Stylishly Scientfic: Staying warm for outdoor workouts

I am going to start to do this more often in this blog so I can bring in a different perspective. I've asked my good friend, Read Wall, of Read's Clothing Project who is an expert in what I call Functional Fashion (my cheesy words, not his). In this post, Read gives great suggestions on what to wear during the fall and winter seasons and I will throw in a little science of why you should stay warm during your workouts.




Cold Weather Workouts


As the weather get colder…and colder…and colder…where was I going with this? Oh right, it's cold outside. It would be easy to call it quits and spend the winter on the treadmill dreaming of green leaves, shorts, and the gentle warmth of the spring sun. But we can't do that. For a number of reasons. First, the treadmill is boring. Like, fork in the eye boring. Second, staying inside deprives the body of vital vitamin D, which, among other health benefits, makes us fell not-crappy all the time. I think we can all agree that's a good thing.

But we need to remember to dress for the weather. Breathable, technical fabrics, layered correctly, provide the perfect level of warmth without sacrificing movement or, just as important, style. Look good, feel good, right?

So get outside, even when it looks like Ernest Shackelton wouldn't. Run, do some body weight movements, even grab a kettlebell. It's good for you.

Here are some ways to keep from getting frostbite while doing so:

Zoot RUNfit Jacket (ZootSports.com)- I've been running with this jacket for about a year now. It's gotten me through a lot. Cold can be tough, but this jacket is tougher.

2XU Thermal Run Tights (2XU.com)- If you've got it, flaunt it. Rock the tights.

Nike Thermal Running Pants (Store.Nike.com)- And if you can't, these will work, too.

Patagonia R1 Hoody (Patagonia.com)- An essential layering piece. Cool colors but warm where you need it.

Accessories (Note: Important!)

Patagonia Lightweight Glove Liners (Patagonia.com)

Patagonia Cap 4 Beanie (Patagonia.com)


Q: SO WHY WOULD I WANT TO STAY SO WARM DURING WORKOUTS?

A: Well, that's a great question. The easiest answer is so that we can avoid hypothermia, where the body temperature drops too low to allow for normal bodily functions to occur which includes, but not limited to, neuromuscular and cognitive function decline. WHOA...That is not good at all and through simple solutions like wearing the appropriate clothes, we can prevent a lot of that. When our body starts to sense a temperature drop, it will divert energy and heat to keep our core body temperature up as much as possible while pulling heat away from our extremities like hands and feet. This can get dangerous especially if we are in an activity like jogging, where our feet and hands are being desensitized because of the cold. The vasoconstriction, or tightening of the blood vessels to reduce blood flow to the muscles also reduces blood flow to the nerves which means we do not respond very well to gravity, ground reaction forces, mass and momentum. Because of our loss of proprioception, we may be more prone to injury.


Q: WAIT...HYPOTHERMIA? CAN YOU GO INTO MORE DETAIL ABOUT WHAT IT IS AND WHAT CAUSES IT?


A: Hypothermia "a decrease in the core body temperature to a level at which normal muscular and cerebral functions are impaired." - Medicine for Mountaineering.

This is caused by a a number of factors which include:

•Cold temperatures
•Improper clothing and equipment
•Wetness
•Fatigue, exhaustion
•Dehydration
•Poor food intake
•No knowledge of hypothermia
•Alcohol intake - causes vasodilation leading to increased heat loss

Q: SO I SEE THAT THE FIRST TWO FACTORS ARE COLD TEMPERATURES AND IMPROPER CLOTHING AND EQUIPMENT.  IT SEEMS THAT I CANNOT CONTROL THE TEMPERATURES, BUT I DO HAVE CONTROL OVER WEARING PROPER CLOTHES.

A: Yes! Great observation and you see the wisdom in Read's selections where he is recommending the ZootRunFit Jacket which is a great outer shell that will keep too much heat from escaping. The 2XU Thermal Run pants, that will "wick away" the sweat from the body which you know is important as the body starts to sweat to cool itself down from the exertion but gets into a dangerous situation when we are soaked with sweat in cold weather. We cannot stop the sweating but can control the effects with layering of clothes. Finally, the gloves and beanie are important as well. Most will be wearing socks but many will neglect wearing gloves which are super important as the hands are the most distal part of the arm and will be low on the priority list of blood flow if the core temperature needs to be regulated.

Q: OKAY, I UNDERSTAND HYPOTHERMIA AND I WILL DO MY BEST TO STAY WARM BY DRESSING PROPERLY BUT I'D STILL LIKE TO KNOW THE SIGNS OF HYPOTHERMIA. WHAT ARE THEY?

A: According to the OUTDOOR ACTION GUIDE from Princeton University are 3 stages of hypothermia: 1) Mild 2) Moderate and 3) Severe. With Severe Hypothermia being the most life threatening.

Signs of hypothermia are the "-UMBLES" of stumbles, mumbles, fumbles, and grumbles which show changes in motor coordination and levels of consciousness


b. Mild Hypothermia - core temperature 98.6 - 96 degrees F
•Shivering - not under voluntary control
•Can't do complex motor functions (ice climbing or skiing) can still walk & talk
•Vasoconstriction to periphery

c. Moderate Hypothermia - core temperature 95 - 93 degrees F

•Dazed consciousness
•Loss of fine motor coordination - particularly in hands - can't zip up parka, due to restricted peripheral blood flow
•Slurred speech
•Violent shivering
•Irrational behavior - Paradoxical Undressing - person starts to take off clothing, unaware s/he is cold
•"I don't care attitude" - flattened affect

d. Severe Hypothermia - core temperature 92 - 86 degrees and below (immediately life threatening)

•Shivering occurs in waves, violent then pause, pauses get longer until shivering finally ceases - because the heat output from burning glycogen in the muscles is not sufficient
to counteract the continually dropping core temperature, the body shuts down on shivering to conserve glucose
•Person falls to the ground, can't walk, curls up into a fetal position to conserve heat
•Muscle rigidity develops - because peripheral blood flow is reduced and due to lactic acid and CO2 buildup in the muscles
•Skin is pale
•Pupils dilate
•Pulse rate decreases
•at 90 degrees the body tries to move into hibernation, shutting down all peripheral blood flow and reducing breathing rate and heart rate.
•at 86 degrees the body is in a state of "metabolic icebox." The person looks dead but is still alive.

e. Death from Hypothermia

•Breathing becomes erratic and very shallow
•Semi-conscious
•Cardiac arrythmias develop, any sudden shock may set off Ventricular Fibrillation
•Heart stops, death

Q: WHOA! THE FACT THAT YOU CAN DIE FROM HYPOTHERMIA IS SCARY. WHAT SHOULD I DO IF I AM EXPERIENCING IT?

A: Well, the first thing I will say is that I am not a doctor so I am obligated to say SEEK PROPER EMERGENCY CARE IMMEDIATELY! Do not pass go or collect $200. This is your life and if you have any doubt in your mind, please seek some professional care.

The OUTDOOR ACTION GUIDE suggests the following:

The basic principles of rewarming a hypothermic victim are to conserve the heat they have and replace the body fuel they are burning up to generate that heat. If a person is shivering, they have the ability to rewarm themselves at a rate of 2 degrees C per hour.
Mild - Moderate Hypothermia

1. Reduce Heat Loss

•Additional layers of clothing
•Dry clothing
•Increased physical activity
•Shelter

2. Add Fuel & Fluids

It is essential to keep a hypothermic person adequately hydrated and fueled.
a. Food types
•Carbohydrates - 5 calories/gram - quickly released into blood stream for sudden brief heat surge - these are the best to use for quick energy intake especially for mild cases of hypothermia
•Proteins - 5 calories/gram - slowly released - heat given off over a longer period
•Fats - 9 calories/gram - slowly released but are good because they release heat over a long period, however, it takes more energy to break fats down into glucose - also takes more water to break down fats leading to increased fluid loss

b. Food intake
•Hot liquids - calories plus heat source
•Sugars (kindling)
•GORP - has both carbohydrates (sticks) and proteins/fats (logs)

c. Things to avoid

•Alcohol - a vasodilator - increases peripheral heat loss
•Caffeine - a diuretic - causes water loss increasing dehydration
•Tobacco/nicotine - a vasoconstrictor, increases risk of frostbite

3. Add Heat

•Fire or other external heat source
•Body to body contact. Get into a sleeping back, in dry clothing with a normothermic person in lightweight dry clothing

Severe Hypothermia

1. Reduce Heat Loss

•Hypothermia Wrap: The idea is to provide a shell of total insulation for the patient. No matter how cold, patients can still internally rewarm themselves much more efficiently than any external rewarming. Make sure the patient is dry, and has a polypropylene layer to minimize sweating on the skin. The person must be protected from any moisture in the environment. Use multiple sleeping bags, wool blankets, wool clothing, Ensolite pads to create a minimum of 4" of insulation all the way around the patient, especially between the patient and the ground. Include an aluminum "space" blanket to help prevent radiant heat loss, and wrap the entire ensemble in plastic to protect from wind and water. If someone is truly hypothermic, don't put him/her naked in a sleeping bag with another person.

2. Add Fuel and Fluids

•Warm Sugar Water - for people in severe hypothermia, the stomach has shut down and will not digest solid food but can absorb water and sugars. Give a dilute mixture of warm water with sugar every 15 minutes. Dilute Jello™ works best since it is part sugar and part protein. This will be absorbed directly into the blood stream providing the necessary calories to allow the person to rewarm themselves. One box of Jello = 500 Kilocalories of heat energy. Do not give full strength Jello even in liquid form, it is too concentrated and will not be absorbed.
•Urination - people will have to urinate from cold diuresis. Vasoconstriction creates greater volume pressure in the blood stream. The kidneys pull off excess fluid to reduce the pressure. A full bladder results in body heat being used to keep urine warm rather than vital organs. Once the person has urinated, it precious body heat will be used to maintain the temperature of vital organs. So in the end urinating will help conserve heat. You will need to help the person urinate. Open up the Hypothermia Wrap enough to do this and then cover them back up. You will need to keep them hydrated with the dilute Jello solution described above.

3. Add Heat

Heat can be applied to transfer heat to major arteries - at the neck for the carotid, at the armpits for the brachial, at the groin for the femoral, at the palms of the hands for the arterial arch.

•Chemical heat packs such as the Heat Wave™ provides 110 degrees F for 6-10 hours.
•Hot water bottles, warm rocks, towels, compresses
•For a severely hypothermic person, rescue breathing can increase oxygen and provide internal heat.


Afterdrop

Is a situation in which the core temperature actually decreases during rewarming. This is caused by peripheral vessels in the arms and legs dilating if they are rewarmed. This dilation sends this very cold, stagnate blood from the periphery to the core further decreasing core temperature which can lead to death. In addition, this blood also is very acetic which may lead to cardiac arrythmias and death. Afterdrop can best be avoided by not rewarming the periphery. Rewarm the core only! Do not expose a severely hypothermic victim to extremes of heat.


I hope this was informative from a style and a scientific standpoint. We all want to reach our best and by being smart and working hard, we can get to those goals. Please make sure you dress properly if you are going to do outdoor workouts during the cold months. We hear a lot on the news about people suffering from heat stroke but we also hear about many who are struck by the various stages of hypothermia.

If you have any comments or questions to either Read or I, please send mail to will@3doptimalperformance and I will pass any questions on to Read.

Read is also the designer of 3 great shirts for men that are made especially for athletes focusing on a nice fit. What is great is that Read is donating part of the proceeds to help promote education in Africa. Please visit his site at http://www.readsclothingproject.com/.

Stay warm!

Read Wall and Will Stewart

5 simple basic steps to prepare athletes for success

Athletes of any level physically work harder than most people. Bones, joints, muscles, soft tissues and nerves are all working together to ensure that the person is able to complete the task they set out to do.
Unfortunately, many athletes are either injured or do not adequately prepare their bodies for the activity. When this happens, athletes can feel stiff, sluggish, tight, etc and performance suffers drastically. In some cases, the athlete may injure or reinjure themselves.

In Part I of the "How to functionally train athletes that win championships", we cover 5 SIMPLE BASIC steps for FUNCTIONAL PREPARATION.

Introduction to the 3-D Shoulder

The shoulder comnplex is another interesting 3-D structure where the oxymoron of "complex simplicity" comes to mind. We see this when as we observe infants grasping for their parents hand, bottle, or anything else in reach. The symphony of bones, muscles, ligaments, tendons, cartilage and other soft tissue is amazing to witness when proper chain reaction biomechanics are occuring. However, like many other structures of the body, the shoulder complex can be as dysfunctional as it is functional.

Another oxymoron that comes to mind regarding the shoulder is "Mobile Stability" or "MOSTABILITY". As we look at the shoulder, we see a complex that has the capacity to be extremely mobile in all 3 planes of motion. However, this is the classic "Goldilocks" phenomenon. Too much mobility we can have instability. Too little mobility, can lead to pathologies like impingements. We are looking for "just right" mobility which is accomplished through a delicate balance of STABILITY in the complex With this MOSTABILITY, we are able to functional load and explode the PELTRUNKULARUS system to allow the shoulder to do its job of catching, throwing, hugging, etc.

In this post, you will be introduced to the complex simplicity of the 3-D shoulder complex along with some simple strategies and techniques for post-rehab as well as training and conditioning.

3-D Soft Tissue Therapy: A deeper understanding of the healing process

In my last two posts on soft tissue therapy, I went into the scarring process in relation to an injury. If you have not already, please take the time to read those two posts, as this post is really the last part of the series.

In the first two posts, I described the healing process from a traumatic injury of sorts and left off starting to describe the FIBROTIC PROCESS.

When an acute injury begins on the linear process of healing, the body responds to that area only. However, with the fibrotic process is cyclical and affects the entire fabric of the connective tissue. Unlike the scarring process which ends, the fibrotic process will continue until the main cause of the irritation is discovered.

The irritant in the fibrotic process, such as repetitive stress, excessive pressure-tension (i.e sitting for long periods of time), postural stress starts a chain reaction in the tissues as follows:

1. Activation of microphages
2. Increase in tissue vascularity
3. Increase in fibroblastic activity
4. Increase in connective tissue
5. Increase in myofibroblastic activity
6. Shrinkage of connective tissue
7. Abnormal motion

Again, this cycle will continue until the irritant is found.

With the scar tissue, we see that lack of ROM is due to the elasticity of the scar as well as the surrounding adhesions; however, the fibrotic process is a change in entire soft tissue region.

A case study would be the difference between a rotator cuff tendinitis caused by too much overhead throwing activities that is caught early, R.I.C.E'd, and taken through the proper therapy as opposed to the 'idiopathic' frozen shoulder or adhesive capsulitis where the fibrotic process has taken over and changed the texture of the entire shoulder capsule where there is little ROM, pain and chronic inflammation. For more info on this, click here. Its a good article by the American Family Physician Newsletter.

Working with clients or patients, its so important to take a detailed medical history in regards to injuries. One of my lacrosse players who trained with me this summer was having some knee issues so we did a little soft tissue work on him to see if we could get a little more ROM in his ankle. I asked him on multiple occasions if he had injured his ankle to which his reply was "I don't think so"; however, I knew something was wrong. The difference of ankle motion in his right foot to his left foot was pretty big. Well, my athlete returned back to college and unfortunately sprained his ankle a few days ago. It was severe enough that they took him to the doctor for x-rays. The x-rays revealed that he had a break in his right ankle from a while ago that had healed but the injury had calcified. WELL THERE GOES MY ASSESMENT OF HIS ANKLE. The feeling was a definite osseous end feel; however, the soft tissue surrounding it was a bit like working on a rope that has several knots in it that prevent it from really stretching out. It's a hard feeling to explain but I confirmed the unusual lack of ROM in the right ankle by checking it against the left ankle. Definitely not the same.

These palpation skills are something that I will go into a little more in depth. I believe that it is an experience that you need to have. The feeling of healthy tissue and dysfunctional tissue is VERY different. As a soft tissue therapist, you learn, through tactiile "observations" what it feels like.

I hope this look into the soft tissue healing process helps. As a soft tissue therapist or really anyone who works the body, we need to understand the process that many of our clients and patients are experiencing. As our knowledge deepends, we are able to tap into that knowledge base so that we can apply the Principles-Strategies-Techniques to our individual clients.

I will continue on this soft tissue journey soon by discussing some strategies and techniques for assessing soft tissue.

In Health,

Will

Again, I would like to thank Lenny Parracino CMT, FAFS for his guidance, knowledge and wisdom in regards to the soft tissue system. Thank you, Lenny!!!!

Introduction to 3-D Soft Tissue Therapy - Part 2

In yesterdays post, I touched on the healing process of soft tissue in the body. It's an amazing process that I believe that we take for granted a lot of the time. We just expect the body to "do its thing" without an appreciation for the process; however, maybe a lack of appreciation of the process stems from a lack of understanding. Functionally, speaking, we must allow the body to heal so creating an environment of optimal healing is of the utmost importance.

A DEEPER LOOK AT THE HEALING PROCESS

There is definitely a simple complexity in the soft tissue healing process. Let's take an injury that unfortunately, I have had more than my share of experience with. This year, my football players have been afflicted with Acromioclavicular Joint (AC joint) sprains. They have mostly been Grade 1's but there was one pretty nasty Grade 2 that required that we take the athlete to the hospital to make sure it was nothing more than an AC joint sprain. The area of injury was the ligament soft tissue that connects the acromion to the clavicle. Sometimes we will see a superior displacement of the clavicle and you can see the discontinuity in the form of a little ridge. I tell my boys that their days of modeling tank tops is over. (Lame, I know)

Introduction to 3-D Soft Tissue Therapy - Part 1

(Technical level: Beginnger-Intermediate)

When I went through massage school a few years ago, I can say that I loved learning about the soft tissues of the body more than anything else, and what got me was that my teachers said "This is just the beginning." Three years later, I look back and I'm still learning about the soft tissues of the body. What's amazing is that we are just starting to tap into the knowledge about and wisdom of the soft tissues of the human body.

As I learned more and more about the soft tissues, I also learned that there were literally hundreds of different methods to facilitate healing of the soft tissue like Swedish Massage, Deep Tissue Massage, Active Release Technique, Graston Technique, Bowen Therapy, Lomi Lomi, etc. The list really does go on and on. The interesting thing is that all of these modalities have a place in soft tissue therapy. However, many people get wrapped up in the TECHNIQUE and forget the PRINCIPLES OF FUNCTION. If we do not anchor ourselves and techniques to the Principles of Function, then we are doing something just to do it. The technique should be applied to the individual if appropriate, not applying the individual to the technique (if that makes any sense).  The interesting thing is that when we start to anchor ourselves to Principles of Function, our "toolbox" is only limited by our imagination (and scope of practice). Let's take a look at the soft tissue of the body, our Principles of Function and then see what we can come up with as far as appropriate techniques.

WHAT IS THE SOFT TISSUE SYSTEM?

The soft tissue system consists of the muscles, fascia, ligaments, tendons, nerves, joint capsules, circulatory and lymphatic structures. Unfortuately, many the soft tissue system has been largely ignored even though it causes more pain and dysfunction than any of the other organ systems.