UE was closed for the Holiday, so I took the opportunity to get a workout in.  I slept late after working New Years Eve, so I was well-rested.  Today was legs/abs day.

Calf Exercise on MedX Leg Press

MedX Abdominal

TSC Hip Abduction

MedX Leg Press

Since my last posting I also did my shoulder and arm rotation.  It has been hectic, so I don’t recall the exact dates, but I have compressed my rotation down from every 5th day, to every 3rd or 4th day.  So far, recovery has been fine.

Shoulders:  MedX overhead press, rear delt fly, lateral raise, shrug

Arms:  Nautilus Plate Load Biceps with SS cam, close grip pulldown, Nautilus Plate Load Triceps, MedX Chest Press (narrow grip on vertical handles), Compound Row, Formulator flex/ext

Things have been relatively quiet on the Myostatin front since the Myostatin blocking drug MYO-029 fell off the map in Phase II trials.  However, Novartis has recently been given approval to proceed with clinical trials on their new drug “Bimagrumab” or BYM338.  This drug reportedly blocks binding of the Activin II receptor where Myostatin  and Activan A attach.  Myostatin and Activin A are proteins that inhibit muscle growth and act as major governors of muscle growth and differentiation.  These proteins are over-expressed in certain disease states such as cancer, AIDS, COPD, glucocorticoid and corisol-induced atrophy, sarcopenia of aging, as well as atrophy related to inactivity or low-gravity environments.  The fact that this drug blocks a receptor rather than abolishing the production of the regulatory protein is promising because it can avoid the unintended side-effects of completely eliminating a regulatory protein, and it allows for a potential dose-dependent effect.  This drug holds great promise for those with muscle wasting diseases that are refractory to the exercise stimulus.  From my own standpoint, I am fascinated to learn what this drug may teach us about the regulation of muscular potential.  While there is certainly a potential for abuse in athletics, there is also the potential for leveling the playing field such that athletes in a given endeavor could have their engines “governed” in an equal way much like the rules in NASCAR racing.  Hopefully, fear of the drug’s potential use (or abuse) in the athletic realm will not prevent it from being available to those with legitimate disease states.

Mol Cell Biol. 2013 Dec 2. [Epub ahead of print]

An Antibody Blocking Activin type II Receptors Induces Strong Skeletal Muscle Hypertrophy and Protects from Atrophy.

Abstract

The myostatin/Activin type II receptor (ActRII) pathway has been identified as critical in regulating skeletal muscle size. Several other ligands, including GDF11 and the Activins, signal through this pathway, suggesting that the ActRII receptors are major regulatory nodes in the regulation of muscle mass. We have developed a novel, human anti-ActRII antibody (”Bimagrumab”, aka BYM338) to prevent binding of ligands to the receptors, and thus inhibit downstream signaling. BYM338 enhances differentiation of primary human skeletal myoblasts, and counteracts the inhibition of differentiation induced by myostatin or Activin A. BYM338 prevents myostatin or Activin A induced atrophy through inhibition of Smad2/3 phosphorylation, thus sparing myosin heavy chain from degradation. BYM338 dramatically increases skeletal muscle mass in mice, beyond sole inhibition of myostatin as detected by comparing the antibody with a myostatin inhibitor. A mouse version of the antibody induces enhanced muscle hypertrophy in myostatin-mutant mice, further confirming a beneficial effect on muscle growth through blockade of ActRII ligands beyond myostatin inhibition alone. BYM338 protects muscles from glucocorticoid-induced atrophy and weakness, via prevention of muscle and tetanic force losses.These data highlight the compelling therapeutic potential of BYM338 for the treatment of multiple settings of skeletal muscle atrophy and weakness.

Post your WOW’s and your thoughts

I apologize again for taking so long to get a new post up, things have been very busy leading up to the holidays.  I hope everyone is having a great holiday season.  I am still following a 5-way split routine done at an every 5 day interval.  I feel that I have “recharged” my recovery pretty well and may likely make adjustments soon.  Initially, I may keep the same split but narrow the frequency to every 4 days.  After that, I may go to a 3 way split or the RenEx A, B, and C routine at an every 7th day frequency.  I find that this sort of “wave” variation over the long haul works pretty well.  Tuesday evening I did my “chest and neck flexion” portion of the 5-way split.  It was done at Fike gym because UE is just booked solid during the week (thanks to Ed, Sherry and Joe).

Dumbbell flat bench press

Chest Fly machine

Dumbbell incline bench press

Chest Fly macine

Manual neck flexion

My comments this time are directed mostly towards those who are trainers or who run facilities, but this also applies to anyone who has friends or family who might be considering starting an exercise program.  As a facility owner I have always found the New Year to be a time where we get the greatest surge of new clients.  The New Year’s resolution tradition really plays favorably for those who offer personal training services.  Even the veterans on this sight probably feel a surge of enthusiasm and renewed commitment at the turn of a New Year.  So if you are a trainer, own a facility or want to inspire your friends and family to pursue improvement….now is the time.

This New Year is even more special and unique, and offers an even more powerful reason to pay attention to one’s fitness and health.  On January 1, 2014 the Patient Protection and Affordable Care Act goes into full effect (although the King…er, President might decide to further override acts of Congress and the law of the land until the next election).  Now, I do not want the comment thread to turn into a big political debate or rant; I just want to point out that you have a massive selling point for getting into proper shape and optimizing health.  As an emergency physician I have an on-the-scene view of how things are going and I’m here to tell you, it’s a train wreck.  It has been a gradual wreck for years, sort of like a plane losing its engines, but we are at the point where we are moments away from hitting the ground.  Already, people that had pre-existing coverage are seeing their premiums go up several hundred dollars a month, while others have had their policies cancelled only to find the replacement policy cost-prohibitive.  Those that already elected not to purchase insurance because it was too expensive are now being forced by law to purchase coverage that is more expensive than that which they already could not afford, or face a tax penalty if they fail to comply (these people are largely avoiding healthcare altogether for fear of being “counseled”-reported to the exchanges).  Those that did have, or do get, coverage find that it is geographically restricted, such that if you need specialized care outside your coverage area that it may be cost-prohibitive.  On the provider side, the pressure to ration care is enormous.  This is done by a byzantine system of regulations that stipulate what “qualifies” for payment of treatment administered.  Three years ago hospitals were completely full with admitted patients housed in the ER.  Now the ER is still overrun with sick patients but the inpatient census in many hospitals is at 30-50%.  This isn’t because the patients are less sick folks.  Even doctors and hospitals respond the the carrot and the stick (in this case almost completely stick).

In the end, if the exchanges all work out so that everyone in the U.S. gets insurance coverage you need to keep in mind that coverage does not equal care.  Insurance coverage will not give you the right to see a doctor of your choosing…it will give you the right to get in the queue for whatever “provider” your coverage stipulates.  So now is the time to get in shape and optimize your health.  It is very important to not need health care at this point in time, and going forward.  It is the best time to eat a clean and healthy diet and exercise in a way that expands your physiologic headroom.  And here is another selling point.  How someone chooses to exercise is important in this healthcare environment.  You will not do yourself any favors by getting into shape if you tear a rotator cuff doing kipping pull-ups, tear a labrum swinging a sledge hammer on a tractor tire, or blow out your ACL doing box jumps.  You don’t want to thrust yourself into the belly of the healthcare beast in your attempts to get healthy.  So if we can combine this message with people’s natural tendency to seek improvement in the New Year, we can truly effect “change we can believe in”.

Now is the Time…to post your WOW’s and your thoughts.

I hope all had a great Thanksgiving.  I apologize for the long absence (long enough to accumulate 472 posts) but things have been very busy lately.  My most recent WOW was my “back” portion of my 5-way split routine (chest and neck flexion, back and neck extension, shoulders/upper traps, arms, legs and abs).  I did the following at UE on Black Friday after all the client workouts had been done.

Chin Ups

Nautilus Pullover with SS retrofits

MedX Row with SS retrofit

Lumbar Extension on SS Systems Pulldown

Neck Extension on SS Systems Neck

I have been allowing 5 days between sessions.  My other two workouts were done at Fike and were as follows:

Legs/Abs:  Calf Exercise, Leg Extension, Leg Curl, Leg Press, Hammer Clam-shell Abdominal- All sets done to simple failure.  All movements felt good except for leg curl which had  a very poor strength curve (lost range of motion with each rep).

Chest/Neck Flexion:  Hammer Chest Press, Cable Chest Fly, Hammer Incline Press, Manual Neck Flexion- Each weighted movement was done with a heavy weight and then a drop-set with about 40% less weight.  The neck flexion was a manual done with 10 second cadence for 4 reps.

Due to extreme business in the medical side of life, I have not had time to include a topic with this posting.  Please post your WOW’s and continue any discussions in a professional and courteous manner.  Once things settle down, I will be able to generate more substantive posts.

Post your WOWs and your thoughts.

On Friday 11/08/13 I did the following WOW supervised by all 3 trainers at UE (Joy!).

MedX Compound Row with SS retrofits (starting with entire stack, then 360, 240 then 140-part of my demo to Ed)

Nautilus Pullover with SS retrofits

SuperSlow Systems Pulldown

SuperSlow Systems Neck Extension

Lumbar Extension via Romanian Deadlift

Then today (111/13/13) I went to Fike and did “shoulders”.

Dumbell Front Raise

Dumbell Bent Fly

Dumbell Lateral Raise

Barbell Overhead Press

Dumbbell Shrug

I have really enjoyed reading over the last WOW’s comments.  People of opposing viewpoints have challenged each other in meaningful ways and the discussions have been enlightening for me.  There have also been several examples of logical fallacies/cognitive errors.  I am not going to name names, since we all do it.  I am especially guilty of many logical fallacies (the sunk costs fallacy and cognitive dissonance have cost me more time in my life than I care to admit).

One of the logical fallacies that keeps appearing in the threads is one that is rampant in the fields of fitness and success.  The fallacy in question is that of Survivorship Bias.  Survivorship bias is the marketing that underpins P90X, Crossfit, as well as magazines such as Fortune, Success, Forbes and biographies of successful businessmen and athletes.  A very popular fitness fad that I have lost clients to (who later came back) are Fitness Boot Camps. These camps fashion themselves after boot camps or Navy Seals physical training camps.  These programs actually accrue some impressive results that are then heavily advertised.  The assumption is that the training was clearly responsible for the results.  What the Navy understands that the lay public does not, is that BUDS Hell week is not done to produce a given degree of conditioning; it is done to weed out.  Those that cannot recover and perform, or who become injured, ring the bell and go home.  Those who can recover, adapt, or even thrive make the cut.  But the boot camp did not make them that way, it was just a way to separate the wheat from the chaff.  The same can be said for programs such as Gym Jones, Crossfit, Insanity or P90X, which is why such programs are so popular amongst Everest-summiting mountain climbers, ex-special forces soldiers or SWAT team members. The fact that they succeed in something so tough only seems to reinforce their sense of superiority and group identity.  This luster of superiority is also what attracts those who ultimately don’t survive.  They too hope that they can forge elite fitness in the crucible of a boot camp that they pay to attend.  These are the folks that are hospitalized with rhabdomyolysis, tear their rotator cuff, herniate a disc or simply get tired of tearing their skin off on a plyo box.  Those that survive are those with the physical attributes that we would all like to have, and they become great spokespersons for the movement.

In medicine survivorship bias drives the use of one of the most marketed therapies in the history of medicine:  the administration of Tissue Plasminogen Activator in ischemic strokes.  The trial that launched this therapy was the NINDS trial.  In the trial those given TPA for their strokes ended up showing better neurological outcomes at 3 months than those who received only aspirin and supportive care.  The thing that was not acknowledged in the conclusions of this study were that results could only be measured in survivors.  If you looked at all patients (including those that died), you found that those who were sicker and got TPA were much more likely to die of fatal brain hemorrhages.  Thus, in the TPA group the sicker patients died leaving on the less sick to be measured for function at three months whereas those in the control group had to include the more severe strokes along with the less severe ones which made their function at 3 months look worse.  Now we see every hospital vying to be a “Stroke Center” and advertising with billboards that say “Time is Brain”.  The survivorship bias that launched TPA for stroke was further reinforced by Confirmation Bias.  Many times a patient presenting with major stroke symptoms will have spontaneous resolution or migration of a clot, or collateral circulation will find an alternate pathway to the area of the brain being deprived of its blood supply.  It is not uncommon to see a patient who is completely paralyzed and aphasic return completely to normal in a matter of minutes to hours (in which case it is called a Transient Ischemic Attack or TIA).  Many a neurologist has recounted stories of pushing TPA and then seeing a miraculous return to normal causing them and the patient’s family to credit the miracle drug.  I cannot tell you how many times I have seen a patient return to normal just seconds before the order to give TPA was carried out.  Just a few seconds made the difference between a diagnosis of TIA versus the actions of a miracle drug.

When I was researching the topic of survivorship bias I came across a website devoted to the subject of cognitive errors (www.youarenotsosmart.com).  In its very lengthy article on survivorship bias it told the story of a group of mathematicians who worked for the DoD during WWII who were asked to evaluate how to decrease the losses of B-17 bombers.  On a given bombing mission up to 50% of the planes would not return.  Crew members called themselves “already ghosts”.  Commanders of the Army Air Force had surveyed the damage of returning bombers and found that most of the bullet holes were in the wings, around the gun turret, and along the center underbelly.  Army Air Force officials had suggested that extra armor be installed at these locations.  Since weight was a critical issue, armor had to be used where it counted.  The DoD mathematicians intervened however and pointed out that these locations are exactly where you did not want to place the extra armor because you were analyzing the planes that survived.  These bullet holes represented where a plane could be shot and expect to survive.  Fortunately, the mathematicians prevailed and bomber crew mortality dropped significantly throughout the rest of the war.

In a similar vein, it is all too easy to observe Ken Hutchins (or other such personal training center) train clients over the years and note how few impressive physiques have been produced.  However, one must consider what kind of client has been serviced.  How might survivorship bias and selection bias skew our point of view.  A personal training center that offers a protocol with an emphasis on safety, in a clinical and private environment is very likely to draw from the very population that did not survive (or would never attend) a boot camp or hard-core bodybuilding gym, or crossfit “box”.  Further if the proprietor was famous for his involvement in The Osteoporosis Study, what kind of client do you think might show up at the door and how selection bias may have more to do with perceived physique outcomes than any protocol or approach itself.  Perhaps this is why a studio in Ohio, using exactly the same protocol, but is owned by a bodybuilder has a whole stable of successful bodybuilders and fitness competitors to point to.

For anyone new to BBS coming to read this blog, a 400+ comment thread may seem overwhelming and may suggest that BBS principles may be in question.  What must be realized is that exercise investigation is actually quite primitive, and those that have access to funding and resources do not understand the issues as well as some of the commenters on this blog.  What we are therefore stuck with is trying to make sense of our observations through the fog of cognitive bias that is part and parcel of the human brain.  Like any field, this one is filled with history.  Some of that history is good and grand.  Some of that history includes people that may have been (or felt that they were) betrayed or somehow thrown under the bus.  Once those lost opportunity costs are factor in, these cognitive biases can be put on steroids.  However, open discussions that get heated and run 400 posts are how refinement and discovery get made, and as long as everyone remains respectful, perhaps we can shore up the plane where it counts.  Like the Beastie Boys say about New York: “On the number 10 bus we fight and fuss, you know we’re thorough in the buroughs because that’s a must.”

A video called the Texas Sharpshooter illustrates Jeffrey’s points on bias

http://www.youtube.com/watch?v=y_3CsKoXwfA

My most recent WOW was the “legs” portion of my 5 way split.  I am still amazed at how well this is working for me.  However, I have been in this game long enough to realize that it is not THE way.  Others without my genetic profile and life circumstances might find it extremely lacking.  But for me, the results are astounding.  This workout was a case-in-point.  I have a love/hate relationship with my MedX leg press.  I love its biomechanics and the way the footplate moves away and down simultaneously, effecting a great stimulation for the hip and buttocks.  However, to acquire this effect, you have to gap out the weight stack to 4 or 5 holes.  This gets the foot position a little lower at the lower turnaround and allows for a hard end-stop when the rubber stopper on the four-bar linkage come into contact.  The down side of this set up is that it necessitates riding the seat carriage forward so that you are parked between the two weight stack headers.  Add a good heavy weight to push against out of the bottom, and a hard end-stop which won’t allow you to lock your knees and what you get is…..a trash compactor.

star-wars-trash1

Every time I get into my MedX leg press, I am reminded of this scene from Star Wars.  However, this time was different.  I knew I was going to be well-recovered, so I decided to use a weight that is in my “heavy” range (those quotation marks are for you David) gapped out at 4 holes.  I pinned 360 on each stack.  I began the set and immediately felt something was wrong.  This was way too light.  I completed 2 reps and released the seat carriage to double check my settings.  I decided to up it to 380 both sides (760 total).  Still felt easy after 2 reps.  Finally, I went up to 420 per side (840 total) gapped at 4 holes.  I ended up completing 10 reps!  At least for now, I seem to have stumbled on the fact that my body operates on a more protracted time scale.  The rest of the workout was equally as remarkable.

Calf Exercise on MedX leg press (entire stack)

MedX Abdominal (really to give some respite before going to leg press)

MedX leg press (see above)

TSC leg curl (done sitting at edge of pullover seat, with belt and heels on foot pedal-works great)

TSC leg extension (done sitting back on pullover seat, with seat belt, shins under footpedal, padded with yoga blocks)

I have really been enjoying the discussion on augmenting performance of exercise with feedback.  This topic is equally as controversial in many fields.  In emergency medicine we struggle with how to teach the motor skills of difficult procedures such as tracheal intubation, cricothyrotomy, thoracotomy, chest tubes etc.  In the fields of athletics, how to provide feedback to optimize skill acquisition is also very controversial.  In BMX racing, the gate start is the most complex motor skill that needs to be developed in order to be successful.  I attended many clinics with real-time professional instruction.  None of these clinics could compare to the value of setting up a video-camera to record my performance, which I then reviewed immediately after carrying out the skill.  I could see instantly what was wrong and corrected it on the very next try.  I came further in 10 minutes of video review than I had in a decade of attending clinics.  Research in motor learning seems to suggest that “terminal” feedback is the most valuable.  In other words, regardless of modality the feedback seems most valuable when it is reviewed immediately AFTER the skill is executed.  I have noted that monitoring my form in a mirror while training is worse than useless, but seeing video of my training is very instructional.  I have no doubt that human instruction as well as ongoing “heads up” feedback devices can enhance training.  I am certain that project X will provide real value.  I hope that the performance can also be stored for review after the performance.  I suspect a combination of real-time performance monitoring (both human and computer) coupled with performance review shortly after completion of the set or session will prove valuable.  At least that is what the literature suggests.

J Mot Behav. 2013;45(6):455-72. doi: 10.1080/00222895.2013.826169. Epub 2013 Sep 5.

Terminal feedback outperforms concurrent visual, auditory, and haptic feedback in learning a complex rowing-type task.

Source

Sensory-Motor Systems Lab, ETH Zurich & Spinal Cord Injury Center, University Hospital Balgrist , Zurich , Switzerland.

Abstract

ABSTRACT Augmented feedback, provided by coaches or displays, is a well-established strategy to accelerate motor learning. Frequent terminalfeedback and concurrent feedback have been shown to be detrimental for simple motor task learning but supportive for complex motor task learning. However, conclusions on optimal feedback strategies have been mainly drawn from studies on artificial laboratory tasks with visual feedback only. Therefore, the authors compared the effectiveness of learning a complex, 3-dimensional rowing-type task with either concurrent visual, auditory, or haptic feedback to self-controlled terminal visual feedback. Results revealed that terminal visual feedback was most effective because it emphasized the internalization of task-relevant aspects. In contrast, concurrent feedback fostered the correction of task-irrelevant errors, which hindered learning. The concurrent visual and haptic feedback group performed much better during training with the feedback than in nonfeedback trials. Auditory feedback based on sonification of the movement error was not practical for training the 3-dimensional movement for most participants. Concurrent multimodal feedback in combination with terminal feedback may be most effective, especially if the feedback strategy is adapted to individual preferences and skill level.

Post your WOW’s and your thoughts.

I performed the “shoulders” portion of my 5 way split.  This 5 way split has proved quite the revelation.  The focused effort on one body part has been enjoyable and somewhat easier to recover from, but the really surprising aspect is the effect of the prolonged recovery period for each muscle group.  I have noticed that I am experiencing a sense of growth in the resting muscle groups, and the groups that have rested the longest are showing the most response.  I am also having a renewed experience of the “indirect effect”.  Even though I trained shoulders, I seemed to experience a pump and response from other muscle groups, and not just those closest to the group being trained or indirectly involved (such as triceps while training shoulders or chest, or biceps while working back).  In fact, the muscle group most distal (my calves) seemed to have a significant response.  I think this has less to do with location on the body and more to do with the fact that they have had the longest recovery.

Also, my body composition is somewhat improved.  I do not attribute this to any particular training effect, but instead I feel less compelled to overeat when I am not overtrained.  There may also be an element of decreased cortisol effect, but I believe it is mostly that I find it easier to refrain from eating when I am better recovered.

Here is my workout performed at Fike Gym at Clemson University (UE was booked, and I had to take my daughter there for an event).

Dumbell Overhead Press

Cable Lateral Raise

Cable Bent Fly (simple row)

Dumbell Shrugs

I did these in Henry W style with an initial set with heavy weight, then a breakdown set with a lighter weight.  Today I was quite sore, and the entire shoulder girdle appeared pumped.  Systemically I felt fine, but I do return to the ER on a Clemson Football weekend, so I will report back after my shift.

When I was at the Clarence Bass event a discussion ensued about poor responders and non-responders where I made an impassioned plea not to give up on such subjects, but instead to try implementing a different protocol with them that incorporates a prolonged recovery period between bouts.  I am beginning to suspect that poor responders may actually show a much more satisfactory response if we applied a recovery interval that is better suited to their genetics.  The study below indicates the very broad range of response to strength training varying from “amazing” to “zippo”.

Variability in muscle size and strength gain after unilateral resistance training.

Source

Department of Exercise Science, Totman Building, University of Massachusetts, Amherst, MA 01003, USA.

Abstract

PURPOSE:

This study assessed variability in muscle size and strength changes in a large cohort of men and women after a unilateral resistance training program in the elbow flexors. A secondary purpose was to assess sex differences in size and strength changes after training.

METHODS:

Five hundred eighty-five subjects (342 women, 243 men) were tested at one of eight study centers. Isometric (MVC) and dynamic strength (one-repetition maximum (1RM)) of the elbow flexor muscles of each arm and magnetic resonance imaging (MRI) of the biceps brachii (to determine cross-sectional area (CSA)) were assessed before and after 12 wk of progressive dynamic resistance training of the nondominant arm.

RESULTS:

Size changes ranged from -2 to +59% (-0.4 to +13.6 cm), 1RM strength gains ranged from 0 to +250% (0 to +10.2 kg), and MVC changes ranged from -32 to +149% (-15.9 to +52.6 kg). Coefficients of variation were 0.48 and 0.51 for changes in CSA (P = 0.44), 1.07 and 0.89 for changes in MVC (P < 0.01), and 0.55 and 0.59 for changes in CSA (P < 0.01) in men and women, respectively. Men experienced 2.5% greater gains for CSA (P < 0.01) compared with women. Despite greater absolute gains in men, relative increases in strength measures were greater in women versus men (P < 0.05).

CONCLUSION:

Men and women exhibit wide ranges of response to resistance training, with some subjects showing little to no gain, and others showing profound changes, increasing size by over 10 cm and doubling their strength. Men had only a slight advantage in relative size gains compared with women, whereas women outpaced men considerably in relative gains in strength.

The abstract does not include methods, so we do not know the specific volume and frequency used, but it is safe to assume it is something fairly typical (ie-80%1RM x 10 reps x 3 sets done 3 times per week).  I suggest that everyone re-read Chapter 8 of BBS and consider how the mix of various genes could play out to produce this wide ranges of response at a given point on the volume/intensity/frequency continuum and how the results might be quite different (or even reversed) at a different point on this continuum.  Also consider the impassioned opinions expressed in the discussions on this blog.  When through trial and error, and N=1 experiments, we finally find something that works well for us, there is a very strong tendency to want to share it with others and feel that we have found an answer that others are either too stubborn or too stupid to embrace.  The problem is, that unless they share the same genetic combination, your revelation could be their downfall.  What I think would be a very interesting experiment is for the different blog participants to group themselves according to their training preferences (Grant D vs Ondrej or Pete Collins vs Marc Pharmacist) and then analyze DNA for ciliary neurotrophic factor, IL-15, alpha-actinin-3, myosin light chain kinase, angiotensin converting enzyme etc.  I suspect that training preferences and DNA expression would match up quite impressively.

This brings up another thought.  Recently Marc innocently attributed the static neck protocol to me, when in fact it had been taught to me by Ken Hutchins and is part of RenEx protocol.  This got me to thinking.  I realized I have NEVER come up with any protocol whatsoever.  John Little has come up with several (max contraction, power factor training, omega sets, done-in-one, max pyramid and others).  Ken Hutchins refined slow cadence training into what is now RenEx.  Brian Johnston has come up with a myriad of protocols (Jreps, chaos training, triangular training and several others).  But I have not come up with ANY original protocol.  Thus BBS should not be thought of as a protocol.  John and I wrote the book to elucidate the scientific underpinnings that support high intensity training and the effectiveness of all of these protocols.  The Big 5 is thus not a protocol.  It is a starting point.  Once the reader has laid a foundation, they will start to get a sense of how it may not precisely fit them.  From there they can begin the journey of sliding up and down the volume/intensity/recovery continuum and finding what works best for them.  As the hone in on their N=1 ideal, they must keep in mind that it will not be their forever answer.  Your response to training changes your physiology and thus you will need to make adjustments on the continuum.  I am hopeful that one day genetic testing can be correlated with a location on the continuum to get trainees honed in that much more quickly.  In the meantime, it gives us all something to discuss and argue about.

As a final note, I want to plug Drew Baye’s new book PROJECT: KRATOS-Bodyweight High Intensity Training. The original goal Drew had in mind was “to provide a sane bodyweight training program as an alternative to a lot of the crazy “boot camp” bodyweight training crap out there, based on high intensity training principles and incorporating practical means of resistance progression without using weighted vests or belts or complex exercise progressions”.  I have only got to skim an advanced copy thus far, but I must say it appears to be a new classic.  You can order it at www.baye.com/store/project-kratos/.

Post your WOW’s and your thoughts.

In an attempt to adjust to erosion of my recovery ability by a protracted period of ER work, I have embarked upon a 5 way split that I will perform about once every 4th-5th day.  Thus, each muscle group will be encountered once every 20-25 days (minus some minor overlap).  I have done two of the five so far.  I am trying to keep the number of exercises to 4 or 5.  So far I have really liked the effect.  The most amazing thing is that I am seeing growth in the areas not yet trained, indicating that my time clock for recovery may be more extensive than I had been allowing for.

9/4- MedX Chest Press (seat 2, back 6, 4 holes, horizontal grips), TSC chest fly with yoga blocks, MedX Chest Press (seat 5, back 6, 4 holes, vertical grips, 40% original weight), SuperSlow Systems Neck Flexion.

9/9- SuperSlow Systems Pulldown, Nautilus Pullover with SS retrofits, MedX Compound Row with SS retrofits, SuperSlow Systems Neck Extension.

Planned workouts:  -Lateral raise, Rear Delt fly, Overhead Press, Shrug

-SuperSlow Systems Biceps, Pulldown, Nautilus Triceps Extension, Chest Press, EZ reverse Curl with Fat Gripz

-Calf Exercise, Lumbar Extension, Leg Press, Abdominal - Or at Fike: Leg Extension, Leg Curl, Squat, Abdominal

For those that asked, the RenEx rotating routines used with their competitive bodybuilders are as follows:

A: Calf, Leg Press, Pulldown, Chest Press

B: Bicep, Pulldown, Triceps, Chest Press, Compound Row, Pushup, Squat position Leg Press

C: Leg Curl, Leg Extension, Simple Row, Compound Row, Overhead Press

My idea behind my split routine mirrors Henry’s,  allow enough time for local muscular recovery within a frequency that does not result in decompensation.  Depending on the intensity of my work schedule, I can rotate between the 5 way split, the RenEx rotating routines and simple Big 3 type routines that others here are using.

Post your WOW’s and your thoughts

This past weekend I had the honor of being invited as a panelist for a conference to Honor Clarence Bass’s 75th birthday and the release of his new book Take Charge: Fitness at the Edge of Science. The format of the conference was to discuss in an academic fashion some of the scientific literature that underpins the content of Clarence’s book and his lifetime approach to physical fitness.  There were 3 separate panel discussions that began with a presentation of the pertinent scientific literature by a leading academic researcher from the field of exercise physiology.  After the presentation of the literature, panelists from the strength and conditioning community would provide commentary and personal insight.

The day began with a meet and greet along with a Continental breakfast.  I was excited, and despite my attempts to blow time on the walk from the hotel to the Stark Center (located in the North End Zone building at the University of Texas football stadium), I arrived early and well before anyone else.  When the elevator doors opened on the 5th floor, I was immediately greeted by a to-scale replica of the Farnesse Hercules.

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As I walked into the foyer, I saw an incredible variety of photos and items from the history of physical culture.  I slowly walked around the room taking in all the sights.  I was amazed at the collection.  Just as I got to the front of the foyer, I looked down what I thought was a hallway and found it was actually an opening to a museum that probably stretched 75 yards back.  On the walls were some amazing photos from the history of strength and conditioning.  As I stood gazing at these amazing photos the next attendee to show up walked up behind me.  It was Dr. Kevin Fontaine who was part of the research team at Johns Hopkins University that was studying the effects of strength exercise on patients with rheumatoid arthritis using RenEx equipment.  Kevin is now faculty at the University of Alabama at Birmingham in the Department of Public Health.  His research there is focused on the use of strength exercise in treating obesity.  They will also be incorporating RenEx equipment in their research, and they will be undergoing training on proper implementation of the equipment from the RenEx team in Cleveland.

Kevin and I toured the amazing photos and talked about how cool the “golden age” of muscle beach looked.  Kevin shared some great photos of his 16 year-old son Joshua who is in very muscular condition.  Kevin also showed an i-Phone video of his son deadlifting 500 pounds at a bodyweight of 142!  Doug Holland would be proud.  My own i-Phone was already running low on batteries, so I took some pictures of the best photos and items which I will share here.

Muscle beach bodybuilders 1947.

Muscle Beach. Santa Monica 1947

Training in a 1947 gym.  Barbells, dumbells and no benches, but great results.

1947 Gym. Barbells, dumbells, little to no benches.

Sigmund Klein's shot-filled barbell.

Sigmund Klein's shot-filled barbell

Pudgy Stockton on stage circa 1940's.

Pudgy Stockton on stage in the 1940's.

Muscle Beach.  Pudgy doing a back-bridge with two bodybuilders on top.

Muscle Beach. Pudgy Stockton back-bridge supporting two male bodybuilders.

Arnold and Sergio at the Duncan Y.

Arnold and Sergio chillin at the Duncan Y.

The first panel discussion was led by Dr. Ed Coyle professor of exercise physiology at the Univerity of Texas.  The topic of this discussion was the aerobic/strength alliance.  The emphasis of Dr. Coyle’s lecture was the most recent scientific literature that shows that the aerobic metabolic system can be very effectively conditioned through appropriate strength training and that the previous notion that only steady state activity could produce aerobic conditioning had finally been disproven.  He presented several papers referenced in Clarences book in support of the aerobic/strength alliance.  I, along with Kevin Fontaine provided commentary after Dr. Coyle’s presentation.  Since this notion was a major portion of what John and I laid out in BBS, this was very easy for me to comment on.  Most of my time was spent illustrating how mitochondria evolved from infecting proto-bacteria that fed of the waste products of single-celled anaerobic organisms.  These proto-bacteria actually became symbiotic with anaerobic cells and became incorporated as part of the cells metabolism.  This shows why the aerobic system is entirely dependent on the engagement of the anaerobic system whose end-product serves as substrate for the aerobic system.  Finally, I emphasized how these systems are not separate and distinct, but actually run concurrently.  This then shows how the cardiovascular system must serve all of metabolism, not just the aerobic portion.  Kevin Fontaine then followed up with his own insights from research conducted at Hopkins and UAB demonstrating benefits from strength training in both autoimmune patients and obese patients that were previously ascribed only to aerobics.

After the first panel discussion, the speakers and panelists were treated to Lunch at the University of Texas Club at the UT Stadium.  It was an incredibly luxurious venue with an amazing buffet.  I sat at a table with Kevin Fontaine, Dr. Waneen Spirduso of the University of Texas Kinesiology department, physique photographer Lazlo Bencze and his wife.  After a delicious lunch and wonderful conversation we headed back to the Stark Center for the remaining panel discussions.

The next panel disucssed “the rise of intervals” and was led by Dr. Joe Signorile of the University of Miami.  He is the chair of the department of exericse physiology and author of Bending the Aging Curve. He presented the literature from Clarence’s book that shows that aerobic conditioning can be obtained using a program of high intensity intervals and that the conditioning obtained meets or exceeds that obtained by steady state activity.  He again reiterated that the aerobic and anaerobic systems operated concurrently rather than separately and dichotomously.  The main point that he gave as a takeaway from his presentation was “There is no such thing as a time-dependent energy pathway”.   Commentators included Dean Brignac and Dan Keating.  Dean is a gym owner (Centurion Fitness) from Baton Rouge, Louisiana who is a lifetime fitness advocate who had always been a “fat but fit” guy until he stopped doing hours of weekly aerobics and began incorporating brief intervals and decreased his volume of weight training.  Now at age 50 he maintains single digit body fat and a 29 inch waste, where he previously weighed in the mid 200’s with a 37 inch waste.  Dan Keating is an attorney and long-time follower of Clarence’s who has also achieved amazing condition in his 50’s.  Dan, Along with Terry and Jan Todd, was instrumental in organizing the event.

The final panel topic was “Forget Heavy, Think Effort”.  The main presentation was made by Dr. Richard Winett of the University of Virginia.  He presented the scientific evidence that shows that it is not the weight or percentage of one rep max that is important in stimulating muscle gains but rather that a high degree of effort and meaningful fatigue were key.  He also discussed at length the importance of an internalized approach of seeking muscular fatigue, instead of the externalized approach of attacking the weights in an effort to lift more weight.  Commentators again included Kevin Fontaine who discussed the success of an internalized approach and timed static contraction as he applies it to himself, his wife and his study subjects at the University of Alabama.  The other commentator was Dave Goodin (AKA The Texas Shredder) who at age 54 is still a champion natural bodybuilder.  Dave was only a few weeks out from competition and was in amazing condition.  He discussed how his approach of internalization and use of more moderate weights with focus on form and fatigue has given him longevity as a still competitive bodybuilder.

The evening was capped off with a wonderful dinner set up in the lobby of the Stark Center with Jan and Terry Todd hosting and honoring Clarence.  Clarence gave a short and humble speech.  He was clearly moved by the event, and I believe he was close to tears at a few points.  Clarence is very reserved and self-depricating and his stoicism at such a moving time was impressive.   A keynote address was given by Dr. Waneen Spirduso who gave a stirring lecture on her area of interest:  how exercise extends human life and the quality of those years.  She thanked Clarence for being a shining example and providing a lifelong documentary of how exercise can extend extreme physical fitness well beyond what we previously thought.

This event was truly legendary.  I got to meet someone that I read and followed since I was a teenager.  I got to meet folks that I have corresponded with often, but had not yet met and I got to meet some legends of the iron game.  I got to meet some of the most renowned researchers in exercise science.  Thanks to Clarence and his wife Carole for allowing me to be part of their celebration.  Thanks to Jan and Terry Todd, along with Dan Keating for putting together an incredible conference.

As a final note (and to provide an insight into the type of person Clarence Bass is) let me tell you about an encounter I had with Clarence.  I was telling Clarence about how I was inspired by him as a teenager and would drive my mom nuts eating his “old reliable” recipe for breakfast and how I ate a peanut butter sandwich, apple and yogurt at lunch copying verbatim what I had read in the magazine articles and the original Ripped. Rather than being flattered that I had copied his diet verbatim, he asked me “why didn’t you personalize it or do something to make it your own?”.  THIS is the kind of guy Clarence Bass is.  He does not think he has all the answers.  He is happy to inspire you and provide you guidelines or a framework, but above all, he wants you to find a way that works for you.  That is the mark of a true mentor and a true champion.  I will close with some photos of the great folks I met at the Take Charge event.

I finally got to meet Clarence after following him since 1981.

I finally got to meet Clarence after following him since 1980

Doug McGuff and Dean Brignac, owner of Centurion Fitness in Baton Rouge.

Meeting Dean Brignac, owner of Centurion Fitness in Baton Rouge

Dean Brignac and the Texas Shredder, Dave Goodin.

Dean Brignac and the Texas Shredder Dave Goodin

Dave Goodin and Doug McGuff.  Jan Todd is in the background.

Meeting the Texas Shredder. Jan Todd is in the background.

Thanks to everyone for a great weekend.  Post your WOW’s and your thoughts.

Today I did the legs, lumbar and neck portion of my 3-way split routine.  Frequency lately has been around every 5th day.  Wendy is on her off week this week, but I will post her WOW from last week.

Wendy WOW:  lateral raise (as pre-exhaust for), MedX overhead Press, SS Systems Pulldown, TSC chest fly (as pre-exhaust for), MedX Chest Press, TSC hip abduction (as pre-exhaust for), MedX Leg Press

Doug WOW: Calf Exercise on MedX Leg Press, Lumbar Extension on SS Systems Pulldown (as pre-exhaust for), MedX Leg Press, Neck Flex/Ext on SS Systems Neck.

On the last WOW, Craig posted about the loss of satellite cells in muscle tissue as one ages and what measures could be taken to prevent it.  Satellite cells are stem cells that lay in reserve for when muscle repair or growth requires them to be activated whereupon they turn into mature muscle cells.  Lacking satellite cells would compromise one’s ability to generate new muscle growth, or fight impending sarcopenia.  It turns out that training itself is a major force for the production of new satellite cells and their subsequent activation.  A fairly recent article explored the use of vascular occlusion with low loads but with sets that culminated in fatigue.  The resultant generation of new satellite cells and myofibrillar hypertrophy was impressive.  As with most studies, its use of untrained 21 year-olds for 8 weeks of training has its limitations, but it is still quite encouraging.  Training with vascular occlusion is something I have tried in the past with a good effect.  This experiment was limited to my arms, because of the ease of achieving vascular occlusion.  Many in the literature have theorized that slow cadence training may produce similar effects of vascular occlusion and increased intracellular acidosis.  The good news is that there are several articles in the references that show preservation and regeneration of satellite cells with standard high intensity protocols without vascular occlusion, but this article’s results with vascular occlusion are intriguing.  See the linked full text article below.

The second article touches somewhat on the last WOW where we showed how skeletal muscle and adipose tissue existed in competition and in opposition to each other.  This full text article goes into great detail discussing the pro-inflammatory cytokines that are generated by adipose tissue and how they contribute to diseases of modern civilization.  It then discusses the various myokines (muscle generated cytokines) that are anti-inflammatory in nature and work in direct opposition to the inflammatory cytokines of adipose tissue.  As you become familiar with the actions of myokines, you can begin to see how muscle tissue obtained via hard exercise works to prevent cancer, the metabolic syndrome, and dementia.  One of the major actions of myokines (interleukin 15 in particular) is the down-regulation of myostatin and a resultant increase in myogenic stem cells (AKA satellite cells).

This article does not make any differentiation about any given protocol with regard to these positive adaptions that myokines generate.  I think this would be a fertile area of new study.   Various protocols could be tested with an attempt to quantitate the level of myokine response generated by one protocol versus another.  Perhaps the researchers at Johns Hopkins and the University of Alabama at Birmingham who are exploring RenEx might be able to include some quantification of myokine response.  This would be particularly interesting with the group at Hopkins who is applying the protocol to patients with Rheumatoid Arthritis (a condition very strongly linked to inflammatory cytokines).

Take a look at these articles.  Post your WOW’s and your thoughts.

www.ncbi.nlm.nih.gov/pmc/articles/PMC3473290

www.ncbi.nlm.nib.gov/pmc/articles/PMC2836182

I did the following WOW before heading into work.  I am still on a 3-way split because of a hectic work schedule.  This was the shoulders/arms portion.  Wendy was due to workout this week, but because I was working the entire holiday weekend she and a friend took the kids to the mountains.  Unlike me, she has little angst about missing a workout and will probably just pick it up again next week.

MedX Overhead Press, TSC simple row, Thick Bar Biceps Curl, Nautilus Plateload Triceps Extension, Thick Bar Wrist Flex/Extension

I have been scanning the literature lately and a new buzzword that is cropping up is “Sarcopenic Obesity”. The term is used to describe the loss of muscle mass and the creeping obesity that can occur as one ages.  Reading the literature on this topic is quite interesting.  The first thing that really stands out is that both muscle and adipose tissue are very active endocrine tissues.  The second thing that stands out is that these endocrine actions are almost in direct opposition to each other.  Arthur Devany has made the case that the tissues of the body (especially fat and muscle) are like competing colonies, working in competition for energy resources, rather than in a cooperative or auto-regulatory fashion as previously thought.  It seems that the science is proving him correct.

I am providing a link to a full text review article on sarcopenic obesity below.  An interesting exercise is to get out a pencil and a scratch pad and write all of the mediators and their effects in separate columns labeled “muscle” and “fat”.  This will make very clear to you the competing relationship between these two tissues.  Age seems to dictate which tissue has the competitive advantage.  When you are young, muscle has the competitive advantage over adipose tissue and the advantage slowly shifts toward fat as the years go by.  Unless…you take measures to make sure this doesn’t happen.

While it is certainly not stated explicitly in the article, I think this lends credence to observations that I have had with clients over the years.  If you begin paying attention to diet and exercise (particularly strength exercise) in your youth, you seem to front-load muscle’s competitive advantage such that, as long as you keep it up as you get older, the competitive advantage never shifts to adipose tissue.  It is probably no coincidence that Art Devany, and Clarence Bass began their serious training around age 15 and never let up.  For those that never exercise or stop in early adulthood, the competitive advantage can still be turned toward muscle, but it is definitely a more intense battle.  We all obviously have strong opinions about the best methods to accomplish this, but the most important thing is that people perform strength exercise.

Another thing that is suggested by this article is that the common notion that it is impossible to lose fat and gain muscle simultaneously is not necessarily correct.  If and when this occurs (losing muscle with fat), it is probably an indication that the person in question has let themselves get too fat and let the competitive advantage tip towards adipose tissue.  The idea of bulking up and dieting down probably works only to a certain point, but then can backfire if you go too far.  Arthur Jones and Ellington Darden both recommended getting lean first, and then attempting to add muscle.  This was precisely the advice that Arthur Jones gave Clarence Bass that launched Clarence’s approach to diet and training.  I suspect that if you are vigilant, and never allow yourself to gain too much adipose tissue, that you can actually experience an increase in muscle mass when you tighten your diet in an attempt to get leaner.

As a final note, I am planning to change the format of my posting for a while.  Rather than posting every time I do a WOW, I will try to limit my posting to times when I have come across a substantive article or topic.  I am hopeful that discussions will be confined to the topic posted and not deteriorate.  If things do deteriorate, I may consider continuing in this format, but with comments turned off, or, if it is not too labor-intensive, blocking those who resort to ad-hominem, profane or juvenile tactics.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3639625/

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