Dealing With Injuries- A Personal Story

I remember it like it was yesterday and very often it doesn’t seem as far away as 8 years ago. I was doing cable curls in the dingy basement gym that I trained out for years in Brooklyn with the full stack of 250lbs. Every sinew of muscle in my arms was focused on getting that weight up as the burn in my biceps became more and more unbearable. I was on my eight repetition, watching the weight go up ever so slowly and struggling against gravity and steel which in the moment were my mortal enemies when it happened. The cable station I was working in had a chin up bar placed squarely in the center and there was a relatively experienced member of the gym doing pull ups right behind me as I was doing my curls. The gym wasn’t big by any stretch of the imagination and so I had been used to people working right next to me as I trained. He wasn’t a novice by any means and so I didn’t pay any mind to the fact that he was only a few inches away from me at the time.

Looking back I ask myself over and over if I should have sensed something but I can honestly say that I didn’t and what happened would have happened the same way if I could relive the experience all over again. While doing his pull ups behind me, the unthinkable happened. His hand slipped from the bar and he fell off to his left side, all two hundred and fifty pounds of him coming crashing down on my neck just as I was in mid lift of two hundred and fifty pounds on the cable curl machine. I heard a snap as his elbow stuck me right at the base of my neck and I felt a white pain stab me all the way down to my fingertips. Perhaps I didn’t fully grasp the enormity of what had happened or perhaps I was in shock, either way I gritted my teeth and did two more pain racked repetitions before putting the weight down and stopping to access the damage.

The pain of a cervical injury is indescribable but I never lost hope that I would learn to work around it.

I remember the gentleman who fell on me saying something in the way of an apology, but I couldn’t really hear him. I was too busy realizing that I couldn’t really move my arms and that I was locked in position. He took one look into my eyes and ran out of the gym, never to be seen back there again. I think he believed- quite I error- that I was going to inflict some damage on him, something that I didn’t and never have considered. It was an accident and accidents happen. The severity of the outcome doesn’t necessitate that someone always has be blamed. Everyone kept asking if I was alright and I mumbled that I would be fine, all the while feeling a growing sense of dread that this wasn’t in the category of a minor injury that I could shrug off. I was hurt and hurt pretty seriously.

I made my way out of the gym and took a car service home- with every bump in the road and sharp turn sending bolts of agony through my neck and down my arms. I remember getting immediately into bed and nothing else. The next morning I awoke with my arms locked in position and a searing pain that I would become intimately acquainted with for the next 8 years. I never had any reason to see him as I never really got injured as an adult while training, but I had a chiropractor in my phonebook who I sent all my clients and martial art students to whenever they were injured. He specialized in sports medicine- and had a strong background in acupuncture as well and I truly respected him as a practioner.  I called him up and he said that he would see me immediately and so I endured the short but excruciating cab ride to his office- with even the vibrations from the door slamming seeming to send shivers of pain into my neck.

He worked on me for a while- an agony that I can hardly recall, and then placed some needles strategically in my back and neck to help relax the muscles.  He said it didn’t look good and referred me to a orthopedist to see what was going on. From that night onwards and for many nights to come I couldn’t sleep very well. You don’t think of your neck very much but when it’s injured you suddenly become aware of how involved it is in almost every move you make. It hurt to keep my head up, it hurt to put my head down, it hurt to sit and it hurt to stand. Worse of all, lying down was agonizing, both with and without a pillow. Sleep consisted of periods where the pain lulled just enough for me to drift off before rearing it’s head again and waking me up with shafts of pain if I moved ever so slightly in any direction. Night and day became one long stretch of misery, punctuated only by light and darkness. My whole life became about finding a position where my neck didn’t hurt too much.

I saw the orthopedist only two or three days later and he ordered an MRI. I have no qualms about being enclosed, nor am I claustrophobic- but the act of laying flat on my back in the machine required every iota of willpower to not scream. The technicians were initially somewhat annoyed by my difficultly in being completely immobile but after they saw the results they became a bit more sympathetic. They wouldn’t disclose the results but one of them touched me on the shoulder and said that she understood why it was so hard for me to lay still. The results from the orthopedist weren’t encouraging. I had two discs in my cervical vertebrae that were bulging out. One was protruding to the left, the other to the right. He said that short of a car accident such neck trauma wasn’t common, and that it may very well have been that my well muscled shoulders were the reason I wasn’t paralyzed from the blow.

It got worse- he said that there really was little that could be done and that the pain in my neck and in my hands would probably never really go away. A spinal injury, he explained, was permanent and there weren’t any options on the table. His advice was that I stop weight training altogether and do some rehabilitation exercises to help me with the injury. I got a second opinion which was pretty much the same and I decided to very respectfully disregard their advice. I didn’t take any of the painkillers prescribed, as I am not a fan of them and in my work in social services have seen many a case of people addicted to those same drugs after months of relying on them to get through the day. I wasn’t going to be one of them- not at all out of any misguided machismo, but out of a very real awareness that if I started something that made the pain go away, I would never stop taking it.

The muscles relaxants they gave me made me feel worse for wear and so I stopped taking those, using only Neurotin- a drug that stopped the shooting pains in my fingers and hands. Two weeks after the injury and wracked with pain, I dragged myself back into the gym. If it was that I could never hold a weight in my arms ever again, I had to see this for myself and if there was a way for me to get back, I was going to find it, no matter how long it took or how much suffering it involved. My neck hurt, but I could do a leg workout as long as I didn’t turn my neck or place any weight on my shoulders, and for the next several weeks, that’s what I did. As time went on I added light, supported movements for my abs, arms and upper back- with each new exercise bringing a fresh layer of pain the next day- but I would not stop.

I filmed my workout DVD in the best shape of my life after my injury.

I had worked with dozens of clients with severe herniations, and my philosophy had always been that if we can’t fix the joint, we can build the muscles around it up to a point where they can compensate and allow for pain free range of movement. A good physician heals himself and that’s what I set out to do. I had been hurt in the summer of 2003, but by the end of winter I was back. Careful- still in constant pain- but able to do most of what I used to do before. I wouldn’t dare try to deadlift 600lbs or clean and jerk 315lbs the way I did in the past- but there was a range of movements I could do and lifting heavy was never a requirement for me- it was just what I was able to do. By the fall of 2004 I had competed in two bodybuilding contests, winning one and making the top three in the other. I did them just to see if I still had it and some said that it was the best I ever looked.

I never said anything about being in pain, nor did I ever give any outward show of it-to admit it was to be defeated by it and I had no intention of being the subject of anyone’s pity. I learned to sleep as best I could without moving and when the weather changed I learned to deal with the pain that came with an approaching rain. That year I filmed my bodybuilding documentary and in doing so, lifted more weight than I had ever thought off in my life. I never let my injuries limit me mentally or physically, and I found that since I was so attuned to how I had to train, that I become far stronger and better for it. My experience as a trainer has always been founded on my injuries and I have had many of them- torn rotator cuffs, herniated discs in my lumbar region and tendinitis in just about every joint in my body. Those injuries defined me- as they very often taught me what not to do- hard lessons that I learned at a younger age when lifting as heavy as I could took precedence over common sense.

As painful as they were they also taught me compassion and understanding. My injuries helped me understand on a very intimate level what those of my clients who come to me with a pre-existing injury are going through. I have learned not only what not to do and how to work around just about any joint or muscle condition- but also how to put myself in their shoes and help them along in the healing process. An expensive education- being injured, but one that I cannot say that I regret in terms of how it helps me do what I do to help others recover from their injuries.

My neck hurts. And probably always will. I have my good days and my bad days, but you would be hard pressed to tell by looking at me. I have learned that there are things in life that you cannot change- but what you can change is your perspective. Thanks to my training, I wasn’t paralyzed by the injury and thanks to my training I can do almost everything that I could do before and more. The few exercises that I lost are made up for in spades by the fact that I am stronger and even more advanced in my own personal physical and spiritual development as a result. Pain is a part of life- one that we can’t ever completely eliminate, no matter how hard we try. But we can learn from it and we can make ourselves more for experiencing it. Every moment can be an opportunity for learning and advancement, but only if we are open enough to embrace the inevitable and do our best to learn from it. Thanks for reading.

Kevin Richardson is an award winning fitness writer, one of the most sought after personal trainers in New York City and the creator of Naturally Intense High Intensity Training^TM. Get a copy of his free weight loss ebook here. If you live in the New York metropolitan area and need help losing weight or taking your body to the next level give Kevin and his team a call at 1-800-798-8420 or click here to get started with 50% off your trial personal training session.

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No Pain No Gain- Understanding Muscle Soreness

We all know the mantra when it comes to weight training or just about any type of intensive exercise- ‘No pain no gain’, and as anyone starting a training program can attest- the first few days after your initial workout can be painful indeed. We call it muscle soreness, or just plain pain, but the techincal term used is Delayed Onset Muscle Soreness (DOMS). Call it what you like but it can Unlike the pain you feel as a result of an acute or overuse type injury, Delayed Onset Muscle Soreness isn’t always a bad thing. On the contrary, in many ways it is a natural part of the adaptation response- the very process that our body uses to make our muscles bigger and stronger. That being said, there is some credibility to the ‘No Pain No Gain’ credo.

As much as pain may be a part of an intense exercise program you have to be aware of the differences between DOMS and an injury or chronic syndrome like as arthritis. The differences are usually quite marked, however after your first bout of exercise after a period of relative inactivity DOMS can feel quite crippling indeed! Given the high intensity protocols that are the hallmarks of my own training style, I can honestly say that there is almost never a day when I don’t have a muscle group that isn’t sore. So much so that some mornings I wake up hoping that someone got the license plate numbers of the truck that ran over me! You might think that twenty plus years of high intensity training would confer some immunity to muscle soreness, but I can tell you honestly that this isn’t the case (my legs hurt right now as I type this article!) Given my years of being so intimately acquainted with this type of pain, you might call me a wee bit of an expert, and in this article we will explore the mechanisms behind muscle soreness as well as dispel some of the myths.

Delayed Onset Muscle Soreness- The Mechanisms

You can think of your muscles performing three different types of contractions- concentric contractions, eccentric contractions and isometric contractions.  Concentric contractions occur when you do an exercise like a biceps curl and bring a weighted barbell up to your face. By flexing your elbow to raise the weight up towards your shoulder you contract your biceps muscles and make the muscle  fibers in your upper arm physically shorter- that’s a concentric (or shortening) contraction. However, when you lower the weight from your face back to the resting position you are performing an eccentric contraction. Eccentric contractions are characterized by a lengthening of your muscle fibers and play a significant role in muscle soreness as you will see as we go along. An isometric contraction is one where you simply hold an object in a fixed position- and so using our model of a biceps curl- holding the weight up halfway without moving it would be a classic example of an isometric contraction (isometric, by the way means no change in length.)

Now there are some points that must be kept in mind when our muscles perform a eccentric or lengthening contraction. Firstly, absolute tensions achieved are very high relative to the muscle’s titanic tension generating ability. In plain English this means that you can lower a weight that is much heavier than what you can lift. Anyone who has ever done weight training with a partner or trainer may have experienced this firsthand as there comes a point where you can no longer lift a weight, but if someone helps you get the weight up, you can still lower it under control. The second factor is that skeletal muscle tissue is resistant to lengthening by its very nature. So unaccustomed exercise of repeated or forced eccentric (lengthening) contractions will induce muscle damage. Damage that we experience as delayed onset muscle soreness. [1,2,3]

An example that most can relate to is the soreness you experience after a day of hiking in mountainous terrain. You may notice days afterwards that your leg muscles and calves are sore and this can happen regardless of whether or not you have strong legs and are in good shape. The soreness isn’t an indication that your leg muscles are weak, it’s just a result of the extensive lengthening actions these muscles have to perform while descending and at unaccustomed angles. Funny enough going up a mountain, or climbing flights of stairs won’t do much to make you sore the next day, it’s the descent that gets you. When I was younger and morbidly fascinated with the idea of sprinting up the staircases of tall buildings (we didn’t have much in the way of skyscrapers where I came from) I found that I didn’t feel sore the next day even running up 20 flights of stairs three or four times. I would always take the elevator down and catch my breath but one day it was out of service and I had to walk down the stairs each time. I was quite surprised to find that I was almost handicapped with pain for the next few days- the reason being the extensive amount of muscle lengthening movements involved in walking down the stairs.

The Myth of Delayed Onset Muscle Soreness & Lactic Acid Buildup

Now running up those stairs, my legs muscles would feel a serious burn! The same burning sensation occurs during all of my high intensity workouts, but contrary to popular belief, this pain has very little to do with lactic acid. In fact lactic acid doesn’t really play a part in delayed onset muscle soreness. Researchers once believed that lactic acid buildup was indeed the cause of the burning sensation you feel in your muscles during any intense exercise and it was further thought that lactic acid was responsible for DOMS.  However this has been proven to not be the case at all. Lactic acid as it turns out is actually a metabolic by product of our muscular contractions and it breaks down very quickly into a useable fuel source for your muscles. Consequently, there is little accumulation in your muscle cells that could explain the burning sensation or the delayed onset soreness felt afterwards.

Before you get mad at researchers for not getting it right the first time, you have to understand that knowing precisely what goes on inside our bodies during an activity is a very difficult task. Much of what we know of the human body and how it works is akin to having an object inside of a box and trying to figure out what’s happening on inside without being able to open it. We can perform tests that allow us to make educated guesses as to what is going on, but we can’t open the box to be 100% sure. The same applies to our bodies, as short of surgically cutting into our muscles and observing what’s going on during exercise we have to rely on tests that give us indications of what happens after the activity is performed- not during. Modern ultrasound tests and magnetic resonance imaging can give us some clues as to what’s going on inside our bodies during exercise, but as advanced as it may be imaging technology it still doesn’t always conclusively answer all of our questions. That being said, research is always ongoing and every day it seems like we learn something new. The current theory for the burn you feel in your muscles while training is that it is caused by calcium or other substrates in our muscle cells but again, it is still an educated guess at this point.

Delayed Onset Muscle Soreness & Pain

Pain is a difficult thing to measure as our perception of pain is influenced by so many factors including age, gender as well as social and cultural norms about acceptable behavior while experiencing physical discomfort.[4] That being said, two different people can experience the same magnitude of tissue damage due to intensive exercise, but experience radically different magnitudes of perceived pain as pain is such a completely subjective phenomenon.[3] There is the aspect of adaptation as well as someone experienced in high intensity weight training won’t react to delayed onset muscle soreness the way someone experiencing DOMS for the first time after their first couple of workouts. You do tend to get used to it over time, and some people absolutely love the feeling of something aching all the time (I think of it as a dress rehearsal for when I am in my nineties!) while others learn to simply ignore it. My personal observations over the years having trained hundreds of clients is that men tend to be more debilitated by DOMS than women. The pain usually starts within 24 hours of the activity and can become worse the second day and at times it can linger for as long as a week depending on the degree of muscle damage and how accustomed you might be- (or not) to the exercise performed. Either way it isn’t ever permanent and unlike an acute or chronic injury, more exercise can actually make it feel better.

Delayed Onset Muscle Soreness  & The Adaptive Response

One great part of delayed onset muscle soreness is that it can in some cases be a step in the process of making your muscles bigger and subsequently stronger. In the event of an overload, the microtrauma experienced by your muscles will lead to an adaptive response by your body to make the muscle fibers of the area you worked bigger and stronger so they won’t suffer as much damage the next time you perform the same exercise. (See my article on how Muscles Get Bigger & Stronger for a detailed look at the adaptive response). That being said, we don’t know why the pain caused by delayed onset muscle soreness isn’t instant, nor do we know whether or not the muscle damage theory is the sole cause. Other theories suggest that the pain may be caused by changes in connective tissue as a result of activity and that there is a significant inflammatory response- which could explain why the pain isn’t instantaneous.[5,6] Given that the inflammation response may play a significant role in activating the adaptive response to make your muscles stronger, the practice of taking over the counter anti-inflammatory drugs as a way of relieving the pain may not be a great idea as it might make you get less out of your workouts. Instead the common treatment would be to ice or cool down the muscles exercised immediately after training, followed by warm baths or showers a day or more after your exercise session. Back home the practice was to train and then go take a bath in the sea right afterwards and it did indeed work wonders in reducing the amount of pain you would feel the next day. Massage therapy can also go a long way in helping you deal with the pain associated with delayed onset muscle soreness as well if you can get it.

How sore you are after a workout isn’t necessarily an indicator of how hard you trained and should not be used as such. Some people have naturally high pain thresholds and don’t seem to ever suffer much from delayed onset muscle soreness, and since it can vary so much from person to person it is a pretty weak barometer of how much work you did. Your level of soreness can also be affected by how well rested you are after the workout and your nutritional intake. Either way it’s a huge mistake to use soreness exclusively as a gauge of how effective your workout was since there are so many variables involved. Some days you’ll feel crippled after a relatively moderate workout, while other times a training hard session you won’t hurt that much at all afterwards. What’s important is to know when the pain isn’t just soreness and always consult your physician if you suspect the pain you are feeling might be injury related.

Related articles:

How Muscles Get Bigger & Stronger

References

1.Fridén et al. Segmental muscle fiber lesions after repetitive eccentric contractions Cell Tissue Res 1988

2 Evans et al. 1985; Fridén and Lieber, 1992

3 K. Noska. Muscle Soreness & Damage & The Repeated Bout Effect- Skeletal Muscle Damage & Repair

4. Strong J, Unruh AM, Wright A and Baxter. Pain A Textbook for Therapists

5. Cheung et al. Delayed Onset Muscle Soreness, Treatment Strategies and Performance Factors. Sports Med 2003;

6. Smith 1991

Kevin Richardson is an award winning fitness writer, one of the most sought after personal trainers in New York City and the creator of Naturally Intense High Intensity Training^TM. Get a copy of his free weight loss ebook here. If you live in the New York metropolitan area and need help losing weight or getting into spectacular shape, give Kevin and his team a call at 1-800-798-8420.

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Weight Training Builds Stronger Bones And Helps Prevent Osteoporosis

Osteoporosis is an ever increasing problem worldwide as people are living longer and the population continues to age. More prevalent among women than men, some estimates report than as many as one in five American women over the age of 50 have osteoporosis. An insidious disease that weakens bone tissue, one of the worst aspects of osteoporosis is that there are no symptoms during the early stages and without a bone mineral density test it can be difficult to detect before it advances to a point where it becomes painfully symptomatic. Most learn of their condition after experiencing a bone fracture as about half of all women over the age of 50 will suffer a fracture of the wrist, hip or spine as a direct result of bone loss. Osteoporosis can be caused by many different factors which are usually lifestyle or hormone related. Excessive alcohol consumption, smoking, poor diet and inactivity are some of the known risk factors as are other circumstances which are not as controllable such as family history or hormone treatments. While there are effective treatments available for osteoporosis today the best defense is to prevent it altogether. Exercise, specifically weight bearing exercise has been shown to be an effective preventative measure against osteoporosis. In an earlier post How Muscles Get Bigger And Stronger we explored how muscles respond to weight training and in this article we will take a look how bones benefit as from resistance exercise.

The word ‘osteoporosis’ means porous bones and one can easily understand that a bone that’s porous would be weak and vulnerable to fractures. Bones weaken as a result of a process called demineralization. Demineralization occurs when our bones lose important minerals such as calcium. If left untreated our bones will no longer have the structural capacity to support the weight of our body and the forces we create when we are physically active- thus resulting in a fracture. Since we can see them all the time most of us are very much aware of our muscles, but we don’t think much of how our bones work in conjunction with them. When you flex your muscles as in a biceps curl for example, the muscles of your biceps generate force that allows you to lift the weight. This force is transferred throughout the muscle and to the tendons at both ends. The tendons are connected to the bones of your arm and cross over your elbow joint. Joints act as levers- which are rigid objects used with a pivot point to increase the amount of mechanical force our body generates to allow us to lift an object. Activation of the biceps muscles in our upper arm causes rotation of the forearm at the elbow (pivot point) which allows us to lift the weight during a curling exercise. Now according to Newton’s third law of motion, for every action there is an equal and opposite reaction. That being said since bones provide the framework for our muscles every muscular contraction will produce forces that act directly on the bones in our body.

Since bones provide the frame for our body tissue our skeleton is always under some degree of stress. As you read this blog post the force of gravity is bearing down on your bones even though you can’t really feel it. Too much stress can lead to bone damage at a microscopic level- in pretty much the same way it does in your muscles and like our muscles when bones are damaged they need to be be repaired. According to Wolff’s law, the bones in a healthy person or animal will adapt to the loads they are placed under so if the forces acting on a bone increases, the bone will remodel itself over time to become stronger and denser to be able to cope with the load that it has to bear. In essence it’s a stress response in keeping with the laws of general adaption. From a physiological point of view, stress isn’t always a bad thing as we perceive it in our everyday lives. Quite simply stress is the reaction of our body to stimulation or forces that puts it out of balance- ( a balance that we refer to as homeostasis.) If the forces are too great or too sudden – like the forces acting on your bones during a car accident or a fall from a great height- your bones can’t adapt fast enough or deal with the sudden overload and a fracture will occur. Also if a force is continuously applied through repetitive strain and your bones don’t have enough time to rest and recuperate it can also result in a fracture- in this case a stress fracture. This is what happens to many runners and aerobics aficionados after years of doing the same activity over and over again. On the other side of the spectrum, if there is a reduction in the forces on your bones, be it from being bed ridden or from living a predominantly sedentary lifestyle, your bones will remodel themselves to be weaker and less dense as a result. Just like your muscles if you don’t use it- you lose it.

Understanding How Bones Get Stronger

How your bones get stronger and denser depends not only on the degree of stress placed on them, but also on the availability of  minerals such as calcium which is required to change its structure. Bones are made of collagen which is the primary form of protein found in connective tissues throughout your body. The difference between bone tissue and other forms of connective tissue is that the collagen in our bones are infused with minerals which makes it solid. When a bone is subjected to overload (from an activity like weight training for example) it experiences tiny cracks and fissures. These cracks need to be filled and reinforced so that the bone will not be damaged in the future by a similar load and thus starts a signal that mobilizes our bones to repair itself. In a process called resorption, cells called osteoclasts dissolve and break up very thin pieces of bone in the damaged area. (Think of osetoclasts as tiny construction workers who smooth over the damage done to your bones- very much the same way you would sand down a piece of wood if it was cracked before you repaired it.) After this part of the process is completed other cells called osteoblasts come in and fill in the smoothed cracks left behind by the action of the osteoclasts. (Think of osteoblasts as tiny construction workers who fill in the holes sanded down out by the osteoclasts.) This is capped off by the mineralization of the entire area which makes the bone denser and stronger than it was before- a series of actions known as bone remodeling. Bone remodeling can be affected not only by mechanical forces acting on our bodies but also by parathyroid hormones and estrogen.

How Weight Training Builds Stronger Bones

Just as muscles won’t get stronger unless there is an load applied to them that it isn’t used to dealing with, the same logic applies to our bones. That being said, to stimulate the adaptive bone remodeling process there must be some degree of overload. Doing a compound exercise like squats with weights requires a large amount of force to be generated by the muscles of your thighs and lower legs. Forces that create bending and compressive pressure within the bones of your femur (located in your upper leg), tibia and fibula (located in your lower leg). These forces create changes in fluid pressure in your bones which in turn creates the micro-fractures that trigger the adaption response for increasing bone strength. Bones can tolerate a lot more force than muscles can, and that explains why non weight bearing exercises don’t have as much impact in building stronger bones as weight training. With weight training you can progressively increase the overload factor by simply increasing the weight as you get stronger (within reasonable margins of course.) With bodyweight exercises such as aerobics or calisthenics this isn’t always possible. If you start such forms of exercise after a period of being inactive then the new stress of such exercises will have a positive effect in helping build your bones (and muscles to a degree). But after an initial period of adaptation your bones (and muscles) will have no reason to keep getting stronger as they will comfortably be able to cope with the forces incurred during body-weight exercises. Even though the exercises may be physically challenging to you, you have to keep in mind that your bones were designed to easily bear the strain of physical activity involving the weight of your body.

Studies have found that high intensity resistance training exercises (weight lifting) are an effective and feasible means to preserve bone density.1 Not only are high intensity weight training exercises useful in terms of building stronger bones, but they also improve muscle mass, strength, endurance and balance while burning extra calories and reducing body fat. [2,3,4,5,6,7,8,9,10] It can also decrease your risk of heart disease, diabetes, hypertension and reduce the incidence of depression. So pick up some iron and start lifting some weights for stronger bones, a stronger body and a stronger mind.

Related Articles:

How Muscles Get Bigger & Stronger

Kevin Richardson is an award winning health and fitness writer, one of the most sought after personal trainers in NYC and the creator of Naturally Intense High Intensity Training™. Get a copy of his free weight loss ebook here. If you live in the New York City area and need help losing weight or getting into shape give Kevin and his team a call at 1-800-798-8420. Check out Kevin’s personal training services here.

References:

1. High-intensity resistance training and postmenopausal bone loss: a meta-analysis.Martyn-St James M, Carroll S. Osteoporosis Int. 2006

2. High-intensity Interval Training: A Time-efficient Strategy for Health Promotion. Martin J. Gibala, PhD, Department of Kinesiology, McMaster University, Ontario, Canada Current Sports Medicine Reports 2007, 6:211-213

3. Impact of exercise intensity on body fatness and skeletal muscle metabolism. Tremblay, A. et al., Physical Activities Sciences Laboratory, Laval University, Quebec, Canada Metabolism.1994; 43(7): 814-818.

4. Effects of moderate-intensity endurance and high-intensity intermittent training on anaerobic capacity and VO2max.Tabata I, Nishimura K, Kouzaki M, Hirai Y, Ogita F, Miyachi M, Yamamoto K.-Med Sci Sports Exerc. 1996 Oct;28(10):1327-30.

5. Similar metabolic adaptations during exercise after low volume sprint interval and traditional endurance training in humans. Kirsten A. Burgomaster, Krista R. Howarth, Stuart M. Phillips, Mark Rakobowchuk, Maureen J. MacDonald, Sean L. McGee and Martin Gibala, J Physiol 586: 151-160, 2008

6. Effects of moderate-intensity endurance and high-intensity intermittent training on anaerobic capacity and VO2max. Izumi Tabata; Kouji Nishimura, Hirai Motoki, Futoshi Ogita, Motohiko Miyachi, Kaoru Yamamoto, National Institute of Fitness and Sports in Tokyo, Japan Medicine & Science in Sports & Exercise. 28(10):1327-1330, October 1996.

7. Impact of exercise intensity on body fatness and skeletal muscle metabolism. Tremblay, A. et al., Physical Activities Sciences Laboratory, Laval University, Quebec, Canada Metabolism.1994; 43(7): 814-818

8. Bahr R (1992). “Excess postexercise oxygen consumption–magnitude, mechanisms and practical implications”. Acta Physiologica Scandinavica. Supplementum 605: 1–70. PMID 1605041.

9. Bahr R, Høstmark AT, Newsholme EA, Grønnerød O, Sejersted OM (September 1991). “Effect of exercise on recovery changes in plasma levels of FFA, glycerol, glucose and catecholamines”. Acta Physiologica Scandinavica 143

10. Bielinski R, Schutz Y, Jéquier E (July 1985). “Energy metabolism during the postexercise recovery in man”. The American Journal of Clinical Nutrition 42

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Leg Day- A Personal Look At High Intensity Training

“No man has ever crossed the border of human suffering”- K. Wotija

I wrote ‘Leg Day’ several years ago after filming my workout DVD and it has since been published in print and praised online as one of  the most inspiring training accounts of all time. I am not sure I deserve that much praise for it, but I wanted to give the public some tangible insight into what my training is like as well as what drives me to take myself above and beyond my limits. I wrote it lying on the floor of the gym immediately after my training session so that I could capture as much as possible in terms of not only what I did, but what I was thinking and I hope it motivates you to higher levels of accomplishment as well.

Author's legs

Leg Day: 10 am

For me, my leg day starts the day before. I always train legs on Sunday but the mental preparation begins on Saturday night. By Sunday morning I have a clear vision of what is ahead and what I need to do to make it a reality. When I finally step into the gym, it is an act that I have rehearsed in my mind over and over again. There is always a certain queasiness in my stomach. A twinge of apprehension that I am not ashamed to admit. My workouts are brutal testaments to the upper limits of human strength and endurance, and just conjuring up images of what is to come, fills me with a sense of dread. But that is what makes it worthwhile. It isn’t ever a walk in the park, but still I do it, and with no one but my inner voice as a guide.

I look up at the clock after a long sip of water from the water cooler. It is exactly 10 am. My lips are pursed in a silent prayer as I make my way over to the leg section of the gym. I never pray for strength or anything so outwardly superficial, I pray instead that the work that I do today will be meaningful in some way. Today I start with stiff legged deadlifts, 135lbs, twenty times, 225lbs 15 times and 315 lbs 12 times, all in rapid, non stop succession, pausing only for as long as it takes to slap on another plate. I am alone today, so I am training fast. Already my breathing is labored and my hamstrings are on fire. But I have more in me and so I do one more set with four 45lb plates on each side.

I set myself over the bar, grab it as hard as I can and use the muscles in the back of my legs to lift it up. I pull, with every sinew straining with the enormous weight until reluctantly, it rises from the chalk dusted gym floor. It comes all the way up and then back down. Up and then down again for a total of six agonizing repetitions. I drop the bar on rep number six after barely getting the weight up and I feel my legs begin to buckle underneath me.

Leg Day- 10:05 am

“Not yet,” I say to myself, there is so much more to do. A quick trip to the water cooler and I am back. It is now 10:05 am. I go straight to the standing leg curl machine and rep out 12 reps with half the stack. With no rest, I do the same with the next leg and then the briefest of pauses to change the weight. Three quarters of the stack now, 12 more reps on each side, hamstrings feeling as if they are ready to snap, and again a weight increase to the entire stack.

Bodybuilding isn’t about lifting weights; it is about making lifting weights harder. An idea that is almost counter intuitive. The goal is to really dig in and squeeze the muscle against the resistance and forcing it to fail. I could easily add more weight to the full stack, but there is no need to, instead I just train faster and make every repetition harder than the last.

Leg Day-  10:09 am

I set myself on the machine and I go into myself to really feel the burn. At rep number 7 the pain is unbearable. My right leg biceps muscles cramping under the weight, but I will not stop. At rep number 10, the weight is barely moving, but I do not yield. Will supersedes the natural instinct to stop as the muscles begin to completely give out. But I want more and somehow, against all logic I get two more repetitions, and with no stop whatsoever, I inflict the same torture upon my left leg. I am back at the water cooler. It is 10:09 am and already the room is beginning to spin. With the hamstring muscles annihilated, it is time for the most painful part, the quadriceps.

Those beautiful muscles that surround the knee and extend all the way up to the hips. As beautiful as they are, there is a price to be paid for them. They are silent monuments to the countless moments of agony.

It starts with leg extensions- first set at 200 lbs for fifty repetitions. I don’t plan the numbers, I just figure out what will be hard and I do it. By number twenty the fire starts. A white, all consuming flame that starts at the teardrop over my knee and spreads throughout my body, searing my very soul. My teeth are clenched and tears begin to well in the corner of my eyes, but I will not stop. There is no one to shout encouragement, today is a lonely endeavor. There is only that inner voice, the one that seems almost older than I am, that gets louder and louder as the lactic acid builds in my legs. That voice that started as a whisper on Saturday night has now grown into an animalistic cry. A cry louder than the pain, with the voice claiming me. Embracing the pain and somehow  finding the strength not only to keep the weight moving, but to find ever fiber in my legs and force them against all that is rational, to contract even harder. At rep 49 I know that 50 is a near impossibility, but that voice just laughs and finds the strength somewhere within me to complete four more.

This is now the point of no return, the place where in order to carry on I have to live completely in the moment, forsaking all thoughts of success or failure or even what is to come next. Every repetition must become a world and a lifetime unto itself, if not I will not endure.  I place the pin at the bottom of the stack after a timed rest of exactly sixty seconds and I go again for my final set, still reeling from the last one.

With the full 250lb weight stack loaded I am a bit more controlled with my cadence. Not out of concern for myself, but for the machine. I have snapped the cable several times before after overloading it with additional dumbbells and losing myself in the intensity of my sets. And so I am a bit cautious. With a deep breath, I begin anew. Staying in the moment, flexing my quads with each painful rep as if it were my last. Somewhere along the way, I lose myself again and thirty-three excruciating reps go by. With a giant slam the weight stack falls to the floor and I heave myself off of the machine and begin falling to the floor, where at least for the briefest of minutes, I can catch my breath.

But I do not let myself fall. Instead I walk drunkenly, on legs made of rubber over to the relief of the water cooler. It is the only comfort I allow myself, as I drink deeply, holding on to the sides of the cooler to support myself, as my legs right now seem to be of little use. Enough water, and I lumber back to the leg press machine and load three 100lb plates and two 45lb plates on each side for my first set.

Without thinking I blast through twenty repetitions before racking the weight and adding four 45lb plates to each side. Loading the weight in it self is a Herculean task at this point. I can barely walk straight and my chest is heaving, my lungs struggling for air, and I have to load all the plates myself. It is all part of the process though, as it helps me focus on what needs to be done, and it keeps me moving, for at this point, if I stop, I shall not be able to continue. Another set of fifteen reps and I feel that my knees are warm enough for the real working set. To the weights already loaded I add another four 45lb plates on each side for a total of somewhere in the vicinity of 1,500lbs. The machine cannot hold any more plates, but to be honest, I don’t care at his point. I have a job to do.

I sit in the machine, set my feet against it and push with all that I have.  The strain of the weight is indescribable. For a second a pulse of fear grips me as I have a realization that there is the equivalent weight of half of a car over me. Any mishap would most likely result in my immediate demise, but I welcome the realization. It keeps me centered on the need for absolute clarity in focus, and the fear is only a passing pulse. Fear has no place where I am now. I lower the weight ever so slowly, knees coming down to almost meet my shoulders, with every muscle screaming as the burden becomes greater and greater. The weight stops for a second and then I explode it upwards. Once, twice, establishing an insane cadence as once again I am overtaken by the fire.

At rep eighteen the sled starts slowing down, as gravity and the laws of physics find their way back into my reality. Pain is all I feel, and yet I carry on. Eighteen is not a good enough number, so I must get to twenty. Holding the weight for a moment of relative calm, I steel myself and eek out two last punishing reps. I rack the weight and the whole machine sways. I pull myself up with my hands, my legs are not up to the task at this point, and I feel the beginnings of a cold sweat.

Out of the corner of my consciousness I see the other members of the gym staring over at me, perhaps wondering what demons drive me to do what it is that I do, but it is only a flicker, as I go back into myself and struggle for control so as not to pass out from the growing nausea and dizziness. I take the weights off- and it seems an age has passed before all the plates are removed. While I am putting them away I am concentrating on my breathing, regularizing it and consciously slowing the pounding in my chest. It is remarkable that no matter how many times I do this, it is always so much harder. Weights racked, I allow myself a minute to sit down before a much needed trip to the cooler, which is now several miles away. I decide against the water break and instead opt to grab the 100 lb plate and start doing vertical jumps. Going down slowly into a full squat position and then exploding upwards, leaving the ground with a terrifying force before falling back into the full squat position. The hundred pound weight helps me to not hit any of the lights overhead, as it has happened before in the past. It also makes it harder, much harder. I barely get twelve jumps before I freeze in the squat position for a count of ten then do a total of ten more jumps. Another full stop in the bottom position for a count of ten before doing eight more jumps.

Leg Day- 10:15 am

My legs are now beyond pain- there is only a numbing ache. I can hardly catch my breath, though and on the eighth jump I drop the hundred pound plate, which has now etched a groove into my upper arms and lower forearms. I try to stand and for a split second everything goes dark. I fight the darkness, not letting it hold me in its grasp, and instead make my way over to the water cooler, swaying as I walk. I make it and drink once again the coldest and most satisfying drink of my life. I stay there for a while, breathing in between sips, until my eyes can focus once again and the ringing in my ears begins to subside. I glance at the clock. It is 10:15 am, but for me an eternity has come and gone several times over.

I limp over to the donkey calf machine and groan as I bend to place the pin at the bottom of the stack. I set myself on the machine and without pause begin my first set of one hundred reps. The counting in my head is somewhere far away as the searing pain in my calves seem to almost fill my ears. Around number seventy I let out a growling scream that is long overdue (although I am told afterwards that I screamed quite more times than I realized). At one hundred there is the blissful relief of putting down the weight, but the bliss is short lived as I load four 45 lb plates on top of the machine for my next set which will be all the weight the machine can hold, plus 180 extra pounds. The second set of one hundred reps is almost unconscious and I do not recall much save the sweet sound of the weight slamming down as I finish the set. I add another two 45 lb plates and begin what looks to be my last set.

I never plan my last sets- they just happen when my body insists that it has had more than enough. This set is harder than all the others, and at my twenty-fifth rep I start to feel as though I am not going to make it. I am truly at the limit of my powers of endurance, and my legs begin to tremble with the strain, but I do not stop. Instead I think about why it really is that I do this to myself. I think of my family, and how very much what I do here serves to provide them with a better life. I think of my training partners, every one that has been here over the years shouting encouragement and believing in my ability to do what seems to be the impossible. I think of that wide eyed boy that I once was and how far I have come on my road. I think of my clients, my fans, well wishers and all those who I have inspired and who, one day I will inspire. I think of you, and in doing so, I find it. The will.

The nerve to keep on going through my own self inflicted hell. Almost magically the count reaches to one hundred and the weight slams to the floor. Gratitude flows over me, overwhelming even the unmentionable pain. Gratitude for being able to have survived yet another day of the impossible, and gratitude for all of you that are not here, but who helped me along the way. Through blurry eyes I look up at the clock from where I am, as I cannot possibly move for at least another five minutes or so and I note the time. It is 10:20 am.

Kevin Richardson is one of the most sought after personal trainers in New York City a lifetime drug free bodybuilding champion and the creator of Naturally Intense High Intensity Training. Get a copy of his natural bodybuilding DVD here.

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Kevin Richardson is a champion natural bodybuilder, one of the most sought after personal trainers in New York City and the creator of Naturally Intense High Intensity Training™

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Do You Really Need Aerobics? Rethinking The Need For Cardio

Walk into any major gym in America and the first thing you will see is the cardio equipment. Mention the word  ‘exercise’ and for most people the first images to come to mind are aerobic in nature- running, treadmills, Zumba classes, elliptical machines, Stairmasters and the like. Say ‘weight loss’ and the images get sharper, as it is a commonly held position that you need to do cardio if you want to lose weight and maintain a healthy body weight. Gyms are filled with people eager to shed a few extra pounds, and yet in spite of the innumerable  number of hours spent sweating, few ever attain the lean and sculpted look that has become the Holy Grail of our time. Most of us double our efforts after seeing so little in terms of improvement after slaving away doing hours of aerobics in the hope that maybe just a little more of the same will bring us that all-so elusive look. We persist for months, sometimes for years, trying to eat better and train harder until finally, over-trained, frustrated and very often injured, we quit. Relegating ourselves to the ranks of those-who-can’t-lose-weight-because-of-bad-genes. It can be an incredibly disheartening and depressing experience to do so much work and get so little back in terms of tangible changes in your body, but it most of the time has nothing to do with our inability to lose weight. In most cases the blame lies squarely on the fact that cardio is not an efficient method for weight loss and that it simply cannot give you the toned and trim body of your dreams. Perhaps millions can attest by their lack of results, that using aerobics as a tool for getting in shape is driven primarily by advertising and misinformation, not results. And yet many experts in the field cling to the idea that cardio is an irreplaceable part of any fitness regime. The science of how our bodies work don’t support this notion, nor do the countless number of frustrated gym goers still waiting to see their six packs. The reality is that you don’t need cardio and anaerobic resistance exercise alone can provide superior results in  terms of weight loss, increasing endurance and improving overall health parameters.

Cardio and Weight Loss- The Case For Anaerobic Exercise Over Aerobics

It goes without saying that if everyone who ever ventured out regularly for a run or frequented a cardio machine was able to lose weight and keep it off that we would have had a simple solution to our growing obesity problems several decades ago, (as well as an influx of six pack sporting magazine cover models.) We all know this not to be the case and many recent studies affirm what so many have learned the hard way, namely that cardio is a poor method of weight management. One study published in the British Journal of Sports Medicine tracked the results of 58 sedentary overweight/obese men and women who participated in a 12 week course of supervised aerobic exercise. The results were positive in terms of increased endurance and decreased systolic and diastolic pressure but not at all glowing in terms of weight loss. The mean weight loss was only a bit over seven pounds in three months, with most of the group losing barely half of that amount. [1]

The amount of calories burned during aerobic exercise is not as much as we would think as well. Consider the fact that to lose a pound of fat you need to burn 3,500 kcal- which may not sound like much, but to lose 1 lb of fat a 190 lb man would have to run a full mile marathon. A 155 lb woman would have to run even further and at a pretty fast pace which shows just how extreme the amount of aerobics you need in order to lose weight.  At the far end of the spectrum, endurance athletes and those who devote an enormous amount of time to very long workouts can keep their body weight down, but they won’t sport the well muscled and chiseled physiques that most hold as today’s Holy Grail, and they will gain a significant amount of weight if they ever stop. Which is often the case with endurance athletes who come to me after either injury or lack of time prevents them from long distance training and they find it difficult to almost impossible to maintain a low body fat as a result.

In terms of fat burning, new research has continued to show that short high intensity, anaerobic type exercise do far more to reduce body fat than conventional aerobic exercise. A study done at Laval University investigated the impact of aerobics versus high intensity anaerobic exercises on body fat using young adults and the findings were quite eye opening. Participants took part in either a 20 week endurance training regime of sustained aerobics or a 15 week high intensity intermittent training protocol. Despite the fact that participants doing the aerobic exercises expended over twice as much energy as the anaerobic group- (120.4 MJ as opposed to 57.9 MJ), those in the anaerobic group lost significantly more body fat than the cardio exercise group.[2] When corrected for the energy cost of training, the decrease in the sum of six skinfold tests induced by the anaerobic exercise was impressively nine times greater than that of the aerobic group.[2]

Many other studies show similar outcomes. A study done at the University of New South Wales inadvertently found that women taking part in anaerobic high intensity interval training burned fat at a rate three times higher than those doing aerobic exercises.[3] This result came from a total of only 20 minutes of anaerobic exercise on a stationery bike, while the second group exercised at a consistent pace in standard target heart rate zones for twice as long. After 15 weeks, researchers found that the women in the high intensity group lost three times more weight than those who rode the bicycles for twice as much time.[3] A testament to the inefficiency of cardio over more intense anaerobic forms of training.  Other studies have found similar patterns with even shorter durations of high intensity anaerobic exercise.

Dispelling The Myth Of Cardio’s Afterburner Effect

For years the party lines for using cardio to promote fat loss have that that increased activity burns more calories- which is true and not at all in dispute and that aerobic exercise elevates the metabolism for prolonged periods after the training session. As standard an idea as this has been for many, it has not stood up to the test of scientific scrutiny, nor has it helped produced a new generation of trim and slim waistlines. The afterburning effect sought by cardio enthusiasts is really what scientists call excess post-exercise oxygen consumption or EPOC. Exercise brings about a change in the equilibrium of our body (See our article on responses to exercise stress here) our body will always do its best to revert to a resting state of homeostasis and this requires an increase in the amount of oxygen (EPOC) which is needed for our bodies to return to its normal state and adapt to the exercise performed. As a result, there is a measurable increase in metabolism and fat burning after exercise. [3,4,5] This increase was originally thought to occur only with aerobic exercise, but studies have shown that it actually is far more prevalent in anaerobic exercise of sufficient intensities.[2]

Cardio And  Heart Health- Do You Really Need It?

Weight loss aside, you must need some form of cardio to increase your endurance and to keep your heart healthy, right? Again, the science disagrees with what has become practiced convention. Aerobic exercise can indeed increase lung capacity and strengthen the heart muscle which is related to a decrease in cardiovascular disease[6] but it isn’t the only way to do it nor the most efficient.  With regards to your heart and lungs it should be noted that

THE CARDIOVASCULAR SYSTEM WORKS TO SUPPORT THE MUSCULAR SYSTEM AND NOT THE OTHER WAY AROUND!

It is physically impossible to train your muscles without working your heart as well. The two are not disconnected, yet this basic fact of physiology is often overlooked in discussions regarding aerobic exercise requirements. Any improvement in muscle mass and strength brought on by anaerobic exercise of adequate intensity will correspond with an improvement in cardiovascular health parameters as well. The impact of a high intensity workout to your cardiovascular system should not be underestimated, and those who argue that it doesn’t stimulate your heart and lungs have simply never executed a compound resistance movement to a point of momentary muscular failure or beyond. Needless to say, a high intensity set of squats to even close to the threshold of muscular failure leaves even the most conditioned of athletes gasping for air. You can’t work muscles at high intensities without significantly elevating your heart rate.

Cardio Is Not The Only Way To Increase Endurance

The idea of a need for repetitive steady state aerobic exercise to improve endurance has been a constant theme in modern sports medicine, however this theory also fails to hold up to the rigors of scientific testing. A study done by Martin Gilba of McMaster University in Ontario found that short, anaerobic high intensity bouts of exercise produced far greater improvements in endurance as compared to conventional aerobics and not only in terms of performance but also with regards to molecular changes in mitochondria related to increased endurance.[7] In one group participants were made to cycle as hard as they could for 20 to 30 seconds for a total of two to three minutes per session while the other group rode a stationary bike at a sustainable pace for 90 to 120 minutes. Each group trained three times a week, and at the end of the two week study both groups showed almost the same increases in overall endurance, with the high intensity anaerobic exercise group having slightly better aerobic performance over their aerobic exercise counterparts, even though they only trained for six to nine minutes a week in while the other group had trained for an weekly average of five hours.[7] Similar findings have been reported in studies by the National Institute of Health and Nutrition in Japan and many experts in the field of sports medicine have begun to question the validity behind the theory of sports specificity for increases in endurance and performance given the new findings on anaerobic high intensity training.[8]

Anaerobic Exercise Conveys The Same Benefits As Aerobics If Not More

So what about the other benefits of aerobic exercise? Pretty much all of them can be replicated or improved upon with resistance exercise of adequate intensity. High intensity anaerobic training has been shown to:

• Improve depression as well as aerobics.[9,10,11,12]
• Reduce insulin sensitivity and the risk of diabetes.[13,14,18]
• Increase bone mass and decrease the risk of osteoporosis.[15]
• Reduce visceral abdominal fat and decrease the risk of metabolic syndrome.[16, 17, 18
• Improve circulation, blood pressure and the risk of cardiovascular disease.[18]
• Strengthening and safely enlarge the heart muscle, to improve its pumping efficiency and reduce the resting heart rate [20, 21, 22, 23]

Cardio Won’t Give You ‘The Look’

It should be said that the toned and defined look sought by most gym-goers is unattainable from simply doing aerobic exercise. As with all steady state type movements, the body quickly adapts and learns to burn less and less calories the more the exercise is continued and there are no profound changes in body fat or muscle mass as there is no stimulation intense enough to bring about an adaptation response in skeletal muscle. No matter how hard you may think that aerobics class may be or that session on the bike was- it can’t make profound changes in the way you look the way weight training can as there is no continued overload. Doing aerobics in conjunction with weight training doesn’t always give the best of both worlds either as the extra work can have a counterproductive effect on your weight loss efforts, since the added workload can lead to overtraining and consequently less results than you would get from resistance exercise alone.

Now it would be inaccurate to say that aerobic exercise is without merit- as such a statements fly in the face of countless studies that show very real benefits to doing it, but it may not be the only path to optimum health and fitness. I personally have not done any aerobic type exercise over the past 23 years and during that time I have been able to distinguish myself as a successful drug free bodybuilder, maintain year round body fat percentage of 6% all while  sustaining an extremely high degree of cardiovascular conditioning. I have personally trained endurance athletes such as triathletes, marathon runners and distance cyclists and helped them increase their performance times using only three ten minute high intensity weight training a week and no cardio exercise whatsoever. Add to that twenty years of helping dozens of fitness models and bodybuilders get into contest winning shape using only high intensity training and proper dietary practices and the  hundreds I have helped lose anywhere from 30 to as much as a 100 pounds- all without the use of aerobics or steady state exercises.

The appeal of cardio is easy to understand, as it requires little in terms of instruction and women for one tend to find it less intimidating than weight training. Cardio exercise are also easy for researchers to study, as creating controlled exercise protocols for groups is far less involved and costs far less to supervise and execute as compared to anaerobic type resistance training. Logically there are more aerobic exercise studies than anaerobic ones, which explains the initial bias towards cardio over resistance exercise in terms of weight loss and health benefits, but as more studies emerge using resistance training, we are learning that it can be equally beneficial and far less time consuming. There are also entire industries based on aerobic exercise- gyms, home exercise equipment, exercise classes and even the sneaker industry all invest heavily in promoting it, while there is very little in the way of promotion of weight training as dumbbells don’t sell gym memberships- cardio machines do. Nevertheless if you are serious about getting into great shape or looking for a more efficient way to improve your health and fitness, high intensity training might be a better fit for you over cardio. So get off the treadmill and pick up the weights if you really want ‘the look’ and don’t forget to watch what you eat as neither aerobic nor anaerobic exercise can negate the ill effects of an unhealthy diet.

Related Articles: Aerobics & Strength Training- Does It Help Or Does It Hurt?

Kevin Richardson is one of the most sought after personal trainers in New York City and the creator of Naturally Intense High Intensity Training™. Get a copy of his free weight loss ebook here. If you live in the New York metropolitan area and need help losing weight or taking your body to the next level give Kevin and his team a call at 1-800-798-8420. Check out Kevin’s personal training services here.

References

1. Beneficial effects of exercise: shifting the focus from body weight to other markers of health, N. King, M. Hopkins, P Caudwell, J. Stubbs, J. Blundell. The British Journal of Sports Medicine 2009

2. Impact of exercise intensity on body fatness and skeletal muscle metabolism. Tremblay, A. et al., Physical Activities Sciences Laboratory, Laval University, Quebec, Canada Metabolism.1994;

3. Bahr R (1992). “Excess postexercise oxygen consumption–magnitude, mechanisms and practical implications”. Acta Physiologica Scandinavica. Supplementum

4. Bahr R, Høstmark AT, Newsholme EA, Grønnerød O, Sejersted OM (September 1991). “Effect of exercise on recovery changes in plasma levels of FFA, glycerol, glucose and catecholamines”. Acta Physiologica Scandinavica

5. Bielinski R, Schutz Y, Jéquier E (July 1985). “Energy metabolism during the postexercise recovery in man”. The American Journal of Clinical Nutrition

7. High-intensity Interval Training: A Time-efficient Strategy for Health Promotion. Martin J. Gibala, PhD, Department of Kinesiology, McMaster University, Ontario, Canada Current Sports Medicine Reports 2007

8. Specificity of training adaptation: time for a rethink? John A. Hawley-J. Physiol. 2008

9. Singh NA, Clements KM, Fiatarone MA. A randomized controlled trial of progressive resistance training in depressed elders. Journal of Gerontology Medical Sciences

10. Doyne EJ, Ossip-Klein DJ, Bowman ED, Osborn KM, McDougall-Wilson IB, Neimeyer IB. Running Versus Weight Lifting in the Treatment of Depression. Journal of Consulting and Clinical Psychology.

11. Martinsen EW, Hoffart A, Solberg O. Comparing aerobic and non aerobic forms of exercise in the treatment of clinical depression: a randomized trial. Comprehensive Psychiatry

12. Singh NA, Stavrinos TM, Scarbeck Y, Galambos G, Liber C, Singh MA. A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults. Journal of Gerontology: Medical Sciences

13. Pedersen BK, Saltin B: Evidence for prescribing exercise as therapy in chronic disease. Scand J Med Sci Sports 2006

14. Extremely short duration high intensity interval training substantially improves insulin action in young healthy males- John A Babraj , Niels BJ Vollaard , Cameron Keast, Fergus M Guppy, Greg Cottrell and James A Timmons

15. High-intensity resistance training and postmenopausal bone loss: a meta-analysis.Martyn-St James M, Carroll S. Osteoporos Int. 2006

16. Influence of exercise intensity on abdominal fat and adiponectin in elderly adults. Coker RH, Williams RH, Kortebein PM, Sullivan DH, Evans WJ.Metab Syndr Relat Disord. 2009

17. Effect of exercise training intensity on abdominal visceral fat and body composition. Irving BA, Davis CK, Brock DW, Weltman JY, Swift D, Barrett EJ, Gaesser GA, Weltman A.Med Sci Sports Exerc. 2008 Nov;40(11):1863-72.

18. Resistance training in the treatment of the metabolic syndrome: a systematic review and meta-analysis of the effect of resistance training on metabolic clustering in patients with abnormal glucose metabolism. Strasser B, Siebert U, Schobersberger W.Sports Med. 2010

19. Resistance training in the treatment of the metabolic syndrome: a systematic review and meta-analysis of the effect of resistance training on metabolic clustering in patients with abnormal glucose metabolism. Strasser B, Siebert U, Schobersberger W.Sports Med. 2010

20.  Graf Ch., e.a.: Fachlexikon Sportmedizin: Bewegung, Fitness und Ernährung von A-Z, Deutscher Ärzteverlag, 2008, p. 209, ISBN 3769112237, here online

21. Reuter P.: Der grosse Reuter: Springer Universalwörterbuch Medizin, Pharmakologie und Zahnmedizin, Birkhäuser Verlang, 2005, p. 1300, ISBN 3540251049, here online

22 Woolston, Chris. “Ills & Conditions – Athletic Heart Syndrome”. CVS Caremark Health Information. 17 January 2007

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