Be Careful What You Ask For: Q&A with Paul

Be Careful What you ask for...

Most questions I get come in through email or text, which is great for ensuring the specificity of my answer, but it also means all other readers miss out on the information. So, today will be the first post in my Careful What You Ask For series.

Question:

“What are the safety considerations for performing squats? Specifically, what application does the squat have for runners? And what concerns exist for individuals with arthritis?”

Answer:

Wow – applications and concerns for the squat, known as “the king of all movements!” This could be a pretty involved topic but I’ll do my best to stay on point.  

First off, let’s cover the basics:

The human body is meant to squat.

baby-squat

As soon as we can stand on two legs, we frequently sit in a deep squat position. Whenever we sit down and stand up from a chair, we are squatting. The legs and hips are some of the biggest and strongest muscles in the body not only to carry us long distances, but to offer a safe and powerful base for when we come to a rest and lower into a seated position.

However, like any other movement, the squat can be risky if performed incorrectly.

So, the best place to start is with proper “squat mechanics”

squat

  1. Stand with feet shoulder width apart, toes turned slightly out, weight evenly distributed through the ball of your feet, the pinky toe, and the heel.
  2. Reach hands out in front for counterbalance and push your hips / butt back, keeping your lower back arched in, and shoulders / chest up.
  3. As hips are lowering behind you, actively push knees out to the sides. Keeping the knees wide, and preventing them from caving in, will reduce any load on the knee and ACL.
  4. Keep sitting back and down, almost between your legs, until you reach depth. This is dependent upon specific hip structure, mobility, and experience. Stop descending if your lower back loses its arch and starts to round, if you start to tip / lose your balance, or if any part of your foot leaves the ground.
  5. The squat back up should be identical – knees wide, back arched, chest high and wide – until you are standing up straight, squeezing the butt and keeping the knees “soft” (not forcibly pushing the knees back, creating hyperextension a the knee joint).

A common training wheel of sorts would be to elevate the heels about 1 inch. This will allow you to sit deeper down, without feeling like you’re going to tip over or the extending the knees too far forward.

Next, let’s look at the specific application for runners.


Running is a sport that involves the body moving in one direction, often for many miles, with a great deal of impact. This will develop some muscles while leaving others completely passive and underdeveloped. The most concerning would be the glutes and the hamstrings.

Four-Steps-to-Good-Running-FormAny exercise moving the knee and leg away from the midline of the body will target the glutes and hips…but the squat may be the most effective option because it requires balance and postural awareness, while also engaging the rest of the muscles throughout the body.

My recommendation for a runner would be to become proficient in a bodyweight squat. Once 2 or 3 sets of 20 repetitions can be completed without breaking a sweat, add an elastic band around the knees, hold a dumbbell in front of the chest, or place a bar on the shoulders.

Progressing to barbell squats or a single-leg version would be a perfect goal for runners! If you want to run 26.2 miles without injury, it’s a good idea to first develop the balance, strength, and endurance to perform 20 squats on one leg.  

Remember my favorite quote from Tim Gould, Doctor of Physical Therapy: “Train to run, don’t run to train.”

And finally, does the presence of arthritis contraindicate squats?

Just to clarify, the form of arthritis determines the risks.

Degenerative arthritis is caused by a breaking down of the “padding” between bones. Rheumatoid arthritis is an autoimmune condition where, simply put, offending foods have broken through the stomach lining and are wreaking havoc elsewhere in the body.

I’m going to assume we’re talking about degenerative arthritis since this is affected by activity and movement.

As always, you should consult your doctor first. No matter how cautious and properly a movement is performed, if your body doesn’t have enough cartilage to protect bones from grinding against one another, pain and further deterioration can occur.

Let’s assume that you can load and bend your knee without any pain. If so, performing a controlled squat may actually strengthen the muscles around the joints!

I have had quite a few clients with arthritis, and we usually make the following modifications:

  1. Progress slower, only adding 2 repetitions per set every week.  
  2. Don’t hold any one position too long. Normally, doing a pause squat, where you sit Squat-2and stay tight in the bottom for a count, improves mobility and strength. But the longer you “hang out” in one position, the more likely your muscles will get tired, transferring the load to the bones and joints.
  3. Allow for more recovery and emphasize diet. Degenerative arthritis cannot be cured through diet like rheumatoid, but consuming enough vitamin D & K, magnesium, iron, and collagen (found in gelatin), can help improve bone health.
  4. And finally, never allow one bad repetition! If your knee joint is lacking its natural cushion, we don’t want even a millisecond to be spent in a suboptimal position.

In summary, the inclusion of properly executed squats can help improve running performance, as well as prevent injuries. Squats can also build the strength and stability of soft-tissues around the joints and improve bone density, thereby benefiting those with arthritis.

How you structure your squat training is up to you – some like to heavy barbell squats once a week, while others prefer to complete 20 repetitions of bodyweight squats at random on a daily basis.

If you need any hands-on guidance learning how to squat or developing a safe and effective program, just let me know!

1095892287454413090816

Eat Protein and Plants!

As most of you know by now, I recommend consuming 1 gram of protein per pound of bodyweight. This means that a 100-pound girl running track should eat 100 grams of protein; a 200-pound strength athlete should consume 200 grams of protein; and a 300-pound adult trying to lose weight should aim for 300 grams of protein.

The reasons for this recommendation are as follows.

  • Protein has the highest thermogenic effect. 30% of the calories from protein are used during digestion and processing.
  • Protein is the most satiating nutrient, leaving one full for 4 – 9 hours.
  • Protein breaks down to amino acids. These are not only used for cell repair and maintenance, but also trigger the release of serotonin, dopamine, melatonin, etc, in the brain. These are chemicals that affect moods, energy levels, and feelings.
  • Excess protein will either be converted to sugars, to be used for fuel, or excreted in the urine.

A reservation people have to eating more protein is that it is “dangerous for the kidneys”. Studies of individuals with renal impairment, or complete kidney failure, show a worsening of symptoms when administering a high protein diet. However, no study has ever suggested that a healthy population can’t handle high amounts of protein. Processing excess nutrients is the main role of our kidneys.

Recent studies have gone as far as feeding participants up to 400 or 500 grams of protein a day. The worst side effects reported were feelings of being “bloated” or “hot”. As a side note, these individuals gained no fat, even though they were consuming over 1000 extra calories a day from protein.

The other concerns I hear stem from certain studies suggesting that protein, specifically meat, causes cancer. Next time you hear this, look at the study to verify the following:

  • Was the meat naturally raised? Was beef from 100% grass-fed cows? Were chickens raised in open pastures, feeding on seeds and bugs? More likely, the beef was from feedlots and the chickens were fattened to the point they could not stand.
  • What were the cooking conditions? Was the meat slow roasted or seared? We already know that black, crunchy sear-marks are carcinogenic.
  • Who were the individuals in the study and how were they tracked? The average American that consumes over a pound of protein a day is usually resorting to McDonald’s and pepperoni pizza, not chicken eggs from a friends backyard or a local burger with multiple cups of fresh vegetables.

Protein does cause an insulin release and increases mTOR signaling, leading to cell survival and proliferation. This is a good thing if you are exercising and attempting to displace fat with lean body mass. However, if you already have cancer, a lower protein diet, such as a ketogenic diet, will be more suitable.

A review of all macronutrient studies shows that diets higher in fat and protein, compared to high carb diets, result in:

  • Maintenance of more lean muscle mass
  • Greater loss of fat mass
  • Maintenance, or even an increase, in strength and performance

The only downside of protein is that healthy sources may not be inexpensive.

In areas with sustainable farming (such as where I live in Vermont), you can buy directly from a farmer. You may even be able to invest in a “cow-share” or similar program, paying for the cow before the government charges various fees. I have found grass-fed ground beef for as low as $3/lb. Search around and develop a relationship with local farmers.

Grass-fed beef, or pastured chicken and pork, may cost $5 – $10 a pound in typical markets. However, sales always occur, and meat can last for up to 12 months in a freezer before it loses flavor. Investing in a meat-freezer can help save money in the long run.

Another option is to find a high-quality protein supplement. I always recommend whole food from nature, but I am aware that having a full serving of protein (4 – 8 ounces of meat/fish, or 3 – 6 eggs) is not always easy and convenient.

In these situations, find a whey protein powder that is affordable and has as few ingredients as possible. I will do a post in the future comparing different forms of protein powders and brands.

In my experience, a client consuming 1 gram of protein per pound of bodyweight, is able to experience easy improvement in body composition and performance.

Ideally, every meal should have a large serving of protein, about the size of your hand, surrounded by vegetables, cooked in healthy fats, with a serving of berries or fruit as desert. And if you’re still hungry, have seconds of the veggies and protein. Don’t wait an hour or two and resort to crackers, cookies, or other packaged goods.

Just eat more protein and plants!

Steak and Veggies

Improve Your Hormone Levels

As I promised a few weeks ago, I’ll provide some simple steps you can take to improve your hormone levels.

Just to reiterate, your hormone levels dictate a large part of your health, performance, and body composition.

For the actual details about healthy hormone levels and effects, please refer to my post about testosterone.

Without further ado, here are the safest and most effective tactics to manage healthy hormone levels:

• Make sure you are consuming a nutrient rich diet.
Any nutrient deficiency has the potential to negatively impact hormones, but the biggest culprits will be zinc, vitamin A, vitamin D, and magnesium. I’ll do a post explaining which foods have the most nutrient value later on but, for now, I’ll just recommend oysters, liver (if you can stand the flavor and have a high-quality source), avocados, eggs (particularly the yolk), and plenty of naturally-raised, well-treated meats, full of the fats and proteins your body needs to manufacture testosterone.

• Consume dietary cholesterol on a regular basis.
The best sources are eggs, shrimp, and fattier cuts of beef (grass-fed of course!). Cholesterol is a precursor to testosterone production. Keep in mind, the cholesterol you eat will only raise your HDL a little and have hardly any effect on triglycerides (the “bad” cholesterol in the blood).

• Avoid over-consuming carbohydrates.
Starches and sugars will cause insulin spikes in the blood. Your muscles can only store so many carbs before the insulin forces carbs to be stored in fat cells. This insulin will also disrupt normal hormone signaling.

• Get 8-9 hours of sleep a night.
During the first few hours of sleep, your body will release the largest amount of human growth hormone, allowing your body to recover from the day. I know everyone says they can get by with 6 hours…but your body composition, mental performance, and energy levels will always be better with a proper 8 hours of sleep.

• Lift something heavy a few times a week.
This will stimulate the body to produce testosterone to recover from the stimulus. Again, keep in mind that heavy lifting isn’t what produces bulky muscles…that would be higher repetitions (8-15) for multiple sets (3-4) with very little rest (30-90 seconds).

• Do some high intensity interval training.
Refer to my post from a few weeks ago. This has the potential of benefiting hormones more than any other exercise.

• Avoid alcohol.
Or at least try to moderate your intake. Alcohol will convert testosterone to estrogen within the body.

• Avoid stress.
This might be the most difficult but cortisol, released when you’re stressed, will lower testosterone levels. Some of the easiest things you can do are to limit your caffeine intake and take time during the day to stare off into nature or distract yourself from the stresses of our modern lives.

One final method for increasing testosterone levels is to supplement directly with hormones (a.k.a. steroids). However, this is a much more controversial and potentially unsafe method that I’ll save for another post.

Give all these things a try and see if you notice an improvement in body composition, strength, recovery, or just general mood and energy on a daily basis!

How To Improve Your Cholesterol Levels

As promised, this week I’ll give you a few easy tips to improve your cholesterol levels. Before I start though, I want to remind everyone that “improving” cholesterol levels does not necessarily mean lowering them.

If you remember my post about cholesterol, you’ll remember that the body creates and uses LDL as a temporary bandage that, once the threat to the body is resolved, HDL will transport back to the liver to be excreted. It is only when inflammation persists in the body that LDL becomes oxidized, hardening and risking blockages in the arteries.

In fact, low total cholesterol levels in the body have been linked to shorter lifespan! Therefore, for this post, we’ll talk about how to adjust your cholesterol levels to the optimal zone…as opposed to the range statin companies usually promote.

First off, the easiest number to alter is your HDL. This is what carries cholesterol back to the liver after it has served its purpose.

The best way to boost your HDL is to consume more monounsaturated fats, such as olive oil and avocado. Consuming these in a raw form, as opposed to cooking them, will be more beneficial. Also, conjugated linoleic acid (CLA) found almost exclusively in grass-fed beef and dairy, will help raise HDL.

In addition, weight training and moderate aerobic activity are shown to increase HDL.

Now, on to LDL. To reiterate, high LDL is not necessarily a bad or dangerous thing. However, LDL can become oxidized in the blood so I understand why people may want to lower their LDL numbers.

To lower LDL, be careful when consuming other saturated fats. Saturated fat is actually the safest to consume, and most stable source of energy for the body, but make sure you’re consuming it from natural sources. This would include coconut products (again, with minimal processing), grass-fed beef, and other humanely raised animals fed a natural diet, with plenty of space to roam and forage.

Exercise may also help control LDL levels since low-level aerobics will improve the body’s ability to metabolize fats for energy.

Finally, the only truly problematic form of cholesterol found in the body is triglycerides. Anytime you see claims that cholesterol in the blood is dangerous, I will guarantee the samples were people with extremely elevated levels of triglycerides and low HDL.

The best way to decrease your triglyceride count would be to avoid processed or heated polyunsaturated fats which are highly unstable and prone to oxidization.

I’m not saying to fear nuts and seeds and every food containing high amounts of omega-6 (the primary inflammatory constituent of poly-fats). Just avoid foods that are high in this AND have been processed or altered. Examples of foods to avoid would be corn oil, soybean oil, and other vegetable oils.

Finally, limit your sugar and refined carb intake. Again, no need to fear fruits, sweet potatoes or other whole foods; instead, skip the center aisles of the market made up of processed and packaged food.

Please keep in mind that all my suggestions of what to eat more or less of are based on the assumption that we already know things like candy, chips, ice cream, and soda are unhealthy. Fortunately, our health and nutrition systems have not yet become so infiltrated by major corporations that McDonalds and pizza is labeled as healthy.

Nonetheless, as exemplified by my own past food choices, there is still a great deal of confusion regarding what is optimal for our bodies. Just last month Mazola ran a massive marketing campaign (and must have spent billions of dollars) to convince researchers and doctors to claim that corn oil is “safer for the heart” than extra virgin olive oil!

And with that, we should all have a decent level of knowledge regarding what to consume and not consume to maintain the most beneficial cholesterol levels in our bodies.

Hope it helps!