Why burpees are an essential clinical tool....

Yes, we love/hate them, and we know that you do, too.  Burpees.  Whether they're done with a chest-to-floor push-up at the bottom or a clap in the sky at the top (or both!), burpees are an envogue fitness activity for conditioning purposes, and they just never seem to get that much easier....no matter how fit you are...

Clinically, burpees(aka squat-thrusts, aka "M"urpees) can give us some valuable information about how our patients are faring during the plan of care. Would we use them on every patient we treat? Probably not, but for those patients who live an active lifestyle and want to return to their favorite activities post-rehab, they will find themselves doing burpees at some point during their stay at Maven. As one of Maven's key clinical movement assessment (and treatment) tools, burpees can be used qualitatively and/or quantitatively to:

1. assess a patient's healing progress after they've passed the subacute stage of an injury
2. provide clinicians with a general "clearing test" prior to discharging a patient
3. determine if a patient is ready to be progressed to more dynamic activities or return-to-sport
4. assess gross and regional dynamic joint and segmental stabilization in a closed-chain position (the most functional position for most everyday activities)
5. assess the general status of a patient's or athlete's muscular endurance and conditioning
6. reveal other areas of the body that may need to be screened and evaluated for injury prevention.

Key areas of closed-chain, dynamic stabilization and/or mobility are assessed at the:

• cervical spine
• scapula
• thoraco lumbar region
• lumbo-pelvic region
• hip
• ankle
• wrist
• knee 

The video below shows Dr. Lee explaining how to perform a standard burpee (sans claps or push-ups in this video). Hopefully, you can appreciate how much mobility the wrists, shoulders, hips, knees, ankles must have in order to execute the exercise correctly. Also, notice how the scapulae and trunk("core") muscles have to stabilize the body in motion during the burpee as well.

If a patient comes to us with a wrist injury, for example, and needs to return to competitive gymnastics, multiple repetitions of burpees should be able to be performed with ease before any kind of floor or beam routine can be resumed.  If a patient has pain during a burpee in the lumbar region, most likely, lumbopelvic stabilization is not adequate to keep the spine from overextending, so we need to work on this more to clear the spine.  If a patient bends more at the back and less at the hip when they squat down for the burpees, we know to look more closely at the hip and pelvis as a potential movement limiting factor that needs to be addressed.

These are just a few examples of how burpees can assist rehab professionals during their physical assessment of the active patient and progress them to a successful return to their fitness goals! 

Stay tuned for videos on our Youtube channel providing more insight into our clinical movement assessment tools!

What's triggerpoint dry needling?

Trigger point dry needling is an effectively used modality to treat musculoskeletal pain. Licensed healthcare professionals including doctors of physical therapy have been using dry needling all over the world including the United States.

Maven Sports Medicine has been at the forefront of pushing for rules and regulations in New Jersey to permit the use of this treatment modality, which finally received NJ State Board approval in 2011. Yes, as you all know, we like to move and shake. Obviously, there is contention with the NJ acupuncture state board, who claims that it is indeed "acupuncture" what we are doing, however, allow me to explain some significant differences (btw, I still refer patients out for acupuncture, if that clarifies the picture):

Acupuncture 
Acupuncture requires state licensure, 4 years of education and/or a masters degree.  Training includes extensive knowledge and application of eastern medicine, anatomy, which includes the meridian system, and herbal medicine.  The pulse (there are three in eastern medicine) along with the history and other clinical and subjective measures are used to determine where systematic, energetic dysfunction may lie, and intervention via acupuncture needles, herbal medicine, or acupressure is employed.  For example, back pain may be a result of stagnation or surplus of energy, "chi" in a particular meridian, and needles may be placed in a region away from where the pain appears to be located. 

Dry needling 
 A systematic method of addressing localized trigger point muscle pain using dry needles (that is, needles that do not have medication, developed by Travell and Simons, MD in the mid to late 1900s. Trigger points in muscles result from overuse, disuse/weakness, or (traumatic) injury to muscles.  Posture-related injuries also can lead to trigger points.  Palpation of the muscles or regions involved is performed with the goal of eliciting a patient's symptoms (whether localized or away from the region palpated), a "twitch" response, or "taut/ropy" bands of the muscle. 

Dry needling can also be used to treat long-standing tendinitis or old muscle tears/strains by bringing about a relatively "controlled" inflammation response to initiate the cascade of physiological responses necessary for tissue healing, as an adjunct to other physical therapy modalities.  Applying dry needling or "TDN" requires extensive knowledge of surface/musculoskeletal anatomy, of which DPTs are experts.  Keen palpation and joint assessment (as well as other components of our comprehensive evaluation) are also necessary skill sets, which we practice and use daily to determine where musculoskeletal injuries may be emanating from.

Dry needling, therefore, is absolutely within our physical therapy scope of practice, and I would never call it acupuncture- this would be an insult to the acupuncture profession and all the training that a licensed acupuncturist must go through.

What to expect
Patients often describe transient discomfort, particularly when a twitch response has been elicited.  Following a dry needling "session", we often have patients perform a few gentle active range of motion exercises to further the effects of the needle, ultrasound to relieve dry needling symptoms, and electrical stimulation with ice as well.  Discomfort or pain resulting from dry needling lasts for about 1-2 days on average and icing or over-the-counter NSAIDs can be used. After a few days, many people (especially if we target the right spot) report moderate to significant relief of their pain.  It's pretty amazing, actually.  We've used it on our everyday computer user to our elite athletes and have had good results, thus far.  Obviously, dry needling is not a panacea, or I'd be living in Fiji with my fam right now, but it does offer another way to help you get back to your activities.

Diagnoses
We have treated diagnoses including (cervicogenic) headaches, IT band syndrome, tennis/golfer's elbow, rotator cuff strains, Achilles tendonitis, neck and low back pain, hamstring and quad strains to name a few ailments. 

For more information on how dry needling may help you, contact us via email at mavenoffice@gmail.com or jerrymaven@gmail.com

Feed Your Injury

Having been in the field nearly 12 years, patients are often wondering what exercises or activities they should be doing at home or avoiding to help accelerate their recovery, but no one really asks,

"Is there anything I can eat or take (that is legal, of course) to help this injury get better?"

There is SO much one can do. 

Setting up the substrate-
our bodies exist in a relatively alkaline state (higher pH or more on the basic side of the acid-base scale).  Musculoskeletal injury causes localized inflammation in a particular region.  Inflammation is GOOD and NECESSARY for healing.  We just want to CONTROL the inflammation so that scar tissue is laid down in the injured area in a more organized fashion instead of one that is haphazard.  We also want to get better quicker, don't we??

So, in order to improve healing, do all that you can to minimize foods that might tip the scale towards inflammation. 

What does this mean?  Are you saying that foods can cause or increase inflammation?
Yes, of course, and you probably already know the macronutrient types that do. Read on-

Foods to eliminate or drastically reduce from your daily consumption (at least while you're healing from an injury or post-op surgery:
-Refined carbohydrates (breads, pastas, white rice, refined sugars) 
-Processed foods
-legumes (yes, a gray area that needs more evidence)
-For many reasons, cutting out these poor sources of carbohydrates will not only benefit your recovery, your waistline and body composition will improve. 
-Dairy (cheese and milk. Eggs are ok).
-Red meat (this is kind of a gray area as there are clear benefits to eating grass-fed red meat including creatine, BCAAs, etc).

Foods to add in or dramatically increase in your daily consumption (at least while you're healing from an injury or post-op surgery (this is by no means a comprehensive list, but will start you off in the right direction):
-Water, water, water- muscle is ~75-80% water.  Does drinking enough water/fluids make sense? During an injury, consider drinking alkaline water with a pH that is 8.0 (Eternal and Iceland spring are brands that I've consumed). 
-whey protein isolate (somewhat controversial since it's processed, but it's known for rapid and nearly complete absorption into muscle tissue.  For vegans, pea/brown rice protein are good alternatives)
-Omega 3 sources:
nuts (unsalted)- particularly almonds, walnuts
chia seed
salmon
avocados
veggies: purple, red, yellow, green
-substitute quinoa for grains (quinoa is a seed).

Obviously, your body has mechanisms in place to keep itself in homeostasis, but we can take an active role in helping our bodies minimize the energy needed to maintain this, ESPECIALLY when an injury is present.

Another temptation active folks face when side-lined during an injury is to reduce caloric intake.  My question back to you- If your body needs X number of calories to function at a certain level per day, do you think that reducing your caloric intake will assist or lengthen your injury progression?  I think the answer is obvious.  Remember, in the grand scheme of things, stabilizing your food intake won't put massive pounds on you (unless you eat poorly to begin with). It can only help, especially if you're feeding your injury the right things as we mentioned above.

Having said that, if you have any questions or concerns (there are almost always exceptions to every rule), send us an email!

The Maven approach to a successful multisport season- Part 1

What's our training philosophy here at Maven?

You all know from Mavenaction (mavenaction.com) that we believe health has to come first.

So, what is health?

Well, generally, we believe that there are 4 major components- physical, mental, emotional, and spiritual. Any strain or pull in one of these areas diminishes the effectiveness and overall state in the other areas.

For this blog's purpose, we'll be emphaszing the physical-

Fitness is, first and foremost, a major constituent to the foundation of general physical health and wellness, which allows one to take on any sport or athletic activity to a maximized level of performance. When we talk about fitness, we must also understand that "clean" nutrition gives fitness the necessary fuel to attain that level of performance. Sleep, rest, and recovery are also well infused components of being more healthy.

Put it this way, how can you even think of having your best race in your respective competitive sport (not exclusive to multisport) when you haven't sufficiently trained ALL of your body's energy systems, incorporated functional strength training as well as flexibility acquisition/maintenance and balance work (let alone managed a solid nutrition plan, recovery, and rest training) ?

Are you fit just because you can do an Ironman? Many people think so, but this is definitely not the case. You've seen them before- the skinny fat athletes, the overweight athletes who are very good at enduring, but have high, double-digit bodyfat.

From my own experiences competing in multisport endurance activities for the past 13 years, I can say for sure that aerobic conditioning (cardio) are merely one facet of fitness, but by no means do they complete the palette. I am faster (and fitter) at 37 than I was at 27. I have been PR'ing every race I've done this season since I really began to take fitness more seriously as part of my tri-training with Mavenaction and crossfit endurance, while my triathlon training volume has decreased....and continues to decrease. I have to admit, while the science supports this way of training, mentally/emotionally, it hasn't been easy...and, to be honest, tri-training is usually more fun than cross-training (don't we all tend to gravitate towards what we love to do?? I am not immune!). While I've been in the fitness industry for over 15 years, the last two years have been the most eye-opening even for me as far as my personal results and professional endeavors.

If you've ever done a Mavenaction workout, you'd know what I mean. There are triathletes, runners, and other endurance specialists who could do laps around me till kingdom come, but if I were to have them do...say...10 minutes of burpees, mountain climbers, jumping jacks, squats, they'd be screaming for mercy (which used to be me, by the way)....if I had them attempt a few sets of pull ups and push-ups, they'd be a goner.

I think you get the drift.

In essence, to be the best triathlete you want to be next season, you MUST be fitter. How do you become fitter? Add cross-training (functional resistance training) as PART of your triathlon training, not as something separate; as a soon-to-be certified USAT level 1 coach, this is how I intend on program designing and mapping out your best tri performance next season.

What do I mean by adding in cross-training? Instead of 7 days a week of all cardio or multisport activities during the season, 3-4 days would be dedicated to your sport, and the other 2 days would involve functional, resistance training or a combo of activities; for example, drop and do 20 burpees or 20 push-ups every 100m of running around a track at your 5k pace for 2 laps x 4 sets...try it, I dare you, then come back and visit my blog for more). Of course, remember that you need to make rest a part of your training as well, and for longevity in the sport, 1-2 days/wk is necessary.

We'll get more into the specifics as we move along in this multi-part series.

Maven PT Guidelines for Running in Minimalist Shoes

In your daily pursuits towards improving your fitness level or running ability, you have probably come across the oft controversial topics of "forefoot strike running," "barefoot running," or "minimalistic shoes" (yes, you've seen shoes like the Vibrams I'm sure- the not-so-pretty running sneakers that resemble fingered gloves for feet). 

So, where do we stand on the topic?  Well, as an endurance athlete and rehab professional, I had been totally against the idea of running in sneakers with a "0mm drop" or flat-bottomed, no-heel rise from an injury point of view.  I had also been against changing the way you run, taking on the "if it ain't broken, don't fix it" perspective, not seeing a benefit in changing running technique, especially as an adult.

Recently, some of my running friends began adapting their running to the Pose method and were really getting some positive gains.  My curiosity was piqued.  I dabbled with it myself, watching YouTube clips here and there, reading about Pose running, and for me the real kicker was the research.  Some of the big guns in the rehab and biomechanics world (notably, Irene Davis), who had been preaching for years about the benenfits of the forefoot (ball of foot) strike....and finally gaining traction in the mainstream (thanks to folks like Chris McDougal), led me to fully embrace the switch.  Preventing injury, improving running economy, AND getting faster...I was sold. I then became certified as a Crossfit endurance coach where most of the course focused on learning the Pose technique and integrating Crossfit principles into endurance as well. 

How has it worked for me?  I have not been able to get under a 20 min 5K (7 min/mi pace) ever.
After the past 6 months of transitioning to/training in Pose style running, I PR'd at the Dumont 5K- 19:41 (6:20 min/mile pace).  So, the evidence for effectiveness for me was clear.  Of course, incorporating consistent speed work on the track and clean nutrition helped A LOT as well, but no doubt, the running technique change was a primary factor in my recent performance.

Is it better to run in the 0 drop sneakers??  Well, yes...and no.  If you have bad running form/technique and you add in shoes with bare minimal support, you would be compromising the well-being and longevity of your feet/lower extremities.  However, running with proper technique, such as the Pose Method, which we subscribe to at Maven, utilizes the minimalist shoes and will enhance your running experience and performance...BUT, it takes a serious committment and investment in time and patience to do this SAFELY.  We take a very conservative approach to introducing our runners to changing their running form/shoes.

First steps to take:
1) Decide if you really care or want to change your running form.  If you're a sub-3 hour marathon runner or elite level runner, and you've had no injuries (which is rare), I would consider keeping things the way they are.  You're gifted.  However, if you've had recurring injuries to the lower extremities (which is the majority of us), consider making a change and continue reading.  Contrary to popular belief, you CAN teach an old dog new tricks!

2) Decide on when or if you will seriously commit to changing your running technique.  Committing to make the change to a ball-of-foot/forefoot srike-to-heel landing from a heel-to-toe landing during running will take a while for your body (especially your Achilles and feet) to adjust to the new stresses.  Perhaps making the change during your running season will not be the best time to devote your efforts.  In any regard, you WILL get injured if you progress yourself too quickly. Trust me.  I have come across one too many eager novices or seasoned runners desiring to run in Pose immediately, who end up getting injured.....you know, though- it certainly would be a profitable move for Maven Sports Medicine to promote an accelerated Pose running program for people who want to learn it in a day. Hmmm...

If you're a seasoned runner, you'll have to accept the fact that you will not be able to run at your usual pace for any races using this technique during the season without the risk of injury (and don't blame the new shoes...or barefeet!).  Think about it.  You've probably been running the heel-toe way for MOST of your life and for you to transition to running on a forefoot to heel running style....it will take months of practice if you want to do it right and SAFELY.

Once you've decided that you're fully on board about the duration and committment level required to take the next steps, so to speak, here's our (conservative) transition protocol:

Recommended transition to forefoot to heel strike (Pose running):  This is subject to change as we continue refining the process, so we'll keep you informed!

Neuromuscular and Tissue Adaption Phase I (two to three months)

1. Practice running in place with barefeet and "quiet feet" running
Slowly work up to 5 minutes x 12 rounds,  2-5 times a week.
Expect some soreness in your calves, in particular, and a bit in your hamstrings during the first few weeks.  The emphasis must be on "pulling" your foot up to towards your butt.  Plenty of drills to practice that we'll be posting up on our YouTube site (search: "MavenPT" channel).  If you're doing things the right way and your form is correct, you will notice immediately that you almost automatically land on the ball of your foot and then on to the heel (let the heel "kiss" the floor). Keep your foot loose.  Also, try some short distance "quiet feet" running.  If you're running quietly, you're naturally engaging the gravity dampeners (your muscles).  Try running in place, heels first for a second. It doesn't feel good to pound your heels on the ground, does it?   If you're feeling soreness in your hip flexors the next day, your technique is incorrect.  Contact our office if you would like some help on your technique.

Ice your calves, take a day off (or two or three) if your perceived soreness is greater than a 5/10.  Basically, if you're gimping around, take the extra time off. Another activity you can add during this transition if you're thinking about barefoot running (particularly for the barefoot folks) to toughen up your feet is to run in place on asphalt or lay out a pile of gravel or pebbles and do the same (reflexology, anyone?). 

I know, two to three months seem like an awfully long time. Right?  This time period will allow for you to be generous to your feet and your body; Your limbs will work better for you as a result.  You have to get your running form to change and your body to adapt. Check out some of our basic Pose running demonstrations on Youtube (Maven PT channel). www.Posetech.com is also a good site to visit. 

Again, we're conservative about this transition, but if you feel like you require less or more time than we suggest, do what feels right for your body. You will appreciate it, trust me.  Everyone adapts differently to stresses on their bodies. 

2. Buy the 0mm or minimalist (4-7mm) drop shoes...but only use them for walking and drills.  Again, performing many repetitions over time is the best way for the necessary adaptations in length to occur in your tendons.  Getting your feet, ankles, tendons used to this feel will only help you ease into the transition. 

Neuromuscular and Tissue Adaptation Phase II (one month):
Transition to practice running short distances with your minimalist shoes or 0 drop shoes for one month.  Attempt distances of 50m, 100m, 150m, 200m, 400m on the track or flat road for another month.  You can attempt a combo of running the "old" way and every few minutes, switch over to Pose running for a mile or so and then back to your old way or running.  You will start to feel the difference and your body will start to get used to running for distance in Pose.

Reintegration Phase I (two to three months):
1.  Now it's time to transition running with a lower heel drop (Nike Free run have been my favorite, but look for a 4mm drop) for two to three months, keeping the mileage around 3-6 miles every other day at a slow pace (I know, this is relative).  Build your mileage up slowly, but steadily.   

Reintegration Phase II (two to three months):
2. Transition to running in a 0 drop shoe for two months.  Keep your mileage around 3-6 miles a day or every other day.  Some short distance speed work on the track can be done once a week, but be aware of how you feel the next day.

All in all, we believe a 5-9 month transition (again, people adapt differently) is a safe duration of time to make the slow and steady transition to a minimalist sneaker or barefoot running.  Depending on your body's ability to adapt, age, weight, flexibility, or running level, this transition time can either be lengthened or shortened. 

For more information on Pose running, check out www.posetech.com.  Contact Dr. Yoo at mavenoffice@gmail.com if you have questions or would like to be coached on running technique or how to succeed in your first sprint or olympic distance triathlon.

Week 4- sprint tri training

Team Maven,
less than two weeks to go!!  We're almost there. 

Tuesday-

Swim: 
warm-up: yes, again- 25 yds with focus on relaxing and keeping body close to the surface of water (you should be looking down at the bottom of the pool with head in neutral and feel for your hips rising to the surface). Repeat 6x and rest for 30 seconds between each length of the pool.  If you can relax your neck to stay in neutral and keep your shoulders and hips up near the surface of the water, you're improving in your basics.
Pre-set: 25 x 4 with 1 min rest between sets
main set: 4x 75 yds with a 1 minute rest between each set.
cool down: 25 x 4 (repeat wm-up above).

Bike: 
warm-up: 10 minutes with emphasis on pedal stroke.  Easy gear (small gear in front, larger gear in the back)
Main set: 60 minutes- sustain aerobic zone pace (click on link).
cooldown: 10 minutes- bring heart rate down to 90-100 beats/minute

Wednesday-

Run: 
By now, your tolerance to run-walk will enable you to handle repeats of
a mile. 
Tip:  run with "quiet" feet.  Avoid stomping or pounding on the asphalt, which can be damaging to your knees, ankles, hips, and lower back.

Keep your cadence, regardless of speed, between 92-96 steps/minute.

Workout:
15 min fast walk warm-up.
Main set:
Run 1 mile x 3 with 3 min walk recovery between each mile (recovery means
you can either stop and rest or just walk for a determined rest duration. In this workout, walk easy for 3 minutes before you continue to the next mile).  If you need less or no time to recover, great!

Cross training:
Perform as many rounds as possible ("AMRAP") in 15 minutes of the following:
10 push ups, run in place for two minutes (again, light on your feet)
10 squats, run in place for two minutes
10 cross-fit sit ups, run in place for two minutes

Thursday-
Swim: 
warm-up: Swim 25 yds with focus on relaxing and keeping body close to surface of water.  (Keep your head in neutral.  Any time you raise your head/eyes to look ahead, you increase drag from your legs).  Repeat 6x and rest for 30 seconds between each length of the pool.
main set: 6x 75 yds (first 25 yds slow, second 25 yds moderate pace, second 25 yds slow) with a 30 second rest between each set.
cool down: 25 x 4 (repeat wm-up above).

Bike: 
warm-up: 10 minutes with emphasis on pedal stroke.  Avoid "mashing" the pedals (pushing down hard). You want to maintain an even, circular motion.
Main set: 60 minutes- build up to aerobic zone pace (click on link) at your own pace.  Try to find a route with a few hills on the course for the extra challenge (but, remember to switch to an easier gear while STAYING SEATED ON THE SADDLE!  Standing up decreases your efficiency on the ride and will make you more tired sooner! It should be your last resort if you absolutely can't pedal while on the saddle)
cooldown: 10 minutes- bring heart rate down to 90-100 beats/minute

Friday
BRICK Workout (bike-run):
Warm-up: (15 burpees, 15 jumping jacks, 15 squats, 15 mountain climbers) x 3
Main set:
Bike 15 minutes, run/jog 1 mile.  Repeat 3-4 times.   Feeling stiffness and awkwardness in the legs is very normal when you transition to the run!

Saturday- COURSE REVIEW AT RACE SITE IN HILLSDALE.
5:45AM-8:15AM. 
Why so early???  We're practicing race day simulation.  
The race starts at 7am.  You will have to get to the race by
5:30 am to start setting up and such (which means, you'll be
up ~4/4:30 am), so you need to practice what it feels like to
be up at those hours if you want to have an ideal race
(also figure, you'll have to have a little breakfast and take care
of toilet business as well before coming to the race!)

If you're on relay, it's still a good idea to come out early since
you'll have to get your race tags, timing chips, goodie bags,
and registration confirmed any way.
Bike: 5:45-6:45 am.
We will be starting on time.  PROMISE. Get your directions set
and your tires pumped beforehand!
If you are not present or ready to start, you can either attempt
to follow the course map yourself or
wait for us on one of the go-arounds since we will be doing multiple repeats
that hour to get a feel for the course.
AND, you can still make it over to Mavenaction bootcamp!

Run: 7:00-7:45 course run through (most likely, one run through)
If you want to run it earlier so that you can make it to Mavenaction
bootcamp, go for it! 
Transition clinic: 7:45-8:15 (Most relevant to the individual triathletes)
We'll review how to set up your transition area.
Bring: 
1 large and 1 small towel
goggles
sneakers
bike cleats
bike helmet
baby powder
sunglasses
Gu gel
filled water bottle(s)

Sunday- active recovery- choose one of the following single sport activities:
swim: 30 minutes (combo of deep water running or easy treading water)
bike: 45 minutes (easy gear)
run: 45 minutes (easy pace, 8 min jog/1 min walk)

Monday- Rest

Sprint Tri workout, week 2

Hope you survived week 1! We had a nice first-time group ride this past Saturday on 9W.

Join us again for the bike-to-bootcamp workout this coming weekend and stay tuned for the group course "rehearsal" we'll be doing in the next two weeks.

Tuesday-

Swim:  400 yds
warm-up: yes, again- 25 yds with focus on relaxing and keeping body close to the surface of water (you should be looking down at the bottom of the pool with head in neutral and feel for your hips rising to the surface). Repeat 6x and rest for 30 seconds between each length of the pool.
main set: 3x 50 yds with a 1 minute rest between each set.
cool down: 25 x 4 (repeat wm-up above).

Bike:  60 minutes- (seems like a big jump from last week, but more emphasis on warm-up.
warm-up: 15 minutes with emphasis on pedal stroke.  Easy gear (small gear in front, larger gear in the back)
Main set: 35 minutes- sustain aerobic zone pace (click on link).
cooldown: 10 minutes- bring heart rate down to 90-100 beats/minute

Wednesday-

Walk/Run: 45 minutes-
walk fast for 10 minutes, jog/run 8 minutes (aerobic zone pace), walk 1 minute. Repeat x 3. Try to keep your cadence (number of steps you run in one minute) between 93-95.  Cooldown walk for 10 minutes.

Cross training:
Perform as many rounds as possible ("AMRAP") in 15 minutes of the following:
10 push ups
10 bent over rows with dumbbells (12-25 lbs)
10 burpees
10 mountain climbers
10 jumping jacks

Thursday-
Swim:  550 yds
warm-up: Yes, this is really important, which is why I have to emphasize it- Swim 25 yds with focus on relaxing and keeping body close to surface of water.  (Keep your head in neutral.  Any time you raise your head/eyes to look ahead, you increase drag from your legs).  Repeat 6x and rest for 30 seconds between each length of the pool.
main set: 6x 50 yds (first 25 yds slow, second 25 yds moderate pace) with a 10 second rest between each set.
cool down: 25 x 4 (repeat wm-up above).

Bike: 40 minutes-
warm-up: 10 minutes with emphasis on pedal stroke.  Avoid "mashing" the pedals (pushing down hard). You want to maintain an even, circular motion.
Main set: 30 minutes- build up to aerobic zone pace (click on link) at your own pace.
cooldown: 10 minutes- bring heart rate down to 90-100 beats/minute

Friday
Walk/Run:  ~55 minutes-
walk fast for 10 minutes, jog/run 10 minutes (aerobic zone pace), walk 1 minute. Repeat x 3. Cooldown: walk for 10 minutes.

Saturday- Bike to bootcamp day
6:30 (sharp)-7:25 am GROUP BIKE Ride on 9W- out and back.
Meet at parking lot behind office building on 2460 Lemoine Ave.
(Lemoine/Washington Ave) in Fort Lee.

then, off to MAVENACTION WORKOUT!!!!!!

BRING A GU OR OTHER GEL, CLIF BLOKS, AND PLENTY OF
HYDRATION TO CONSUME BEFORE THE MAVENACTION WKOUT.

Sunday- active recovery- choose one of the following single sport activities:
swim: 30 minutes (combo of deep water running or easy treading water)
bike: 45 minutes (easy gear)
run: 45 minutes (easy pace, 8 min jog/1 min walk)

Monday- Rest

Sprint tri workout. week 1

Team Maven-
Thanks for your patience!

Overall program design for the team- we're doing our best to provide an appropriate beginner's level tri workout that incorporates a heavier emphasis on cross training and high-intensity interval training.  Your feedback is appreciated (too hard, too easy, just right). 

We really believe you'll have a much better first-time triathlon experience when your overall conditioning and nutrition are humming along at their best.

Where to Swim???
-Glen Rock Pool has a daily admission rate of $12.  Great pool.  50 yds (similar to race length).
-Paramus Munical Pool- daily admission of $20 as a guest (we have a few team members who are members there).  This is also a 50 yd pool.
-Maywood Pool- $10 admission as a guest (we have a few team members who are members here as well).  This is also a 50 yd pool.
-24 Hr Fitness- currently has a flat month-month rate of $80 for use of the entire facility.  This is a 20 yd. pool.
-Wyckoff YMCA- feel free to come as my guest for $10 and intro swim lessons by yours truly.  This is 25 yd. pool.

Training tools-

Heart rate monitor:
Using a heart rate monitor is very useful to have during training so that you can monitor your response to and progress during activity.  You can a get a decent one (Timex, eg) for a relatively low price on Amazon.com, and it will last you a long time. 

If you don't have one, not all is lost. Click on this target HR link, so that you can get a general idea of your aerobic range...this means you'll have to stop and check your pulse during activity, which can be a bit of an inconvenience.  The best way to take your pulse is at the wrist area below your thumb (radial pulse).  Take your pulse within 1 minute to get the most accurate reading. 

Bike computer:
Even if you never use it again after this race, the $20 investment will be a good one.  Track your mileage, your speed, time spent on the bike.  Better yet, if you own an iPhone, download the free Strava app.  Strava will track your bike metrics as well via GPS.

Here's the workout regiment for this week!!

Tuesday-

Swim:  300 yds (8 laps in a 25 yd pool or 4 laps in a 50 yd pool)
warm-up: 25 yds with focus on relaxing and keeping body close to the surface of water (you should be looking down at the bottom of the pool with head in neutral and feel for your hips rising to the surface). Repeat 4x and rest for 30 seconds between each length of the pool.
main set: 2x 50 yds with a 1 minute rest between each set.
cool down: 25 x 4 (repeat wm-up above).

Bike:  30 minutes-
warm-up: 10 minutes with emphasis on pedal stroke- if you have "basket" or clipless pedals, try pedalling with one leg only for 1 minute, then switching for total of 10  minutes.  Goal is to keep an even stroke with minimal forward rocking feeling.  Try this activity in every gear on the bike.  Use a stationary bike if you can't get on a real saddle!
Main set: 20 minutes- sustain aerobic zone pace (click on link).
cooldown: 10 minutes- bring heart rate down to 90-100 beats/minute

Wednesday-

Walk/Run:  40 minutes-
walk fast for 10 minutes, jog/run 8 minutes (aerobic zone pace), walk 1 minute.  Repeat x 3.  Cooldown walk for 5-10 minutes.

Cross training:
Perform 3 rounds of the following:
15 push ups
15 air squats
15 burpees
15 crunches
15 jumping jacks

Thursday-
Swim:  400 yds
warm-up: 25 yds with focus on relaxing and again keeping body close to surface of water. Repeat 6x and rest for 30 seconds between each length of the pool.
main set: 6x 50 yds with a 10 second rest between each set.
cool down: 25 x 4 (repeat wm-up above).

Bike:  40 minutes-
warm-up: 10 minutes with emphasis on pedal stroke- if you have "basket" or clipless pedals, try pedalling with one leg only for 1 minute, then switching for total of 10 minutes. Goal is to keep an even stroke with minimal forward rocking feeling. Use a stationary bike if you can't get on a real saddle.
Main set: 30 minutes- build up to aerobic zone pace (click on link) at your own pace.
cooldown: 10 minutes- bring heart rate down to 90-100 beats/minute

Friday (repeat of Wed workout)-
Walk/Run: 40 minutes-
walk fast for 10 minutes, jog/run 8 minutes (aerobic zone pace), walk 1 minute. Repeat x 3. Cooldown: walk for 5-10 minutes.

Saturday-
6:15 (sharp)-7:20 am GROUP BIKE Ride on 9W- out and back.
Meet at parking lot behind office building on 2440 Lemoine Ave.
(Lemoine/Washington Ave) in Fort Lee.

then, off to MAVENACTION WORKOUT!!!!!!

BRING A GU OR OTHER GEL, CLIF BLOKS, AND PLENTY OF
HYDRATION TO CONSUME BEFORE THE MAVENACTION WKOUT.

Sunday- active recovery- choose one of the following single sport activities:
swim: 20 minutes (combo of deep water running or easy treading water)
bike: 45 minutes (light gear)
run: 45 minutes (8 min jog/1 min walk)

Monday- Rest

Best treatment for "Runners' Knee" aka IT band syndrome, Part 1

IT band syndrome or "runners' knee" is quite common in the athletic community and particularly with runners. Patients often complain of pain on the outside of the thigh or near the outside of the knee while they run or after sitting for a long time (aka the "movieogers' sign).

Anatomy
The "IT" band or iliotibial band is a long stretch of connective tissue that runs from the side of your hip down the side of your knee, anchoring just below the side of the knee cap. It's a very sturdy length of tissue and provides a great deal of stability to your limb particularly during dynamic activities like running and jumping. The gluteus maximus and TFL muscle (tensor fascia lata) attach to the IT band with the TFL located at the very top of where the IT band originates.

Causes of Dysfunction
Tightness of the hip flexors, TFL, relative weakness of the hip external rotators (glutes, eg) and quadriceps (VMO) can contribute to a tight IT band. Hyperextended knees may also cause more stress on the IT band, causing it to be more stiff and painful. Without addressing these regions and correcting the biomechanical and movement faults through specific strengthening, neuromuscular re-education, and flexibility exercises, it is almost meaningless to do things like friction massage or foam rolling, since the heart of the problem has not been gauged out yet...allowing the problem to return quickly.

Treatment
The treatment approach to IT band syndrome is multi-factorial from a physical therapy perspective. Deep friction massage, rolling on the foam roll, relative rest, and IT band strapping are important mainstays in treating the SYMPTOMS, however, we must first address the aforementioned causes before deciding on what approach would be most suitable. So.....

WWMD? (What Would Maven Do?)
For runners and triathletes in particular, we have to look at a few things with a finer lens.  Running form can be a telltale sign of IT band pain causation, especially for those who run "knock-knee'd".  Does the athlete's foot pronate?  Is an orthosis necessary (you say, orthotic, we say orthosis)? If an athlete bikes with his/her knees turned in, as some have been taught, there is a risk of stressing the IT band unnecessarily.  We always check a person's single and double limb squat, as described by Dr. Chris Powers from USC, and gain a lot of information about how much contribution gluteal weakness may be involved in an athlete's IT band pain.

In addressing a patient's IT band pain symptoms, we have found Jenny McConnell's IT band taping strategy to be particularly helpful in managing symptoms as well as velcro ITB straps. We usually tape or strap up the IT band prior to strengthening the knee to maximize the effect of the exercises while "quieting" the IT band from interfering with our treatment goals. Sometimes with chronic cases, using therapeutic ultrasound on a higher setting (1.0 MHz, 1.8-2.0 W/cm2) to improve elasticity of the IT band before exercises helps. Having the patient warm-up on a non-pain-provoking cardio machine (bike or elliptical, usually) before we start strengthening activities can also suffice.  

Exercises
Strengthening the gluteals is an absolute mainstay in treating the IT band.  Period.  Hitting up the glutes often gets overlooked by some rehab professionals continuing to use antiquated knee flexion/extension activities (they are important to include, but only a part of  the solution).  For a complete list of exercises we use at Maven, stay tuned.

Prognosis
Depending on how long the patient has waited to see a medical professional and how willing he/she is to limit the pain-causing activity temporarily, IT band treatment can take a good three to six weeks before symptoms begin to subside and a return to sport protocol can be implemented.  I can tell you from my own experience, the waiting period for an injury to improve is absolute mental torture more than it is physical pain at times. Can I get an AMEN?!

In the meantime, running in the pool, cross-training (including Mavenaction or CrossFit type workouts) at your heart rate in 80-90%+ range over a sustained period of time can be quite beneficial in maintaining your level of fitness for competition or training. 

Pre-race meal for a triathlon!

In years prior, when I was but a fledgling of a triathlete, I often made the mistake of overcarbing and/or overeating the night before, thinking, "Oh, I need to pack it in for the race (which was merely an excuse to go on a feeding frenzy)."  I was also 18 lbs heavier back then and a bit too cavalier about what I thought I knew about endurance nutrition.
Present day, many of you already know that my nutrition consists of an 80-90% vegan/paleo (yes, and I used to scoff at the mere thought of those vegans) with most of my day-to-day fuel coming from veggies, nuts, fruit, quinoa, brown rice (in small quantities), eggs.  I do eat meat, just more sparingly.  My dairy consumption is sparse.  Yes, I still consume quantities of "bad-for-you" food once in a while.

So, I've been experimenting with what foods work for me, and I'll tell you as well.  You have to figure out what works best for your body.  Eating for me has become a fun and quasi-experimental activity as I now pay more attention to how I feel and respond to different combinations of food, especially during and after training.
Jerry's Pre-Race Meal Axioms: 
1.  Never try to eat something new and different the day of or the night before a race.  Commonsensical, right? Wrong.  I've had one too many late night poop-attacks on the potty in the past resulting from adding new foods or consuming too much food the night before..what a God-awful way to get your race day started...as a sleep-deprived, dehydrated, anxious, and bloated mess! Ugh..please, Mr. photographer, no race day shots!

You really should be experimenting with food, relentlessly....but, months or weeks before your race. You never know which foods may really click (or not click) with your body until you try them out during a training run. As an endurance athlete, I never knew I would really enjoy being mostly vegan and less of a "carbivore".

2.  Eat for your race/event/training type. Fueling for a sprint triathlon is way different from fueling for a half-IM ("IM"= IronMan).  I do believe you should carbo load a bit more for the longer duration races (and of course, while racing), but consider adding higher quality sources of carbs like quinoa (which, btw, is actually a seed, not a grain), lower GI fruits, like apples, pears, berries, and foods that contain medium chain triglyerides (coconut, avocado, nuts, eg) to your nutritional regiment.

I've provided a typical morning/pre-race meal that has been working for me. I get plenty of fuel from the nuts, fruits, and veggies.  Timing is important, so I try to consume the following at least 1.5-2 hrs before activity:

1.  20 oz. water
2a.  20 oz. veggie juice (kale, parsley, banana, applesauce, berries, alkaline water, handful of almonds or sunflower seeds) blended in my Blendtec blender with a scoop of Vegasport performance protein and a cup of the MavenShake (of course), 1 tablespoon coconut oil
2b. (for longer workouts/races)  Handful of crushed almonds, 1 tablespoon of coconut oil, 1 tablespoon of almond butter, handful of flax seeds, handful of goji berries, 1 tablespoon of honey mixed and spread on apple slices
3. 3 Hammer endurolyte capsules 
4. Chlorella, curcumin supplements
5. Wait 20-30 minutes
6. Make "the deposit" in my porcelain bank. ;)
7. Get ready to take on the world!

What to do when you get hurt (PART 1: The P.R.I.C.E. is right!)

The P.R.I.C.E Is Right!

Man, I wish I had come up with this acronym. If Bob Barker only knew....

PROTECT- (I would add PREVENT...that's worth at least 10 cents)

REST- (active rest is key)

ICE- (not heat?)

COMPRESSION (squeezing out the juice)

ELEVATE (you mean, gravity can be your friend?)

Since common sense seems to flee even the most erudite amongst us when we're caught off guard, we'll be writing a mini-series on injury and post-injury management over the next few blogs.  If you're active, it would behoove you to read on, since you've probably been injured in the past and maybe in the same region over time.  Obviously, the guidelines I've provided are general, and always free free to email me if you have a specific concern.  

Some of the more common questions we come across as far as immediate injury and post-injury management are, "Should I heat or ice?" "Should I stretch?" "Can I still workout?"

Of course, seeking medical attention should always be on the forefront of your mind when there's severe pain...and not how the injury is going to affect your beachbody in the making!

Protect

This is a huge part of the initial recovery process.  Using immobilizing aids such as, splints, crutches, slings can be essential in getting you to recover quickly and give your body a chance to drive the necessary chemically-mediated responses to the injured region. Taping, such as Kinesiotaping (well, at least it looks cool) and McConnell taping (my personal fave for most joint or tissue injuries to the extremities) usually work great for temporary or short term use for a few reasons- one, to keep you mindful of your injury (and hopefully, hinder you from doing something dumb). Two, to support the injury during necessary activity in the acute phase (like walking...not running) and physical activity beyond the subacute phase (10-14 days post-injury).  Three, to help you gain some sympathy from your co-workers and/or loved ones (results not guaranteed).

If It Hurts, Don't Do It

Duhhh....Stop "testing" out the injured bodypart; if lifting your arm to certain point causes pain,  don't lift beyond that...I even amaze myself about how I obsess over trying to test out my fresh injuries (oh, I practice what I preach all right...).  When you constantly move a joint or contract a muscle that's been injured, you run the risk of prolonging the acute phase, which sets you back further from getting back to what you love to do.

Active Rest 

This means, avoid continuing the activities or movements that caused your injury, but doesn't necessarily mean you need to stop being active.  For example, if you sustain an injury to your ankle, it doesn't necessarily mean you can't do an effective upper body cross training workout (Click to watch...and yes, I have two stunt doubles performing in my stead.  Special thanks to John Kim and Dr. Taylor Lee).

Stretching?

Resounding "No".  Surprised? Avoid stretching during that first two weeks of an injury.  You won't give scar tissue the chance to start layering and webbing around the injury.  It's like picking at a fresh scab. Ouch.  After that two week time period, yes, definitely a graded stretching approach would be absolutely beneficial and necessary for healing and PREVENTION.

Ice or Heat or Both?

The general "medical" recommendation out there is to ice for the first 72 hours after an injury.  Apparently, there is a questionable benefit of using ice after this time period.  I disagree.  Being that the acute stage of a musculoskeletal injury is about 7-10 days, controlling inflammation is absolutely necessary.  I think it's good to mention here that inflammation itself is not a bad thing. We need that initial inflammation after an injury to get the healing process started.  In addition, guiding the inflammation to lay down scar tissue in a more orderly fashion (ie, more along the lines of the existing fibers and less haphazardly) is the first step in preventing future injuries to the same area;  I'll discuss this more in a future blog.   

So, when should I use straight up heat?  Like I said, I'm a big fan of icing long after the acute phase of an injury.  I reserve the recommendation to heat for people who have complaints of long-standing stiffness or muscle/joint aches not related to an immediate injury.  We've also recommended heat (like a hot shower or moist heat) modality just prior to stretching out in the morning or at night to get a little more flexibility into the area.  

Ok, when would I use both ice AND heat? There's debate on this, but we use it quite a bit at Maven.  In simplified terms, a heat-ice-heat combo works, theoretically, by inducing a compression effect on superficial blood vessels, which would allow for excess fluid in a swollen region to be resorbed by the lymphatic system; essentially, you're creating a poor man's version of a compression sleeve at the level of the superficial tissue.

Elevating the injured limb also facilitates this fluid resorption as gravity promotes the excess fluid to head back towards the heart. 

Compression (using the GameReady, for example) further expedites the reduction in swelling.  We frequently recommend compression garments as well. 

Anti-inflammatories

You should discuss with your physician what the best choices are for you regarding types of anti-inflammatories, especially if you're on other supplements or medications.  People often ask us if anti-inflammtory meds "mask" the pain.  No, they do not.  Some of the heavy duty pain-killers like Percoset, morphine, or Vicodain would be on that pain-masking level.  As with ice and active rest, anti-inflammatory meds (ibuprofen, acetomeniphen, diclofenic sodium, eg) have been shown to actually work on helping injured tissue lay down scar tissue in a more organized fashion.

When To Seek Immediate Attention

If any of these symptoms ring a loud bell for you, stop reading this blog and seek medical attention...NOW!

-burning pain

-pain that is constant whether you move or rest

-pain that wakes you up at night

-chest pain

-inability to bear weight

-numbness and tingling in any given area (especially the left arm)

-redness,warm or hot to touch, and swollen

-loss of bowel or bladder function  

Ok, that's enough for now.  Hope that gives you a few things to think about when you get injured.

Part 2: Eatin' for Healin', up next time....

Today's quick track workout!

15 min warm up:
1600m easy warm up
30 mtn climbers/20 burpees/20 jump squats/20 pushups/30 crunches x 1 round
50m x 6 striders

Main set:
100m sprint x 10:  (10 push ups, 30 jumping jacks after each 100m sprint)

NO REST

Pace: <5k

Rest 60 seconds after entire set complete

400m x 4: run 400m, then do 15 burpees, 30 crunches
Rest 90 sec after complete set

pace: (5k pace)

800m x 4:  

run 800m, then 90 sec active recovery

Pace: 10k to 5k pace. 

Attempted negative splits: 7:06/6:48/6:36/ (all out)- 6:06 pace

 

cooldown

Outdoor track-bike trainer BRICK workout

The Demarest Sprint Triathlon on June 3rd is our next Team Maven race, so I dialed in the distances and pace of today's workout for a sprint tri. A constant work in progress, we've been refining/testing out/tweaking some training variables to effectively combine an anaerobic and aerobic conditioning program for the endurance athlete.  In essence, we want to see what activities work best during practice to excel at a given tri distance (mixing science with experience).  

The emphases of today's workout were to perform a short interval, high intensity bike-run workout, aka, "BRICK" (hence, the comical pic above), incorporate some cross-training, and sharpen the T2 transition (clipping in/out bike shoes to sneakers) of the triathlon. Oh, what fun!

Bike trainers were set up on the track.

Warm-up: ~20 minutes (VERY important to get warmed up sufficiently for injury prevention)
-10 min mile
-One round of 50 jumping jax, 20 burpees, 50 mountain climbers.
-Striders (50m x 6)

Brick workout:
Bike: 5 min moderate pace spin, then-
-1:1 min (work:active rest ratio) interval bike training x5 rounds

Intensity: 80% HR max (~160 bpm).

Clip out/switch shoes
Run: 400m. Attempted 5k pace**- (actual- 1:32-1:38/400m).
Intensity: 85-92% HR max, REPEAT ENTIRE CIRCUIT X 4 ROUNDS

Rest 3 minutes, then:
Run: 100m, followed by 15 push ups, 15 squats, 20 burpees, 30 crunches
Repeat entire circuit x 4 rounds. NO REST
Intensity: 88-90% HR max
Rest 1 minute, then:
Run: 200m, 2 min complete rest

Repeat circuit x 4 rounds
Pace: under 5k (~40 sec/200m)
Intensity: 89-90% HR max

Run: 400m, then active recovery jog, 100m

Repeat x 4 rounds
Pace: 5k (1:30/400m)
Intensity: 91-92% HR max

Total running- 4+ miles.  Done!

** 5k pace refers to goal time to complete a 5k race. My 5k goal this season is to complete it in ~18-19 min; during training today, I aimed for a 6 min/mile or less.  Take the desired goal pace and divide it according to distances (400m, 100m, 200m, etc) you're training during a particular workout (e.g., if you look above at the workout, I completed 400m in 1.5 min. If I multiply this x 4 = 6 min/1 mile). Still confused? email me at jerrymaven@gmail.com