to start with just walking. That is OK, just make sure you do it. You may not feel that is enough but it is a starting place to build your foundation. Strong Medicine has a walking program for the absolute beginner that starts out very slowly and builds gradually.

Lack of social support from family or friends and lack of partner for exercise are less discussed barriers. We touched upon conflicting responsibilities as it overlaps with time in the intrapersonal barriers but how do we overcome lack of support? Let’s look to our family first. Getting a family member to join us in exercise can increase the time we spend with loved ones as well as provide support and a workout partner for us. Here are a few ideas to start:

  • Find a family member or friend willing to go for a walk with you regularly. Once a routine is formed you can try out alternate exercises and intensities together. Building the exercise relationship first this the is key.
  • Instead of a ladies or guys night out at some bar, how about 30 minutes of exercise with your friends before dinner? Make exercise a part of the social bonding of a night out.

So now that we have made a time commitment to ourselves and found a workout partner, let’s look at our final group of barriers. These can include:

  • Lack of facilities/equipment,
  • Lack of role models for physical activity

Gym memberships and equipment can be expensive, and choices of where to join and what to buy can be overwhelming. If you are a beginner to exercise, you are born with all the equipment you need to get a good workout, your own body! Learning simple bodyweight exercises can be a great beginning. If this is where you are starting you are probably pretty safe working out on your own. The safety concerns should be minimal but if you are ready to attack advanced moves, you will want to consult a professional (Dragon Door’s PCC is an excellent place to start).

Finding motivating exercise role models can be extremely difficult. All of the images on TV or the Internet are of extremely buff individuals with bodies that appear unattainable. However, it is this image that sells products with the promise that you also can look like this. Uh oh! We are back to body image.

Perhaps we should stop looking for role models and just find motivation first. Personally, I find this quote by physician and athlete George A Sheehan helpful for motivation (maybe not so inspirational): “Exercise is done against one’s wishes and maintained only because the alternative is worse.” The fear of poor health can kick you in the butt to get you moving, but once you start making exercise a habit in daily life, you will find that the good feeling you get after a workout is its own reward and will keep you coming back for more (endorphins are wonderful!) Become your own inspiration instead of looking for it in others.

This article was originally written to discuss both barriers and motivations for exercise. Motivation, like exercise, is not one size fits all. The quote from Dr. Sheehan above should be enough to set your body in motion but you will need to find what motivates or inspires you to take control of your health and your life. Obtaining a better body and health is achievable if you prioritize exercise and make it a habit. The barriers you perceive are not insurmountable. Besides, who doesn’t want to be really, really, ridiculously good looking…

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Carrie Hardy, M.S. is a former biochemist, 4th year medical student at Bastyr University, mountain biker, amateur photographer and a neophyte in Brazilian Jiu-Jitsu. Her passion is combining science with individualized medicine to empower individuals to lead a healthier life.

Finding a Balance Between Building and Repair: Part 1

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Strong Medicine Maximizing Health-Span: Introduction

For the second MHS (Maximizing the Health-Span) post, I set out to write an article focused on intermittent fasting (IF). But, I quickly realized we needed a “first principles” foundation for context first. We need to understand the underlying physiological systems that are affected by intermittent fasting instead of taking a reductionist approach. A very simplistic way of thinking about the two major body systems most affected by intermittent fasting (and also training and other lifestyle choices) is categorizing them as systems of building and repair respectively.

The body has to achieve a balance between building and repair at a cellular level. This balance will necessarily change depending on environmental demands such as physical activity and nutrition as well the aging process.   Finding the right balance between building and repair at the right time is key to maximizing the health span.

Building and Repair Diagram

At the center of the building and repair systems is a protein complex known as mTOR. The technical name for mTOR is the mechanistic target of rapamycin (formerly known as the mammalian target of rapamycin). mTOR functions as a molecular switch between building and repair.

Turning mTOR on promotes building. Turning mTOR off promotes repair.

BUILDING

Building—the mTOR switch is on
Building—the mTOR switch is on

Building (growth) is an anabolic process that happens when mTOR is turned on. Stimuli such as resistance training and eating protein (especially the branched-chain amino acid leucine) turn the mTOR switch on. The hormone insulin also turns on the mTOR building pathway. This effect of insulin should come as no surprise to readers of Strong Medicine (SM pages 107-108) as we discussed insulin as a hormone of growth and storage.

As Dan Cenidoza covered in his Strength after Sixty post, the anabolic pathways of building are crucial to grow and maintain muscle mass especially as we age. Not enough of “turning on” the mTOR switch can lead to sarcopenia and frailty in old age.

At the extreme end of the mTOR building pathway is cancer. By the simplest definition, cancer is uncontrolled cell growth. Recent science has shown that many cancer cells have abnormally high mTOR signaling, putting them is a perpetual state of growth. People with insulin resistance (SM p. 180) have higher levels of insulin in their bloodstream at all times which keeps the mTOR switch activated. Thus, it is no surprise that those with insulin resistance/diabetes are known to have increase risk of cancer.

We also now know that high levels of sustained mTOR activation can lead to accelerating aging in many species, including humans. With this information in mind, it becomes evident that getting the proper “dose” of mTOR activation is key.

We need enough “turning on” the mTOR building (growth) switch to prevent the loss of muscle mass so crucial for healthy aging, but no so much that we accelerate the aging process and become at increased risk for diseases such as cancer.

mTOR Activation

REPAIR (AND RECYCLING)

Repair and recycling- mTOR switch is OFF
Repair and recycling- mTOR switch is OFF

The opposite side of the mTOR coin is the repair and recycling system. This system is activated with the mTOR switch is turned off. The main process that carries out repair and recycling in our cells is called autophagy.

Autophagy literally means “self-eating.” Autophagy is the mechanism our cells use to recycle damaged proteins and cell machinery (including mitochondria) and use their parts to make new machinery and new sources of energy. Recycling old cellular machinery helps protect a cell from premature aging. This is similar to replacing a roof or hot water heater in your house to keep it functional as a dwelling longer. We can replace some of the parts for quite a while before having to buy a new house.   Autophagy does the same thing for cells.

Autophagy is a cell-survival mechanism during times of stress. Fasting is one of the most common sources of cell stress that activates autophagy. Low protein intake and low insulin levels create a perfect environment for the mTOR switch to be turned off and autophagy to take over. Autophagy allows your cells to recycle used material for use as energy during stresses such as fasting, instead of breaking down valuable things such as muscle. Preventing catabolism (breaking down) of muscle is always a good thing!

By allowing recycling and repair within the cell, autophagy effectively extends the life span of the cell. This is one of the reasons why we seen increased lifespan with fasting and calorie restriction in animal such as mice and worms (it has not worked as well in humans as we will discuss in subsequent posts).

FINDING THE BALANCE

We know that turning on the mTOR building pathway in the right doses is crucial to maintaining muscle mass through the lifespan, a key to healthy aging. We also know that autophagy is a valuable process to extend the life and health of your cells. Finding the right balance between these two processes is where it can get tricky.   This balance is also a moving target throughout our lifespan. We are going to use the concept of balancing mTOR activation (building) and mTOR deactivation (repair/recycle) to discuss training, eating, fasting, and lifestyle modification in upcoming posts. We will couple this with the concepts of hormesis and allostatic load (the Stress Cup) from Strong Medicine to create a framework to form a foundation from which to decide if practices like intermittent fasting have potential to maximize the health span.

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Chris Hardy, D.O., M.P.H., CSCS, is the author of Strong Medicine: How to Conquer Chronic Disease and Achieve Your Full Genetic Potential. He is a public-health physician, personal trainer, mountain biker, rock climber and guitarist. His passion is communicating science-based lifestyle information and recommendations in an easy-to-understand manner to empower the public in the fight against preventable chronic disease.

Roots and Mentors: Mac McCallum’s Profound Insights Are Still Relevant

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John McCallum: our mentors had to walk the walk before we listened when they talked the talk. He wrote 100 + articles; he gave us our marching orders every month.
John McCallum: our mentors had to walk the walk before we listened when they talked the talk. He wrote 100 + articles; he gave us our marching orders every month.

There is no school like Old School!
“Train, eat, sleep, grow – repeat!”

John “Mac” McCallum was a hugely influential figure that burst onto the muscle and strength scene in the 1960s. He built a cult following with his superb column in Strength & Health magazine. The “Keys to Progress” series ran for years and presented a viewpoint and tone that struck a resonant chord with alpha males worldwide. Mac was a man’s man, he offered up a vision of the idealized man—then provided a blueprint for morphing yourself into that ideal. In Mac’s way of thinking, the ideal man was large, muscular, athletic and smart. He loved the rugged, functional physiques of the Olympic weightlifter. Mac was generally dismissive of bodybuilders: they were too effete, preening, egotistical and un-athletic. But, having said that, he worshiped the “power bodybuilders” as exemplified by Reg Park and Bill Pearl.

First and foremost, Mac’s goal was to become strong. The key to transforming into the idealized alpha male was to grow dramatically stronger. Everything flowed from strength; in order to grow stronger, Mac championed the strategy of getting bigger. How did a man grow bigger and stronger? He first and foremost lifted weights in a very specific and disciplined fashion. Secondly, the acolyte purposefully ate a massive amount of food. The goal was to lift weights hard, heavy, often and with incredible training intensity, or “effort,” as he called it. To “support” the intense lifting Mac wanted athletes to eat big and eat often. The emphasis was on protein but his nutritional approach was the “seafood diet,” i.e. see food, eat it. When it came to packing on muscle size, intense lifting and intense eating will grow a body.

He was also a huge proponent of rest, and deep sleep. He rightly believed that if a man shatters himself to the required degree in weight training—lifting long and often—food and rest are needed to recover and grow. The entire growth equation was simple: lift, eat, sleep, grow. Genius.

Mac’s strategy was lift hardcore and eat like a ravenous animal—purposefully and repeatedly, unapologetically… What a profoundly fun, easy and delightful philosophy for a young man to follow! Eat as many calories as possible from the time you get up until the time you go to bed. Protein was favored over all nutrients; McCallum had one article entitled, “Protein is King! But other calories were welcome too”. One particularly awesome Strength & Health article circa 1966, but not a Mac column, described the successful “bulk up” strategy of an air force sergeant stationed in a hut by himself at the North Pole monitoring the missile-detecting DEW line. He had a 500-pound set of weights, unlimited amounts of food, and nothing to do for six straight months in 1965. His inspired tale told of how he spent his time: he lifted weights daily in marathon sessions, and why not? There was nothing else to do! He actually had some metabolism-spiking cardio activity as each day he had to slog around outside in sub-zero temperatures and 60 mph winds for hours each and every day. Then he would come inside, eat like a starving wolf, and sleep for as long and a soundly as he liked. The radio was his only company. Six months later he came back to civilization having gained 100 pounds. That man was a hero to me—I longed to be sent to Greenland, exiled with my books, LP records, weights and unlimited amounts of delicious food.

As a stud high school athlete, I ate two lunches and drank four pints of milk for less than a dollar. Being an alpha male leader of boys, I routinely had food offerings from other students dropped off in front of me. Whatever class followed lunch I predictably went narcoleptic. I was forcefully morphing my body. I engaged in lots of aerobic sports activities which kept my metabolism kicking. The lifting built muscle and the copious calories supported recovery and growth. Shot full of teen testosterone and training hard enough to trigger hypertrophy, I grew muscle—lots of muscle. I was burning thousands of calories in sports activities and eating thousands of calories of all types. I had hit upon a metabolic nirvana. I inadvertently combined my immersion into hardcore weight training with a hormonal growth spurt manifested by dramatically elevated levels of testosterone. The results were immediate and sensational. By age 14, I was a regional weightlifting champion. By age 17, I weighed 200-pounds at 8% body fat. I set my first national records and won my first national championships. Only awful grades prevented me from attending a Division I school on a football scholarship. All of my progress was rooted in the profound teachings of Mac.

Forced Evolution

The goal was forced evolution; we would morph ourselves by exerting our iron will. We would faithfully combine copious and indiscriminant consumption of calories with hardcore weight training. We sought to morph from human to inhuman, from normal into abnormal, from forgettable into gargantuan. We would not become another cog in societal machinery; we sought distinction from our fellow man. We were of the warrior caste. This martial mentality dug its talons deep into me, and by the time I was 14 years old I had been into the hardcore progressive resistance scene for nearly four years. I took my training cues from heavyweights like Bill Pearl, Norbert Schemansky, Reg Park, Paul Anderson, John Grimek, Bill Starr, Terry Todd, Tommy Suggs, Pat Casey and Morris Weisbrott—not in person, but through the pithy, informative, no-bullshit, all-man training articles untainted by any whiff of commercialism.

The Mac Daddy communicator was Mac: a folksy writer who made his bones by engineering his own radical physical transformation. Mac was both the curator and repository of the cutting-edge philosophic protocols of the day. Yet he was no dry academic; he taught his lessons using a storyteller’s approach. Like an Iron Aesop, he beguiled us while relating profundities.

“Nobody knew much about squats twenty odd years ago. {Written in 1965} Nobody bothered with them and bodybuilding standards were way down. If you had a fifteen-inch arm you looked like the village blacksmith and a 40-inch chest would bring out the beast in your old lady…you can solve all of your muscle and size problems with squats alone. You can make gains you never dreamed of before. You can build unbelievable size and power.”

Prose like that put me on the squat bandwagon right then and there. Fifty years later, I can tell you that everything Mac said about squats was and is true: mastery of squats opens the door to everything of value in resistance training. McCallum pointed his acolytes down the right pathway on a dozen interrelated topics. In his “Keys to Progress” article, “The Time Factor”, he inadvertently outlined the generalized workout schematic I would use for the next half century…

“There aren’t many exercises in this {resistance} training program. Work hard on every one. Work out three times a week—no more! Don’t touch the weights at all on your in-between days. When you finish your workout, take a shower and forget all about weight training until your next training day. Get plenty of sleep and rest and eat lots of good food.”

Mac had Boy Scout earnestness, a lack of irony and a great, Mark Twain-like sense of humor. His lessons were all about building power and how power begets muscle. The idea of morphing from whatever you are into a muscle monster has motivated men for eons. McCallum’s modus operandi was purposeful primitivism: Mac was the first one to get us to stress the 5-rep set in all our exercises. I am not quite sure how or why he came to the conclusion that 5-reps strikes the perfect balance between low rep power and torque acquisition, but per usual he was prophetic. I think it no accident that “the five” became universally practiced in powerlifting. Mac’s was the first to say, “Men, seriously, concentrate on 5-rep sets in all the big movements.”

He was a big fan (deservedly) of Reg Park and the preference for the 5-rep set might have originated with the Englishman. Other possibilities include Maurice Jones or Bill Pearl. Bill loved 6-rep sets, a miniscule yet significant differentiation. The mystery of Mac and the 5-rep set was buried with him—all I can attest to is that based on his advice (which we slavishly adhered to) we began subsisting on 5-rep sets in squats, overhead presses, bench press, deadlift and power cleans. Our Olympic lifts used lower reps and our arm work used higher reps. He wrote in an era before there were warning labels on cigarette packs, seat belts in cars, computers or access to information we now take for granted in this day and age. This makes the rightness (to this day) of his prognostications all the more impressive. If you’d like to read the collected works of Mac, Randy Strossen at Iron Mind has collected all the Keys to Progress columns and placed them sequentially between two covers of a book. Genius.

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Marty Gallagher is the author of Strong Medicine, The Purposeful Primitive and Coan: The Man, The Myth, The Method.  Gallagher coached the United States team that won the IPF powerlifting world team title in 1991. He is a 6-time national masters champion and national record holder.  He was the IFF world master powerlifting champion in 1992.  He currently works with elite athletes, spec ops military and governmental agencies.