The secret to fat loss part 1.

What a perfect time to make this post as all of us our recovering from our holiday binge this weekend.  My guess is after reading this you may think twice about how you eat on the holidays to come. 

So what is the point I am trying to make?  If calories in and calories out isn’t all it’s cracked up to be then how does fat loss or gain happen. 

Well, I will let you in on the secret.

Insulin!  Most of us are familiar with insulin, its role in blood sugar and type II diabetes.  Insulin may actually be the cause of all of the chronic disease and health problems we are facing.  Insulin causes our tissues to take in fat and sugar for storage and therefore tissue growth.  Ask any bodybuilder.  Insulin is the most anabolic hormone that exists.  It is just as much if not more effective at adding muscle as steroids if utilized appropriately.  It is however more dangerous because at very low dosages it can induce diabetic coma and death very easily.  The term anabolic just means to build up or save energy.  It does not mean steroid.  There are different types of steroids.  The most common are anabolic, bodybuilder, steroids and anti-inflammatory steroids like prednisone.  The opposite of anabolic is catabolic, meaning to break down or release energy. 

High insulin levels in the body are now actually being implicated in the increasing cancer rates and deaths we are seeing in the U.S..   It makes sense.  Let me explain.  We all have cancer cells inside our bodies.  Yes it’s true! They are simply mutated cells. Not the kind that kill us.  Not yet for most of us.

Still a little scary!

When we are healthy our immune system is able to clean up those cells without much problem.  This also implicates that an impaired immune system must lead to cancer cell development as well.  There are many things that can decrease the function of our immune system.  Guess what, one of them is ingesting high amounts of sugar.  Surprise! Ingesting more than 50 g of sugar, about 1 can of soda, in one sitting can lower White Blood Cells count by 50%. 

I will go into more detail about insulin later but now I need to explain a few other things. 

There are many reasons why we gain or lose weight and less of it has to do with the calories in calories out hypothesis.  Actually, most studies show people placed on bed rest for prolonged periods of time will drop a significant amount of weight.  However, that weight is usually lean tissue and is not a desirable way to lose weight. 

Weight loss is more than just losing mass.  We don’t want to end up being a smaller, fatter version of ourselves.  The idea is to keep as much lean muscle as possible while getting rid of any undesirable or unnecessary fat.  This is where exercise really comes in.  But what we are really talking about is what causes people to gain weight or more importantly body fat.  This has been the question myself and millions maybe billions of others have been trying to discover then answer to.    

Yes, genetics play a role.   A human’s body size and shape, anthropomorphic characteristics, are passed down from their parents and maybe as unique to their genetic coding as their facial features and finger prints.  Unfortunately for some people this can be a limiting factor.  I said limiting, not defining. 

This just means that a person is more likely to convert nutrients such as carbohydrates and fats, into body fat.  Why does this happen?  How can one person eat the same things and they gain body fay but another does not?  The answer revolves around insulin and I will explain later.  Promise! 

Yes some people will have to fight a harder to not convert nutrients into body fat.  These people just have to understand what the process is that allows fat to be converted to muscle.  They may have to work harder at this but so does anyone who isn’t born with the perfect genes.  Not sure the perfect person exists, Hollywood and E! wouldn’t let you think that.  Having excessive body fat is more than aesthetics.  It leads to decreased energy, chronic diseases such as Diabetes and metabolic syndrome and possible disability.  Once we all understand how to fight fat gain, we can possibly cure obesity. 

We can also be our leanest and healthiest.  Maybe better than we ever have been.  The answer is really easy if you ask me.  Changing isn’t the hard part.  Convincing ourselves that we need to change is.  Once we have convinced ourselves or allowed ourselves to change, we can easily have anything we want. 

There is more to it than just genetics.  Gestational diabetes may also play a role.  Altered sugar metabolism and excessive fat gain during pregnancy causes children to be pre-disposed to fat gain. Cultural practices are passed down to our children as well.  Who teaches a child what to eat?  The parents!  In this era, our schools also play a great role in providing meals for our children and educating them on food selection.  None the less, children tend to eat a similar diet as their parents.  If their parents eat cookies, cakes, soda, and chips all day long, the kid has no reason not to think this is normal behavior.

Many of the chemicals and concentrations of macronutrients in foods today do not exist in nature.  Corn has fructose in it.  High fructose corn syrup doesn’t really have any corn it.  It is a concentrated  carbohydrate.  There are many other concentrated forms of natural food substances we are fed which do not exist in the nature.  Sugar and other carbohydrates however are the largest and most widespread natural foods found in the American diet that are concentrated to toxic levels.   Other toxic chemicals found in our diets that should be avoided are but not limited to MSG, aspartame and trans fats. 

The human mouth would never encounter these in nature and they would not encounter levels of carbohydrates in nature which we find in candy bars, soft drinks, and any type of fructose or sucrose syrup.    

A young child experiences pain at lower thresholds because their nervous system receptors are still really sensitive.  This is the same for all of the child’s senses including taste.  Soda tastes sweet to an adult.  A soda to a child is like cocaine.  Just go to Chucky Cheese.  What do you see? A bunch of cracked out kids going nuts!  Watch the car ride home.  A bunch of cranky kids going through withdrawal, passed out, coming down from their high. 

I look back and think that maybe I was drugged at a young age.  It wasn’t fair.  I didn’t have a choice and my parents didn’t know they were giving us poison.  Now, I am forever ruined.  Once you cross the line there is no going back.  You have been exposed.  I will always know how good a, “insert favorite junk food” tastes. (Mine is probably a good milk shake or Cadbury Cream eggs this time of year) You can never forget.  I have never done heroin but my guess it feels pretty good for the people who do or have done it.  Unfortunately they will always know that feeling. They even convince themselves they need it.  You can’t need something unnatural that is killing you.  That’s the addiction, the pathological thinking. 

At one point in time the government had a rule that food companies had to put a label on imitation foods that said imitation.  At one point some states actually required margarine to be colored pink.  In the 1970’s the law was over turned by food companies and lobbyists who were going to benefit from the sales of imitation foods.  People are less likely to eat foods that say imitation on them. Or at least they were prior to the 70’s. 

The foods we eat today may actually be making us malnourished and over fat or obese.  Obesity is often described as an energy imbalance.  Too many calories in and not enough calories out. 

I am here to paint a different picture.  The foods we eat are very high in carbohydrates and low in the nutrients and vitamins which keep us healthy.  Insulin spikes when we ingest food.  Insulin causes

• ·         Increased protein and DNA synthesis
• ·         Uptake of nutrients in to cells and subsequent lowering of blood sugar
• ·         Increased fatty acids uptake or increase of fat in fat cells contributing to guess what body fat

Our bodies get fatter and larger due to increased exposure to insulin, just as a body builder.  A body builder does several other things to use insulin to turn body mass increases into muscle and not fat.  This will be similar to what I will explain for all of us to do later to limit are fat gain. 

When we are malnourished are bodies will try to hold onto everything.  Our bodies like to use sugar instead of fat for energy because it is easy to break down.  The body also likes to store fat because it has much higher energy yield per gram the either glucose or protein.  Similarly to heroin, our bodies get used to high levels of insulin and we become resistant.  Now our bodies will not respond to insulin as well, leaving high levels of blood sugar circulating through our circulatory system.  This in turn causes insulin levels to increase even further.  It is a downward spiral from here unless we make a change. 

 So, the body that is gaining fat is likely to be exposed to high insulin levels.  It is also malnourished from eating unhealthy foods that are also high in energy or calories primarily from carbohydrates.  This causes spikes in insulin which is anabolic(making us into a growing machine) and causes our bodies to convert excess sugar into fat and not muscle because we are insulin resistant.  Insulin then pushes the nutrients into the fat cells.  If our systems stay in this state for say 40-50 years we get sick.  We experience chronic diseases such as Type II Diabetes, Cardiovascular Disease, and Cancer.  High levels of insulin exposure to a pathological human body that has a weakened immune system and does not clean up mutated cells will get cancer. 

Stay tuned for part II.  I will give you specific things you can do to address this.  It is more than what you eat, how much you eat and if you are physically active.  The answer lies in when you eat what you eat and how you exercise.  Ask yourselves why does someone go to the gym for months or more and never lose an ounce of fat or weight.  Are they eating too many calories? I hope I have helped you think otherwise.  Are they not burning calories during exercise?  Sure they are.  Fat loss requires much more specificity.  Look forward to talking to you soon.  Sorry for the delay as well.  Easter holiday got a little in the way.

Thanks and talk to you soon!

Lyneil Mitchell DPT

A sound mind in a sound body is a short but full description of a happy state in this world - John Locke

ACL tears Disproporitionate rates

Females tear their ACL, anterior cruciate ligament, up to 10 times more than their male counter parts from non contact injuries.
This means that they are just running along, cutting, pivoting, and landing and boom! They are on the ground.  There are approximately 22,000 ACL injuries in female athletes each year from high school to collegiate sports.  1/10 girls that compete collegiately in any sport(not just jumping, cutting and pivoting sports) will tear their ACL prior to graduation.  That is crazy.  It is especially crazy when it is preventable.

The Cause:  Different biomechanics.  Females demonstrate different landing and decelerating patterns than men.   Females have tendency to land with their feet flat and heels hitting the ground.  This also occurs with less flexion of the hips which causes excessive force through the knees.

As a female hits puberty the long bones of the leg the femur(thigh bone) and tibia(shin bone) grow as they begin to ascend to their adult height and skeleton.  However this occurs with an increase in estrogen and a decrease in testosterone.  A boy typically sees a significant spike in testosterone as their limbs begin to grow.  This in turn creates an increase in the ability to develop more muscle tissue and control the movement of the now increasing long levers of the tibia and femur producing torque at the knee.

The knee is a hinge joint primarily but has 6 degrees of freedom.  It can move forward and back, side to side and rotate each direction however most of the motion is front to back.  The joints in which most of the rotatory motion occurs are at the ball and socket joint of the hip and the pseudo ball and socket joint of the ankle.

When the hip and knee joint are not controlled during dynamic movements, the excessive rotational torque is distributed to the knee tearing the ACL.  There are 2 and sometimes 3 bundles to the ACL which is actually twisted and runs at an angle. It is designed to resist some rotational and angular forces but easily tears in the position of dynamic knee valgus, which you see above with opposite side hip drop, thigh bone and knee medially deviating and rotating internally.  This is often seen with pronating of the foot and ankle or collapsing of the medial arch of the foot.
 

Females also demonstrate less of an ability to fire their hamstrings at high speeds.  During slow speeds they are equal to boys but at faster speeds they are deficient.  This makes sense.  The ACL is a restraint to anterior tibial movement and tears with excessive anterior tibial translation.  The lachman test, pictured above, is the gold standard for testing the ACL in which anterior force is exerted manually on the tibia by an examiner to assess integrity of the ACL.

 When the hamstrings contract, they exert a posterior pull on the tibia which allows the knee to flex or bend as pictured above.  Females typically tear their ACL during high velocity movements such as decelerating, cutting and landing from a jump.  This suggests that the nervous system is not sending the appropriate message to fire the muscles to stabilize the knee quickly enough.

The best part about this is that bioemechanics and nervous system responses are easily trainable.  Most ACL injury prevention programs have a greater than 90% success with participants not experiencing these devastating injuries.

Females are not built like males and they need specialized training.  They at least need to be screened to determine if they have high risk biomechanics.  I often say that female athletes are the most neglected population in the country.  How can we allow 22,000 of our sisters, daughters, cousins, nieces and friends to experience this nearly preventable injury each year.

In conjunction with the Sport Science Lab, Revolution Physical Therapy has an answer for our young ladies.  I am now offering a free screening for any female who would like to know if they are at risk.  I feel  so strongly about this that I am willing to help people for free.  If you don't know if you or your loved one is at risk, then how can you know how to prevent it.  It's like smoking cigarettes, at some point a smoker will get health problems.  Undeniable.  If you are a female athlete playing sports involving cutting, pivoting and jumping  without the appropriate training, you are eventually going to have a knee problem.  This could be season or career ending.  Thousands of college bound females lose their scholarships every year from indifference, denial and neglect..  Time to make a change.  Join the Revolution!

Please contact me or my office at 724.591.8005

Lyneil Mitchell, DPT
drlyneil@revolutionphysicaltherapy.com
www.revolutionphysicaltherapy.com


20630 Route 19 Suite 102. Cranberry Twp, PA 16066

Lyneil what is your opinion on holistic medicine? - Shalana Villella

I am very open to alternative forms of treatment.  Medicine in the past few decades has been dictated by insurance reimbursements and has primarily become treatment of symptomatology.   Historically, up until about the late 1800's, medicine was primarily preventative and holistic. Then the microscope was invented and researchers could see what happened on the cellular level.  Today we know so much more happens on even a smaller level and still we don't know for sure what it is going for everything.  They didn't always have a pill or a surgery to "fix" something and had to try to stop things before they happened.  They also thought of hygiene much differently than we do today. They didn't put chemicals on their skin and hair, in their mouth and in their bodies to attempt to look and smell a certain way.  They promoted daily exercise regimens and proper nutrition to control disease.  It’s crazy but they had a good gauge on health as long as 3-4000 years ago.  Today we place little value on these types of things because there is no immediate consequence.  We can quickly get a pill, injection or surgery to save us and get us back to work so we can make money for our employers and/or the government.  It's a vicious cycle.  As I have said in the past health is about homeostasis or equilibrium.  When we move away from equilibrium we place ourselves into a state of pathology.  This makes our immune system weaker and us more susceptible to pathology.  If you think about we are always being exposed to bacteria and viruses, every minute of every day.  We have bacteria that live inside our bodies.  So why aren't we sick all of the time?  Most of the time our immune system is strong enough to fight off the pathogen and we never experience anything.  The problem is many things we do can cause our immune system to be suppressed.  If it stays like this for too long we are bound to catch some thing.   If it stays pathologic for way too long the unbalanced nature of our systems gets out of control and we develop serious problems such as cancer.  there are studies which show that eating too much sugar (about 50 g or one can of your favorite soft drink, soda or pop whatever you call it) in one sitting can lower your white blood cells(immune system cells)  by 50% for up to 5 hours.  Think about how many people basically live like this.  When we get dehydrated we can experience feelings of fatigue, nausea, irritability, headaches, and muscle pain.  These symptoms are often associated with fibromyalgia.  But when is the last time a physician checked to see if you were hydrated at a visit.  Studies show that 70% of people are chronically dehydrated and don't even know it.  Vitamin C is the most abundant in green vegetables like broccoli but have you ever seen a commercial for kale or broccoli? 

So in conclusion, we have a difficult time with medicine today.  We have started a war on cancer and many others simply to see an increase in the incidence, prevalence and deaths.  There is a reason our health care system is in shambles.  We are letting too many people get sick.  When they do get sick we treat it with things doctors can bill insurance for. I.e. medicine, injections and surgeries.  Even physical therapists don't get reimbursed for the education we give patients.  We typically as a profession do it because we want to see our patients and clients get the best results.  Medicine is good for saving lives and helping with many horrible diseases out there.  For the average person however it actually creates an avenue that allows neglect, irresponsibility and complacency. 

In order to have good health we have to understand what that means.  So the question is what allows us to have good health?  What truly is moderation?  For example many people think drinking a few beers on the weekends is harmless because it is a socially acceptable norm.  Don't get me wrong I still have a few beverages every once and while.  I know however that more than .5 glasses of beer or wine in one day has a negative long term effect on our health.  That is how fragile we are.  There is more and more data coming out that shows what we used to think the human body could tolerate is now way less and people are experiencing disease because of this.  A holistic preventative mind set is the best approach to avoid getting sick, joint problems and becoming disabled.  If you do happen to have an unhealthy occurrence, you can always seek medicine if you really need it.  Just remember for most of us who are still borderline healthy, there are silent symptoms such as dehydration and mineral imbalances occurring in us right now that could be leading us to pathology and disease.  We need to start thinking about restoring our equilibrium and ultimately optimizing our chances for a healthy life.  I am not saying avoid physicians and medicine.  Just realize you have a lot more control in the situation than you think.  My advice is to do what they tell your children, a kindergarten teacher typically knows how to live life for health and wellness.  Eat your fruits and veggies, tie your shoes, laugh a lot, play games, roll around on the floor, get your daily physical activity, learn as much as possible and last but not least continue to use your imagination and chase your dreams. 

Sorry this was so long.  I know my social media director is going to be upset.  Oh well I hope this answered your question well enough.  If not feel free to ask me somethign more specific.

Thanks

Fast Twitch: Part 1

What is fast twitch sports specific conditioning?  Part 1. 

Fast twitch muscles fibers are commonly known as the type of muscle fibers humans possess to perform powerful movements such as sprinting.   Fast twitch muscle fibers are developed through specific training geared to emphasize recruitment of the fast twitch muscle fibers. 

Some muscles are more heavily composed of fast twitch muscle fibers than others.   Fast twitch fibers are able to react and respond more quickly to develop tension than their counterparts.  Appropriate training methodologies will incorporate strategies to express these fibers to their maximum potential.

Muscles can be primarily defined as tonic or phasic.  Tonic muscles are considered as postural muscles and are heavily composed of slow twitch muscle fibers.  Phasic muscle, with fast twitch fibers, are utilized for larger ranges of movements and velocities.

Table 1: Characteristics of the Three Muscle Fiber Types
Fiber Type	Type IA Slow twitch oxidative	Fast Twitch Type IIA Oxidative	Fast Twitch Type II B Glycolytic
Contraction time	Slow	Fast	Very fast
Size of motor neuron	Small	Large	Very large
Resistance to fatigue	High	Intermediate	Low
Activity used for	Endurance - Light to moderate intensity steady state and interval training or activities lasting > 1min	Power Endurance – High intensity interval training or intense activities and movements sustained ranging   seconds to minutes	Power – the highest of intensity movements lasting at most several seconds
Force production	Low	High	Very high
Mitochondrial density	High	High	Low
Capillary density	High	Intermediate	Low
Oxidative capacity	High	High	Low
Glycolytic capacity	Low	High	High
Major storage fuel	Triglycerides	CP, Glycogen	CP, Glycogen

CP is creatine phosphate, Glyocgen is storage form of glucose or sugar.  Triglycerides are lipids of fats.

There are 3 identified types of muscle fibers as listed above.   Muscle fibers are often described as a certain type of twitch but muscle fibers are more accurately categorized by fuel source pathways. Therefore it is a misnomer to seek a training system that looks to recruit fast twitch muscle fibers for speed development.  Fast movements are not simply relied upon by which type of muscle fiber is being utilized.   What type of fuel that is being utilized has little impact on how fast a human can produce a movement.   Fast movements are actually more of a neurological phenomena.  Your nervous system properly recruits these muscles and also turns the right ones on at the right times.  


The ability to react is also a neurological phenomena.  Reactions under high rates of loading are even more particular of interest because of the practical need to decelerate objects, the movements of other opponents and our own bodies in sports.  Reaction to forces under high speeds require fast twitch muscle fiber recruitment and tremendous coordination of our nervous systems.  Our skin, joint, and muscle sensory receptors have to first sense the the force and quickly send a message to the brain or spinal cord.  The brain or spinal cord then propagate a message to the muscles to respond to absorb the force and even possibly create an equal or greater force against the resistance.


This all occurs in milliseconds, often with little conscious input.  If there is an alteration in our sensory perception or any delay, poor performance results and even worse, injury to our tissues may occur.  Minor impairments in these pathways are very common in athletes which results in overuse injuries.  For example, even a small percentage of poor force absorption during repetitive jumping or running will overload our ligaments, tendons and cartilage over time resulting in damage.  

The best athletes have the ability to produce coordinated movements with power and speed.  Sports training or any training should be focused on specificity.   This means in order to be as fast or powerful as possible we

• Need stability and superior control of our movement
• Must be able to progressively increase the force our muscles are able to generate
• Must progress to performing these movements as fast and powerful as possible
• Must practice doing this with movements that are specific to our sports

Training with specificity is the only way to get a desired outcome.   If a technique or method does not result in the specific enhanced attribute, such as speed, then it should be discarded.  The technique maybe a useful  activity.  However, activities such as long distance running or weight lifting are common modes used incorrectly in athletic performance programs.  If you train slow you will not get faster or more powerful.

An athlete’s performance is only improved through sports specific training.   These sport specific movements may incorporate running and resistance training but these will be performed specifically to the sport itself.   Sport specific training is setting ours goals to improve coordination, speed and power.  Running long distance and lifting weights may be very limiting aspects to focus an athlete or any human being’s training because they do not relate to most aspects of sports.  In very few sports, does it require someone to run for longer than 1 minute or press a weight into the air while lying on the back.

Training for enhanced coordination, speed, and power is improved by enhancement of the nervous system in recruiting a greater number of muscle fibers. The best athletes are able to coordinate movement patterns with a synergy not reproduced by their counterparts.  This occurs by repetitive practice with a sport specificity training style which allows for highly integrated development of the nervous and musculoskeletal system.   

Stay tuned for part II in which I will discuss and reveal how to properly train for increased speed and power.   I will also include more specific training principles and exercises.   

Thank you

Lyneil Mitchell DPT, 

A sound mind in a sound body is a short but full description of a happy state in this world - John Locke