Intermittent fasting

episode #14 on SportsDocDC take it with you!

aka 18/6 – OMD (one Meal Daily), and a million other ideas.

Although not really a revolution in nutrition or eating pattern, Intermittent Fasting has been gaining major publicity lately and a HUGE following on social media, celebrity mentions and with a lot of the heavy weights in the health and nutrition game.

So what’s all the hype about and is this idea for you?

At its roots, it is exactly what it sounds like – a mini fast – you’re going to skip a meal or two.   (Spoiler alert, you’ll live through it)

(Spoiler alert number 2 – you won’t waste away and burn all your hard earned muscle up either)  

The following is the best example I can give you:  After dinner one night, you go to bed and wake up and skip breakfast, possibly skip lunch too and then have a dinner.  Rinse, recycle and repeat as needed.

That’s Intermittent fasting – hope you have a nice day.

Wait, you want more info? Well –  lets get some details in then.

The above example may very easily be done and the health benefits are a mix of both the obvious and subliminal.

First the obvious – you’ll eat less.  You’ll lose weight most likely just because of the difference in daily calories.   It’s very tough to cram 2200 Calories into one dinner meal and it doesn’t feel good to do so even if you can.   So there’s that. It’s cheap, you’ll save money – you’ll save time as you’re not thinking about nor preparing 3 to 6 meals a day.   It’s simple.

But rich celebrities and health guru’s don’t need to save money or time, they have a dudes for that –

Surprisingly, yes, there’s actually a lot more to it.  There’s real science and some extraordinary benefits to both intermittent and even on the more extreme actual fasting.

Intermittent fasting is also  known as a “reduced window eating program” which fits.  If my first meal was lunch after my workout, say 2 pm and I had dinner eaten and dishes washed by 8 pm – I have a 6 hour eating window – essentially an 18 hour fast.

For what you ask?  Why?….Because the jacked dude at the gym does it of course…

Because your wife’s friends are thinking about swearing by it.

Because its tending and cool and that hot celebrity from Hollywood does it.

You know I need a why?  a real why…

How about some hormone optimization Holmes, that do anything for you?  No, how about gut reset and autophagy – the cleaning out of bad and potentially dangerous cells and the proliferation on new healthy cells, particularly stem cells.  (yep you have them) -also decreased Insulin and the reset of insulin resistance which is every day becoming THE BIG DEAL – as in – it seems insulin just screws up everything.  Add to that a HUGE reduction in the variety of foods you eat thereby reducing potential reactive foods.  

How about because you need to try something different – what you’re doing isn’t working and you feel like crap.

Now after all this “known entity” stuff, the whole idea of a definition or  “what exactly is Intermittent fasting” gets a little blurry as different people classify their version differently.

Many proponents of Intermittent fasting actually are working their eating window similar to above (16 hour, 18 hour fast) but are more than happy to add high quality fats such as coconut oils , MCT’s, and Ghee (often to their coffee) for the keto like effects.   Proponents of both Keto, paleo style and Lectin reduction diets all seem to find the Intermittent fasting done this way, as in a lack of solid foods or a whole meal, as their go -to diet. So is it really fasting if you’re having the fats? What if you take supplements and vitamins?  Coffee OK? tea? This is where the lines blur and different people say different things. My take is to find out if ANY of these versions seem to work for you.

When done like this, over a certain time frame, say a couple of weeks, it seems to really jump start fat loss or better yet, fat utilization.   (aka true keto…Where you actually start to burn fat (see ketosis article and lectin article coming soon.)

This is my version of intermittent fasting – I love this style – I try it often usually for a few days or weeks.  I’m not opposed to breakfast at times as long as it’s not sugary goop and cereals so on a day Bacon and eggs sounds right I’m not fasting anymore – but I will share with you my experience which is echoed by the players in the industry.

My brain works better – my guts reset –  I feel super strong at workouts, I drop fat (not just weight) but fat – quickly and can see a difference in the mirror in just a couple days – my joints don’t ache and I get over soreness soon.   My ideas on why? Because a lot of food we eat in America is crap and you’ve just excised a significant portion of crap out of your system.

I am quite confident I will try an extended fast for 36-48 hours in the next few weeks as an experiment because I have seen real world result from the intermittent.  Note: extended fast seem to work much more quickly, especially with true keto type results after you’ve prepped the system with intermittent fasting for a couple weeks – the idea is that the insulin is low and resistance has reset so you are already a few biological steps ahead on where you are trying to get to.

Recap – I know it’s kind of new and trendy over the last year but there is a feeling I get when trying intermittent fasting and there is something to it.   I would push all of you to at least try a version of this is the near future and just to “look into it.”

Understand there are multiple versions and that your social media friends may not be doing the same version as you – it’s not a one size fits all deal nor is fasting as a whole, nor keto, nor low carb – none of the internet sensation magic bullets.   It’s all personal. There is something to the whole “what we are eating is causing issues” however and although, much like global warming, a lot of famous spokespeople and trolls will just deny and these new trends until they are all but forced to see reality – it is happening now and it is all real.  You need to see what works for you and react to changes you see and feel and start to become your own best doctor, your own best nutritionist and your own best trainer.

I understand all this directly opposed to the “Breakfast is the most important meal of the day” dogma that your mom and PE coach were adamant about.  

Seems like all those kids on the filmstrips of my youth weren’t actually tired at school because they were too poor to eat, it was actually because they had a really shitty home life and most likely were up all night with problems we don’t want to even dive into.   Alright that was crappy, no kid should go hungry – I’m just trying to make a point that our diets are the solution – to all of it – the fat gain, the diseases, the feeling crappy, the sleep problems. The answer isn’t anti inflammatories, antacids and more caffeine – those are the treatments and band aids – it’s time to start playing with real solutions and changes, not treatments    Causes vs treatments – We all need to experiment with what works for us and look for a “better way.”

“More” vs “Some”

episode #24 on Beawesome365 take this podcast with you!

My wife and I were at the end stage of a 4600 mile road trip.  The passengers were us and 4 kids stuffed into a suburban and touring the OLD west. Cowboy gun fights, rock climbing, staying in yurts…you name it, we did it. We crushed this vacation.

We decided a great finale to the trip would be to stay at the Great Wolf Lodge for a night.   Great Wolf Lodge is an amazing indoor water park, arcade, magic quest, kid’s paradise -money making machine.

There is so much to do it’s mind boggling and often stressful for all involved just trying to maximize the experience.

You guys know me by this part of the game – I want to maximize. In an effort to do so I think many times I miss the point that maximization is often not equal to more. I think there is a peak point of optimization and then anything beyond that shows diminishing returns.

This idea really seemed to prove itself on this trip… often times I don’t need more to be happy I just need some.

Case in point, The Great Wolf Lodge.

After a few hours of water slides, pizza, Dr. Peppers, running around, and craziness, my oldest asked if he and the other kids could just go up to the room and chill a little.  “Dad, we’ve done it…Another hour of doing it more isn’t going to make me feel better, I just want to relax a little.”

Now I’ve been and will probably always fight being one of these guys…”Whaaaat?  There’s still 2 and a half hours left?”

I could easily see myself talking my kids into staying another hour, squeezing the last drop of joy out of the water slide and taking my cost per slide rate from $15 to $8 giving me a financial “thumbs up” in the process as well.

But it wouldn’t have made anyone happier. It would have been forced and played out. In fact, it would have been conversely unhappier and less fun.

Remember, as a kid, how much fun it was to have a hotel room with no parents in it? Now that’s fun man.

So I let them go.

My wife and I decided to stay down and have a Mojito and watch the end of a World Cup soccer match.  Also fun. We talked. Not having to scream over our kids…OK, we had to scream over 100’s of other people’s kids still water-parking, but you get the point.

The next day I was talking to her about our vacation and expenses and usually family stuff and she said, “I think a lot of why we were so relaxed last night and today was just the 15 minutes we had.  It didn’t need to be a 3 week vacation by ourselves or a long drawn out 4 hour dinner…it was nice to just have a drink and watch a game with you. Sometimes a few minutes is all it takes.”

And as she does with her uncanny ability to summarize she states, “You don’t need more,  you just need some.”

The exact same idea and application as my son.  Some beats more.

Since, I have looked for this and saw a lot of application all over my life.  Look for this in your life – I’ll bet it’s the same amount of joy and pleasure (or more) …with some.

I once heard of the 3 X rule – a similar principal.  It’s used mostly for dietary things but seems to have a lot of spillover for mentality and mindfulness.

The 3 X rule is practical with pizza and beer as my primary analogy.

With Pizza and Beer, the first one is great. It hits the spot oh so perfectly. The second one is OK and, by the time you get to the third, it’s just so-so.  Any more just gets miserable and is often filled with regret later.

Guys, I could literally come up with a million scenarios to back this point, but why do more?

Nutrition Basics

get the basics - it's ok if you dont know this already..
episode #19 at SportDocDC wherever you podcast

formerly titled…Nutrition _a_ics

Nutrition without the BS….

While talking to my father yesterday on the phone, we started discussing modern diets and how he was going to attack the next few months as he is looking for a change.

He is looking at getting into some of the new stuff, specifically keto and zero sugar hoping for a fat utilization reboot.

The more questions he asked the more I realized I wasn’t getting through.  At one point he stopped me and said, “you are assuming I know which and how much of any given food is made up of carbs, protein and /or fat…and I don’t.”

“But dad”, I stated, “you taught me all of this.”

“No I didn’t.” he said, “I planted the seed of your nutrition interest by teaching you how to use diet to lose weight, taper before wrestling matches and increase muscle…I don’t know details and specifics…”

Bang!   Just like that another great life lesson at the hands of a great master.

Assume makes an ASS of U and ME.

I’ve been writing all of this stuff over the last 2 years.   I’ve tried to get a lot of nutrition stuff to you lately and at least a part of it, is in hieroglyphics.

So here you go – the incredibly abridged crash course of nutrition.  In the old days we’d say the lesson with all the fat cut out but guys…fats are good nowadays, not bad.  Keep the fat baby!

Prior to my diatribe into nutrition, I think its only fair to give you a brief course syllabus.

Most of what we were all taught isn’t exactly correct any more – it seems 100 years of research has shined some light onto dogma that has been relayed as facts. So try to keep an open mind as I relate the “new rules.”

There is by no means a “definitive” Rule of Nutrition. Every one is going to have things that work and things that don’t – everyone responds to food differently.  What I am offering is a way to grasp basics so you can better experiment.

There is no super foods, wonder drugs and/or good and bad foods. Certain foods react different to different people so use your head. packaging labels, advertisements, books, magazine articles are all written with an objective in mind. Typically $.   Labels telling you “how healthy stuff is” are put on food packaging by market research and evil spectacled, goatee twisting, red BMW convertible driving frat dudes you hated in college. Form your own opinions.

This is going to start simple.. and then just like sophomore year pre-calculus, just when you think you’ve got it -I’m going to throw in a slew of parabolas and mix all of it up.   (“2 types of carbs…puh”)

These are the basics, so concepts like reactive foods and lectins and ideas about what makes foods good or bad are not going to be used.  That’s deep, next level stuff that you can find on my links.

This is why everyone in kinesiology and pre-med, at one time in their studies,  decide they are going to major in Nutrition.  Because it’s a ton of impressive sounding words that is a blast to dive into and has set rules like math – you can figure it out in the classroom and it’s just grand..until you put in into real life and it all goes to hell.   Nutrition is chock full of “yeah buts.” As in last night when my dad asks, “A potato is a vegetable right?” uhhhh sort of. ”yeah…..but.” Peanuts are good right? ugh.

Basics – there is three general categories of food.

All food, breaks down into these 3 categories.   Lately, they are called “Macros” as in macro nutrients, a term you’ll come to just HATE if you’ve even been cornered by a friendly cross fitter, bodybuilder and new to paleo/primal diet experimenter.   These guys are obsessed with discussing each specific gram of Marcos they ingest each meal and ratios and blah blah blah – the macros…

The 3 Macros are:

Carbs   (Carbohydrates)

Proteins

Fats

Your foods are made up of these – in different ratios.  They provide the calories the body burns to live, run, work, think etc.   Carbs, proteins and Fats are the ENERGY sources for the body.

It’s important to understand the differences in these because they all act differently when adjusted in your diet.   They all do different stuff when eaten.

So where are these then?

Carbs are anything bready, sugary, starchy, and grainy.   Pasta, cereal, bread, rice, oats, cookies, syrups, potatoes, rice.

They also are the primary energy in fruits and vegetables – apples, oranges, papaya, asparagus and lettuce.

Carbs as a term, is often interchanged with sugars when speaking about diet. This is because when you eat carbs, the saliva in your spit and the acids in your stomach  break down these carbs into sugars – Carb molecules are big and big molecules can’t get past the gut lining so they break down into little components:  sugars and pass into the blood.

Your body can then use these sugars to top off levels in the muscles and store a little bit more for later.

Your body makes insulin to allow this transportation and storage.   Think of Diabetics here – this is why they need to stay away from a lot of carbs and away from sugars – they don’t make insulin so there is no way to haul it away and sugary blood is “No Bueno.”

Carbs are neither good nor bad – they’re needed.  BUT…not nearly as much as previously taught in the 1990’s and prior,  with “carb loading” and giant spaghetti dinners before competition.

In fact, hang with me here, because the body is a miraculous machine:  If you have too many floating carbs, the muscles cant take it all in, so it starts dumping it off on the liver.  The liver fills up quickly and says, “screw this – there’s way too much sugar floating around. Turn the extra into fat and store it for the days when we’re starving  (as in body fat, love handles, fat ass, flabby triceps) – we can use it then.”

Seems our ancestors didn’t have 70,000 square foot grocery stores down the street and occasionally had to go hungry at times.  Hence fat storage which is simply saving energy for a later date. (psst. Guys…you don’t need to do this anymore)

OK that’s deep enough for this article – the main point is start to “get” what foods have carbs in them.

There will be a Quiz later!

Proteins:

Think Meats primarily – muscle baby.  Actually, the muscle from other animals.   Now before Vegans start throwing bean burritos and tofu burgers at me – yes, there is protein in some plants, I get it.  I teach it, but this is Nutrition basics, 101.. and I want a basic understanding here. There is also some protein in milk etc.   But for the most part animal products.

Proteins can also be used for fuel and similar to how the carb craze of the 1980’s and 1990’s kicked in, the protein craze of the 2000’s and 20 teens exploded for basically the same reason the carb kick decades earlier did.  There’s a lot of protein in muscle – so the scientists…wait, that’s not fair. The journalist’s reporting what the scientists found, said – “eat a ton more protein, it’ll go to the muscles!”

Well….kind of.

Hopefully its pretty easy to imagine protein as muscle because that’s what muscle is made up of.

Your steak, your burger, eggs, fish, tofu (the protein from soy), chicken and sausage is high protein.

Just like sugars, proteins shouldn’t get into the blood – if your gut is working perfectly, they will break down into small parts called amino acids. The AA’s are what get’s into the blood and travel via the highway system of the body to organs, muscles and skin and repair damage.

Caveat: too many proteins can also end up being stored as body fat. You better truly need that 75g protein blast shake after your 12 minute “workout” there champ!

Fats:

Fats are the trickiest to explain. Back in the WWII era it was easy – fat was fat – the fat on the steak was fat – the meat was protein with a fine marbling of fat.

Milk was milk and 2% had 2% of the natural milk-fat still present.  Whole had the whole amount of fat (about 4-5%) and skim milk was basically milk without the fat – the fat was skimmed off because anyone from the 1930’s with a butter churn worth a damn would tell you that when you let milk set for a while, the fat rises to the top (as crème)  – you can then skim it off – a la butter. Or crème. The fat part.

Wow! Chad that’s not too hard.   Well, the mad scientists in the food industry can basically do magic with fats and carbs and turn it into anything.  Think “double stuff.”

Both the cookie part and the cremey goo – Fats started getting a really bad rap in the late 70’s and 80’s because all the chemical shit that was coming out of the mad scientist’s labs was making people sick and cancerous and actually physically fat.   But it can’t be the scientists – PhD’s are doctors and doctors are our friends – it must be the fat. Yep too much fat!…

Scientist 1: (Bob)

“Fat might be bad Earl”

Scientist 2 (Earl)

“OK, then Let’s substitute fat in food for transG-glutimate-1K-3G-polymersaccharidelactorglutimthionecarbonate. “

and….  “Damn Earl, that tastes like shit.”

2: “OK.   add 32 Grams of sugar, how is it now?”

1:  “Well it’s doable…actually the 5th time I tried it I kind of crave it”

2:   “Well…Hell, technically we can call it fat free now – wonder if the guys at marketing can sell it?”

1:   “Phew that was close. Despite millions of years of getting by, we avoided a fat-pocolypse”

2:   “Good, work Earl, want a Diet Coke?”

They were lab chemicals  – an amazingly incredible blend of carbs, fats and carbon chains replaced in ways nature never intended.   These blends resulted in some of the most crazy, technologically advanced products in the world – some of which were deemed ok to eat and further altered to make them tasty over repeated exposure.   Cheese puff dust on pringles as an example.

Well, science food blending has all grown up.    Cheesy chemicals are now just called cheese.   It’s not actual cheese. Cheese doesn’t do what Valveeta does, but its called cheese just the same.

For this article – don’t think of chemicals as fats here – its just soooo deep it’ll melt your mind and I just am not great at explaining organic chem. easily.

Let’s get modern.  No strike that… let’s go ancient! and think of fats as God intended. Fats come either as a semi solid or liquid at normal temperatures so think of things cremey and slippery. Butter, Oils (avocado oil, olive oil etc), Avacado itself is a high fat veg/fruit.   Nuts are high in fat. The fat part of meat – such as bacon – ½ fat, ½ protein and now we’re dancing everyone:

Time for a quiz.

Dissect a Whopper for me.

The bun is carbs, the meat is protein and a little fat, the sauce is chemical crap, the tomato, lettuce and onion is carbs, the ketchup is chemical crap that your brain will so desperately try to convince you is tomato, the cheese is basically fat.

Review… and this is where is gets sooo difficult because at the “billion served forces” like fast food joints, food just isn’t what it appears. The buns are modified, so is the sauce, the meat was until a few years ago and I still have a hard time thinking there’s not something more added to it to give it a unique taste and make it last longer via shipping routes, shelf life etc. Cheese, we talked about already and…you know what? – I have an easier way.

Grab whatever food you want and just look at the ingredient list.  Go ahead.

I mean if I bake bread its flour (carbs), small amount of sugar, (carbs), water, salt and yeast.  It’s basically all carbs.

Now go to the pantry and look at the ingredient list on bread for me.  I’ll wait here for a minute.

Holey, schemoley Batman…what’s all of that? Exactly. That’s why we’re all confused.   The bread in the package has about 37 ingredients!

Yet education on all of this nutrition stuff is at the 1900’s level. AND that’s just not how food is made anymore.

That’s why the revolution in caveman type eating and diet plans called Paleo, Primitive, Caveman, Carnivore and hunting/foraging is here to stay.   Kill it or pick it and you can probably eat it right with not too many problems.

Wait? Your food doesn’t have an ingredient list?   Well then, it’s probably real food!

OK hang with me here as we get to the diet revolution.

Let’s just say that you’re a, I don’t know, 20 to 70 year old man and decades of eating crap and confusing diets have left you in sub-par health.

If you decide to try keto, let’s say in an effort to reset insulin resistance (huge killer in our country), that means basically no carbs.   You need a reset…There is a reason for you. As I said earlier, carbs are neither good nor bad but there are people that a low carb diet would greatly benefit – such as diabetics and people trying to starve off cancer cells and people looking to reset a chronically inflamed body.  These guys are going for keto –

The body is a miracle see..  you can still make fuels for your muscles and brain from fats – so in keto you sub in good fats as a replacement for carbs.

Good fats are non scientist altered – coconut, avocado, olives, nuts, and oils – and for God’s sake be careful because there a million poser’s out there- Margarine is not butter.   Coconut and olive oil comes as “virgin” or “processed.” Guacamole can be quite fair game but if it’s in a package it’ll have 100 ingredients. It’s not the same as an Avocado, salt and pepper – So know this – Look for it.

This leads us to why in some diet plans – some Carbs, even fruits are out- until the results you need are seen – in some cases long term or even life long.

In fact the term keto is actually ketosis – which is “burning fats for energy rather than carbs” and not to be substituted for keto acidosis which is basically a by product and over-spill of fats.

Oh man we can get deep with this…my brain is whirling right now with body miracles and how to explain this all.

Lets step back a second here.   Those big 3 were the Macros, remember?

There are also micros – these are the vitamins and nutrients the body needs to make the miracles happen… There that’s it – that’s as far as I’m willing to go with this.

But get this – if a fruit is deemed a “super food” or “miracle” food, you need a context before you jump on board. Is it a huge boost of a micro nutrient (say vitamin A which is a great micro nutrient for your eyes) but surrounded by a gazillion carbs (as a fruit is likely to be) .   Because that jacks with a guy with diverticulitis or a guy on a low carb diet because he’s attacking a prostate cancer?

This is the amazing difficultly with writing a nutrition 101 paper – because this stuff is intertwined like a spiderweb. Everything is connected.  And there is a profound amount of dogma and old wives tales – such as..”this is good or this is bad”

Don’t despair however yo!   Keep it simple and experiment.

But at the same time, see why the newest trends like Intermittent fasting, Keto and heck even Adkins from 2 decades ago do so well. You just simply have a lot less variables to add to the equation because you are eating less ingredients.  

If you just simply start to eat PURE, you’ve just taken the difficulty of nutrition from senior year calculous back to 7th grade algebra…still a little crazy but do-able. OK take a Deep breath.  Actually take 6 deep breaths – the studies for mind reset and immediate blood pressure drop is 6 deep breaths.  

Quiz question #2 –

Why are people such as myself adding coconut oil and some ghee (clarified butter) to their coffee in the morning?

It’s a way to add a little good fats to their morning usually in an effort to get the body some macros but ensure there isn’t any carbs in their early routine.

If I am doing that with a stack of pancakes (carbs) with syrup (carbs) and powdered sugar sprinkles (carbs) I’m basically doing it because I’m uniformed OR feel a prolonged state of fasting is coming up and want to increase my fat storage (as in love handles) because I fear an impending ice age. Extra fats added to your diet while keeping high carbs in a bad idea!

OK – quickly – which macro am I primarily?

Avocado?  _____

Macadamia nut?    Both fats.   Good Fats.

Tortilla? Carbs.

Water?   Nothing, as much as you want.

Apple Juice?     T erribly high in sugars, not healthy for any.  Juice itself really.  It’s like powerslamming 7 apples into your gullet and blood with no digestion which just ins’t really very healthy.

Peanut Butter?   A wicked twist engineered to make your brain hurt….answer?  read the label, there’s a million different types and concoctions of peanut butter.

Spinach?  Healthy veg yes, but it’s macro Carbs – (see stage 2 below)

Honey?  Pure sugar.  Carb

Potato?   Carb (not a vegetable at all – it’s a starch)

Broccoli?  Carb – but mixed with a lot of fiber….hmm)

An this is how we get to stage 2 in my article –Carbs from vegetables and some fruits are different.

Yep – too bad – you have to learn this – there are actually 2 carbs:

Simple and complex.

Simple Carbs go straight into sugars in your gut – apple juice – its sugar people. Similar to drinking a coke.   (trivia – you can use apple juice in place of oral Glucose when testing for diabetes it has so much sugar!)

But an apple – has a lot of fiber and form to it – a little more complexity.  It’s a mix of complex and simple carbs (tastes pretty sweet still so you know its got a lot of sugar)

Move over to veggies like Broccoli and you have a much higher ratio of complex carbs and a way way lower amount of simple sugars.

Not very sweet is it dad?

Same goes for spinach, arugula and leafy salad ingredients – These “complex carbs” are what all of us should be injecting in our diets as they basically have a nil amount of insulin requirement and help shunt in good fats into your system.

So a big green salad with olive oil and a sprinkling of nuts may be a bang up incredible meal even for those trying to stay with a high fat diet.

A glass of orange juice however is akin to speed eating 4 oranges in 7 seconds – your body is in shock mode!

Oh my gosh guys, I’m sorry – I now this is long and I know it is complicated – the idea was to make it easier to process so you can make better decisions.  Not sure I have.

How about I leave you with this.

Get your carbs to the complex variety – leafy greens, cauliflower, broccoli etc.

Get in good fats – if you’re 27 to 85 year old, don’t be scared of fats anymore – it wasn’t them that was to fear, it was the chemicals and sugars used to replace them!  “Fat free” labeled food is out!  It’s no good.

Protein – you need some – maybe not as much as you thought though.

Start to look at labels – it explains the ratio right there: Fats, Carb (with a breakdown into sugars) and Proteins right on the label.   Hey, and while you’re browsing the label just look at ingredients. Is there is a lot of 50 cent, tough to pronounce words? Well then, yeah, those are chemicals.  That “food like Substance” came from a lab somewhere.

Lastly – don’t make this miserable – I have tons of articles about just substituting a word to change your mindset.   Diet is the word in question here. If that means the food you eat, well then no problem. If “diet” means restrictive misery, change your word.   Real Food is delicious and should be enjoyed, loved and fun. Food should make us happy!

You can create – cook, learn to love food, REAL food again – that means not concocted sauces, chemicals and packaged drivel.

Your tastes will change – I’ve mentioned before on an article how absolutely terrible a Pringle tastes when you haven’t had one for a few months.  Yet, how incredible the 14th Pringle tastes when you chow em down. It takes time but I’m telling you …Its amazing to have your real-world taste buds open up and explore the world again when the chemicals clear out.  

My dad constantly tells me how he’ll never eat Broccoli, as a fist pounding fact.  But as his taste buds naturalize to what nature intended I’m thinking maybe it won’t taste so horrible…Roasted to perfection with a great butter dollop, dash of salt and spritz of orange splash could change his mind…well probably not – but I guess we’ll see huh?

Reactive Foods and the tie to CHRONIC INFLAMMATION

take this podcast to go at: SportsDocDC episode #30

Hold onto your menu everybody and start to look closer. A new type of diet is in town and it’s all the rage. You are about to hear about it at barbecues, at the gym, and your doctor’s office andy will see it nonstop in every magazines you subscribe to.

The hot new buzzword for health and longevity with nutrition is elimination diets. Sometimes referred to as “Reactive Foods” 

The above was my headline for a lecture I presented back in 2014.  

Fast forward today – this idea is NO longer revolutionary, no longer cutting edge and no longer controversial.

Hopefully you’ve heard of it and have either tried to play with it or wanting to learn more. If not, well…that’s exactly why I write this stuff.

OK, so what are these, what does it mean and how does this affect you? Do you need it?

Short answer – Yes, It is something you should be familiar with. There will be success in eliminating bad stuff out of your diet and out of your body immediately – in all aspects of your life. You will lose weight, feel better, lift more, run faster, have better sex, think more clearly – life as you know it -will be better. 

But the people who really NEED this – like desperately HAVE to figure this crap out, those are the people with real deal medical conditions. Fatigue, rashes, joint pain, fibromyalgia, sleep pattern issues and seriously, damn near everything. If you have anything “weird” going on – chances are the diet is a HUGE part of the issue.

This idea has and will continue to change the medical treatment for people with long-term inflammatory issues and the implementation of this is WAY BIGGER than what you think.

My own brother had a lot of success treating his rheumatoid issues that took him from a “peak of life high school wrestling coach” to some days needing a cane just to get around. 

So what are we talking about here? 

Many of these plans, and there are thousands of them out right now, focus on a new way of looking at health by “eliminating” foods that your body treats basically like an allergen. Now look, allergy and reactive foods are not the exact same thing. However, the line that the common media and subsequently a lot of doctors use to differentiate these two terms is blurring. The terms are thrown around sort of interchangeably and really, the treatment – which is simply  the elimination of these from your system, is the same – so get the gist here… You eat X and your body reacts poorly.

It sounds a lot like an allergen right? Well it’s not exactly – an epi pen wont be needed nor will it even help. The proper term is reactive food and it is a bit different than a common allergic reaction such as a bee sting or cedar oils. But…It is a really easy concept if you think of it similarly.

Typical food reactions will show increased water retention, so a short term weight gain. The extra water is part of the response to try and process the food through your guts. You’ll also notice, if you’re paying attention, an instant histamine reaction. (stuffy nose, light congestion).

Sometimes it is the amount and frequency of the foods. For instance steak might be fine for a person, but have it two days in a row and you get the reaction. Sound crazy? Actually it’s fairly common. Your body just doesn’t like a certain product at certain levels and it bugs out. Probably, at some level, you’ve already been flirting with some version of a reactive food plan already. It’s not obscure anymore and the whole Gluten Free thing has got HUGE – Your supermarket has an entire row dedicated to it!

I have shared ideas on Lectins, Keto, intermittent fasting on this site even – and the article reads about the same . Dr. Gundry and his Lectins diet and book, takes this whole thing deeper – from reactive foods, to the actual cause – so if you want more info – click on all the links I’ve posted above –

I wrote this article to basically water it down a bit, make the pieces easier to digest and understand.

Small proteins traveling through the gut wall due to cell wall barriers working incorrectly or being hijacked is tough. Reactive food? That’s easy…

Grog eat X. Grog feel Bad. Grog no eat X.

I’m sure you or a friend has heard of grains, especially gluten causing problems? Lactose Intolerant? Dairy, sugars, Paleo, RAW, Vegan – all of these, minus a few basic ethical food choices are types of elimination plans. These plans aren’t new, just newly packaged and marketed. And lately, researched and advanced.

And I will tell you, they aren’t bunk. This idea of reactive foods is quite real and backed by real science. I have tried a 20-30 day trial myself and learned a ton about my body. I have taken a new style reactive foods blood test. I constantly test and experiment. I make better decisions  because of the knowledge I have about what reacts with my body and in what volume and have become fairly acute in understanding when something that has been ok for me for a long time, or even a “healthy food” is now a reactive food – and obviously, not healthy for me anymore.

How do I know when I’m reactive? Clues…such as a 3-4 lb weight gain the next day, a feeling of bloatiness, soft(er) abs {I’m not a six pack guy on normal days by any stretch} and usually within fifteen minutes of eating something I’m reactive to- just a little more snappy and jumpy than normal – Stuff my kids do that usually makes me chuckle now makes me agitated. Give me 7 Pringles and have my kids get all the pets out and play…It’ll drive me nuts! And this is after just a small amount – can you imagine 3-4 potato chips causing a 3-4 lb weight gain? I couldn’t – but it does!

A single granola bar or bowl of oatmeal, yep…for me it does – Potatoes and oatmeal were my first Reactive foods! The removal of these from my diet basically jump started my entire “re-look” into what I was taught in school and what most of us in the health field regurgitate about Nutrition but is basically 20-50 year old science that is wrong. I sat and ate lunch with my 5th grader today – it was very eye opening to see what these kids think about Nutrition by 5th grade. – much of it is terrible advice and poor science. More old wives tales than solid  nutritional foundations at this point in time. It’s turned into bad and good. Only – either/or. Food isn’t a pass/fail test. It is a relationship with lots of moving parts.

Back to potatoes and oats – “whoa Chad – does this mean oats and potatoes are out?” well no, not really. Potatoes and oats aren’t bad foods, (well maybe oats (see Lectins) -heck sweet  potatoes and oatmeal are supposed Superfoods right?…but not for me. For you? Who knows…you have to test it to find out.

As I’ve stated, reactive foods are not allegies. Many times, reactive foods are reversible, not a true allergy, just something that’s not wanted in your system at this time… weird yes, but I make better choices for me because of this info.

The problem with the way foods react is inflammation. Yes! The biggest HEADLINE word for health in the last 2 years and sure to be the main issue treated worldwide over the next 2 decades. Look, it’s not that a little inflammation will kill you, but with food, and especially without knowing what is causing it, is chronic inflammation (the next biggest buzz word in medicine.)

Your body, in basic terms, just doesn’t function while it’s fighting inflammation. Nothing works like it should – not energy creation, fat removal, cancer fighting cells, muscle growth, healing capabilities, hormones, sleep pattern, pain regulation…NOTHING! You have to get rid of inflammation to let the body heal correctly. This is why real diseases like rheumatoid, psoriasis, cholesterol problems, diabetes and Cancer are all jumping on the inflammation bandwagon for treatment options.

AND THIS IS WHY there is a million new drugs, ads, diets and trainers focusing on it. Because it’s worth Million$$.

Like I stated earlier, I like the idea, I like the plans but ladies and gentlemen, if I come off preachy sometimes, I’m sorry but I’ll say it again, “USE YOUR HEADS!!!”

Do you have to give up all wheat, all potatoes, oatmeal? – NO! “Wait Dr. Peters, did you say Dairy was BAD?, NO wait, Just ALL GRAINS?” NO NO NO! Please don’t throw a hand grenade at a problem that needs a hammer and nail.

Again, as I’ve said over and over in the healthfield, it’s not the idea that’s wrong, it’s the practical application (ex: removing all grains when it’s a gluten or rice meal. Or all dairy and all meat, when it may be just one form or too much at once.)

You need to take the time and figure out what works for you and you only. Quit jumping on the fads and use the information to make a better decision. If a gluten free, Paleo diet that a caveman would be proud of and it works for you, fine, but c’mon, BJ’s Pizza tastes really good! sometimes I can handle a pizza and beer sometimes because I’m not fighting a disease state. If you ARE in fact treating Cancer, diabetes, colitis or anything like this then DUDE, the pizza isn’t worth it right now. Fix your body. Help your body fix itself!

This chronic inflammation and elim diets deal is going to just get bigger and bigger. It has already – its already better than when I wrote this article the first time 4 years ago. Look at my site. We have evolved! Play with what works for you and believe me you can. I started this morning differently than I do nearly every other morning and felt like crap all day long. Its real, and by paying attention to just how junky you feel after eating junk you’re on your first part of the journey. We’re all built differently, so what works for you won’t work for me. You can make your body healthier, feel better and find those hidden abs with the right approach and decision making while still enjoying some of the great foods and drinks that work with your system.

The article is pretty much over but I have a couple tools I like to help with this idea.

The book the Plan was a revolution and the one that started me on the journey of reactive foods but its tough – it takes 30 days plus and has a lot of prep. This is the future and now…

The company Everlywell has an incredible blood test that is about $200 you can do at home – I sell these in my clinic and you can get them on Amazon. It changed my world! This is so much easier than a 30 day test!

There is a company called 1 Step – where you fill out a food journal and the company has a dude that looks over all your stuff and systematically removes just 1 food at a time that is a likely candidate of crap your eating. Genius, for those a little less motivated and stubborn – but even without the website – the idea itself is powerful – remove just 1 thing at a time that’s crushing your day. Do it for a month – now find another.

Why We’re Not The Experts For Our Kids

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I’m in the middle of soccer, baseball, softball and Ninja Warrior season right now. Both as a dad and as a coach – I’m involved! I have a career as a sports based chiropractor but spend a significant amount of my time and energy on human performance. I love helping adults and kids at becoming faster, stronger and more energetic. It is a passion of mine and after 4 or 5 generations of coaching I feel like coaches and teaching is in my genes –  especially for the age of my kids right now and their sports teams.

I often hear parents say, “It’s nice to have you coach because we can tell our kids what to do but they won’t listen.” That’s true. It’s difficult to be experts to your own kids.   Watch my teams.10 kids paying attention and fired up and ready to work and my two girls doing cartwheels 20 feet away. I’m no expert for them. I’m the dad – not the expert. Barely the coach.

The other kids might think I invented the sport and what I say is GOLD – but let’s get real..to my kids I’m just dad.

This may happen to you as well. Especially the young parents that have their oldest in sports for the first time –  “why won’t she listen to me??!! I played college ball for crying out loud!”

Don’t be discouraged. I have figured it out, and I can help you. I use my friends (whom are coaches) as the experts for my kids. I used to have issue with this but I’ve seen the light and learned from my mistakes.. I’ve done dozens of Tough Mudders and obstacle courses, hell, I built the stuff in our back yard they play on, but still – NO advice from dad please.

Guys it’s no big deal. Stop worrying and see it from the kids’ perspective and you’ll see why – for millennia, parents have RARELY been the experts. Even the best coaches in the world use outside help.

Little known fact – little Vito Columbus, Chris’ kid, learned to sail from one of his friends.  Not his dad.  It was pretty much peer pressure alone that made his, although lesser known – equal in longevity, sailing career profitable and secure.

Here’s why.

They’ve seen you in your underwear.

Pretty much sums it up. How can you be an expert when the kids know you like that.

They’ve seen you in the shower, swearing while tripping on Legos, in the morning before the coffee has kicked in, hungover, swearing after you stubbed your toe, Irrate over some little insignificant thing like clothes on the floor, swearing again about another thing not picked up that you stepped on – whining, begging for them to just. Go. To. Bed. Please. Basically everything that entails being a parent.

We are intimately tied to our kids and this is a GOOD thing, but it does lend itself to familiarity and comfort– both traits that keep you from being the end all –be all expert of the universe. And let’s get real, the real job of parents is in the comfort and familiarity department. That’s social development homey. The real stuff.  . Confidence and Security. That’s OUR job #1 and something to be proud of. Our kid hitting the slider can take a back seat for a while.

Have you ever noticed how your kids get when they see their teacher at the grocery?  That’s because Teachers haven’t been thought of as actual real people with real lives. They don’t just live at the school and think of nothing but furthering the human race by the education of the youth?

Use this information. Be OK with it – you still are the person they trust and love the most and they will always come back to you. Be the one that supports what the coach says and help reiterate the lessons they need. Ask the coaches to bring up something you want to instill.

Your kids’ universe is different than yours. Their perspective is different than yours and the same information coming in different ways helps reinforce the lessons they need for sports, life, love family and development. These little guys and girls are observant and when they see others listening to your advice and ideas, they’ll eventually get the point and understand that you actually do know whatever it is you’re yammering on about over there. No matter how they act – you’re still mom and dad..the smartest, strongest, kindest and most specialist person in the whole world.  Even in your underwear.

You Have A Choice

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In this hand, I have the fix for your problems. A TOTAL fix!

You will live better, feel amazing and life as you know it will improve beyond comprehension.  Your struggles, your weight gain, your illnesses will vanish and life as you now know it will cease to exist. You CAN truly make a change!

In the other hand, I have a blue pill. It’s a placebo. You’ll wake up tomorrow and everything will be exactly like it is right now.

I’ve written about the enormity of ‘the system” and the problems that are dangerous rip currents in healthcare. (“Why are doctors so…)

You don’t have to read that article – it’s actually more of a rant than anything educational anyway – The gist is just to “be better” in society as a whole. Each of us but especially all of us in healthcare need to be better and hold ourselves to a higher standard.  It’s Just good advice for anyone, anytime.

But often…OK more often than not, in my particular brand of healthcare, ie “feeling better, therapy type treatments, rehab and performance enhancement” –

 It is the patient that is the problem, not the system!

Yeah, you don’t want to hear this

If you are indeed the patient, it is indeed a tough pill – but too bad, it is Captain Obvious time.

During such a disregard for any act of effort I feel a ‘call out’ is in need.  Maybe this helps you become a better patient and in part helps the relationship you have with your doctor so when you pay this hard-earned money to someone like me you get what you really want.

As is my norm..

I’ll preface this article with a story or two – entertaining while enlightening, I’m trying to get you to laugh.

A found laugh is like finding a dollar bill on the curb – Nothing that will change your life but still feels like you’re one up on the rest of the world.  Let’s see what I can do.

Today I had a client who wanted worked on after a massage.  Routine chiro stuff and typically its easy peesy, this workup’s cheesy.

Today however the client looked me in the eyes and said, “Hey doc – I know all this feels good, but I want a fix.”

Seriously?! You do? YES!!!

I love to fix things and although I’m happy to let you spend your money however you see fit, I want to FIX you girl! I was pumped. And dammit…I had the fix all lined up.

This was a rather common issue – she has had constant upper back tightness along her shoulders -she feels all her stress “here” (grab her shoulders and neck move) and although chiro, PT and massage all seem to help, she just feels like it all comes back 2 days later.   Sound familiar?  I hear this daily. Repeat  Daily – probably sounds like you huh?  Yeah its aggravating, but far from unique.

Remember that video I posted a month or so ago with the purple ball and the idea of how there are muscles that are movers and muscles that are “stabalizers” and on and on…No? but I made a video guys. I posted it to this page even. Here’s a link for it. Neck Stabilization Video.  

Well exactly. That’s what happens.

I went through it piece by piece – full on tilt awesome therapy delivered to your face. Aaaand nothing.

She loved the little song and dance and nodded appropriately and asked appropriate questions and even had a few insights.. I could tell she “got it.”  Although this rehab is insanely low brow, low tech AND cheap  – it is incredibly effective.  Cameron, my therapist commented -, “it’s a life changing tool that nobody wants.”

Yep it is – despite being a semi flat ball and hokey and cheap it is an incredible new look into the human body and functional kinesiology rehab work. Minds should be blown!   But.  Alas, they are not. It’s like the gong show every time I get all worked up. BONG!!!! Exit, stage Left.

Don’t laugh – that video has been viewed all of 8 times since being posted with zero likes and only one comment. Even my mom didn’t “thumbs up”

Over lunch I discussed this with my staff and they concluded its just a lack of effort.   Yeah, that’s an easy answer -lack of effort.   But you see the work required for this particular life altering, headache reducing, sleep affecting rehab tool is 30 seconds of leaning on a damn ball. Leaning….It CANT be lack of effort as it is next to zero effort!

So, after my 10 minute soapbox rant, I asked her…“Or you could just have me pop your neck?”

“Yeah, that’s all I want.”

“But..But that’s not the fix, that’s just a pop – you’ll feel like crap again 2 days later”

“Yeah, well..OK – it feels pretty good – you want me face up or face down?

OK so what is this? What do I call this phenomenon?

Instant gratification? Close. Wanting a pill for a problem? Yes close. It’s a real world problem that affects many aspects of our life and we are ALL guilty of it.

I see this idea reflected in nearly ALL aspects of human behavior.

In the health fields, nutrition diet fields and with personal training field we, in the industry, often say, “people just want a pill.”

Look, we all know the dangers of antibiotics overuse at this point in the game.They don’t help viruses guys, different bug – you’re just basically killing all your good gut bacteria for no reason, which affects your ability to get well and counteracts, actually increasing your chances to just get sick again greatly – but hell, we still want it – AND, strangely we feel better when we do have a pill to pop. But let’s get real, its not helping us – we just feel like we have a fix – when in fact we don’t.

I want to change this. But I’m not sure I have the ammo for this battle.

Anyway, my take on this article is to just become aware. Wake up and seek out the actual fix not the bandaid here. Increase awareness, look for clues (It’s called a CLUE.) and dammit, care about yourself enough to want to experiment!

I write on the diet stuff often. Right?  It works. But not many try it – many claim to – remember Adkin’s diet? A million people lost a crazy amount of weight on it but if you ask people now they’ll say it was a failure – no one even read his stuff, they just cut out bread and cookies and ate crap – not at all Dr. Adkins idea. And I see this same response happening for the new trends (new and improved by the way)

Keto? Yeah mention that in public – you’ll be loved or hated and 12 different people do it differently. I mean guys, there are dudes out there preaching they have CURES! For diabetes, cancers, PAIN! And no one even looks up a correct application. What I’m saying is I need an effort here people – you need to experiment with your body.  You have to try new things! We’re humans! Our DNA is the same as everything on planet EARTH – the difference is we are incredibly adaptive and implementive. We thrive because we can make changes more rapid than the other species. Yet –  we have lost the ability to figure out what even makes us feel good. This isn’t the article telling you to try Keto by the way – it’s the article telling you to try something.  For Yourself.

Many of my patients just don’t have the energy/willpower/effort to just try something, even with the problems that cause them the most discomfort, time wasted and money.

I have one more amazing story on this. I’m going to relate it to you because it blew my mind last week.  I’ve never seen it up close and personal like this before and although it’s maybe a common psychology deal – it affects our health and entire being. I’m still shaking my head in awe.  Wow!

I had another patient, the same morning as the decade of neck pain girl from above. Let’s call him Gary, as really, I just don’t think there are many Gary’s in any of my tales.

So Gary has been coming to me for years. He always tells me he’s “getting ready.”   Getting ready to start working out. Getting ready to start eating better. Getting ready to just get his life back. Annnnd, he just moved back in with his mom for the 8th time this decade. He’ll start soon enough he just needs to get it all squared away and I guess he’s waiting for the planets to align and an eclipse to tell him the universe is FINALLY READY for him to just take that first step.

As I was working on him, he mentioned an accident he had that was the cause of all his misery. He had a major issue that I’m sure was both painful and traumatic and was the onset of all his sloth.

Casually I asked him when that was. “oh, at 7 years old he answered.” Seven?

Wait. You’re a grown ass man!  I thought, not said.

He continued…”I think the layer upon layer of scar tissue and bone destruction from the accident is the reason for a lot of this low grade pain and hesitation I always feel.

As I work on him with my hands, I just started kind of moving him around…”you know, Gary, I don’t feel ANY scar tissue or problems here man. I’ve been working on you for years, you’re good.  Seriously, you’re fine, you just need to go already. Start that workout, Start that diet you’ve been thinking about, read that book you’ve been telling me about. Dude, You’re perfect.  In fact  -There’s not even really a single cell left in your body from back in the days of that accident. Your body has remade itself a thousand times over – it’s not your body keeping you from any of this stuff – you’re good to go. As a professional in healthcare AND physical Fitness I am TELLING YOU, NOW! Is the time – You’ve got this, you can remake yourself into the image you see in your mind’s eye!

I got all fired up, basically, I became a tornado of motivation and positive quips and Ansel Adams pictures of inspirational quotes, Icebergs with giant mountain sunder the sea out of view and mountain climbers at a peak rah rah feel good, Pinterist, Artsy, Etsy motivational confetti throwing high school coach fire up incredibleness. My GOD! This is what I got into healthcare for everybody!  To Fix people to give them back their lives and Win the day!

As I disengaged my brother like grasp and  removed my arm from off his shoulders I looked deep into his eyes after wiping the sweat from my brow and saw…

Well?…

I saw nothing.

He wasn’t there.

Totally disconnected and offline. Like a robot that has lost his charge.

Blankness.

And then I saw it – a whirring in the back of his mind, his eyes more like windows at this point. A spark and a reboot.   Like restarting a computer –  he just came back online.

“OK”, he stated, “I’ll see you next time.”

He never even heard me – He honestly just went 100% offline, his brain not even registering any of the positivity I was spewing, 100% ZERO.

I mean what is that? He physically and mentally just couldn’t digest the wares I was peddling. It didn’t fit into his life plan.

It was Keanu Reeves in the Matrix amazing to me. To be there and witness it firsthand. That’s real y’all. A human reboot!

Later that weekend I was talking to my wife about this.

Her gift in this world is the ability to summarize. If she ran this website, each article would be 47 seconds long and Buddhism simple.

She put it as an analogy –

See its like this. When you Chad take your pickup into the mechanic and have them look at it, you give the mechanic your perceived basic symptoms.   “Hey Joe, my truck seems to be running weird and I’m having a hard time slowing down for stop signs and red lights and hobos.”

Joe the mechanic starts to exam and diagnose and then, like you, explain the changes that need to be made on the truck, and the brakes and tires and racks and pinions I just nod off and say, “yeah just do whatever it takes to get this fixed.”

I don’t understand mechanics much and although I love to occasionally try, it seems like voodoo and science fiction. It’s just foreign.

I just glaze over and don’t care about what Joe is yammering on about over there – I have articles to write on his back and diet and exercise routine and can’t wait to tell him how much I know if he would only shut up for a minute about my truck.

You see the irony on this yes? It is similar no doubt. So now I’m a hypocrite and a moron for spouting my faith at you but not listening to your reply.

Maybe a bit

BUT…

Now, after witnessing the life changing neck pain girl not caring and the mental reboot from Gary over there, I think I will be a better human for it. If nothing else, I can learn from expert’s advice and just…I don’t know…try harder?

I guess the worst case scenario is that I will know I have surrounded myself with people that care.  And if they are going to make the effort to care, I suppose, I owe it to the universe to care a little myself.

Be aware. Instant gratification, the pop a pill mentality is out there in all aspects of life and most likely rarely works. I know when dealing with changing the body – like cellular level reconstruction of your body, your fat %’s, your gut bacteria, your sore shoulder and hip, and muscle development – it just takes time. And effort. It’s a road and guys, it all works – all workouts, all diets, all treatments…it’s just that some work better. More efficiency and fun and enjoyment is what I’m after here.

Find out what you need changed in your life. Right now. Write down the top three things that would impact your life right now and spend just a few minutes each day improving these three things.

Example:

  • My knee is sore
  • I want to play with no sugars for a week
  • I want to see my kids hoop it up

Now work on these three things. When one of them is no longer one of the big three add a new one to the list.

Plan on having a lifetime big 3 list and what you’ll find is that these three things keep becoming smaller and smaller issues.   You’ll whittle it down to minor changes that maybe just take seconds…maybe just take awareness and you will reap the benefits in life.

Realize you are not the person you were 5 years ago. Your cellular structure is remade constantly and you can literally become whomever you want to be. If we took the time frame off of anything…fixing a shoulder, losing 100 pounds, creating kiss butt eating habits so you look amazing walking out of the shower, learning a language and on and on and on – make the effort, give it time and you can change anything!

Be aware of your blind spots and brain computer reboots and fix this stuff.

OK, this article just took on a life of its own and went all directions, sorry guys – the moral of the story is

Care about yourself and be willing to work a bit. You’ve got this!

Return to Play Criteria (For Coaches, ATC’s and YOU!)

to listen to the podcast version of this article:

YouTube: htv=https://www.youtube.com/watch?v=2ROyqDcxUSA

There is an issue that we have been seeing with Return to Play after Injury in high school aged athletes. It’s a small issue, more bureaucracy – not actual treatment issue.

It’s the problem of athletes/patients seeking treatment outside of the school.

As in, the high school softball player coming to my sports based chiropractic clinic for treatment for her sprained ankle.

I have presented this idea at high school in-services and have had great feedback and great implementation of plan improvement with a minimal effort and next to no expense.

My proposed idea gets the athletes, coaches, athletic trainer and ancillary staff on the same page and makes discussion of injury much more thorough with a huge addition of information. This, in my opinion, allows for better treatment of injured athletes, better compliance from the athlete and an improved ability to evaluate progress while returning from an injury.  

The above idea is what we all kind of have in our heads as the right way to work athletes.  It’s EXACTLY what the parents think happens. That the coaches and AT’s and the docs and the personal trainers all get together and discuss each case and nail out a full proof recovery action plan for every sprained ankle and tweaked muscle.   

The problem lies in reality.  

I don’t have your number and possibly even the time to go through every case.  My own kid’s practice is right after work and many of us in every field – aren’t getting home until 9 pm some nights!

If a patient is seeing another doctor, outside of the athletic trainer’s room, the buck passes to the MD, Pediatrician, chiropractor, PT etc rather the the athletic trainer and coach to make treatment, rehab and return to play recommendations.

While this may seem like a great idea for administration and liability issues, it creates room for problems.

Although I think the diagnosis and occasionally rehab/treatment for some athletic injuries and definitely for illnesses can best be managed by an adjunct doctor… 

The athletic trainer in conjunction with coaches is best suited to assess the athlete’s day to day recovery and return to play and practice.

The doctor is hampered in this regard as we just don’t get to monitor day to day function and have to rely on standard and structured testing to secure our diagnosis. Our job, as ancillary staff, is in the diagnosis. Further x-rays, testing, recommendations for surgery, ruling in/out major illness etc is our job and where our expertise is best utilized.

How long a basic sport injury keeps an athlete out of activity is not our strong suit.  

In this article I will explain this idea in more depth with a proposed idea on how to implement a BASIC but possibly improved “return to play criteria” for your athletes.

Let’s use an ankle sprain, in a high school track athlete, as an example.

A junior in high school 400 m track athlete sprains her ankle while playing pick up basketball one day after practice.   

Because the injury happened “after hours” – the parents take her to a minor ER clinic just down the road from their house.

The doctor makes the easy diagnosis of a grade 1 to 2 ankle sprain and recommends rest, ice, compression and elevation. Common Injury, Standard treatment.

The athlete then gets a note for time away from activity as it’s needed for the sports participation/ athletics period etc. as well as a courtesy for the coaches and training staff.

In some instances, this athlete may not even be able to receive additional treatment from the Athletic trainer due to the issue happening outside of the school. That’s a shame. Most of the athletic trainers I know would still treat the athlete… however their hands may be tied due to policy.

Before this athlete can return to play and practice, the MD that saw her must sign a note for release.   

Typically, the parents call the clinic and say, “Can I get a note for my kid to get back to competition?”    

That’s a fair enough request and this is how the system works on paper. It seems uncomplicated and proper policy. The MD wrote the note and decided, based on their expertise, the treatment plan.

And here is where the bureaucracy train starts the locomotive of inadequacy.

The doctor, in all good conscious, cannot sign a letter for return to play or practice without first running the athlete through a set of tests again to see if the ligaments are in fact strong enough, as in enough healing has occurred, to allow for resistance and activity.  To protect the athlete from further injury.

Is there a set standard – what should be done? This is in a clinic remember, not on the field of play – this is at the doctor’s office and even this is assuming the same doctor is in the same stand alone minor ER setting. It could be weeks before the athlete’s and doctor’s schedules even match up. Anyway, what should the doctor do in this situation?

Just call it in?  Have the receptionist just write a note after the suggested time frame?  That’s poor doctoring, I don’t think you’ll get much of that anymore…so what else?   Feel it? Have the athlete stand on it? Run up and down the hallway a time or two? Or more commonly – just go by the standard 6 weeks! rest and no activity.   I mean, that’s safe right?   (NOTE: recovery for this injury should not take 6 weeks.)

Is this doctor even qualified to make these decisions? A license as a chiropractor, MD, DO, dentist, PA, NP etc don’t necessarily make you expert level at sports injuries.  Diagnoses? Yes. Treatments and Return to Play, not necessarily. That kind of stuff takes experience even if you did have a sports specialization – which most don’t have – not to the degree an Athletic Trainer does.

Even if the athlete looks strong through the clinical exam and testing – Does that correlate well with the sports field, the track and the court?  The demands are completely different and maximal ‘game play’ exertion is unobtainable in the clinical setting.

So let’s assume this athlete waited 6 weeks for the ankle sprain and then has been cleared medically…ahhh finally. Well half the season has passed and now the athlete has not only been deconditioned and is behind the curve competitively but I would make a strong argument that 6 weeks of rest has in fact, not helped the sprain heal well but mostly just decreased pain. The initial sprain has need of a progressive resistance return and strengthening program and usually sooner rather than later.

Stated differently- Rest may have in fact, weakened the entire joint complex at the expense of rest and pain control.    

Again, the most qualified person to perform these treatments and exercises are an athletic trainer although I’ll allow the argument of a sports based physical therapist/ rehab specialist such as some chiropractors and even personal trainers work as.   There are qualified people, I’m just suggesting, most athletes at the middle school/high school level aren’t getting this.

Communication is the key to any and all patient recovery. It speeds up everything. But let’s not forget reality. This isn’t the NFL and there is not an infinite resource of trained staff and doctors and athletic trainer in a one on one setting out in the field. 

The athletic trainer ratio to athlete is not 1 to 1. More like 1 to 150, especially in the high school setting.

The athlete needs help – the Athletic Trainers need help too!

Using coaches in decision making.

Coaches are the ones out there. Despite not having as extensive of background to make complex medical decisions, they intimately understand body mechanics, gait, pain levels, wimpiness as well as just “knowing their athlete.”

Coaches can tell how hard to push an athlete and any ethical coach will not want to push an athlete too far. They need that competitor on their team!

Coaches and Athletic trainers have much more immediate communication with both the athlete and the injury. The athletic trainer with coaches input ARE THE BEST at the evaluation of the injury itself with regard to recovery.

Is the athlete going to make themselves worse? Do they need further consultation? Are they OK to move?

Ancillary staff – chiropractors, PT’s, pediatricians, team doc, surgeons etc can work one on one to help mitigate serious risk and allow for more direct work in a one on one setting and help get through the injury itself.

Again, my argument is that the ancillary staff is not qualified for return to play criteria. We aren’t on the field and don’t get to see the athlete in movement and sports specific situation.

Athletic trainers and coaches are together, the best qualified and should work together with input from the athlete on any and all return to play.

If “passing the buck” to ancillary medical staff, plan on a generic 6 weeks rest.

Basic return to play criteria

Use “pennies”

In the upper level sports teams..college and professional – the use of different colored jerseys or “pennies” are extremely common.

These pennies allow for immediate recognition to the coaches and staff both in live practice and video that the athlete is not 100%.

They allow for the athlete to still be present, play in correct positions, see in-play decision making for game day corrections, have movement and be participating with the team.

Teammates can easily recognize the injured athlete is not 100% – so contact, speed etc should be appropriately controlled so as to allow for recovery.

Coaches can evaluate practices with the understanding that the athlete is understanding week by week adjustments and is engaged mentally with the ability to digest that the athlete may not be fully functional in practice but with the understanding that by game day they may. Reps, even at a reduced speed,contact and ability is infinitely better than no reps and I think in 2019 everyone can agree rest alone is almost never the best recovery option.

My suggestion: use pennies in nearly every practice. Get the athlete on the field.

I utilize a 6 day recovery to 100% model for low grade injuries.

Day 1 : 50%

Day 2 : 65%

Day 3 : 75%

Day 4 : 85%

Day 5 : 95%

Day 6 :100%

The athlete can not go past his assigned percentage for each day.   

If the athlete passes the day with no setbacks or recurrences he is moved up the chart to the next percentage.

If there is a re exacerbation, the athlete stays at the same percentage for the following day or a reduction in percentage based on the Athletic Trainer’s and coach’s discretion.   

Further therapies, rehab techniques, clinical work etc is done IN ADDITION to practice, not in substitution of.    

Certain max ability drills such as sprints, gassers, max out weight room workouts etc are not done until the athlete can tolerate them. The additional therapies required for maximal recovery may work into these time slots.

By game day, the AT and the coach will have a good “working idea” of the athlete’s ability and chance of exacerbation and re-injury.

The reality is in all sports, the athlete may not be 100% in each case. I’m not suggesting 100% before competition as I think that’s another “on paper” reality that isn’t a realistic in the sports world.  By 6 games in to a typical high school football season, I would argue, no one is 100%. I bring this up because I had conversation with an athletic trainer that didn’t want his athlete’s seeking out my care as a sports based chiropractor because he had a policy of “100% healthy or No Play.”   This meant that if they were seeing me for a pre-game “tune-up” , it equated to being injured and he threatened to sit athletes out of competition that week.

The reality of this is that athletes rarely would seek out treatment form the athletic trainer for fear of being benched for little tweaks or tight muscles. They knew that if they had any reported “complaints” it was viewed as injury.

This is a double kill situation where the athletic trainer saw very few athletes. He could go about his day blissfully unaware of basic, simple care his teams would benefit from – completely confident that his teams were perfect with no complaints.  The actuality was no one dared seek their team’s “professional.” The coaches wouldn’t use him as they knew he would sideline their players, the parents used outside staff exclusively for the same idea and the athlete’s themselves had no confidence or even worse were scared to talk to the athletic trainer about injury or sports performance. The best qualified member of the staff was “out of the loop.”

Back to return to play…

The alternative to doing what I feel is correct, is rest. Wait for a release from a doctor that doesn’t have any way to make a decision other than allotted time, and I feel, a significant chance of re-injury, as the athlete has had no ability to re adapt and prepare for the demands of competition.

I understand there needs to be policy. I understand that policy at certain districts are at odds to my proposed ideas. Understand this is a very generic, very vanilla return to play criteria offering an improvement in the current status quo with minimal effort level.   It benefits the athlete, the team, the coach and the training staff. It isn’t created to circumvent policy but to focus on the fact that the sports arena as a whole has a lot of gray areas and a one policy for all is a dangerous concept and often not in the athlete’s best interest.  

Obviously, any criteria for an injury and return to play is a case by case scenario and should be adapted for each individual case to best match the needs.

My points…

We are having the return to play being either negated or done sub par in cases.

Often it is by the wrong provider based on circumstance and perhaps policy.

Policy should reflect what is best for the athlete, not be based on the degree of the practitioner.   

I argue that the Athletic Trainer with help from the coaches is THE BEST qualified people to create and implement return to play criteria, not a note from an ancillary provider.

Communication helps. Use the information from the ancillary staff to help make better informed decision in certain cases. A text or quick call makes a huge difference.

Return to Play can be fairly simplistic and done in a way that benefits…EVERYONE.