Mon 25 Aug 2014
It has been a couple of weeks since I’ve last posted. Our most recent WOW was performed on 8/24/14. I was due for shoulders/arms/leg press. After the Mercola interview, I received lots of requests for how to begin training when you have little or no equipment. For this reason, Wendy elected to do a minimal equipment workout. We recorded snippets of video and posted them on instagram at ultimate_exercise_. Hopefully this will encourage newcomers to just get started and build from there.
My WOW: Thick Bar Overhead Press, Rear Delt Fly, SuperSlow Systems Biceps, Triceps Presses on the SS Systems Pulldown, EZ bar reverse curl, Formulator Flex/Ext, MedX Leg Press in reclined (squat) position
Wendy’s WOW: Chin Up (regular cadence), Pushups (regular cadence), Lumbar Extension on SS Systems Pulldown, Thick Bar Overhead Press (slow cadence), Goblet Squat holding barbell plate (slow cadence)
Recently Chuck Spencer over at www.go2strength.wordpress.com made a post that resonates with a major component of BBS: the contribution of skeletal muscle to cardiac function. Chuck eloquently made a connection that cardiology researchers still have not fully realized: that the loss of skeletal muscle is a major contributing factor in the development of congestive heart failure. Traditionally, congestive heart failure is thought to occur almost exclusively due to cardiac muscle damage that occurs from coronary artery blockages and resultant death of cardiac muscle. Congestive heart failure (CHF) is also attributed to damage that occurs when the heart has to pump against elevated systemic blood pressure (left-sided heart failure) or elevated pulmonary artery pressure (right-sided heart failure).
The medical literature has tons of articles discussing the existence of sarcopenia (muscle wasting) in congestive heart failure. Traditionally, CHF is thought to decrease exercise tolerance, which results in decreased exercise and thus sarcopenia. There are even articles that show that resistance exercise increases muscle mass and exercise tolerance in those with CHF. What the medical literature fails to do is to consider is how sarcopenia may be an independent contributing factor in CHF….that pre-existing sarcopenia may induce or make one much more vulnerable to CHF.
Skeletal muscle is “the forgotten pump” in cardiac output. The reason that skeletal muscle is so integral to cardiac function is because of Frank Starling’s Law of the Heart (http://en.wikipedia.org/wiki/Frank–Starling_law_of_the_heart). Starling’s Law states that cardiac output is directly proportional to the volume of blood that is returned to the heart. If a larger volume of blood is returned to the right side of the heart, the ventricle is stretched and the cardiac myocytes are in turn stretched, which causes them to contract more forcefully. Well, guess what the major determinant of venous return to the right heart is? You got it…skeletal muscle mass and how hard it is working at any given time. Through this mechanism, cardiac output can auto-regulate on an almost purely mechanical basis. So when a large mass of skeletal muscle is working really hard, a large volume of venous blood is massaged and milked back toward the heart, which in turn automatically provides an increased cardiac output to fuel the very muscles that are providing the needed venous return.
Here is another cool thing about skeletal muscle’s contribution to Frank Starling’s Law: coronary artery blood flow is directly proportionate to the volume of venous return on the right side of the heart. When a given volume of blood arrives in the right heart, Frank Starling’s Law dictates that this is the volume of blood that will be delivered to the left ventricle, which in turn determines the volume of blood that will be ejected out of the aortic valve into the aorta during systole. During diastole (the relaxation phase) a portion of the blood ejected into the aorta will backwash into the now closed aortic valve. At the base of the aorta are three valve leaflets that are now closed and look like a Mercedes emblem. Two of these leaflets have “ostia” or openings that lead into the left and right main coronary arteries (http://www.vhlab.umn.edu/atlas/aorta/coronary-artery-ostia/index.shtml). Thus we can now see that volume returned to the right heart determines blood ejected from the left heart and thus the amount of blood that will flow through the coronary arteries. This is the basis for a type of treatment for coronary artery disease and congestive heart failure called “extracorporeal counterpulsation” (http://en.wikipedia.org/wiki/Enhanced_external_counterpulsation). This system uses air bladders on the legs that contract in synchrony with diastole to enhance venous return and thus improve coronary artery blood flow, collateralizing of coronary arteries and improvement of cardiac function in those with CHF. Well, guess what does the same thing by the same mechanism? You got it…resistance exercise.
Am I saying that resistance exercise will prevent coronary artery blockages. No! Even someone that follows a very clean diet (insert your favorite) and performs resistance exercise (or cardio or whatever) can still develop coronary blockages for reasons that are still not well understood. (As an aside, I am becoming more convinced that other elements are at play, such as an infectious process or perhaps alterations in the gut microbiome.) However, if you have blockages, it would be great for there to be lots of large calibre collaterals and a myocardium with lots of physiologic headroom. So next time someone asks you what you do for “cardio”, tell them that you do high intensity resistance exercise.
Post your WOW’s and your thoughts.