November 2018

Suppose you purchased four gallons of gasoline for the virtually empty gas tank of your car on Monday, and used three of those gallons to drive to work and back. That leaves you with one gallon remaining. Tuesday, you purchase another four gallons and again use three gallons for your daily commute, now leaving you with two gallons remaining. Repeat this on Wednesday through Friday and at the end of the work week you will have five gallons remaining in your gas tank. The fuel you did not use will remain stored in your gas tank until needed. Just like gasoline is the fuel your vehicle converts to energy, food is the fuel your body converts to energy. Just like any gasoline remaining after energy and waste production will remain stored in your vehicle, any remaining food beyond what your body converts to energy or waste will be stored in your body. In an automobile, the remaining gasoline just sits in the gas tank. Of course, in your body, excess "fuel" gets converted to body fat. You can think of the fat on your body as a lot of potential energy! Unfortunately, this accumulation of potential energy (aka fat) is happening to a majority of Americans due to the exact same mechanism I described with the automobile - a slight daily over-accumulation of fuel.

Throughout most of human history, having the energy storage capability of extra body fat was a life saver. When food sources were scarce, which likely happened with some regularity, humans could literally live off of their body fat for weeks at a time if needed. With our modern abundance of food, however, what was once a boon to human survival is now the bane of many Americans' existence. Consume just 50 calories of food energy per day more than your body uses for fuel, and you will likely gain about five pounds per year of body fat. For reference purposes, 50 calories is about half a banana, half a piece of whole grain bread, or a quarter cup of cooked white rice. Over ten or twenty years, the weight gain can become dangerously unhealthy. The prevalence of metabolic disorders, Diabetes, heart disease, and certain cancers all increase dramatically in those who are overweight. These modern diseases of over-abundance cost us hundreds of billions annually in medical and insurance costs. Something has to be done, and it has to be done at the individual level. We each have to take responsibility for our own health. We can no longer blame advertising, or the government, or the internet, and then expect to distribute the cost of our health care to our neighbors. It is simply unsustainable. This is bankrupting us.

Before getting into what we can do to reverse this terrible calculus of the modern human diet, let me be clear about something. Eating too much of any type of food will result in weight gain. If you eat mostly protein and fat, as recommended in many "low-Carb" diets, but you overconsume calories, you will still gain weight. If you eat 50-80% dietary fat, such as in the currently popular Ketogenic diets, but overconsume calories, you will gain weight. If you embark on a low-fat, low sugar, or vegetarian, or vegan, or any other diet plan, but overconsume calories, you will gain weight. The reason people have fat loss success with any given diet plan is that the foods they eat either satiate them enough or they allow the dieter enough psychological will power to eat at a caloric deficit to the calories/energy they burn. With some diet plans it may be a combination of the factors.

Now, how can we thrive and get ourselves to an ideal body weight in this current environment of food abundance, which our bodies clearly did not evolve to handle?

First, we need to consume a bit less fuel. Eat less food. What is the best way to accomplish this? To me, relying on willpower will not work for most people. The alternative is to find healthy energy sources that are also very satiating; that is, they provide the vitamins, minerals, and overall nutrition we need but satisfy our hunger with moderate quantities. Most protein sources are extremely satiating, so I would recommend leading meals with protein, such as fish or beef. Interestingly boiled potatoes (but not french fries) are among the most satiating foods and have a very complimentary nutrition profile to beef, hence the old meat and potatoes meal may be a great way to moderate caloric intake. Other high satiety foods include oatmeal, oranges, apples, cheese and several others. Search the internet to find some you like. So, lead with protein on your plate and add some low calorie vegetables or fruit and maybe some potatoes, and minimize non-filling food such as sweets, most breads, most cereals, most pasta, etc.

Second, we need to burn a bit more fuel. There are two ways we can burn more calories in a day. First, we can be more active. We can stand more, walk more, and pursue recreational activities and athletic pursuits more. Second, we can add some lean muscle mass to our body through high intensity weekly weight training. By adding a few pounds of lean muscle mass to our body, we burn more fuel all day, every day in order to maintain that increased mass. I recommend walking several miles per day if you are not engaged in an athletic or recreational pursuit on a given day. I also recommend once or twice weekly lifting of heavy things, such as we engage in at Total Results.

These seemingly minor changes in diet and lifestyle can cause massively significant changes in your body. Once you tip the scales from slight over-consumption to slight underconsumption, the excess body weight will slowly but surely start to burn away. To go back to the automobile analogy, the excess fuel you will require will come from your gas tank stores rather than from the pump. You will have to burn body fat in order to make up the deficit you have created by reducing your fuel intake and increasing your fuel usage. It may take months, or it may even takes several years depending on how much you have to lose to get to your ideal, but if you start today, you will improve the quality and perhaps even the length of your life. You will look and feel better. You will get to your genetic ideal. You will not be a financial or medical burden on your fellow Americans. You will thrive. Get started today!

As we age, especially if we live an active lifestyle, we find ourselves a bit more susceptible to aches, pains, and even injuries, than we were in our twenties and thirties. Play a few rounds of golf in the course of a week, and you may feel a twinge in your lower back. Play pickup basketball regularly and you're likely to feel some pain or discomfort in your knees, hips, ankles, or feet. If these conditions persist, you may decide to schedule an appointment to be examined by your family doctor. If the injury is serious, you may get a referral for an orthopedist. If the condition is less severe, there is a good chance that you'll be given a prescription for physical therapy.

The physical therapists that I have encountered are educated, knowledgeable about many aspects of the human body, and well-intentioned. Prior to coming to work at Total Results, I worked in an exercise studio that was across the hall from a physical therapy clinic. The owner of the business was affiliated with the Washington Redskins, and he had a good professional reputation. Unfortunately, from what I observed the therapists relied upon a variety of modalities and practices that are, at best, outdated and largely ineffective, and at worst, dangerous. It resembled an assembly line; therapists were often juggling up to three patients at a time, which meant the patients were receiving very little individual attention. One patient might be administered ice, while another received electrical stimulation, and a third used resistance bands. When actual strength training exercises were performed, there was little to no consideration for force or speed of movement, and the number of repetitions and sets performed was completely arbitrary. This is where the problem lies. You don't need to see a physical therapist to administer RICE protocol (rest, ice, compression, elevation) for an injury; that can be done in the comfort of your own home. Electrical stimulation provides very little benefit. Physical therapy clinics often use electrical stimulation as an additional modality to impress patients and charge insurance companies. In my experience, most people that participate in physical therapy make improvements in spite of what they're doing, not because of it. It's a testament to how resilient the human body is and what it can withstand. I have even seen clients' injuries worsened by participating in traditional therapy. There has to be a better way.

Proper strength training, like the exercise philosophy we instruct at Total Results, should be the majority of one's physical therapy. In order to successfully rehabilitate an injury, we need to improve a muscle/joint's functionality. The only way to effectively do that is to perform exercises that track muscle and joint function properly, and to perform them in a low-force manner that will not exacerbate the problem. Excessive force is the root cause of injury. A muscle that is measurably stronger will function better. Charting and record-keeping are very important, so that progress can be objectively measured. Resistance bands do not progressively overload the muscle; we must be able to increase the amount of resistance over time. We also must take into consideration a safe and pain-free range of motion, and also to make sure that the client is able to differentiate between muscular discomfort (the burning that one experiences with muscular fatigue) and injurious pain (something sharp and sudden). It's also critical that we have consideration for proper head/neck position, spinal and pelvis positioning/restraint, avoidance of unilateral loading (which can unevenly load the spine and pelvis), and proper breathing. These requirements and standards of care are often not performed in traditional physical therapy. Finally, it's important to avoid strengthening exercises that try to mimic a certain skill, as is often seen in occupational therapy or so-called functional training. Trying to combine a specific skill with weight training is a recipe for injury.

At Total Results, we have a variety of "tools in our toolbox" to work around nearly any injury or issue. We use traditional dynamic exercise (10/10 speed of movement), manual resistance, Timed Static Contraction protocol, negative-only exercise, and even static holds to allow us to target the muscles without exacerbating the injury. We also make sure to carefully supervise proper entry and exit of each machine to avoid unilateral loading. Traditional physical therapy often doesn't do those things. The next time you get an ache, pain, or injury, be cautious of your choice of physical therapist and make Total Results an important part of your healing and strengthening process.