From Shannon Miller

From Shannon Miller: "I began working with Chip over 8 years ago. I have been active all of my life but my exercise training schedule varied depending on my other schedules. (Work, children’s schedules, etc.). I am now 55 and I am absolutely sure my consistent training with Chip allows me to continue doing other activities that I love. I play racquetball, swim every week, run 5k and 10k races and even ran a 1/2 marathon. I have a passion for waterskiing, ran several triathlons and fly fish in the mountains and the SC coast. I literally feel like I can do anything. I am absolutely sure it would not be possible without the consistent strength training with Chip.
Chip makes it fun. He encourages, challenges and pushes me every week and the workout is designed specifically for my lifestyle and activities.
My health and life are better because of Chip. "

Wanting to change your life around and feel better physically than ever before? Don’t let age or time hold you back. Give Chip a call and set up your complimentary exercise session. You won’t be disappointed! 704-231-8648

IMG_Shannon Miller.JPG

Me with one of my Best & Premier Clients and also a Great Person and Friend!

Thank you Chip!

I was given a gift, to train with Chip for 6 months.  (Apparently, the person who gave me the gift thought I needed it!) I was 54 years old, 240 pounds, had done little to no exercise for the past 20 years and my eating habits were less than stellar.  I remember the first day walking through the weight room and meeting Chip in his office.  I was extremely nervous!  Chip immediately curtailed my anxiety with his broad smile, sense of humor, energy and knowledge of strength, conditioning and nutrition.  He took all my measurements, (body weight, height and body fat % etc.) I can’t remember what they were, and we headed to the gym.  I remember not being able to do a sit up unassisted!

During the 6 months, I noticed a considerable change in my body and cardio fitness.  I looked forward to my workouts and Chip always made it new, exciting and challenging.  (To this day, I can honestly say, I have done something new every time I have worked out) When my 6 months was up, I made the commitment to continue.  I have now been with Chip for 3 ½ years. I have also added early morning boot camp workouts three days a week to my routine.

In this time, I have lost 55 pounds, and 4.5 inches off my waist.  I have run two Spartan races (with a third scheduled); a 3-mile Sprint and a 13-mile Beast.  This past weekend I did my first GORUCK Tough event, 13 hours of hiking with a 40 lb. ruck, carrying extremely heavy things and a fair amount of PT.  This December my son and I have a trip planned to climb Mt. Kilimanjaro in Tanzania.

I can honestly say without a question of doubt none of this would have happened without my gift (thank you Mom) and Chip.  Not only is Chip the best at what he does he’s extremely knowledgeable, a great motivator, dedicated to his profession and clients, kind and fun to train with.  Chip builds his workouts around me and my goals, and because of that has definitely transformed my life!

Thank you Chip!

Stuart Simon
Simon & Watson Construction

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A Lifestyle of Responsible Choices

If you're sitting at your desk right now reading this you have a lot to be thankful for! Why??Because there are so many other people out there that are sick, have constant pain, heart disease, or are battling some type of cancer. So yes, there is quite a bit to be thankful for. We could easily be one of those individuals, but only by the Grace of God and being proactive with our health can we stand here today working for a great company!

 Being proactive with our health is simply “A Lifestyle of Responsible Choices”. Yep, that sums wellness up in 5 words. Making responsible choices each day can be the difference between success and failure in anything we want to achieve or do. Whether it's choices about what we eat, going to the gym, how we spend or save our money, or choosing to better a skill. The key word is “Lifestyle”! It must be something you do almost every single day!

It’s a lifestyle of eating nutritional meals, making time to go to the gym two or three times a week, or expanding your knowledge by reading a good book. Wellness must be intentional. Everyone wants to be healthy, be financially secure or be knowledgeable and great in his or her line of work. All coaches want to win every game. But are they willing to put in the work. Are they willing to put in the time and work to be healthier? Are they willing to make sacrifices and endure some pain to get to where they want to be? One may have the passion but when the hard work comes can they endure? 

A Lifestyle of Responsible Choices isn’t something you just do in the gym. It’s choosing courage over comfort, overcoming fears and setbacks, and taking action toward creating the life you desire to live. It’s giving your best effort, every single day. 

So realize that at the Heart of Wellness is simply “A Lifestyle of Responsible Choices” with an intentional work ethic leading the way. You can live "A Lifestyle of Responsible Choices”. And you will mess up from time to time. I have failed in life more than I have succeeded. But that’s life. From those failures comes personal growth—and from personal growth---SUCCESS!

DOES DRINKING MORE COFFEE = A LONGER LIFE?

I’m finishing up my first cup of coffee this morning while scanning the International Society of Sports Nutrition (ISSN) Facebook page and an article got my attention. The article: “Coffee Lengthens, While Caffeine Shortens Your Telomeres”. WHAT?? Telomeres? What’s a telomere and what does that have to do with drinking coffee and by doing so increases my chances of a longer life? Let me explain!     

The article started off by stating that the evidence is strong and that a majority of studies indicate that the chronic consumption of coffee (even in amounts of 5 cups a day) has potential health benefits – at least in normal healthy individuals. Dr. Larry Tucker conducted a recent study and evaluated the relationship between caffeine intake and coffee consumption and Leukocyte Telomere length.   

 In this study it seems that coffee has the ability to lengthen Telomeres! Why is this important? Because the longer the Telomeres the healthier the cell. A DNA cell that is!! However, on the flip-side Caffeine has the ability to shorten these same Telomeres, which is not good for DNA cells.  Now as we all know coffee contains caffeine (unless of course the coffee is decaffeinated), the good news is that one of the main active ingredients in coffee is chiorogenic acid and this all-important ingredient negates caffeine’s ability to shorten these same telomeres.     

I am sure that you are aware there are other sources of caffeine other than coffee. The breakdown is as follows; (coffee 71%, soft drinks 16% and tea 12%). While coffee takes up the majority of the caffeine consumed in the USA, remember that when drinking soft drinks or tea, (as many people do) these two items do not contain the valuable ingredient that keeps caffeine from making the telomeres shorter; which again is chiorogenic acid.     

Now what are telomeres? Telomeres are sections of DNA cells that are found at the end of each chromosome cell. They help protect each end of the chromosome cell by forming a cap, much like the plastic tip on shoelaces. If the telomeres weren’t there then our chromosomes would end up running into other chromosomes and that’s not good! To put this in very simple terms, when these telomeres shorten as they can do as we age, then DNA cell has a harder time being replicated and they age and die much sooner! The result of an aging cell is an aging body and the telomeres play an important role in helping to keep the cell healthy by not shortening! And the longer they are, the better!   

 One of the most important things to remember about Dr. Tucker’s study is that it adds to the evidence that your coffee addiction (if kept to less than 5 cups a day) will positively affect your telomere length and by doing so could then even have life-extending effects!     Now I’m going for my second cup!    

Chip Sigmon CSCS* D, USAW, CISSN, RSCC*E Wellness & Fitness Director, Europa Sports Products References:

1.    Coffee Lengthens, While Caffeine Shortens your Telomeres: An Essential Paradox, SuppVersity-Nutrition and Science for Everyone

2.    What is a Telomere? Yourgenome.org

MY TOP 8 IMMUNE BOOSTING SUPPLEMENTS

Listen, the coughing and sneezing, have you noticed and heard it also? People are getting sick now that the change of the seasons are upon us with cooler temps at night and warmer temps during the afternoon hours. I saw one of our employees heading home from work the other day. He sounded terrible, all of his chest and head was congested and very weak…a lesser man would have died!

So what can we do to be proactive and help us have a fighting chance against these colds and infections this time of year? Remember that there are no guarantees, however, we do (the last time I checked) work in the nutritional supplement industry, so supplements can and do play an important role in helping prevent these types of sicknesses. So with supplements right at our finger tips, which ones can help reduce the risk of colds and Upper Respiratory Tract Infections (URTI’s)?

Remember also that it’s all about the immune system staying strong to help ward-off infections. Once the immune system gets weakened by a number of things including stress, the lack of sleep, improper foods that don’t supply the body with its nutritional needs, and the body just simply becoming run down because of work, over training, and too many responsibilities, then at that point one can become sick.

Since we have so many people at Europa who are active, I thought I would share this important point on how exercise is good for keeping the immune system strong. According to the “Essentials of Sports Nutrition and Supplements” (page 129): there is evidence that moderate levels of training and exercise actually improve immune system function whereas exercise protocols that are intense and prolonged inhibit immune status for up to 6 hours after training. This is why overtraining can be so detrimental this time of year and also why it’s so important to refuel the body with the right kind of nutrition and supplementation.

So let me share with you what the International Society of Sports Nutrition (ISSN) says are some of the best supplements to help keep that all important engine known as the immune system in top shape. I said “My Top 7 Immune Boosting Supplements” just to get

your attention! It’s really the ISSN that this information comes from! The ISSN list 5 supplements that can help boost your Immune system; Glutamine, Protein, Vitamin C, Zinc and Echinacea. I have added 2 more of my favorites. So here goes:

1. VITAMIN D: 5 TO 10,000 IU’s daily for most adults is safe and effective for the prevention of colds, the flu, cancer and over 200 more different diseases. Thousands of studies help support its use in higher than the RDA recommended doses. For more information and documentation of all the benefits of Vitamin D visit www.vitamindcouncil.org

2. OMEGA-3 FATTY ACIDS: (fish oil) 4000mg daily for most adults not only helps prevent heart disease but also is a powerful nutrient when needing to boost the immune system. Omega-3 is also needed to help Vitamin D work in its optimal form and by doing so, helps prevent Vitamin D deficiency. Omega-3 supplementation increases the activity of white blood cells that destroy dangerous bacteria. Omega-3 also protects the lungs from colds, the flu, and other respiratory infections.

Inflammation in the body can play havoc with the immune system and omega-3 fatty acids can play an important role in reducing that inflammation due to its anti- inflammation properties.

I’m sure you’ve heard that cod-liver oil is great to take during the winter months, (at least from your grandmother) because of it helping fight off winter colds. Come to find out, the major active ingredient in cod-liver oil that helps with boosting the immune system is Vitamin D and Omega-3 fatty acids!

3. ZINC: Zinc is important in the structure of cell membranes and proteins. Zinc also is responsible for over 100 different enzymes that are involved in catalytic reactions. So when these reactions and cell membranes are healthy and active, it strengthens the immune system. 50mg daily is effective in the prevention of various infections. There is some evidence that Zinc can shorten the length of a respiratory infection.

4. VITAMIN C: (or ascorbic acid) around 1000mg or more daily has an anti-viral plus an immune enhancing effect. Something to remember: Research has shown that Vitamin C does not help during a cold; it helps keep the immune system strong in helping prevent respiratory & sinus infections. So load up now, before the common cold can ruin your day--or days! Note: Going over the recommended upper limits of Vitamin C (2000 mg) is not recommended because of the possibilities of inducing cellular damage and in some cases diarrhea.

5. ECHINACEA: 1000 mg or more is recommended daily and is well documented as an immune booster. Many suggest that Echinacea should be used for or beyond several weeks, however in many studies this has not been proven to be the case. One German study says just the opposite and can be taken for years without concerns.

Echinacea has been labeled the “Immune herb” for its ability to enhance the immune system according to “The Essentials of Sports Nutrition and Supplementation” by the International Society of Sports Nutrition.

6. PROTEIN: What, Protein, why would Protein be listed as an immune booster? One of the main if not the main thing that protein does besides increase protein synthesis is help recovery from a hard day on the job or a good intense workout. And what happens when you don’t recover properly? The body gets run down the immune system suffers! It’s that simple! 20 to 25 grams of good quality whey or casein protein after a hard workout should do the trick (or 1.8 to 2.0 g/kg of BW.) To help make it simple, that’s almost 1 gram per pound of body weight.

7. GLUTAMINE: This amino acid is one of the most abundant and “conditional” (which means you need more or less during different times of one’s life) than any other amino acid in the body. Glutamine has been shown to be a vital metabolic fuel during exercise for a variety of components of the immune system. Low Glutamine levels in the body make it more difficult for the body to respond to attacks on the immune system, thereby hindering health profiles and performance outcomes.

8. Quercetin: Quercetin exerts strong anti-oxidative, anti-inflammatory, anti-pathogenic, and immune regulatory effects in vitro and in animal-based studies. Epidemiological data indicates reduced rates of cardiovascular disease and various types of cancer in groups self-selecting diets high in Quercetin. In human studies, quercetin has shown to lower blood pressure, and in athletes it significantly reduces the incidence of the common cold, especially during periods of heavy training and race competition"

Dr. David Nieman: Director, Human Performance Lab - North Carolina Research Center A side note to boosting your immune system: EXERCISE!!

Exercise can also boost our resistance to viruses and infections by stimulating the release of immune cells in the bloodstream. These cells can be the “upfront marine corps of the immune system” says David Nieman, Dr.PH, Director of Human Performance at

Appalachian State University (God Bless him) and vice president of the American College of Sports Medicine. “When they (the immune cells) circulate at a higher rate than normal then their ability to detect and deal with pathogens (the bad guys) is greatly improved.” This response kicks in just minutes after the start of exercise and last for one to even three hours afterwards. Though the benefits are short-lived, exercising has a cumulative effect that keeps the immune system strong!

If that’s not enough to keep you exercising on a regular basis then read below the benefits of physical fitness when dealing with STRESS. According to the Journal of American Medical Association, the effects of long-term stress on the immune system and the inflammation can influence depression, autoimmune diseases, heart disease and even some types of Cancer. ***Listen to this… While it is not completely understood how, the article goes on to say, studies show that the more a person exercises, the more capable he or she is of handling psychological stress! Exercising on a consistent basis also helps build self-esteem, which can make you more capable of handling life’s challenges.

Chip Sigmon CSCS*D, USAW, CMFT, RSCC*E, CISSN
Fitness & Wellness Coordinator, Europa Sports Products

References:
The Essentials of Sports Nutrition & Supplements (ISSN)
Vitality Magazine; Dr. Zoltan P. Rona

MEDIUM CHAIN TRIGLYCERIDES IN MUSCLE MILK

Shortly after the first of this year (2016) I remember walking down the hall at Europa Sports Products coming upon cases of CytoSport’s ready to drink (RTD) Muscle Milk. Lifting a bottle of the product up, to my amazement a picture on the front of the product was that of Stephen Curry! WOW, that picture brought a flashback in time. You see, Del Curry (Stephen’s father) played for the Charlotte Hornets of the NBA when I was the strength and conditioning coach for the same team 1990 through 2001.

When Stephen was just a kid he would be at practice or before games shooting basketball. I remember Stephen asking me on several occasions to rebound for him and would for a while but then having to tell him that “I must get in the weight room but I’ll rebound for you until I have to go.” Little did I know I was rebounding in years to come for one of the greatest players in the NBA. I also trained Stephen for a short time while he was in his High School years at a sports performance facility, but that is another story for another time.

I must say that CytoSport could not have picked a better person, let alone a great basketball player to represent their product. CytoSport will never have to worry about this celebrity embarrassing their product for sure. But let’s turn the table and not examine Stephen because you can go anywhere on any website and not find anything bad about Stephen, especially as a person. However let’s do examine CytoSport and one of its signature products, Muscle Milk.

Usually a product that has been around for many a year and that has stood the test of time is generally because of the quality of the product and Muscle Milk has done just that! Since 1998 CytoSport has been at the forefront of the science behind Nutritional Supplements and Muscle Milk has lead the way. 

Yes, the most important ingredient in Muscle Milk is the type of protein it contains. CytoSport does an excellent job of explaining the different types of proteins. Just go to the Muscle Milk website, www.musclemilk.com and you’ll get all the information you’ll need on the type and quality of the different proteins and protein blends. What I would like to touch base on and what gets unnoticed in a lot of nutritional circles is the all-important “Medium Chain Triglycerides,” (MCT) that is contained in each bottle or container of Muscle Milk.

We’ll get to just what MCT’s are and what they do, but for now let’s focus on just what are Triglycerides? Simply, Triglycerides are a type of fat (Lipid) found in the blood. When you eat your body converts any food that it doesn’t use right away for energy to Triglycerides. So if these Triglycerides are not used over a period of time for energy they are shipped from the blood to fat cells. Later however and between meals hormones release this type of fat for energy if needed. If one eats more calories than they burn one may have high Triglyceride levels which is called Hypertriglyceridemia. That’s why it is so important to exercise, and with high performance athletes, that shouldn’t be a problem!

On a side note one may ask, what is the difference between Triglycerides and Cholesterol? Simply this; Triglycerides are used for Energy and Cholesterol is used to help produce cells and certain hormones such as testosterone. 

So then, what are MCT’s? You have to understand first what fats are made of. Fat molecules are made up of chains of carbon atoms. Long-Chain fatty acids (LCT’s), which make up much of the Standard American Diet, are in length from 16 to 24 carbons. However the MCT’s are composed of only and anywhere from 4 to 14 carbon links. And because these MCT’S have fewer carbon atoms they have some advantages over the LCT’s.

Even though MCT’s are fats, they cannot make you fat! In fact, they resemble carbohydrates more than fats. Why, because of only having 4 to 14 carbon atoms they are more easily digested and because they are so easily digested they are more available for energy. Also, because of the low carbon density the body really doesn’t know what to do with them and because of the low carbon numbers they are also hard to store as fat! 

MCT’s even yield fewer calories than other fats. Why? According to Bruce Fife, N.D. , author of the book The Healing Miracles of Coconut Oil, “All fats, whether they are saturated or unsaturated, from a cow or from corn, contain the same number of calories. The Medium Chain T’s however are different. They contain a little less and actually yield fewer calories than other fats.”

So with all of this said, what is the major benefit of putting MCT’s in Muscle Milk? As you can see, naturally you have the high quality protein for recovery and to build muscle. You also have the carbohydrates for the much needed energy, but then you also have the Medium Chain Triglycerides as another source of energy. Research is mixed on whether or not MCT’s has a sparing glycogen effect and therefore can delay time to exhaustion. But still the research is clear that they do most definitely supply another source of energy besides the carbs and athletes need all the energy sources they can muster when in the mist of competition or intense training. 

So as a strength & conditioning coach and a certified sports nutritionist I see Muscle Milk as not only a high quality protein source but also a sport nutritional supplement that is able to give me the energy that you need when called upon. And with layers of beefed up energy that Muscle Milk contains it’s ready to help you in performing at your very best in your training or competition!

Chip Sigmon CSCS*D, CISSN, USAW, RSCC*E

Strength & Conditioning, Wellness Coordinator, Europa Sports Products chipsigmon@europasports.com
 

References: 

  • Medium Chain Triglycerides (MCT’s): The fat that Makes you lose Fat By Smart Publications
  • Does medium chain triglyceride play an ergogenic role in endurance exercise performance? ISSN, On line version, May/June 2003

Fitness Facts or Fiction

I’m a firm believer that you cannot claim expertise until someone learns from your experience. That’s why I’m happy to answer questions all day,
every day. Is static stretching bad? Is foam rolling a waste of time? What’s better to put on an injury—ice or heat? With over 35 years in the coaching, athletic injury, and fitness industry, I am often asked to share my
perspective. It’s an honor. Let’s chat about a few of the recent questions I received.

Fact or fiction: Static stretching is bad and it can hurt performance

Fact: There is some research indicating that static stretching can be harmful and hinder performance to a degree. But static stretching still has
its place. When I worked in the NBA with the Charlotte Hornets, we would do a few minutes of light static stretching with bands before our dynamic movements. Fact: There’s a right way and a wrong way to implement static stretching. If you perform static stretches for too long, the elasticity leaves the muscle. All the energy is taken out. You want to perform static stretches for 30 to 60 seconds at most. Research also points to static stretching as being more productive at the end of a workout session or a hard practice. If used properly, it won’t hurt performance. Do whatever feels best for your body.

Fact or fiction:  Foam rolling is a waste of time

Do you know about the 1% rule when it comes to supplements? What if supplements can only help you improve your health or athletic performance by 1%, is it worth it? Of course it is! That 1% may be the difference between finishing first or second place in an event or having some type of health issue or not. Well, the same is true with the foam roll.


Fact: The foam roll is used to smooth out the muscle fascia which is a band or sheet of connective tissue fibers, primarily collagen, that forms
beneath the skin to attach, stabilize, enclose, and separate muscles and other internal organs. After a workout (or before) fascia can get all bound
up causing the muscle to be stiff. This can limit range of motion.


Fun fact: Last summer, I worked with Michael Chadwick, an all-American swimmer from the University of Missouri. He used the foam roller to help
massage the muscle fascia around the area of the upper back. On a personal level, I used the foam roller after I had surgery on my quadriceps
tendon. It helped me return to squatting months earlier than expected.

Fact or fiction:  Ice is not good after an injury

Fact: There is research indicating that ice may be detrimental in some cases. Kelly Starrett, a leading Physical Therapist in the field of movement,
has done a very good job in bringing this to the forefront. We’ll know more in years to come if this holds substance. Until then, I still think it’s a good idea to ice the first 24 to 48 hours when there’s an injury.


Fact: I’m not a Physical Therapist, but I have assisted some of the best PTs in the country. I have seen firsthand how ice can help relieve the
stress and reduce the swelling to help retain the range of motion in a joint. A lot of researchers haven’t worked with 12 to 15 patients a day for over 20 years. They haven’t seen what ice can do by taking the swelling down.  Another thing, a lot of times a surgeon can’t operate until the swelling goes down on a particular injury. Go ahead and put heat on the injury and watch
it swell that much more! The surgeon will wait.


Fact: There are times to heat and times to ice. Only time will tell which one will win out. And change our way of thinking. More research is needed. I hope this answered some of your questions. Or maybe it raised a few more? Feel free to reach out to me anytime. I would love to hear from you. And that’s a fact.


Chip Sigmon
Europa Sports Products Fitness/Wellness Coordinator
Head Strength & Conditioning Coach Appalachian State University
1984-1990
Strength & Conditioning Coach Charlotte Hornets NBA team 1990-2001
Certified NSCA
CSCS*D

Hump-Day" Motivation

                I took my youngest daughter to the Charlotte Hornet Basketball game last Friday. The Heck with the game, I cherished the time I spent with my daughter, Sydney. Time is nothing but segments of experiences, (good & Bad) and this was a good experience for sure! Even at work the experiences with co-workers and our relationships with others during the day should be cherished also. Why, because these are times we will never get back.

 

                I’ve heard it said over and over (and I’m sure that you have also), “don’t just want to get through the day…..get from the day”. So on this cold winter’s day in February embrace every situation that comes our way good or bad. As the Bible says, “this is the day that the Lord has made, let us rejoice and be glad in it. What influence can I have on my co-workers? Is it where I lift people up or tear them down? Yes, constructive criticism is a good thing, it makes us and the company better and we should learn how to handle it, knowing that it will always make us better if we handle it in the right way.

 

                Yes, we would always want things and work situations to be better, “but things don’t get better by chance, they get better when we change.” That’s right, if you want things to change then it starts with you, and let me tell you, I have had to do a lot of changing in my life…. A lot!! Too many failures and faults to count in my life. But just like wanting to shed or gain a few pounds of muscle, you had better hit the gym, it will not happen any other way! Don’t wish things were easier, wish that you were better. It’s simple, things won’t get easier, they seldom do, so let’s get better in the skills we have to help make Europa better, and when we do that it will always come back and bless us….always!

 

                So let’s cherish this Wednesday, February the 10th because we’ll never see it again!!

JUST WHAT EXACTLY IS DIABETES?


Diabetes can strike anyone, from any walk of life.

And it does – in numbers that are dramatically increasing. In the last decade, the cases of people living with diabetes jumped almost 50 percent – to more than 29 million Americans.

Worldwide, it afflicts more than 380 million people. And the World Health Organization estimates that by 2030, that number of people living with diabetes will more than double.

Today, diabetes takes more lives than AIDS and breast cancer combined -- claiming the life of 1 American every 3 minutes. It is a leading cause of blindness, kidney failure, amputations, heart failure and stroke.

Living with diabetes places an enormous emotional, physical and financial burden on the entire family. Annually, diabetes costs the American public more than $245 billion.
Just what is diabetes?

To answer that, you first need to understand the role of insulin in your body.
When you eat, your body turns food into sugars, or glucose. At that point, your pancreas is supposed to release insulin.

Insulin serves as a “key” to open your cells, to allow the glucose to enter -- and allow you to use the glucose for energy.

But with diabetes, this system does not work.

Several major things can go wrong – causing the onset of diabetes. Type 1 and type 2 diabetes are the most common forms of the disease, but there are also other kinds, such as gestational diabetes, which occurs during pregnancy, as well as other forms.

The more severe form of diabetes is type 1, or insulin-dependent diabetes. It’s sometimes
called “juvenile” diabetes, because type 1 diabetes usually develops in children and
teenagers, though it can develop at any age.

Type I Diabetes:

Immune System Attacks:
With type 1 diabetes, the body’s immune system attacks part of its own pancreas. Scientists
are not sure why. But the immune system mistakenly sees the insulin-producing cells in the
pancreas as foreign, and destroys them. This attack is known as "autoimmune" disease.
These cells – called “islets” (pronounced EYE-lets) – are the ones that sense glucose in the
blood and, in response, produce the necessary amount of insulin to normalize blood sugars.
Insulin serves as a “key” to open your cells, to allow the glucose to enter -- and allow you to
use the glucose for energy.

Without insulin, there is no “key.” So, the sugar stays -- and builds up-- in the blood. The
result: the body’s cells starve from the lack of glucose.

And, if left untreated, the high level of “blood sugar” can damage eyes, kidneys, nerves, and
the heart, and can also lead to coma and death.

Insulin Therapy

So, a person with type 1 treats the disease by taking insulin injections.

This outside source of insulin now serves as the “key” -- bringing glucose to the body’s cells.
The challenge with this treatment is that it’s often not possible to know precisely how much
insulin to take. The amount is based on many factors, including:

•Food
•Exercise
•Stress
•Emotions and general health

A Balancing Act

These factors fluctuate greatly throughout every day. So, deciding on what dose of insulin to
take can be a complicated balancing act.

If you take too much, then your body burns too much glucose -- and your blood sugar can drop to a dangerously low level. This is a condition called hypoglycemia, which, if untreated, can be potentially life-threatening.

If you take too little insulin, your body can again be starved of the energy it needs, and your blood sugar can rise to a dangerously high level -- a condition called hyperglycemia. This also increases the chance of long-term complications.

TYPE 2 Diabetes:

The most common form of diabetes is called type 2, or non-insulin dependent diabetes.
This is also called “adult onset” diabetes, since it typically develops after age 35. However, a growing number of younger people are now developing type 2 diabetes.

People with type 2 are able to produce some of their own insulin. Often, it’s not enough. And sometimes, the insulin will try to serve as the “key” to open the body’s cells, to allow the glucose to enter. But the key won’t work. The cells won’t open. This is called insulin resistance.
Often, type 2 is tied to people who are overweight, with a sedentary lifestyle.

Treatment focuses on diet and exercise. If blood sugar levels are still high, oral medications are used to help the body use its own insulin more efficiently. In some cases, insulin injections are necessary.

Reference: From the American Diabetes Research Institute

ATTACKING SARCOPENIA

“TRYING TO HOLD BACK FATHER TIME”

In November of 2010 I wrote an article entitled “Middle Age and the Decline of Muscle Mass”. That writing focused on the effects of Sarcopenia towards the middle age and even the elderly. The purpose of this article will be to go into further research and gear towards the more serious weight lifter. We will not only review the literature on what Sarcopenia is and its effects, but also shed light on how one may go about being proactive (with the latest research) in the fight to keep as much muscle mass as possible as we age. This will be done from a strength & conditioning and nutritional standpoint addressing the serious athlete, former athletes, bodybuilders, power lifters and even the general fitness people who were weight training in the 1970’s and 80’s who still just want to retain and even obtain a muscular look.

LET’S REVIEW: The term Sarcopenia comes from the Greek word Sarx (meaning flesh) and Penia (meaning loss) and was termed by Dr. Rosenburg in 1989 in which he made an effort to identify the age associated with the loss of muscle mass and functional capacity. Sarcopenia is neither a disease, nor a syndrome and until 2009 there was no generally accepted definition in the Medical Literature.

From a general population standpoint, muscle can start to atrophy in individuals as early as the third decade. However that’s the general population. We’re focusing on the serious lifters, “baby boomers” and individuals who make fitness a lifestyle. These individuals may not experience the effects of Sarcopenia until they reach into their late 40’s or even into one’s 50’s. However Sarcopenia appears to begin generally in the fourth decade of one’s life and accelerates after the age of 75 years. (Waters, Baumgartner & Garry 2000).

Sarcopenia is determined by mainly two factors: the initial amount of muscle fiber an individual has and the rate in which aging decreases muscle mass. With the loss of muscular strength, comes muscular wasting and this can vary greatly from person to person and even the most serious of lifters. However, to the extent it happens is up to the individual. With appropriate measures, Sarcopenia can partly be reversible especially with resistance training.

Resistance training as most people know affects the Type II muscle fibers (Type IIa muscle fibers are fibers that demand short plus long bouts of energy and Type IIb muscle fibers are strictly for short bouts of power and for maximal force generation that can last up to 8-10 seconds). With Sarcopenia, there is a decrease in circumference in these types of muscle fibers with little to no decrease in the Type I (slow twitch) fibers. Type II fibers are often converted to Type I fibers reinnervation by slow type I fiber motor nerves. Anytime type II fibers are switched to type I fiber, there can be some serious loss of muscular size at any age but especially in the older population.

CAUSES: One theory is that Sarcopenia is caused by a certain degree of failure in satellite cell activation. Satellite cells are small mononuclear cells that abut the muscle fiber. These cells are activated mainly by exercise or even upon injury. These cells during exercise differentiate and fuse into the muscle fiber helping to maintain the muscles function. (Ryall JG, Schertzer JD, Lynch GS, August 2008). When these cells as we age fail to activate due to the onset of Sarcopenia, maintaining the muscle mass that we do have is even harder to accomplish. In addition to age, the onset of certain chronic diseases results also in a greater risk of muscular degeneration and functional deficits. Osteoporosis, arthritis, cardiovascular disease, obesity, and insulin resistance are demonstrated to be highly associated with the onset of Sarcopenia.

Another cause of Sarcopenia and the muscle loss associated with it are the lack of anabolic signals such as growth hormones and testosterone, plus the production of catabolic signals such as pro-inflammatory cytokines (Ryall JG, Schertzer JD, Lynch GS, August 2008). A decrease in protein synthesis may also contribute to Sarcopenia. Because of these many factors, a person may not be able to lift as heavy of weight as they once did when they were younger.

From this lack of muscle mass and thus lack of strength also comes another very important factor - joint degeneration. I’ve always said that the muscles will get smaller but they’ll last forever, the joints however will wear out long before. The integrity of the joint can suffer, whether it’s the shoulders, hips or knee joints. This is due mainly because of the onset of arthritis and or the degeneration of soft tissue. The joint can also suffer because of the reduction of elasticity plus the range of motion that the joint suffers due to the stress it was put under during resistance training when one was younger, all the way up until his or her present age. The wear and tear of daily activities due to what’s simply called “life” can also be a contributing factor to joint degeneration.

MY INJURY: On January the 21st of this year (2015) I was scheduled to do some light snatches that morning. Each Wednesday I will either perform a type of “Clean” variation or (like I was that Wednesday morning) some type of snatch variation. That particular Wednesday it was light hang “Snatches” just to rev up my metabolic rate to get me ready for the rest of my workout which included Hamstring work.

I did my usual warm-up consisting of light static and dynamic stretches then performed some light snatches with a PVC pipe, a 15 Kilo bar, and then a 30 Kilo Olympic bar. I decided after the first 2 sets from a hang position I would perform a set from the floor—no big deal since I was using some very light weight. However on the very first rep (all sets were reps of 4) when the bar passed the knee on the second pull, I exploded up into extension, and when I did my right knee exploded! I had pulled the quadriceps tendon off the knee cap, which is called an avulsion fracture.

So where do I go from here? Well as of today, July the 23rd I am now 6 months out from surgery. My physical therapy went great and just a few weeks ago I was back squatting performing the leg press and doing single leg squats (Bulgarians), all light weight of course and working slowly into full range of motion on all exercises. On my next leg training day, I have been given permission to start adding the weight slowly to all my exercises except for one exception; NO explosive movements such as the snatch in which I was injured.

I must admit that I have been known to push the envelope from time to time but there’s a difference between being mentally tough and just plain stupid! Don’t think I’ll be attempting any Snatches or Cleans at least for a while. Why? As we age, the joints take on (especially in active individuals) a lot of stress during that time. The day to day wear and tear can cause arthritis, cartilage degeneration, tendonitis, and something that caused my quadriceps tendon injury, calcium deposits on my quad tendon.

Before my injury my knee joints had never felt better. Yes, I had had some quadriceps tendonitis in the past but that was years ago. I was very fortunate to have one of the best orthopedic doctors and surgeons, Dr. Scott O’Neil. When Dr. O’Neil showed me the x-rays and the MRI, he pointed out something that really caught me off guard and that was calcium deposits forming on the quadriceps tendon. This can cause the tendon to become weak and can certainly compromise the integrity of the joint especially with explosive movements. So how was I to know that these calcium deposits were forming and weakening the quad tendons, unless I went to have an x-ray every 6 months? But as Dr. O’Neil states, “Chip’s history of prior quadriceps tendinitis was a risk factor for developing the calcium deposits, but that having them does not require prophylactic surgery to remove and re-attach the tendon unless they are causing symptoms. In Chip’s case, he had no symptoms until the injury. The pathologic process that leads to the condition is primarily degenerative in nature. The insertion site of the tendon into the bone moves through a transition zone from primarily fibrous tissue (the tendon itself) to a fibrocartilage zone (the actual attachment site on the bone). With repetitive microtrauma comes inflammation and classic changes associated with acute tendinitis. These changes are reversible with rest, anti-inflammatories, and rehab. However, with continued injury/trauma and continued and repetitive stress on the joint the changes become degenerative in nature. As a response the body can deposit calcium in the area of chronic inflammation and degeneration, leading to what is described as an enthesophyte. This occurs within the fibrocartilage transition zone, which weakness the attachment site of the tendon to bone. Typically fracture or avulsion of the enthesophyte will occur with an explosive movement, which in Chip’s case was doing snatches, which of course is an explosive movement. Enthesophytes are common and can develop in other sites around the body such as the achilles tendon, patella tendon, or tricep tendon. Again, prophylactic surgery to remove the enthesophyte is only necessary if they are symptomatic. Usually they can be managed with some activity modification and rehab, but occasionally they do require operative intervention.

So with that being said by my personal orthopedic, my injury didn’t take place until I was 59. I started lifting in high school so my knee injury didn’t take place until after 40 years of lifting and training each body part once or twice a week. How about the popular routines now where one is training each body part or one particular exercise every day? This population should definitely take notice.

(NOTE: I was back squatting and working legs 6 months after the surgery).

SLOWING DOWN OR MINIMIZING SARCOPNIA: So what does one do to slow down or minimize this process that naturally occurs to a lesser or greater degree? From a strength and conditioning standpoint, let me offer what the research states and what I believe to be some sound principles when trying to hold back “father time” and being proactive against it. I’m going to include some of my own anecdotal evidence as well because of me being in the strength & conditioning field for over 35 years, plus continuing to resistance train 4 to 6 days a week since the mid 70’s, in addition to competing in bodybuilding in the late 70’s and early 80’s, (the Golden Age of Bodybuilding).

THE IMPORTANCE OF RESISTANCE TRAINING: Sarcopenia is accelerated with the lack of exercise and physical activity, especially when it comes to the lack of overload to the muscle, as in weight training. So naturally it can be stated that physically inactive adults will experience a faster and greater loss of muscle mass than physically active adults. Resistance training does not put an end to Sarcopenia completely, however it can be slowed down to a lesser degree in those who are more physically active plus the type of resistance training is the key. The intensity and progression will also determine positive results, but remember, we’re referring to (in this article) the serious weight trainer. The one set per major muscle group that the ACSM recommends is not going to get the job done. Most studies involving strength and hypertrophy with older adults have performed 2 to 3 sets per body part (Porter 2000). Still in my personal experience working with the serious middle-aged and older individual, and with my own personal workouts, I’ll perform anywhere from 8 to 15 sets per muscle group per week and will also perform anywhere from 3-6 sets per exercise.

A Meta-Analysis study that was published in the Journal of Strength & Conditioning Research (2009) 23: 1890-1900 by James Kreiger, addresses this issue of just how many sets per exercise is optimal. A Meta-Analysis is a study that looks at a collection of research studies as one entity and makes a conclusion based upon the data from the cumulative research. Kreiger found 14 studies that compared single- set to multiple-set workouts and took into consideration other variables that could affect the results such as training intensity and the frequency of workouts. Kreiger found that the 2-3 set protocol produced 46 percent greater gains in strength than did the one set, however the 4-6 set range produced 13 percent greater gains than did the 2-3 set protocol. So in the long run, the extra set (4-6) definitely was worth the effort according to his research.

However, for this article we’re talking about the middle age and older group. How much more important is it for the age range that we’re discussing, to perform more work to hold on to more muscle mass than those in their 20’s and 30’s? I would say, much more! And in reference to more work, the type of resistance training that would give an individual a better chance to hold on or to even build hypertrophy would be centered around movements that would give one more Time Under Tension (TUT). Yes, I love the Kettlebell swings and the Olympic Lifts and variations of those exercises. However the movements that will give one more “bang for their buck” when it comes to strength and hypertrophy, will be that of the bench press, squats, dead-lifts and over- head presses, plus variations of each. I still believe however in training in all rep ranges even into ones 50’s and beyond. By that I mean,from 20 reps on up for muscular endurance and to enhance work capacity, to 10’s and 15’s for hypertrophy, 4-6 reps for muscular strength, and 2’s and 3’s for power. Reps and the weight used should be dictated by the periodization model that you are in or following at the time.

WORKOUT FREQUENCY: The frequency for a mature and frail adult has not been definitely established. Maintenance of strength in senior adults has been achieved with as little as just one workout per week (Porter 2000). But again we’re not talking about frail senior adults! There is plenty of research to confirm that resistance training preformed up to 2-3 X per week, one should separate those workouts at least by 48 hours. However, if I had trained each major body part two or even three times a week during my 40 some years of training, I would have had joint replacements a long time ago! The recovery of one’s Central Nervous System (CNS) and the stress on the joints are just not the same as it was when we were in our teens, twenties and even our thirties.

However, with new research coming out all the time, training each major body part just once a week with multiple sets ranging anywhere from 12 to 20 may not be the best way to obtain muscle hypertrophy. Brad Schoenfeld spoke this past July in Orlando at the National Strength & Conditioning Association National Convention in which I attended. Brad spoke on “Manipulating Resistance Training Variables for Maximal Muscular Growth” In his presentation he stated that in his research 2/3’s of all bodybuilders train each major body part only once a week with multiple sets anywhere from 12 on up. Interesting enough in his studies, bodybuilders who trained each body part 2-3 times a week yet reduced the number of sets in a single workout gained more muscular growth or hypertrophy than those who trained each body part just once a week. So as an older adult or really at any age, instead of performing 12 sets a body part in a single workout once a week, try performing only 6 sets each workout twice a week. Your sets can be more or less but you’re still getting the same number of sets a body part for the entire week.

This would be a great way to obtain more frequency when training a particular body part while having another way to save the joint from the wear and tear of resistance training. Just make sure there is at least 48 hours recovery time. Frequency and just how much volume during a given week is something to consider when trying to obtain as much muscle mass as possible and more importantly trying to head off sarcopenia.

THE IMPORTANCE OF CONSISTANCY: Your workouts can’t be consistent one week and then inconsistent the next when results are desired. Consistency is not an option. Whether your routine is 3 days a week or a 4-6 day split, each workout must be one where you stimulate muscle fiber enough to force a neurological response and hypertrophy comes about. You’ve heard the old saying, “stimulate, eat, rest, and repeat.” This is so very true and repeating consistently is the key! And yes, “easy to lose and hard to gain muscle” is correct especially as we age, however the mistake I made as a young adult is not taking enough time off during the year to help the recovery of injuries and of the central nervous system (CNS). I would take a week off 2-3 times during a year of hard training but should have taken more.

As an older adult, taking time off is even more important than during those younger training years. One still wants to still be consistent when it comes to a lifestyle of training but taking time off to keep the bodies and the CNS from burning out, trying to rest because of injury or when one has hit a plateau in their training is of the most importance. During those times, it’s important to back-off for a few days or even a week to let the body recover. Don’t let this down time turn into a weeks or a month because there’s too much muscle to be lost when taking that much time off especially now that we are wiser to the effects of sarcopenia.

THE ROLE OF GOOD NUTRITION & SUPPLEMENTATION: Look at the collegiate or the NFL football players of the 1970’s, 80’s, 90’s and into the 2000’s. Each decade these athletes get bigger and stronger. The reason is better and more advanced strength & conditioning programs plus the tremendous impact proper nutrition can have on athletic performance. So then, it stands to reason that the same can be said for the advancement of nutrition when it comes to aging muscularity.

If you are still living an active lifestyle and trying to stay in good shape into your 40’s and beyond, then you should be aware of how important good nutrition is and just how important it is to be eating from all of the different food groups. However for this article I’d like to put the emphasis on the different types of nutritional supplements that can aid with overall health, immune system function along with anti-inflammatory responses and supplements that will help with trying to keep as much muscle as possible during the latter years. There’s a long list of these types of supplements. I’ll just list what I fill are the most important and what the current research states on each.

- FISH OIL: “Google” the benefits of fish oil and you’ll be reading for days. Find me a disease that fish oil is not good for and well you’ll be searching for a while. Fish oil, krill oil and flaxseed are the major players when it comes to omega-3 fatty acids, which is a polyunsaturated fatty acid. These polyunsaturated fatty acids are considered essential mainly because the human body cannot manufacture them in appreciable amounts. I put fish oil at the top of the list because it’s the grand-daddy of the Omega-3 fatty acids simply because of all (and there’s ton) of research on fish oil. As far as helping the fight against sarcopenia, fish oil helps in the process of Muscle Protein Synthesis (MPS). According to an article by Keith Baar PhD at the department of Physiology and Membrane Biology at the University of California Davis, and Lisa E. Heaton MS,RD, CSSD at the Gatorade Sports Science Institute, the majority of studies examining the impact of Omega-3 fatty acids on MPS have been conducted in older populations (>60 yr) or animals. In one particular study, Omega-3 fatty acid intake resulted in greater activation of m-TORC1 during periods of high insulin and amino acid infusion in older adults (Smith et al., 2011a). In another follow-up study, the authors found that the anabolic response to insulin was greater after supplementation with 4 grams of long chain Omega-3s (including 1.86 g EPA, 1.50 g DHA) daily for 8 weeks Smith et al., 2011b). Baar and Heaton go on to say that these studies support the hypothesis that when insulin and amino acid levels are high, such as following a large meal, adequate amounts of Omega3 fatty acids may improve MPS through the activation of m-TOR1. The article states that while this research is very exciting more needs to be done to establish whether these findings extend to athletes. However we’re not taking about athletes when it comes to the older population. For the “baby-boomers” this is very good useable information! These are just two of many studies and the list goes on and on with research pointing towards the positive benefits of fish oils. One of the leading authorities on fish oil is Hector Lopez, Chief Medical Officer for The Center for Applied Health Sciences. In his presentation at the 13th annual ISSN conference in Colorado Springs, “Fish Oil for Athletes”, Hector presented a study that was conducted by Cintia Rodacki which was entitled, “Fish Oil Supplementation Enhances the effects of Strength training in Elderly”. In this study that she conducted along with her colleagues, there were some very positive markers pointing to the fact that fish oil did just that, improve strength. So if little old ladies can improve their strength by supplementing fish oil into their diet it stands to reason that some old time weight lifters can also. Suggested use is between 1 and 3 g/d.

- VITAMIN D: One of the leading, if not the leading authority in sports nutrition and supplements, is the International Society of Sports Nutrition (ISSN). In one of their latest books, “The Essentials of Sports Nutrition and Supplements,” it states that other important nutritional needs for the exercising elderly include vitamin D and calcium intake plus adequate hydration. It goes on to state that among other functions vitamin D promotes calcium absorption and bone mineralization and in recent studies indicates that vitamin D may have a role in muscular strength! Vitamin D deficiency can also lead to an increase in hip fractures in older adults plus elderly individuals have a higher risk for developing a vitamin D deficiency because of decreased synthesis and a decrease in conversion of vitamin D to its active form in the kidneys. The dietary allowance for vitamin D, recommended by the “Food and Nutrition Board Institute of Medicine” is 4000 IU’s a day for men and women between the ages of 51-70.

- PROTEIN: One of my favorite individuals to listen to is Darryn Willoughby, PhD who is currently an associate professor of Exercise and Nutritional Biochemistry at Baylor University in Waco Texas. This past May (2015) at Europa University (a nutritional seminar held by the ISSN in conjunction with Europa Sports Products), Dr. Willoughby presented a lecture entitled “Supplements for Muscle Mass”. As we all know gaining muscle mass is hard to accomplish without a good amount of protein. Dr. Willoughby presented 4 basic facts about the different types of protein.

1) Whey, casein, egg, and soy protein supplements have all been shown to be effective at increasing MPS (or markers indicative of MPS) when provided before and/or immediately following resistance exercise.

2) Of these, whey has been shown to be the most bioavailable, thereby presumably resulting in a greater impact on MPS for several hours following ingestion and resistance exercise.

3) However, other protein sources are effective too. Their bioavailability may be slower than whey, but over the course of 5-6 hours following ingestion/resistance exercise, their overall impact on MPS can be similar to whey.

4) Moral of the story….whey is good as a pre-and/or post-workout protein, but casein and others may be more suitable as between-meal or nighttime protein sources to maintain muscle anabolism over several hours. Now with all the facts being stated above and how important protein is for increasing MPS, the question is, does the older population need more total protein? We do know that ISSN position stand on daily protein requirements are as follows: General Population (19 years of age and up) for non-exercising individuals is 0.8 g/kg of BW Endurance Athletes: 1.0 to 1.6 g/kg of BW Strength & Power Athletes: 1.6 to 2.0 g/kg of BW and with new research that may go up to even 2.2 g/kg of BW. We also know that those strength & power athletes should be getting around 20-25 grams of protein with each meal. Anthony Almada, nutritional / exercise biochemist even suggest that those same strength & power athletes under 225 pounds should be getting anywhere from 18 to 25 grams of protein per meal. 25-30 grams per meal for if one’s body weight is over 225 pounds! Makes since, the more muscle mass the more protein needed.

But what about the older population when it comes to protein requirements? Should it be higher because of a reduced rate of absorption as we age? This question was posed to Dr. Darryn Willoughby at that same nutritional seminar “Europa University” and he agreed, “it would seem so, as we get older if we can’t absorb as much protein it would make sense that we would need more so that we can ingest more.” In the “Journal of the International Society of Sports Nutrition”; ISSN exercise & sport nutrition review: Position Stand, Protein and Exercise; states that “The active elderly population may require intakes ranging from 1.4 to 2.0g/kg of BW a day, and that this level of protein is safe. Isn’t it interesting that this level is the almost the same as the “strength & power” athletes!

- BRANCH CHAIN AMINO ACIDS: If sarcopenia starts sometime in the 4th decade of one’s life, then there’s nothing more important than to stay anabolic during the day and that requires the stimulation of muscle protein synthesis (MPS). The reason why I like Branch Chain Amino Acids (BCAA’s) so much is because they do just that, help stimulate MPS and the BCAA that stimulates it the most is Leucine. The BCAA’s also contain Isoleucine and Valine in which all three of the BCAA’s are a part of the Essential Amino Acids (EAA). They are Essential (along with 6 other amino acids) because the body cannot manufacture them; they must be consumed in one’s diet. One of the many great things about BCAA’s is when ingested they appear rapidly in the blood stream exposing muscles to high concentrations which in turn make them exceptional regulators of (MPS). Research conducted by Garlick, and his colleagues titled “The role of Leucine in Regulation of Protein Metabolism”, using rodents found that BCAA’s were able to stimulate MPS to the same degree as all 9 EAA’s. However, when they examined even further, only Leucine was able to stimulate MPS all by itself! They also found that taking BCAA’s between meals extended MPS by extending the energy status of the muscle fiber. It should be noted that other studies have also supported the contention that leucine stimulates MPS using more importantly, human subjects. So as you can see, ingesting BCAA’s with a greater ratio and concentration of leucine is a great way to help stay anabolic at any age.

- CREATINE: In my opinion this supplement is what any strength and power athlete should be taking no matter what the age. The research is clear: Creatine works. If you want to get stronger and more explosive, then this supplement is the first to take. For the older population who still hits the weight room on a regular basis—BINGO—this is what we need! According to the “Essentials of Sports Nutrition and Supplementation,” the majority of studies (about 70%) indicates that Creatine supplementation promotes a statistically improvement in exercise capacity. It goes on to state that this means that 95 times out of 100 one will experience an improvement in exercise performance and the only side effect weight gain. Dosages should range from 3-6 grams a day taken before, during or after workouts, however most of the studies indicate that better results will come when taken after workouts.

- HMB (Beta-hydroxy-beta-methyl-butyrate): Jacob Wilson PhD, professor in the department of Health Sciences and Human Performance at the University of Tampa has probably done more on HMB than anyone I know. In his presentation at Europa Universities Nutritional Seminar in April 2013, “HMB, A Novel Look”, Dr. Wilson had some very interesting facts and positive statements on this supplement for gaining strength, power and hypertrophy. First the facts:

1) HMB is a metabolite of the branch-chain amino acid, Leucine.

2) The average man only produces 0.3 grams of HMB a day.

3) However the most efficacious dose seen in studies is 3 grams a day. It would take nearly 600 grams of protein to produce this amount.

4) HMB blunts age related muscle loss by preventing muscular breakdown and as we know when we age, muscle goes down and fat mass I’m sorry to say goes up. Then Dr. Wilson asked the question, “If HMB prevents muscle breakdown, then how might it affect the aging? He presented at Europa University a 12 week study on the elderly that showed increases in knee extensor, knee flexion and grip strength with subjects on HMB. Also HMB was shown to decrease protein breakdown and increase mitochondrial biogenesis (improve endurance) and decrease fat mass.

- JOINT SUPPLEMENTS: A whole article could be written on the importance of Joint Supplementation, especially when it deals with the aging population. As I always have said, “the muscle may get smaller as we age but they’ll last forever, however the joints will not.” Being proactive with taking joint supplements should be the protocol for every person over the age of 40 no matter if they “Hit the Iron” or not. But because of the wear & tear on the joint (that we discussed earlier), I believe it’s essential to do everything we possibly can to head of any kind of joint problem; especially God forbid, joint replacement! Type 2 Collagen: Type 2 collagen is the foundation for articular cartilage and hyaline cartilage. It makes up around 50% of all protein in cartilage and 85 to 90% of collagen of the articular cartilage. This type of cartilage provides tensile strength to connective tissues. Tim Ziegenfuss, PhD is one of the leading researchers when it comes to Type II Collagen. He spoke at the 2014 ISSN National Convention in Clearwater, Florida (in which I attended) and presented his 6 week study and found that his Biocell Collagen may enhance skeletal muscle tissue and/or EMC (Extracellar Matrix) remodeling in response to repeated, intense resistance exercise. Repeated and intense are the key words. When one has been lifting and exercising anywhere from 4 to 5 decades or longer then that’s repeated! So then, if Type 2 collagen supplementation showed an improvement with no side effects, then it’s worth taking.

Glucosamine: “The Essentials of Sports Nutrition and Supplements” documents that Glucosamine is taken to help maintain cartilage and improve joint elasticity plus inhibit joint degradation. Glucosamine is an amino sugar and is found in greatest concentrations within the articular cartilage. Suggested use is between 1500—2000 mg/d as Glucosamine Sulfate.

Chondroitin Sulfate: “The Essentials of Sports Nutrition and Supplements” also states that Chondroitin Sulfate Inhibits joint degradation and helps maintain cartilage and connective tissue elasticity. Chondroitin Sulfate is found in the joints, where they bind water to maintain fluid volume within the joint and help keep the joint moist and also spongy. Suggested use is between 800mg/d and 1.5 g/d consumed with food.

Hyaluronic Acid: Acts much like Chondroitin Sulfate and is actually in the same family as Chondroitin which are called Glycosaminoglycan’s (GAGs) and are unique unbranched polysaccharides that play an important role in the maintenance of joint cartilage. Hyaluronic Acid also helps maintain cartilage and elasticity in the connective tissue and acts as a cushion and lubricate the joints. Because it binds with water, both Chondroitin and Hyaluronic Acid may work better when drinking plenty of H2o. Hyaluronic Acid can also be found in the supplement Biocell Collagen.

- PROBIOTICS: Those of us in our 50’s and beyond know the importance of stomach and gastrointestinal health. It seems like digestive issues are or can be a part of everyday life as we get older. Probiotics have come to the forefront in the last decade as research has shown that they have helped with the overall improvement of gastrointestinal health. As stated in “Sports Nutrition and Performance Enhancing Supplements,” probiotics are often referred to as the “friendly bacteria” and are live microorganisms which when administered in adequate amounts confer a health benefit.” The consumption of probiotics has been shown to improve intestinal macrobiotic balance and thereby supports healthy immune functions and digestive health. They have also been shown to reduce the number, duration and the severity of the upper respiratory tract infections (URTI) and gastrointestinal (GI) distress in the general population and in the risk sub-groups such as the older population. Probiotics also have been shown to improve nutrient absorption (critical when protein absorption is of the upmost importance when aging).

FINAL THOUGHTS: Ten out of every ten people die; no research needed to back up that statement. We can try to hold back father time and can hopefully slow it down to some extent, but sooner or later the clock will stop. However, we at least can try to improve the quality of our lives in our latter years with proper nutrition and exercise. Sarcopenia can be slowed down if effective protocol is followed as described in this article. The “baby-boomers” try to hold on to those great workouts they had in the 70’s and 80’s but time does take its toll, with torn tendons and joint replacements. In the golden age of body building and power lifting (although power lifting is compensatory acceleration), our workouts were slow and controlled movements. Just an observation (for another article) but I wonder what the “Crossfit” community will look like in 20 to 30 years since their movements are explosive and ballistic in nature. Not to bash Crossfit, I like the sport, it gets people moving and that’s always a good thing but nevertheless, what will the joints look like?

The same holds true with Power-Lifters and people wanting to simply gain hypertrophy. I’m sure you’ve seen the “You-Tube” videos of the popular workouts which include squatting and bench pressing every day or multiple days a week (the Bulgarian Method). Now if I was in my 20’s, 30’s or even in my 40’s (instead of being 60 which I am now) that’s the workouts I would perform simply because I like hard work and love to squat (not sure about everyday)! However once again, yes the tendons and ligaments will adapt and get stronger, but what about the soft tissue of the shoulders (the labrum) and the cartilage in the knees? What will they look and feel like in ones 50’s and beyond? And let’s not forget the calcium deposits forming on the tendons. One thing is for sure, the older we get the smarter we must train to help prevent injury. Hopefully in the near future exercise science and more advanced nutritional supplementation will help us hold back “Father Time”.

Until then, when our time does run out and they lay us to rest, our bodies will be broken and worn out, why? Because we did something. We were competitive. We lived life and tried new things and took chances---and that is what life is all about…isn’t it?

Chip Sigmon CSCS*D, USAW, CMFT, RSCC*E, CISSN
Wellness Coordinator, Strength & Conditioning
Europa Sports Products
Contact Chip at chipsigmon@europasports.com

REFERENCES:

- Rosenburg I. PhD., “Age and Ageing” 2010 Jul; 39(4): 412–423

- Waters D.L., RN. Baumgartner & Garry. 2000. “Sarcopenia: Current Perspectives.” The Journal of Nutrition, Health & Aging. From the article, “ Sarcopenia: The Mystery of Muscle Loss” by Chantal Vella, MS and Len Kravita, PhD

- Ryall JG, Schertzer JD, Lynch GS, August 2008. "Cellular and molecular mechanisms underlying age-related skeletal muscle wasting and weakness". Biogerontology (Review) 9 (4): 213–28.

- Krieger JW. Single versus multiple sets of Resistance Exercise: A meta-regression. Journal of Strength and Conditioning Research, 2009; 23 (6): 1890–1901

- Porter, M.M. 2000. “Resistance Training Recommendations for Older Adults” Topics in Geriatric Rehabilitation 15(3): 60-69. From the article, “ Sarcopenia: The Mystery of Muscle Loss” by Chantal Vella, MS and Len Kravita, PhD

- Schoenfeld B., Presenting at the NSCA, National Convention, 7/2015 “Manipulating Resistance Training Variables for Maximal Muscular Growth”

- Baar K.PhD. Heaton L. “In Season Recovery Nutrition for American Football”, Gatorade Sports Science Institute, Sports Science Exchange, (2015) Vol. 28, No.144, 1-6

- Lopez H. CMO, Presenting at the 13th Annual ISSN national conference, (2013) “Fish Oil for the Athlete”

- “Essentials of Sports Nutrition and Supplements”, Edited by, J. Antonio PhD., D. Kalman PhD, RD, J. Stout PhD, M. Greenwood PhD, D. Willoughby PhD, G. Haff PhD, Chapter 19, Pages 404-405 (Vit. D)

- Willoughby, D. PhD. Presenting at Europa University, ISSN nutrition seminar, May 2015 “Supplements for Muscle Mass”

- Almada, A, MSC, FISSN, “Protein Needs and Wants: Gut Empty and Muscle Full”

- Protein Requirements; International Society of Sports Nutrition, Position Stand: Protein and Exercise

- “International Society of Sports Nutrition position stand: protein and exercise” Journal of the International Society of Sports Nutrition 2007, 4:8

- Garlick PJ. “The Role of Leucine in the Regulation of Protein Metabolism”. J. of Nutrition June 2005; 135 (6 Suppl): 1553S-1556S. From the book: “Sports Nutrition and Sports Enhancing Supplements” Antonio J. PhD and Ryan-Smith, A., PhD. Chapter 2 Page 33.

- “Essentials of Sports Nutrition and Supplements”, Edited by, J. Antonio PhD., D. Kalman PhD, RD, J. Stout PhD, M. Greenwood PhD, D. Willoughby PhD, G. Haff PhD, Creatine, Chapter 20, pages 422-423

- Wilson J. PhD. Presented at ISSN Europa University Nutritional Seminar, April 2013. “HMB, a Novel Look”

- Ziegenfuss T. PhD., Presented at the ISSN June, 2014 nation conference, “BioCell Collagen”

- “Essentials of Sports Nutrition and Supplements”, Edited by, J. Antonio PhD., D. Kalman PhD, RD, J. Stout PhD, M. Greenwood PhD, D. Willoughby PhD, G. Haff PhD. Glucosamine, Chapter 22, page 492-493.

- “Essentials of Sports Nutrition and Supplements”, Edited by, J. Antonio PhD., D. Kalman PhD, RD, J. Stout PhD, M. Greenwood PhD, D. Willoughby PhD, G. Haff PhD. Chondroitin Sulfate, Chapter 22, page 476-475

- “Sports Nutrition and Performance Enhancing Supplements” Antonio J. PhD and Ryan-Smith, A., PhD. Hyaluronic Acid, Chapter 3, page 59.

- “Sports Nutrition and Performance Enhancing Supplements” Antonio J. PhD and Ryan-Smith, A., PhD. Probiotics, Chapter 9, page 321.

“STOP THE MADNESS!!!”

Lately I’ve had some people coming up to me saying that they had just read an article on how bad Static Stretching is, how Foam Rolling is a waste of time, and how bad putting Ice on an injury is and that in most cases we should be putting on heat instead. As Mr. Wonderful would say on the popular TV show “Shark Tank”, “Stop the Madness!!” Don’t get me wrong, I like when people come to me about these subjects and I feel honored and humbled that they would come to me and I want them to feel that they can. So I’ll tackle each subject one by one with my opinion (and you know just how much opinions are worth). However I will say that with over 35 years in the coaching, athletic injury and fitness industry, I will give and pull my feeling on the subject from the perceptive of experience.

  • Static Stretching is Bad & can Hurt Performance: The thing that bothers me about this statement is that yes, there is some very good research that static stretching can be harmful and hinder performance to some degree, but the problem I have is that “we want to throw the baby out with the bathwater.” We want to do away with Static stretching all together not thinking that it might have its place. This is what I mean. When I was with the Charlotte Hornets of the NBA I had two things that happened that will give substance to what I have to say on Static Stretching.

Each morning the Hornets would have practice at 10:00, and to a professional athlete this is early! We had just played a game the night before and were at practice at our training facility the very next morning. The players would be shooting for 10 to 15 minutes then I would call them up for our stretching session for 12 minutes. Dynamic stretching that is! After a couple of weeks I was getting complaints from a few players that they just weren’t warmed-up enough, and that they were just too stiff from the night before. So before I got fired and began looking for another job I changed my format.

Here’s what I did. We had two practice courts at our facility. On court one I had our stretching bands laid out all around that court, then I would call the players over and we would do 10 minutes of static stretching with the bands and THEN we would walk over to the other court and perform our dynamic stretching! Man did they love that! They felt better and were able to MOVE! All I did was add a little movement prep before our dynamic movements—and that movement prep was some light static stretching!

I also remember a player we had. This particular player had a personal trainer who would stretch him before practice and before games for 30 minutes, maybe longer! The type of stretching he was doing? Static Stretching! You see, static stretching wasn’t made to be performed for that time frame. Maybe only 30 to 60 seconds at the most. The thing with this player was that he was hurt ALL the time…I mean all the time! My dog buddy is 12 years old and you couldn’t tell (oatmeal, with whey protein on top and fish oil every morning). When he gets up from a nap or his night’s sleep he will do what? Stretch, like most all animal do..........Static Stretch! He hasn’t pulled a quad or Hamstring yet! That static stretch that animals do is only for 2-5 seconds at the most. When one static stretches for too long the elasticity goes out of the muscle. Get a brand new rubber band and stretch it for 5-10 minutes and see how it goes limp. All the energy is taken out. Your muscles react the same way. Research does point to static stretching as being more productive at the end of a workout session or after a hard practice session, but it does have its place and it’s not going to hurt ones performance if used properly.

So please don’t throw the baby out with the… well you know. Both types of stretching have their place. All the internet experts just want to add some drama to draw attention to themselves, with good intentions I’m sure. Yeah—right! “Stop The Madness!”

Oh, and by the way, go out to the warehouse each Tuesday, Wednesday and Thursday mornings at 11:00. You’ll see our WH Team, Group 1 performing Dynamic Stretching and Group 2 lying down on mats performing Static Stretching—they have their choice of either. Whatever they feel is best for them.

  • Foam Rolling: You’ve heard me talk about the 1% rule when it comes to supplements. What I mean by that is, if supplements can only help you improve your health or athletic performance by 1% is it worth it. Of course it is! That 1% may be the difference between finishing first or second place in an event or having some type of health issue or not. The same is true with the foam roll. The foam roll is used to smooth out the muscle fascia which is a band or sheet of connective tissue fibers, primarily collagen, that forms beneath the skin to attach, stabilize, enclose, and separate muscles and other internal organs. After a workout or even before this fascia can get all bound up causing the muscle to be stiff and this can limit range of motion. Yes, the foam roll can be used too much or in some cases not needed at all, however if the foam roll can improve performance or help with an injury by 1% would you still use it. I had the pleasure of working with Michael Chadwick this summer. Michael is an All-American swimmer from the University of Missouri. He’s getting ready for the US Nationals in Austin Texas. I have him foam roll his Lats, and foam roll his Lats, and foam roll his Lats. Why? If the Lats are tight then a swimmer shouldn’t even jump in the water—they have no chance! So the foam roller is used to help massage the muscle fascia around the area of the upper back. Ask Sue Walsh, the All-American Swimmer, I worked with at the University of North Carolina in 1982-1983- if she would have loved to have had access to a device like the foam roller back then. She would have given her right arm for one, (well maybe not her right arm—she wouldn’t have been able to swim, but something just as valuable). Please, “Stop the Madness!”

And if I may, can I mention one more thing? I foamed rolled and foam rolled after I tore and had surgery on my Quadriceps Tendon January the 21st of this year. Instead of coming back and squatting in October they let me come back in July (it feels so good to squat again). If it would have helped to get me back sooner only just by 1% I still would have done it!

  • ICE not good after an injury: Yes, do we use Ice too much in the healing process? I know I am guilty of this. There is some very good research to indicate that ice may be detrimental in some cases. Kelly Starrett a leading Physical Therapist in the field of movement has done a very good job in bringing this to the forefront. We’ll know with more research in years to come if this holds substance.

Until then I still think it’s a good idea to ice the first 24 to 48 hours when there’s an injury. Now I’m not a Physical Therapist, I have only assisted some of the best in the country. With helping and assisting those PT’s in seeing 10 to 15 patients a day, I have seen firsthand how ice can help in reliving the stress and reducing the swelling to help retain the range of motion in a joint. Alan Tyson a leading PT and owner of Architect Sports here in Charlotte makes a great point. “When you work with 12-15 athletes a day and you see the positive results of what ice can do” Alan says, “and by seeing these positive results day in and day out you know and see the benefits that ice can have”. Besides, a lot of these researchers haven’t worked with 12 to 15 patients a day for over 20 years and haven’t seen what ice can do by taking the swelling down! Another thing, a lot of times a surgeon can’t operate until the swelling goes down on a particular injury. Go ahead and put heat on the injury and watch it swell that much more! The surgeon will be waiting that much longer.

Yes, there are times to heat and times to ice. Only time will tell which one will win out and we change our way of thinking. Plus there is still more research needed to be done. But until then I’m still an Ice guy!

One more item of interest (a funny story-but true) pertaining to ice. In 1978 when I got my first teaching and coaching job, I also received my athletic training certification. I coached football and track but also took care of all injuries and let me tell you, “I iced everything that moved.” If it was hurt I iced it and believe me we had some pretty good “back to playing time” stats after a jury…mainly because I threatened them if them didn’t get back to practice! I iced so much the athletes called me “Dr. Freeze!” “STOP THE MADNESS, PLEASE!”

I hope that answers some of your questions…….or raised even more!!

Chip Sigmon CSCS*D, USAW, CFMT, RSCC*E
Wellness & Fitness Coordinator
Europa Sports Products

INJURY UPDATE FOR AUGUST 11TH

  • This past July the 21st was the 6 month anniversary of my Right knee injury (Quad tendon coming off the Patella). That Saturday the 25th I squatted 135 for 10 x 3 sets.
  • The next Saturday, August the 1st I squatted 175 x 5 along with leg Press (315 x 12 x 3 sets) Then single leg Bulgarians with 25 pound DB’s in each hand x 3 sets of 8.
  • Then this past Saturday got down to business and upped the intensity:
  1. Leg Extension x 12 S/S with Leg curls 4 x 12 reps / 8 / 6 / 4 adding more weight with each set.
  2. Back Squats (Wave Reps) 10 / 6 / 3 then back to 10 / 6 / 3 adding weight with each wave a total of 6 sets. Using 185 x 3 both sets. Goal = 225 x 3.
  3. Leg Press: 4 x 6 pause at the top and contract / and 6 with no pause at the top. Up to 405 x 12.
  4. Walking Lunges x 3 with 30 pound KB’s in each hand.

INJURY UPDATE for JUNE 15th - JULY 4th

Just trying to get my strength back during the last 2 weeks of June until now (July the 6th. The ROM is almost there with knee flexion seated at 133 degrees however when lying or standing I still can’t get my heel on my glute—still about a fist length to go.

            When training legs this past Saturday morning my knee felt good. Spent 10-12 minutes on my movement prep then:

·      Leg Extensions (Light) S/S with Hip Thrusters  4 rounds of 10-12 reps

·      Back Squats 5 x 10 working up to 135 pounds (good depth but lower back tight and weak). Just not use to have weight on my back in a while.

·      30 degree Leg Press 5 x 6 reps pause at the top / then 6 reps with no pause  x 5 sets and S/S with lying leg curls with 6 reps full range squeezing at the top, then I rested 10 seconds and repeated but the reps were performed from the top to half way down, then I rested 10 seconds and performed 6 more reps but this time from the bottom to half way up.

·      Performed Walking Lunges for the first time in 7 months using kettlebells holding down by my side. Holding the KB’s down by my side prevented me from going all the way down with me back knee. Felt good! 3 sets of  down and bacl for a total of 18-20 yards.

My knee was stiff the next day but my glutes, HS and Quads were on fire! I activated my fibers for sure!!

Again—ROM is fine, now its just getting stronger!

July 25th is when I really get to start pushing it. That will be 6 month since the injury!

INJURY UPDATE FOR JUNE 5TH

The Knee feeling stronger everyday. PT is still once every 2 weeks then once on my on during the week with training Legs still on Saturday mornings.

Physical Therapy consist of:

·      The Elliptical for 10 mins
·      The Shuttle Leg Press 4 x 25
·      BW Squats  4 x 25
·      Single Leg Squats  3 x 10 on each Leg
·      Balance Reach 3 x 10 on each Leg
·      Standing single leg –Leg Extensions  3 x 10 each leg

Then on Saturday Morning (June the 6th)  6:30 am

·      Leg Extensions  15 lbs  4 x 10  S/S with Band Slides
·      Leg Press (30 degrees) with 225 lbs (feels the same as the shuttle weight at OC) 5 X 15 S/S with RDL’s  55 lbs  4 x 10
·      Goblet Squats 5 x 10 with 45 lbs  S/S with  Leg Curls  5 x 4/4  (4 reps hold 2 seconds and 4-5 reps fast partials)
·      Had to cut workout short---work at Fort Mill HS with Grid Iron Club

 Note: Should be on Target to start Squatting July the 25th!!

INJURY UPDATE for MAY 19TH

Weeks of May 4th –16th: Physical Therapy is now once every other Monday. ROM really good, 132 degrees knee flexion—where it’s supposed to be. Leg Workouts still every Saturday morning (which it has been for around 20 or more years, then rehab on Mondays with Physical therapist and on Thursdays by myself. Last Monday Jeremy started me performing single leg squats—non-supported. It showed me just how far I have to go, still very weak and atrophy still in the vastus lateralis.

Leg Workout last Saturday May 11th:

  • Leg Extensions S/S with Lying leg curls  (leg ext 10 pounds)  both x 10  Leg Curls 5/5 meaning 5 reps hold at the top and 5 reps explosive yet controlled on the eccentric phase plus 3-6 partials

  • Leg Press 30 degrees  5 x 15  only 3 45 pound plates total on leg press =145lbs + carriage which feels like nothing but counted as 45 pounds – total weight 225. S/S DB RDL’s  x 10 reps

  • Back Squat out of the rack to limit ROM went up to 65 pounds. HS stopping short of parallel.

  • Bulgarian Split Squats with back foot on bench using 15 pound DB  3 X 10 each leg

  • Standing Heel Raises 8 x 10-12 S/S with Cable kneeling Crunches x 15

Financial Peace

The last person that you would want to get financial advice from is me! First of all, I’m not qualified and secondly,  I’ve made way too many financial mistakes. However, you’ve heard me from time to time mention the name Dave Ramsey. Well my wife and I just got through taking his 13 week class called “Financial Peace University” (FPU). Now why in the world would I be talking about Dave Ramsey and Finances?? Because, much of the stress that falls on us comes from financial problems. So when we have our finances under control (instead of it controlling us) we have taken a big step towards Wellness!

                “Financial Peace University” taught me so many things i.e. how to save money, start a budget, how to get out of debt and so much more! I just wish I had known all of this 30 years ago. Some school systems are even teaching the FPU in the classrooms, that’s how popular this FPU is! Our class met every Sunday evening for 2 hours for 13 weeks. The first hour was a video with Dave Ramsey teaching and the second was a group discussion. But believe me, the last thing this class is ---is boring!! So much information!

                If you are also interested in attending (and believe me, it will change how you think about money) then go to www.daveramsey.com. But don’t take my word for it, just ask our very own Robert Carter in our Accounting Department, who has also taken this class.  Even someone like him, who’s job is directing and managing money every day, has benefitted from this class!!

                IMPORTANT NOTE: You can hear Dave Ramsey each night on the radio on WBT 1110 am and / or 99.3 fm

                One more item to mention (like this e-mail is not long enough already), there is a book on Wisdom called The Book of Proverbs that was written over 4,000 years ago. Most of what this book states still holds true today.  In the 13th chapter, 4th verse, it states; “A lazy man’s appetite is never filled, but the desires of the diligent are fully satisfied.  The key word is diligent. Diligent in all areas of life that we want to succeed in. Diligent in our faith, family, job, finances, even our health.  So when you’ve worked so hard to get ahead, and things keep falling down around you. When things seem so unfair and you ask yourself why, continue to “keep pounding”, to stay DILIGENT and to fight the good fight, no matter how long it takes, no matter the hard ship, no matter if it’s fair or not, yes fight smart or even smarter, but be diligent and as The Book of Proverbs states, you will be satisfied!!

                                Finish Strong,

 

Chip Sigmon  CSCS, USAW, CFMT

Fitness/Wellness Coordinator,  Europa Sports Products

704-231-8648

chipsigmon@europasports.com

INJURY UPDATE for May 4th

Weeks of April 20th—May 1st: ROM is still where it needs to be, now just a strength issue. BW squats 5 x 10 reps—still leaning to the strong leg (left leg) when at the bottom of the squat. Like the standing single leg knee extensions while keeping the upper leg parallel to the floor.  3 x 10 with each leg. Still going to PT each Monday. Most everything for the quad is BW except however I may go from time to time squatting with just the Olympic Bar performing squats. Performing Hamstring work is with no limitations—going heavy for reps of 5 to 12.

INJURY UPDATE for April 14th

The week of March the 30th through April the 10th: Performing a lot of body weight squats. Still leaning to the left hand side because of the left leg being so much stronger.

Met with Dr. O’Neil April the 10th last Friday. He was very impressed with my progress. He said that I could go back to squatting (Back Squats) any time after July the 22nd. That will be 6 months after surgery. July 25th will be back in the squat rack for me!!

Range of flexion yesterday April the 13th was 132 degrees—right where I am supposed to be!

INJURY UPDATE for March 30th

The Weeks of 16th through the 28th of March: Knee feeling great. Flexion at 120 degrees- Goal is at 132. Still no pain just tight at the very end of flexion. Able to do more glute work such as hip thrusters and RDL’S single and bi-lateral. Also started stationary bike and Ellipital. Just tight at the top of flexion on the Bike. Elliptical on problem however the right quad will not fire like the left—about a 50% difference!

**NOTE: PT ONLY ONCE A WEEK, Started the 23rd of March