Monday, December 8, 2008
Recommended Reading on the Topic of Nutrition
I have recently crossed paths with a book I feel is worth mentioning. The book is “Dr. Abravanel's Body Type Diet and Lifetime Nutrition Plan” by Elliot Abravanel. After reading and implementing Dr. Abravanel's ideas I was quite impressed with the effects of my dietary changes. Personally I was experimenting with the books suggestions in an effort to help control my depression. The book is primarily aimed at those interested in weight loss and after a week I noticed the last little bit of body fat that I usually have starting to disappear. This is the first book I would feel comfortable recommending as a realistic and effective means for someone interested in modifying their dietary habits in order to loose weight. The strength of Dr. Abravanel's dietary suggestions is that they are straight forward modifications to how most people already eat. The guidelines set down in the book are meant to work with the physiology of a particular body type so that the individual gains the benefits of that diet no matter what their goals. If weight loss is not the goal then the person can simply modify their caloric intake to meet their training needs. I also must admit that I am pleasantly surprised with how effective the dietary suggestions have been in helping to stabilize my moods.
Tuesday, July 15, 2008
The Improvement Mindset
The process of optimizing a biological system is an on going experiment. Most people become stagnant with respect to their climbing. This seems to be most true of people that have been in the sport for five years or more. Those who persevere typically do see gradual improvement but are usually plagued by nagging injuries and periodic set backs due to a recurring injury. This stagnation occurs because your rate of improvement as a climber will begin to plateau as your climbing performance reaches your genetic baseline. If you want to continue on toward your genetic potential an intentional effort is required and your participation in climbing changes. You now become not only the climber you also take on the role of scientist in an ongoing experiment of considerable complexity. In addition to these two roles you must also wear the hat of coach, sport psychologist, physician, dietitian, physical therapist…etc. Eventually, anyone who is interested in becoming better at a skill will come to the point where natural ability, genetics or whatever term you prefer has taken you as far along the path as it can.
When you’ve reached this crossroad along your climbing journey you have a choice to make. If you want to become better at climbing you must consciously choose to continue down the path of improvement. You must decide if improving your climbing performance is a primary concern because now you will have to work for further gains in the sport. Climbing is no longer climbing, it is a research project and you must embrace this change. You must adapt your perspective to accommodate for this paradigm shift or you will become exceedingly frustrated with climbing and rapidly head toward overtraining and burn out. Climbing more difficult problems becomes a secondary pursuit to the primary question, how do I improve? Becoming a better climber is the catalyst of the reaction but it is the individual reagents that are of interest to the scientist. The perspective of the scientist and that of the climber will clash. You have to be able to switch between them. You need the analytical objectivity of the scientist to see the options before you and make the correct choices to get you where you want to go, i.e. your climbing goals. At the same time you need the passion of the athlete, the single minded drive to push as hard as you possibly can with no thought of saving the reserves.
I mention these roles simply to suggest the complexity of what it takes to get better at climbing. Each of the roles mentioned play their own part in keeping the climber injury free, recovering properly, training their weaknesses…etc.
However, the two perspectives that are central to the improvement mindset are within the role of climber itself. The two perspectives that the climber must now develop are those of the student and of the warrior. I have chosen to draw on the tradition of martial arts in hopes that it will aid me in my explanation of these two roles. The philosophy of many martial arts includes the concept of beginners mind. The idea is that a person just beginning their journey to perfection in a discipline has no knowledge of the subject and therefore no preconceived ideas of what is right or wrong or even what is possible. It is only through your practice that you learn your limitations in the subject you have chosen to study. With continued practice and study of the subject you become more and more proficient, you learn where your weaknesses are and progressively over come them. Eventually you reach a point where you have studied and practiced so much that you then strive to take your thinking mind out of the action and simply let the performance happen. The expert marital arts warrior is said to have a beginner’s mind. There is no conscious problem solving going on during the confrontation. The mind perceives the information of the senses and acts accordingly to create the perfect performance for the situation. The perfect climbing performance therefore involves no active thought it is as though you are a spectator. More accurately you are a passenger, you see, hear, and feel what is happening, however, all of this information is processed and responded to without your having to think about the incoming information, formulate the best plan of action and then execute that plan. This head space or mind state of beginners mind is what you strive to attain.
In sports psychology the beginners mind has been labeled “the zone” or a “flow state”. In order to get to the point where you are able to experience this flow state you must practice and study until you have an intuitive understanding of the skill you’re trying to become better at. Until you have some degree of proficiency at a given skill you will have neither the physical ability nor the insight to apply it during a climb. In scientific research it is a well established trend that flow states occur most readily when the climber’s skills most closely match the demands of the problem. So, in order to achieve flow states on increasingly difficult climbs the climber must improve their base level climbing proficiency. This base level ability is comprised of all the skills necessary to climb well, foot work, general fitness, strength, endurance, proprioception, coordination and so forth. This is where the mindset of the student is critical. Any time you are trying to learn a skill you are actively engaged in trying to understand what is going on in the skill.
The critical component to the student mindset is one of intention. The student’s primary objective is not to perform the skill well. The student removes the skill from the overall climbing performance for closer inspection. The student focuses on one single skill or one aspect of a skill and then practices that single portion with the goal of learning all of its nuances. Even after you have a working idea of the mechanical process of the skill you must still practice it over and over until the physical act becomes hard wired. Take for example two climbers working on a crux that involves very precise foot work. The difference between the student and someone who just wants to send is that the climber wanting to send simply keeps trying the problem over and over until they finally link it. The student, however, looks critically at the crux to determine why they are not successful at doing the problem. Realizing that the reason they keep failing on the crux is due to their foot popping off a tiny foot hold that has to be pivoted on in order to make a drop knee work. The student now has a very specific goal to accomplish and so sets about playing with just the drop knee move, doing it again and again with the intention of understanding/learning/feeling everything going on during that single move. An extreme example of this intentional focus might manifest in a climber working only drop knees. They might spend ten minutes to a half an hour or an entire session simply focusing on pivoting on their feet and doing nothing but drop knee moves. The student’s motivation is to learn and wire individual skills rather than sending routes or problems. The objective is to be able to execute a skill flawlessly every time. In motor learning research there is a generally accepted theory that a movement pattern needs to be repeated at least ten thousand times before the performer is considered to be an expert at that pattern.
“Take infinite pains to make something that looks effortless.” –M
The second perspective that the athlete must cultivate is that of the warrior. In essence the warrior is all about the struggle. This is the part of you that can honestly say, “I love slab climbing” or “there’s nothing more satisfying than linking together a run out section of really technical climbing”. The perspective of the warrior is one of thriving in the unknown, the joy of confidently pushing outside your comfort zone.
The warrior is concerned with those aspects of climbing which revolve around the mental and emotional states that effect performance. In practical terms this is where you learn to lie to yourself, compartmentalize your emotions or to develop the ability to be so intently focused on the climbing before you that even your thoughts and emotions become only a vague awareness which is eclipsed by your absolute involvement in the performance. This aspect of your climbing is just as important as the meticulous attention of the student. By venturing to the edge of your comfort zone you learn new boundaries and so become more relaxed climbing closer to those boundaries, which translates to an overall better performance. This expansion of your comfort zone is exactly how you dispel the anxiety associated with climbs near your current ability limit and make it that much easier for you to experience a flow state while climbing these routes.
This mental exploration is a probing into the esoteric side of climbing. Unfortunately this is the least clear and consequently the most difficult aspect of climbing to learn. In order to even understand the obstacles before you each climber will have to take an objective look at themselves. Often this stark scrutiny of your motivations, fears and weaknesses in order to obtain a realistic idea of where you are as a climber is the worst part of the process. This is where each person must own up to who they are as a climber and accept both the positive and negative within themselves. These obstacles that the warrior must overcome are more often than not the common short comings of the human psyche. If a climber is truly interested in perfecting themselves egoism, competitiveness, fear in all it’s manifestations, self doubt and all the myriad emotions that allow us to get in our own way have no place in the mind of the warrior. If a climber is able to make this step with a measure of honesty they will then have made a monstrous leap towards improving their climbing. Once you know what your weaknesses are you can then set about changing these habits.
Since before recorded history there have been innumerable practices developed to better integrate the functioning of mind and body. At the core of the warrior is an unwavering belief in self. The warrior strives for this perfection of self by attempting to be constantly vigilant of their mind and rid it of those petty emotional self indulgences that hinder them from achieving their goals. Irrespective of which practice(s) you choose the warrior has but a single goal, self awareness, everything else stems from this beginning.
The warrior mindset could just as easily be termed the yogi or philosopher mindset. However, the concept of the warrior concisely embodies the seamless integration of the intellectual and the physical. The warrior tradition is one rich in using the mind to focus intention in the pursuit of perfecting physical performance in emotionally charged situations.
There are many paths to the summit and climbing is only one of them.
Brent Apgar DC
When you’ve reached this crossroad along your climbing journey you have a choice to make. If you want to become better at climbing you must consciously choose to continue down the path of improvement. You must decide if improving your climbing performance is a primary concern because now you will have to work for further gains in the sport. Climbing is no longer climbing, it is a research project and you must embrace this change. You must adapt your perspective to accommodate for this paradigm shift or you will become exceedingly frustrated with climbing and rapidly head toward overtraining and burn out. Climbing more difficult problems becomes a secondary pursuit to the primary question, how do I improve? Becoming a better climber is the catalyst of the reaction but it is the individual reagents that are of interest to the scientist. The perspective of the scientist and that of the climber will clash. You have to be able to switch between them. You need the analytical objectivity of the scientist to see the options before you and make the correct choices to get you where you want to go, i.e. your climbing goals. At the same time you need the passion of the athlete, the single minded drive to push as hard as you possibly can with no thought of saving the reserves.
I mention these roles simply to suggest the complexity of what it takes to get better at climbing. Each of the roles mentioned play their own part in keeping the climber injury free, recovering properly, training their weaknesses…etc.
However, the two perspectives that are central to the improvement mindset are within the role of climber itself. The two perspectives that the climber must now develop are those of the student and of the warrior. I have chosen to draw on the tradition of martial arts in hopes that it will aid me in my explanation of these two roles. The philosophy of many martial arts includes the concept of beginners mind. The idea is that a person just beginning their journey to perfection in a discipline has no knowledge of the subject and therefore no preconceived ideas of what is right or wrong or even what is possible. It is only through your practice that you learn your limitations in the subject you have chosen to study. With continued practice and study of the subject you become more and more proficient, you learn where your weaknesses are and progressively over come them. Eventually you reach a point where you have studied and practiced so much that you then strive to take your thinking mind out of the action and simply let the performance happen. The expert marital arts warrior is said to have a beginner’s mind. There is no conscious problem solving going on during the confrontation. The mind perceives the information of the senses and acts accordingly to create the perfect performance for the situation. The perfect climbing performance therefore involves no active thought it is as though you are a spectator. More accurately you are a passenger, you see, hear, and feel what is happening, however, all of this information is processed and responded to without your having to think about the incoming information, formulate the best plan of action and then execute that plan. This head space or mind state of beginners mind is what you strive to attain.
In sports psychology the beginners mind has been labeled “the zone” or a “flow state”. In order to get to the point where you are able to experience this flow state you must practice and study until you have an intuitive understanding of the skill you’re trying to become better at. Until you have some degree of proficiency at a given skill you will have neither the physical ability nor the insight to apply it during a climb. In scientific research it is a well established trend that flow states occur most readily when the climber’s skills most closely match the demands of the problem. So, in order to achieve flow states on increasingly difficult climbs the climber must improve their base level climbing proficiency. This base level ability is comprised of all the skills necessary to climb well, foot work, general fitness, strength, endurance, proprioception, coordination and so forth. This is where the mindset of the student is critical. Any time you are trying to learn a skill you are actively engaged in trying to understand what is going on in the skill.
The critical component to the student mindset is one of intention. The student’s primary objective is not to perform the skill well. The student removes the skill from the overall climbing performance for closer inspection. The student focuses on one single skill or one aspect of a skill and then practices that single portion with the goal of learning all of its nuances. Even after you have a working idea of the mechanical process of the skill you must still practice it over and over until the physical act becomes hard wired. Take for example two climbers working on a crux that involves very precise foot work. The difference between the student and someone who just wants to send is that the climber wanting to send simply keeps trying the problem over and over until they finally link it. The student, however, looks critically at the crux to determine why they are not successful at doing the problem. Realizing that the reason they keep failing on the crux is due to their foot popping off a tiny foot hold that has to be pivoted on in order to make a drop knee work. The student now has a very specific goal to accomplish and so sets about playing with just the drop knee move, doing it again and again with the intention of understanding/learning/feeling everything going on during that single move. An extreme example of this intentional focus might manifest in a climber working only drop knees. They might spend ten minutes to a half an hour or an entire session simply focusing on pivoting on their feet and doing nothing but drop knee moves. The student’s motivation is to learn and wire individual skills rather than sending routes or problems. The objective is to be able to execute a skill flawlessly every time. In motor learning research there is a generally accepted theory that a movement pattern needs to be repeated at least ten thousand times before the performer is considered to be an expert at that pattern.
“Take infinite pains to make something that looks effortless.” –M
The second perspective that the athlete must cultivate is that of the warrior. In essence the warrior is all about the struggle. This is the part of you that can honestly say, “I love slab climbing” or “there’s nothing more satisfying than linking together a run out section of really technical climbing”. The perspective of the warrior is one of thriving in the unknown, the joy of confidently pushing outside your comfort zone.
The warrior is concerned with those aspects of climbing which revolve around the mental and emotional states that effect performance. In practical terms this is where you learn to lie to yourself, compartmentalize your emotions or to develop the ability to be so intently focused on the climbing before you that even your thoughts and emotions become only a vague awareness which is eclipsed by your absolute involvement in the performance. This aspect of your climbing is just as important as the meticulous attention of the student. By venturing to the edge of your comfort zone you learn new boundaries and so become more relaxed climbing closer to those boundaries, which translates to an overall better performance. This expansion of your comfort zone is exactly how you dispel the anxiety associated with climbs near your current ability limit and make it that much easier for you to experience a flow state while climbing these routes.
This mental exploration is a probing into the esoteric side of climbing. Unfortunately this is the least clear and consequently the most difficult aspect of climbing to learn. In order to even understand the obstacles before you each climber will have to take an objective look at themselves. Often this stark scrutiny of your motivations, fears and weaknesses in order to obtain a realistic idea of where you are as a climber is the worst part of the process. This is where each person must own up to who they are as a climber and accept both the positive and negative within themselves. These obstacles that the warrior must overcome are more often than not the common short comings of the human psyche. If a climber is truly interested in perfecting themselves egoism, competitiveness, fear in all it’s manifestations, self doubt and all the myriad emotions that allow us to get in our own way have no place in the mind of the warrior. If a climber is able to make this step with a measure of honesty they will then have made a monstrous leap towards improving their climbing. Once you know what your weaknesses are you can then set about changing these habits.
Since before recorded history there have been innumerable practices developed to better integrate the functioning of mind and body. At the core of the warrior is an unwavering belief in self. The warrior strives for this perfection of self by attempting to be constantly vigilant of their mind and rid it of those petty emotional self indulgences that hinder them from achieving their goals. Irrespective of which practice(s) you choose the warrior has but a single goal, self awareness, everything else stems from this beginning.
The warrior mindset could just as easily be termed the yogi or philosopher mindset. However, the concept of the warrior concisely embodies the seamless integration of the intellectual and the physical. The warrior tradition is one rich in using the mind to focus intention in the pursuit of perfecting physical performance in emotionally charged situations.
There are many paths to the summit and climbing is only one of them.
Brent Apgar DC
Wednesday, March 5, 2008
Climbing References:
Here is a list of books related to improving climbing performance. I've compiled this list to serve as a great starting point for anyone interested in creating a more academic foundation when it comes to the study of how to become a better climber. Of all the texts listed here I consider "The Rock Warrior's Way" and "The Self Coached Climber" to be required reading for anyone serious about improving their climbing performance.
Psychology:
“The Rock Warrior’s Way” Arno Ilgner
This is a phenomenal resource on many levels. This excerpt from the book pretty much sums up the entire text. “The Rock Warrior’s Way is a method for cutting through the mental clutter, gathering your attention, discerning exactly what the risk is, deciding if the risk is appropriate for you, and then fully committing your resources to your choice.” Even more significant than creating a tangible means of improving our mental abilities Ilgner admirably illuminates how the “rock warrior” thinks. He shows us what it takes to not only become a better climber but what it means to use the discipline of climbing to become a better person.
Climbing Performance & Injuries:
“The Self Coached Climber” Dan Hague and Douglas Hunter
I can’t imagine a climber wanting to improve at the sport and not reading this book. Hague and Hunter have done an excellent job of attempting to put exact definitions to some of the esoteric concepts climbers use to discuss climbing movement. They also give the student practical drills designed to improve each of the individual skills fundamental to creating a better overall climbing performance. More importantly the authors are equally adept at integrating the details of individual training sessions into the bigger picture of how to go about achieving your specific climbing goals. Through the use of self assessment questionnaires and concise goal setting plans “The Self Coached Climber” can help anyone from the newbie to the seasoned veteran put together and implement a training plan to start shortening their tick list.
“Training for Climbing” Eric J. Horst
This is an all around reference giving suggestions on how to improve climbing performance. Horst has done a respectable job and I really like the fact that he isn’t one dimensional in his approach to improving climbing performance. The book touches on all the variables that play into climbing, with this in mind the bulk of his material is focused on sport climbing. The one reservation that arose concerning Horst's recommendations was his view on training antagonistic muscles. From an injury prevention perspective his notion that doing a few pressing exercises at a moderate intensity is inadequate. This is especially true if you are trying to maximize your climbing performance.
“Performance Rock Climbing” Dale Goddard and Udo Neumann
This is another good general reference that looks at most of the variables involved in climbing. Again this book addresses both the physical and mental aspects of climbing. Goddard and Neumann speak to the importance of overall fitness and the fact that recovery time is essential in preventing overuse injuries.
“One Move Too Many: How to Understand the Injuries and Overuse Syndromes of Rock Climbing” Thomas Hochholzer, Volker Schoeffl
This is a little more technical and goes more into the reasons behind why certain injuries are more common in climbing. You don’t need a background in anatomy to get a lot of good information out of it and the authors include some good exercises and stretches for the arms. This book may be a little more difficult to get from a local store since it’s only being distributed through Petzl. Most good climbing shops will either have it or should be able to get it and there are always on-line sources that should have it.
Functional Conditioning & General Sport Performance:
“Power to the People” Pavel Tsatsouline
This is a good reference for those of you who want something simple, straight forward and effective when it comes to supplemental training. Pavel’s philosophy is dead on when it comes to strength conditioning. He’s all about getting the job done efficiently and maximizing the return on the amount of time you spend in the weight room. This is probably the most fundamental of his books on the subject. This book is refreshing because he includes many ideas on strength training that are not from the body building perspective. If you’d like an alternative to this he also has a book called the “Naked Warrior” which focuses on strength conditioning exercises using only your own body weight. If that’s not enough, he has a several other books that get into more diabolical training regimens mostly involving Kettlebells.
“Periodization Training for Sports” Tudor O. Bompa, Ph.D.
This reference is included for those of you who identify with the following: “Obsessed\ n. -a word used by the lazy to describe the dedicated.” -Anon. If you like to plan out your training months in advance or are interested in scheduling your training to “peak” for a comp or trip this is a great resource. It’s also a good source of information concerning the details of what separates Hypertrophy training from Endurance and Maximum strength training protocols. The entire book comes at the subject from the perspective of training athletes for strength related sports. However, there are no climbing specific routines laid out so you’ll have to get creative and put together your own route and bouldering pyramids, interval training sessions, campus routines...etc.
Nutrition:
“Eat, Drink, and Be Healthy” Walter C. Willett, M.D.
This book presents an overview of dietary guidelines. The strength of this book is that he gives general recommendations for a healthy diet that are easy to apply but doesn’t get overly involved in the topic. The other nice thing about this book is that Dr. Willett also compiles a plethora of current research on dietary guidelines and looks at it from a public health perspective.
“Optimal Muscle Performance and Recovery” Edmund R. Burke, Ph.D.
For you technical geeks out there... and you know who you are. This reference looks at the current research on optimizing muscle performance and recovery through diet and supplementation. It’s getting a little dated at this point but still serves as a good general resource for learning about the subject while providing examples of how to implement the information. It’s aimed more toward traditional endurance events such as cycling but the information is quite applicable to anyone spending a day at the crag or bouldering.
Psychology:
“The Rock Warrior’s Way” Arno Ilgner
This is a phenomenal resource on many levels. This excerpt from the book pretty much sums up the entire text. “The Rock Warrior’s Way is a method for cutting through the mental clutter, gathering your attention, discerning exactly what the risk is, deciding if the risk is appropriate for you, and then fully committing your resources to your choice.” Even more significant than creating a tangible means of improving our mental abilities Ilgner admirably illuminates how the “rock warrior” thinks. He shows us what it takes to not only become a better climber but what it means to use the discipline of climbing to become a better person.
Climbing Performance & Injuries:
“The Self Coached Climber” Dan Hague and Douglas Hunter
I can’t imagine a climber wanting to improve at the sport and not reading this book. Hague and Hunter have done an excellent job of attempting to put exact definitions to some of the esoteric concepts climbers use to discuss climbing movement. They also give the student practical drills designed to improve each of the individual skills fundamental to creating a better overall climbing performance. More importantly the authors are equally adept at integrating the details of individual training sessions into the bigger picture of how to go about achieving your specific climbing goals. Through the use of self assessment questionnaires and concise goal setting plans “The Self Coached Climber” can help anyone from the newbie to the seasoned veteran put together and implement a training plan to start shortening their tick list.
“Training for Climbing” Eric J. Horst
This is an all around reference giving suggestions on how to improve climbing performance. Horst has done a respectable job and I really like the fact that he isn’t one dimensional in his approach to improving climbing performance. The book touches on all the variables that play into climbing, with this in mind the bulk of his material is focused on sport climbing. The one reservation that arose concerning Horst's recommendations was his view on training antagonistic muscles. From an injury prevention perspective his notion that doing a few pressing exercises at a moderate intensity is inadequate. This is especially true if you are trying to maximize your climbing performance.
“Performance Rock Climbing” Dale Goddard and Udo Neumann
This is another good general reference that looks at most of the variables involved in climbing. Again this book addresses both the physical and mental aspects of climbing. Goddard and Neumann speak to the importance of overall fitness and the fact that recovery time is essential in preventing overuse injuries.
“One Move Too Many: How to Understand the Injuries and Overuse Syndromes of Rock Climbing” Thomas Hochholzer, Volker Schoeffl
This is a little more technical and goes more into the reasons behind why certain injuries are more common in climbing. You don’t need a background in anatomy to get a lot of good information out of it and the authors include some good exercises and stretches for the arms. This book may be a little more difficult to get from a local store since it’s only being distributed through Petzl. Most good climbing shops will either have it or should be able to get it and there are always on-line sources that should have it.
Functional Conditioning & General Sport Performance:
“Power to the People” Pavel Tsatsouline
This is a good reference for those of you who want something simple, straight forward and effective when it comes to supplemental training. Pavel’s philosophy is dead on when it comes to strength conditioning. He’s all about getting the job done efficiently and maximizing the return on the amount of time you spend in the weight room. This is probably the most fundamental of his books on the subject. This book is refreshing because he includes many ideas on strength training that are not from the body building perspective. If you’d like an alternative to this he also has a book called the “Naked Warrior” which focuses on strength conditioning exercises using only your own body weight. If that’s not enough, he has a several other books that get into more diabolical training regimens mostly involving Kettlebells.
“Periodization Training for Sports” Tudor O. Bompa, Ph.D.
This reference is included for those of you who identify with the following: “Obsessed\ n. -a word used by the lazy to describe the dedicated.” -Anon. If you like to plan out your training months in advance or are interested in scheduling your training to “peak” for a comp or trip this is a great resource. It’s also a good source of information concerning the details of what separates Hypertrophy training from Endurance and Maximum strength training protocols. The entire book comes at the subject from the perspective of training athletes for strength related sports. However, there are no climbing specific routines laid out so you’ll have to get creative and put together your own route and bouldering pyramids, interval training sessions, campus routines...etc.
Nutrition:
“Eat, Drink, and Be Healthy” Walter C. Willett, M.D.
This book presents an overview of dietary guidelines. The strength of this book is that he gives general recommendations for a healthy diet that are easy to apply but doesn’t get overly involved in the topic. The other nice thing about this book is that Dr. Willett also compiles a plethora of current research on dietary guidelines and looks at it from a public health perspective.
“Optimal Muscle Performance and Recovery” Edmund R. Burke, Ph.D.
For you technical geeks out there... and you know who you are. This reference looks at the current research on optimizing muscle performance and recovery through diet and supplementation. It’s getting a little dated at this point but still serves as a good general resource for learning about the subject while providing examples of how to implement the information. It’s aimed more toward traditional endurance events such as cycling but the information is quite applicable to anyone spending a day at the crag or bouldering.
Wednesday, February 27, 2008
Avoiding Injury Plateaus
Traditional medicine is a great resource for delving into all the problems associated with the human performance game. However, protocols designed to rehabilitate injured patients are extremely nearsighted in scope when it comes to maximizing an individuals’ performance at a given physical skill. How often have you heard the following scenario from fellow participants in any number of sports? The story is typically told by someone who is proficient in their sport and who has been participating in it for at least a few years. The plot goes something like, “…so I’ve been psyched and have been training to meet X goal. Things were going really well and then X injury happened or X injury that I’ve had for years now flared up and I’m back to where I started.”
Unfortunately most of the time the story goes on to express the athlete’s frustration at the failure of the “sports medicine” community to fully address this problem. Your comrade goes on to tell a tale of having seen Orthopedists, Chiropractors, Physical Therapists, Rolfers, Massage Therapists, etc only to have the same scenario play itself out. The clinician addresses the problem, returns the athlete back to their pre-injury status and sends them on their way to resume their activities. All may go well for a time until the athlete starts pushing themselves to again take their performance to the next level and then… the same thing happens. Many climbers, runners, cyclists and others have told me this story again and again. For most of these athletes their injuries were never completely resolved the first time. So they continue on, trying to improve their performances and at the same time managing nagging little aches, hoping that those injuries waiting to happen don’t crop up and take them out for another four to six weeks. This begs the question, whose responsibility is it to ensure that the athlete continues improving while avoiding injury plateaus? Is this a case of clinicians wanting to work with athletes and not being well enough equipped to do so and/or clinicians who want a piece of the sports medicine pie and so throw out buzz words like, “sports injury rehab”, “functional training”, and the like? Or is this a case of the athlete having a distorted perspective of what medicine can accomplish combined with a portion of being the classic “non compliant” patient? The true problem here is that both sides are trying to assume as little responsibility as possible. Rather than look at this problem as one of where to place the blame, it would be more beneficial to look at this situation as one of misunderstanding. My hope, as both an athlete and a clinician, is to clarify what I believe each party’s responsibilities should be.
Before making a list I would like to say that when choosing a clinician it is important to do your homework. Personally I’m not going to call a plumber to ask questions about my computer problem. Certainly this is an oversimplification but my point is that even though the human body is pretty standardized from one individual to the next, the particular variables associated with each sport create an equation unique to that sport. For my own part I know that as a clinician it would take me much more effort and I would have less insight into trying to solve a shoulder problem that arose through swimming versus one that happened due to bouldering. It comes down to the simple truth that theory and practice are not always the same. Having two docs who are of equal talent I would have to go with the one that has read no books but is a an active participant in the sport and works with other athletes in the sport versus the doc who has read every book but has no personal experience with the subject. So what should an athlete expect from a sports medicine clinician?
It is the clinician’s responsibility to come up with a plan of action to help resolve the athlete’s problem(s). This is what the clinician is getting paid for, to take all of their experience and expertise and bring it to bear on the problem at hand. This is the responsibility that every health care provider must assume regardless of the particular area of medicine in which they practice. The business of diagnoses and treatment is one of probability and best guesses. Medicine is not an exact science but that is how it works and each clinician should own up to their decisions. It would seem that the better clinicians are more willing to use their own judgment and experience in order to come up with a unique solution for each problem. Rather than playing it safe and always following “established guidelines”, these clinicians strive for better than average results exactly because they are willing to take responsibility for their choices. In any field this is certainly the more challenging route to take, requiring much more thought and effort. Invariably it is those who do choose to put in the time and work who excel and become the innovators that increase the overall standards within their respective fields.
One of the primary responsibilities of the sports medicine professional is to adapt to the athlete’s progress. Anyone claiming to work in the field of sports medicine should ensure to the best of their ability that their athletes are able not only to return to the sport at the athlete’s previous level but also to have a plan of action that will allow the athlete to continue achieving gains in performance while risking as few injuries as possible. Much like a coach that ensures the athlete’s training continues to improve their performance; the clinician working on athletes should adapt their treatment plan in order to keep the athlete healthy and prevent as many potential injuries as possible. This is where it seems that most sports medicine provider’s performances are wholly inadequate. If this means that the clinician or therapist themselves is unable to provide the necessary education, then that clinician should be able to provide the athlete with a recommendation on how to proceed and who to seek out. The current situation within sports medicine is one where nobody really wants to be held responsible for this task. Unfortunately for the majority of us that play and train like athletes but are not full time professionals, as well as some who are, we do not have the resources to resolve this problem. The typical athlete doesn’t have a dietitian, coach, and therapist all keeping tabs on how they’re performing, continually tweaking their training in order to prevent all manner of problems and allowing them to keep training as hard as they can. In actuality the case is one in which athletes are left trying perform all of these roles themselves. It is not too much of the athlete to ask of their sports medicine clinician to address this issue. In fact it should be a fundamental responsibility of a sports med clinician to educate their athletes how to better perform each of these roles themselves.
This then leads to the question: what are the responsibilities of the athlete? Most athletes would have a much better experience working with sports medicine providers if they would simply believe their clinicians. Actually they wouldn’t even have to believe their clinician but simply trust them enough to commit themselves to that clinician’s treatment plan. As an athlete/patient your number one responsibility is patient compliance. This means that you do what your clinician tells you, it is not a suggestion. The treatment plan is what that clinician feels is the best approach to resolving your problem. You have sought out a professional to diagnose and treat something that is beyond your capacity to take care of. You are paying them for their expertise, follow their instructions. It is interesting that this dilemma seems one peculiar to the health care profession. It is amazing how athletes will either form their own opinions for the best course of action, even while pretending to listen to what their clinician is telling them, or flat out argue why their idea is a better solution. This doesn’t mean that athletes should blindly follow what their clinician tells them. The athlete’s sports med provider should be able to justify all the points of their treatment plan and give satisfactory answers to their questions… and the athlete should have questions.
The second main responsibility of the athlete is to be a good student. If you’re serious about improving in your sport you should make a point of educating yourself in how to do so. This means that you’ll have to learn something from each of the roles previously mentioned. You’ll need to learn about those aspects of sports medicine that affect you. You will need to understand the basics of nutrition as they pertain to you. What types of protein do you tolerate best? Do you need to pay attention to caloric intake and aerobic training more than the 15 year old waifs that flash V11 in their tennies because it’s more difficult for you to stay lean? The objective of the athlete as student is to learn the specifics of their own body. As an athlete you should know how your body responds to the training you are performing, how much is too much or too intense, what foods are the best fuel sources for you, how much sleep you need, etc. You are the primary subject in an ongoing experiment in how to improve as an athlete. How will you know if you’re improving? How else will you know which variables are causing the improvement if you don’t record your data and then look it over to draw conclusions about your progress? As the athlete you are in the best position to do this work, you know the most about the intricacies of the experiment. Outside help is just that, it’s an “expert” in the field checking out your findings and collaborating on creating more efficient techniques for improving. They should also be able to look at your work and suggest new directions within the experiment that might give better results.
One final point that athletes and clinicians alike should be aware of is the influence of the media. For those of you that aren’t clinicians but know one personally ask them the biggest down side of the job. The likely answer you’ll get, the patients themselves. At worst patients can seem exceedingly ignorant, have no common sense and then want to argue with you about the best course of action for their treatment. The easy way out would be to simply blame patients as a consumer group. This misses the bigger picture. The blame should be directed toward the media. It is the media that perpetuates most of the attitudes and misperceptions that the medical community constantly struggles to overcome. Foremost the media must sell a product in order to sustain its own existence and this often times is in direct conflict with conscientious reporting. At best this means that inventions, discoveries and new trends in science are painted to be more promising than they are. Science is a tedious and frustrating labor of love where the rewards are often few and far between. Since this one paragraph is unlikely to create the changes I would like to see, this means that athletes and clinicians serious about performing their best in the realm of sports medicine must do their utmost to learn, think and make sound decisions based on that information.
“In connection with the Columbia accident, most engineers I spoke to speculated that the tiles on the underside of the craft, designed to absorb the heat of reentry, probably caused the problem. Dan Canin of Lockheed wrote in an e-mail, ‘Every precaution and material science known to man has been applied to the problem of making the thermal protection system work. It’s a know risk. The tiles are soft, and every astronaut knows that if the wrong ones are damaged, the shuttle burns up. But the odds against it are pretty good, especially when compared to the rewards of being an astronaut, so they’re willing to take the chance. In fact, they FIGHT for it… as would a lot of us. But getting the public to buy this is a lot tougher, especially a public that expects every risk in their lives to be mitigatable to zero. It will be interesting to see if NASA tries to take on this challenge, explaining to the public that doing bold thins isn’t about engineering risk to zero. Shit happens, and if we just want to restrict ourselves to things where shit can’t happen… we’re not going to do anything very interesting.’” (“Deep Survival” by Lawrence Gonzales)
In order to earn the trust and respect of athletes, clinicians must realize that simply fixing problems as they arise and returning the athlete to training without preparing them for the future simply will not get it done. Athletes need to understand that sports medicine doctors are practicing scientists that don’t have all the answers but are improving and refining their skills one problem at a time. Both clinician and athlete need to understand what it is they are trying to accomplish, have clearly defined goals and be realistic about what it will take to achieve those goals.
Brent Apgar D.C.
Unfortunately most of the time the story goes on to express the athlete’s frustration at the failure of the “sports medicine” community to fully address this problem. Your comrade goes on to tell a tale of having seen Orthopedists, Chiropractors, Physical Therapists, Rolfers, Massage Therapists, etc only to have the same scenario play itself out. The clinician addresses the problem, returns the athlete back to their pre-injury status and sends them on their way to resume their activities. All may go well for a time until the athlete starts pushing themselves to again take their performance to the next level and then… the same thing happens. Many climbers, runners, cyclists and others have told me this story again and again. For most of these athletes their injuries were never completely resolved the first time. So they continue on, trying to improve their performances and at the same time managing nagging little aches, hoping that those injuries waiting to happen don’t crop up and take them out for another four to six weeks. This begs the question, whose responsibility is it to ensure that the athlete continues improving while avoiding injury plateaus? Is this a case of clinicians wanting to work with athletes and not being well enough equipped to do so and/or clinicians who want a piece of the sports medicine pie and so throw out buzz words like, “sports injury rehab”, “functional training”, and the like? Or is this a case of the athlete having a distorted perspective of what medicine can accomplish combined with a portion of being the classic “non compliant” patient? The true problem here is that both sides are trying to assume as little responsibility as possible. Rather than look at this problem as one of where to place the blame, it would be more beneficial to look at this situation as one of misunderstanding. My hope, as both an athlete and a clinician, is to clarify what I believe each party’s responsibilities should be.
Before making a list I would like to say that when choosing a clinician it is important to do your homework. Personally I’m not going to call a plumber to ask questions about my computer problem. Certainly this is an oversimplification but my point is that even though the human body is pretty standardized from one individual to the next, the particular variables associated with each sport create an equation unique to that sport. For my own part I know that as a clinician it would take me much more effort and I would have less insight into trying to solve a shoulder problem that arose through swimming versus one that happened due to bouldering. It comes down to the simple truth that theory and practice are not always the same. Having two docs who are of equal talent I would have to go with the one that has read no books but is a an active participant in the sport and works with other athletes in the sport versus the doc who has read every book but has no personal experience with the subject. So what should an athlete expect from a sports medicine clinician?
It is the clinician’s responsibility to come up with a plan of action to help resolve the athlete’s problem(s). This is what the clinician is getting paid for, to take all of their experience and expertise and bring it to bear on the problem at hand. This is the responsibility that every health care provider must assume regardless of the particular area of medicine in which they practice. The business of diagnoses and treatment is one of probability and best guesses. Medicine is not an exact science but that is how it works and each clinician should own up to their decisions. It would seem that the better clinicians are more willing to use their own judgment and experience in order to come up with a unique solution for each problem. Rather than playing it safe and always following “established guidelines”, these clinicians strive for better than average results exactly because they are willing to take responsibility for their choices. In any field this is certainly the more challenging route to take, requiring much more thought and effort. Invariably it is those who do choose to put in the time and work who excel and become the innovators that increase the overall standards within their respective fields.
One of the primary responsibilities of the sports medicine professional is to adapt to the athlete’s progress. Anyone claiming to work in the field of sports medicine should ensure to the best of their ability that their athletes are able not only to return to the sport at the athlete’s previous level but also to have a plan of action that will allow the athlete to continue achieving gains in performance while risking as few injuries as possible. Much like a coach that ensures the athlete’s training continues to improve their performance; the clinician working on athletes should adapt their treatment plan in order to keep the athlete healthy and prevent as many potential injuries as possible. This is where it seems that most sports medicine provider’s performances are wholly inadequate. If this means that the clinician or therapist themselves is unable to provide the necessary education, then that clinician should be able to provide the athlete with a recommendation on how to proceed and who to seek out. The current situation within sports medicine is one where nobody really wants to be held responsible for this task. Unfortunately for the majority of us that play and train like athletes but are not full time professionals, as well as some who are, we do not have the resources to resolve this problem. The typical athlete doesn’t have a dietitian, coach, and therapist all keeping tabs on how they’re performing, continually tweaking their training in order to prevent all manner of problems and allowing them to keep training as hard as they can. In actuality the case is one in which athletes are left trying perform all of these roles themselves. It is not too much of the athlete to ask of their sports medicine clinician to address this issue. In fact it should be a fundamental responsibility of a sports med clinician to educate their athletes how to better perform each of these roles themselves.
This then leads to the question: what are the responsibilities of the athlete? Most athletes would have a much better experience working with sports medicine providers if they would simply believe their clinicians. Actually they wouldn’t even have to believe their clinician but simply trust them enough to commit themselves to that clinician’s treatment plan. As an athlete/patient your number one responsibility is patient compliance. This means that you do what your clinician tells you, it is not a suggestion. The treatment plan is what that clinician feels is the best approach to resolving your problem. You have sought out a professional to diagnose and treat something that is beyond your capacity to take care of. You are paying them for their expertise, follow their instructions. It is interesting that this dilemma seems one peculiar to the health care profession. It is amazing how athletes will either form their own opinions for the best course of action, even while pretending to listen to what their clinician is telling them, or flat out argue why their idea is a better solution. This doesn’t mean that athletes should blindly follow what their clinician tells them. The athlete’s sports med provider should be able to justify all the points of their treatment plan and give satisfactory answers to their questions… and the athlete should have questions.
The second main responsibility of the athlete is to be a good student. If you’re serious about improving in your sport you should make a point of educating yourself in how to do so. This means that you’ll have to learn something from each of the roles previously mentioned. You’ll need to learn about those aspects of sports medicine that affect you. You will need to understand the basics of nutrition as they pertain to you. What types of protein do you tolerate best? Do you need to pay attention to caloric intake and aerobic training more than the 15 year old waifs that flash V11 in their tennies because it’s more difficult for you to stay lean? The objective of the athlete as student is to learn the specifics of their own body. As an athlete you should know how your body responds to the training you are performing, how much is too much or too intense, what foods are the best fuel sources for you, how much sleep you need, etc. You are the primary subject in an ongoing experiment in how to improve as an athlete. How will you know if you’re improving? How else will you know which variables are causing the improvement if you don’t record your data and then look it over to draw conclusions about your progress? As the athlete you are in the best position to do this work, you know the most about the intricacies of the experiment. Outside help is just that, it’s an “expert” in the field checking out your findings and collaborating on creating more efficient techniques for improving. They should also be able to look at your work and suggest new directions within the experiment that might give better results.
One final point that athletes and clinicians alike should be aware of is the influence of the media. For those of you that aren’t clinicians but know one personally ask them the biggest down side of the job. The likely answer you’ll get, the patients themselves. At worst patients can seem exceedingly ignorant, have no common sense and then want to argue with you about the best course of action for their treatment. The easy way out would be to simply blame patients as a consumer group. This misses the bigger picture. The blame should be directed toward the media. It is the media that perpetuates most of the attitudes and misperceptions that the medical community constantly struggles to overcome. Foremost the media must sell a product in order to sustain its own existence and this often times is in direct conflict with conscientious reporting. At best this means that inventions, discoveries and new trends in science are painted to be more promising than they are. Science is a tedious and frustrating labor of love where the rewards are often few and far between. Since this one paragraph is unlikely to create the changes I would like to see, this means that athletes and clinicians serious about performing their best in the realm of sports medicine must do their utmost to learn, think and make sound decisions based on that information.
“In connection with the Columbia accident, most engineers I spoke to speculated that the tiles on the underside of the craft, designed to absorb the heat of reentry, probably caused the problem. Dan Canin of Lockheed wrote in an e-mail, ‘Every precaution and material science known to man has been applied to the problem of making the thermal protection system work. It’s a know risk. The tiles are soft, and every astronaut knows that if the wrong ones are damaged, the shuttle burns up. But the odds against it are pretty good, especially when compared to the rewards of being an astronaut, so they’re willing to take the chance. In fact, they FIGHT for it… as would a lot of us. But getting the public to buy this is a lot tougher, especially a public that expects every risk in their lives to be mitigatable to zero. It will be interesting to see if NASA tries to take on this challenge, explaining to the public that doing bold thins isn’t about engineering risk to zero. Shit happens, and if we just want to restrict ourselves to things where shit can’t happen… we’re not going to do anything very interesting.’” (“Deep Survival” by Lawrence Gonzales)
In order to earn the trust and respect of athletes, clinicians must realize that simply fixing problems as they arise and returning the athlete to training without preparing them for the future simply will not get it done. Athletes need to understand that sports medicine doctors are practicing scientists that don’t have all the answers but are improving and refining their skills one problem at a time. Both clinician and athlete need to understand what it is they are trying to accomplish, have clearly defined goals and be realistic about what it will take to achieve those goals.
Brent Apgar D.C.
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