November 2020

We are in late November, and based on the temperature outside when I leave for work in the morning, I'd say that cooler weather is finally upon us. It's been a fairly mild fall, which has probably encouraged people to pursue outdoor activities, but there is no reason that should stop simply because the temperature is dropping. Humans were not designed to be cooped up indoors and sedentary all day; our ancestors spent much of their time outdoors in pursuit of food and other life necessities. Regardless of what season we happen to be in, regular exposure to sunlight and fresh air is something that your body needs.

Many people misunderstand why flu rates tend to increase in the winter months. It's not because the colder weather makes you more susceptible, it's because we tend to spend less time outdoors during those months and more time in close quarters with family members (and others) while breathing in recycled air. Most of us do not work outdoors the majority of the time. We tend to spend our working hours indoors at a desk or on an electronic device. Just a few minutes outside can be reinvigorating and refreshing, and will give you a sense of calm. Try doing this a few times throughout your workday.

I recently read an article on the Long Island Weight Loss Institute website that discussed many health benefits of regular exposure to fresh air. One benefit is that it helps to clear your lungs, as you are breathing in air with a greater concentration of oxygen, compared to indoor air. Another benefit is that you will have more energy and mental focus, due to improved circulation. Have you ever wondered why you often feel a renewed sense of purpose and less fatigued after being in the sun for a little while? This explains why. Fresh air and sunshine can lower your blood pressure and resting heart rate, again due to breathing in a greater amount of oxygen. A fourth benefit is that taking in fresh air can help you heal faster from injury and illness. Every cell in your body requires oxygen, plus sunshine causes your body to produce the Vitamin D that is essential for your immune system. Lastly, exposure to fresh air can improve digestion due to improved blood flow.

I don't want to dive too deeply into the political realm, but the mandate that the establishment implemented during the spring Covid wave was precisely the wrong strategy for our psychological and physical health. Forcing people to stay isolated indoors and without exposure to fresh air and sunlight contributed to a spike in rates of depression, anxiety, suicide, domestic abuse, and substance abuse, not to mention the closure of businesses and cratering of the economy. Abroad, countries that did not impose lockdowns, such as Sweden and Brazil, ended up with lower death rates than neighboring countries that used more draconian measures. In my opinion, a more sensible approach would have been to isolate the people who were truly ill or had the risk factors that made them the most susceptible to the virus rather than forcing everyone behind closed doors. People should have been allowed outdoors to get fresh air and sunshine, and instead of hoping for a vaccine (which may or may not be safe and effective), Americans (and those worldwide) should have been encouraged to supplement with Vitamin D, zinc, magnesium, and Vitamin C in order to optimize immune function. Mid-March, when the sun angle in the Northern Hemisphere is such that it enables your body to produce Vitamin D from sunlight exposure would have been the perfect time to recommend spending time outdoors. Remember, this virus has a survival rate of over 99 percent.

Being outside at all times of year, even for just a few minutes at a time, can pay big dividends in your physical and psychological health. Find any reason to breathe in some fresh air and let the sun shine on your face. Go outside and walk around the parking lot while making a phone call. Play games with your kids, take your dog for a walk, or walk to the convenience store up the street instead of driving. Going for a hike in chilly weather can be just as invigorating as during the spring or summer. Humans don't usually expose their bodies to wide temperature gradients; a little cold now and then can be good for you. Any excuse is a good excuse.

At Total Results, we perform full body workouts each session. These workouts include all major muscle groups of the body, but also include many critical smaller muscle groups. Strengthening these smaller muscle groups is essential for pain free living, injury resistance and, if you have already experienced an injury, successful injury mitigation and management.

One of the most important areas we emphasize are the muscles of the lower and mid back. These muscles include the muscles of the Erector Spinae, the Multifidus muscles , and the Quadratus Lumborum.

Why are these muscle groups so critical to strengthen? According to Statista there were 947,000 Emergency Room visits in the U.S. in 2017 alone for Lower Back pain. Additionally, 80% of adults will experience a back injury in their lifetime. Back injuries are the top cause of job-related disabilities. Americans spend over $50 Billion annually on treating back pain. (link) These numbers are staggering. However, just two minutes of proper back exercise per week in the context of a full body workout can help you avoid becoming part of these statistics.

To exercise the muscles of the lower/mid back, we utilize a unique machine called the Medx Exercise Lumbar Machine. We have several of these machines in our studio because we believe this is such a critical exercise. The Medx Exercise Lumbar is unique among back machines throughout the exercise equipment industry for several reasons: relative isolation of the low back musculature due to leg and waist restraints, a safe 50 degree range of motion, a safe starting and ending position, and a friction free weight stack. As in every part of our workouts, we provide 100% oversight by an experienced instructor.

It is quite amazing how quickly back strength can improve with such a small amount of work each week. We have many clients who have had back surgery in the past or are living with herniated discs or other back derangements and after a few months of weekly workouts at Total Results, they have less pain, more mobility, and are capable of activities they thought they would never enjoy again, like skiing, hiking, and more. We of course monitor client's physical condition closely over time, and if a chronic back issue like herniated discs become inflamed, we might alter the low back exercise (change the weight, time, or range of motion) or we might avoid the Exercise Lumbar Machine altogether for a few weeks so we don't further inflame the area.

I have two herniated discs in my low back (L4-L5, L5-S1) which I have lived with for more than twenty years. Before I started doing this workout I would throw my back out several times per year and have very limited and painful mobility for a week or more. Now that my low back muscles are strong, I still occasionally get inflamed in the lumbar region, usually due to lifting too much mulch or furniture in poor form. When that happens, I follow the above prescription of temporarily altering the exercise or taking a week or two off, but still try to complete the rest of my workout. Invariably, within a few days, I am 100% back to normal. This strength gives me a great deal of physical confidence, and I plan to hike, mountain bike, snow and water ski, and do all other activities I enjoy for decades to come!

As you can tell, we are passionate about getting and keeping your low and mid back strong. It is critical for a happy and physically productive life. What are you doing to strengthen your back muscles? Walking or Jogging or Cycling don't cut it. Most standard weight training exercises are not intended for this region of the body (A stiff legged free weight deadlift is the exception, however, this can be a very unsafe exercise if you use improper form). As you think about your fitness, consider the necessity of strengthening your low back. Consider Total Results for your low back strength and your full body fitness. Do not put it off any longer!

People often wonder why we are so particular when it comes to exercise instruction; many of our clients occasionally kid us about how obsessive we are when it comes to certain aspects of their workouts. Several years ago, Ken Hutchins (the founder of our exercise protocol) was actually described as "a fitness Nazi" by someone in the mainstream fitness industry. While being compared to some of the worst people of the 20th century is irresponsible and extreme, I can understand why those not familiar with our methodology do not grasp the importance of us being so detail oriented. We aren't purposely trying to be obsessive, but details are incredibly important for the efficacy of your workout, and can make the difference between an amazing muscular and metabolic experience and an increased likelihood of injury. Simply put, it's the little things that matter the most.

Speed of movement matters. You may ask why we are so strict about it, but it's really very simple. Movement speed can get very fast in a hurry if we do not adhere to a standard. If you go to a regular gym and watch people lift weights, you will see it typically amounts to throwing and catching the weight over and over; it's appalling. No meaningful muscular loading can occur if you move faster than six seconds on either the positive or negative phase, and most people move a lot faster than that. In addition, the potentially dangerous forces placed upon your muscles and joints increase exponentially the faster you move. Force equals mass times acceleration (F=MA). Our protocol emphasizes a ten second positive phase and a ten second negative phase for each repetition, but anything between eight and twelve seconds in each direction is acceptable. If a positive or negative is completed in 7.99 seconds, we do not count that repetition. If we make an exception, then we lose objectivity, and poor form is reinforced. Once bad habits creep in, they are hard to reverse. Furthermore, turnarounds (change of direction) are important; in fact, they are just as important (if not more) than overall speed. Properly performed turnarounds ensure that the musculature stays under load. Unloading gives the muscles a brief respite, and that is contrary to the primary exercise objective. We want to safely inroad (fatigue) the muscles as deeply as possible to stimulate body improvements.

Record keeping matters. This is how we can accurately gauge a client's progress, and this ties in with the earlier topic of speed of movement. If we don't standardize speed for each repetition, then record keeping becomes haphazard at best and meaningless at worst. Exercise settings, sequence of exercises, and additional notations need to be documented for every workout on the client's spreadsheet. As instructors we have a common language and shorthand that we use, so that if you need to work with a different instructor on a particular day, you won't miss a beat. I propose poundages for a client's next workout at the end of their current workout. I do this because the client's performance is still fresh in my mind and I can be objective in selecting what they do in their next workout. I don't trust my memory if I wait until just before the next workout to do this. It may be a bit obsessive, but it ensures that I am fully prepared. Total Results clients deserve it!

Proper entry and exit of the equipment matters. This is a topic that probably seems a bit petty to many people, but it makes more of a difference than you might realize. Client safety is paramount, and it is the responsibility of the instructor to make sure that the client moves efficiently and safely from one exercise to the next. This is one reason why we generally don't allow clients to carry water bottles during their workouts or drink from them while they are walking, as their vision will be obstructed and they could take a misstep. If a client insists on a water bottle, it should be kept in a centralized location, rather than taken from one machine to another. When entering a machine, unilateral loading of the pelvis and spine must be avoided, and this most commonly occurs when stepping over and balancing on one foot (as on the entry of the Leg Press or Lumbar Extension machines). On these machines, one should enter by sitting down first and swinging the feet across, just as patients who have recently had back surgery are taught to enter a car. I have seen people injure themselves by entering the equipment incorrectly, so I remind them to do this every time. I'm sure clients get tired of hearing me say it, but hopefully they appreciate my concern for their safety.

Correct breathing matters. This is intuitive and usually goes without saying, but sometimes during intense exercise the "fight or flight" response kicks in and panic can result. The fact that you must breathe during exercise is just as important as how you breathe. Try to avoid overbreathing initially, as this can wear you out. Breathe normally and as needed, but realize that as the exercise becomes more intense you will need to breathe more frequently. The muscles need oxygen in order to continue to produce the effort that we seek. It may seem unnecessary to tell an intelligent human being to breathe, but clients have remarked to me on many occasions how thankful they are for the reminders we give them.

Outside of the exercise studio, other little things matter: maintaining a consistent bedtime, minimizing exposure to artificial light just before going to sleep, finding ways to minimize stress (such as meditation), and getting regular sensible sun exposure (to maintain healthy levels of Vitamin D). We care about your safety and well-being, and we will do whatever it takes to help you succeed. Your Total Results instructor will focus on the little things during your workout while you concentrate on the big picture: getting stronger and healthier so that you can get the most out of life.

It is normal that as we age, we tend to experience some aches and pains in our bodies, particularly in places like the hips, knees, and lower back. I think that living an active life (within reason) is preferable to living one that is sedentary, and I believe it is better to wear out than to rust out from underuse. Having said that, sometimes novice Total Results trainees have a tendency to attribute occasional joint discomfort to something that is new (Total Results exercise) rather than some other form of activity they are currently doing, or to something they have done in the past. I am confident in saying that if you are experiencing joint problems or not making the progress you hoped toward your fat loss goals, your Total Results workout is probably not the culprit.

Overuse injuries, such as tendonitis or arthritis, are the result of repetitive motion and trauma. In contrast, an ACL tear is a single-event injury due to significant force that exceeds the structural integrity of the ligament. While a ligament can be weakened by repetitive stress, it generally tears as a result of a macrotrauma. Repetitive stress injuries can take months or years to manifest. In fact, young distance runners often scoff at the dangers of running and remark that they are injury-free. Many years later they often suffer from knee, hip, and back pain, but don't realize all the thousands of miles they have logged have been the root cause. Numerous long-time golfers experience back pain to varying degrees (see Tiger Woods). A golf swing involves a tremendous amount of torque (a twisting force) to the spine every time it is executed, and doing this repeatedly over the course of several years can result in injury. If a golfer experiences back pain on the Lumbar Extension machine, there is often a tendency to attribute the back pain to the exercise itself, rather than years of playing golf. Remember, correlation does not imply causation.

Yes, I have seen a few clients over the years experience an injury during a Total Results workout, but that is largely the result of committing form discrepancies rather than our exercise protocol. Total Results exercise is carefully regulated in terms of frequency, intensity, and duration, as well as speed of movement, selection of movements, and entry/exit of each machine. If you follow your instructor's directions and try to implement their instructions, the chances of injury are infinitesimal. As we like to say, Total Results exercise is safer than stepping off of a curb.

Fat loss is a common goal for many of our clients, and Total Results exercise is a big ally in terms of changing your body composition. Building lean muscle increases your metabolism, contributes to a positive change in body shape, and aids in fat loss. However, Total Results exercise in and of itself is not a fat loss program. Regular strength training workouts should be performed in conjunction with a reduction in calories consumed, avoidance/reduction of sugar, consuming a largely single-ingredient whole-food diet, and regular practice of intermittent fasting. In addition to that, it is important to get between 7-9 hours of restful sleep per night. If you are keeping up with your workouts but falling short in other areas, your fat loss results will probably not be optimal. Exercise is an important component of achieving fat loss, but it is only one of several components. We want to help get you there safely and efficiently. There is also a chance that your Vitamin D levels could be insufficient or even deficient (this can lead to difficulty in metabolizing fat), so it's a good idea to have your levels checked. Regular sensible sun exposure and Vitamin D supplementation can make a big difference.

We relish the opportunity to work around pre-existing or new injuries that a client presents to us, just as we experience tremendous satisfaction in helping clients to achieve their fat loss goals. In order to achieve success on both of these fronts, it requires trial and error and patience. It will take some time to find the right sequence and selection of exercises to work around or rehabilitate injuries, and it will take some experimentation with your diet and daily routine to start seeing some tangible fat loss results. Recreational activities, especially those that are physical in nature, have their virtues, but they also carry injury risks that must be assumed by the participant. Our mission at Total Results is to educate our clients and pass along what we have learned over the past two decades, and we will do everything that we can to give you the best chance for success.

A study published in the Archives of Internal Medicine in 2009 by researchers from Harvard University and the University of Colorado showed that 70 percent of whites, 90 percent of Hispanics, and 97 percent of African Americans have insufficient blood levels of Vitamin D. Insufficient Vitamin D has been linked to psoriasis, depression, periodontal disease, and autoimmune diseases; even people with Parkinson's Disease and Alzheimer's Disease have shown lower levels of Vitamin D. I discovered this information in the book "The Vitamin D Solution" by Michael F. Holick, PhD., M.D. Dr. Holick is a professor of medicine, physiology, and biophysics at Boston University, and is one of the world's foremost researchers on Vitamin D. He has devoted nearly four decades to the relationship between sunlight and the body, and his book is full of valuable information that can make a huge impact on our health and well-being.

The book first details what Vitamin D is, what it does, the effects of a deficiency, and diseases or medical conditions that are related to insufficient levels. According to Dr. Holick, "Generally speaking, vitamins are organic compounds that cannot be made by the body but are necessary for proper functioning." That being said, "Hormones...are synthesized in the body from simple precursors and go to distant tissues where they have an intended effect and make multiple metabolic improvements." In this respect, Vitamin D acts more as a hormone rather than a vitamin; sunlight is absorbed by the skin cells and then sent to the bloodstream, where it is then activated through your liver and kidneys to become the Vitamin D that circulates throughout the body. Much has been made over the years about the dangers of sun exposure, and it's true that too much sun can cause skin damage and increase your risk for skin cancer, but sensible exposure to sunlight is very healthy for the body. While sunlight contains UVA, UVB, and UVC radiation, only exposure to UVB can stimulate production of Vitamin D in the body.

The benefits of Vitamin D in the body are numerous; Vitamin D can improve bone and cellular health by preventing osteoporosis and certain types of cancer, it prevents heart attacks, strokes, and type 2 diabetes, and can keep your brain healthy by preventing depression, schizophrenia, and dementia. Vitamin D is also a key component of muscular health, as it helps to absorb the calcium that is needed for muscular functions. This amazing vitamin (hormone) also plays a pivotal role in regulating mood and improving sleep disorders, as well as preventing autoimmune diseases like rheumatoid arthritis and multiple sclerosis. The author provides a very helpful barometer of your Vitamin D status. The ideal range is between 40 and 60 nanograms per milliliter (ng/ml). 21-29 ng/ml is considered insufficient, while a reading of 20 ng/ml and below falls into the deficient category. Vitamin D intoxication occurs with a level of 150 ng/ml and above, however intoxication can only occur through diet and supplementation. It must be noted that it is impossible to achieve toxic levels through sun exposure; you would get sunburned long before that happens.

Part two of this book explores some strategies to improve Vitamin D levels. One recommendation is to have regular and sensible sun exposure on your skin, particularly during the months of March through October; since we live in the mid latitudes (between 35 and 50 degrees), Vitamin D cannot be manufactured from direct sunlight between November and February. It is important to know your skin type and how long to stay in the sun before applying sunblock, and Dr. Holick provides a chart detailing six different skin types based on pigmentation and tendency to burn. Another suggestion is to consume an adequate amount of calcium, either through diet or supplementation. As Dr. Holick says, "Calcium is required for skeletal and cardiac muscle contraction, blood vessel expansion and contraction, secretion of hormones and enzymes, and transmission of impulses throughout the nervous system." High levels of Vitamin D can demineralize bone if adequate calcium is not consumed. Rich dietary sources of calcium include dairy, leafy green vegetables, and nuts. For those who do not consume enough calcium in their diet, a calcium supplement is a good alternative. The final recommendation to improve your Vitamin D levels is to take a daily Vitamin D supplement. I encourage everyone to do this, since we do not live in the tropics and most of us do not work outdoors year-round. Dr. Holick recommends, "...that everyone take at least 1,000 IU (International Units) of Vitamin D a day (and preferably 2,000 IU) along with a multivitamin containing 400 IU of Vitamin D all year long." I have taken 5,000 IU per day for a few years now, and have suffered no ill effects. In fact, Dr. Holick and Dr. Robert Heaney conducted a study that showed one can take up to 10,000 IU of Vitamin D per day for five months without toxicity. Vitamin D is fat soluble; it is stored in fat cells and can be used during the winter months, even if we spend less time outdoors or stop supplementing for a time.

The body is full of Vitamin D receptors; every tissue and cell has one. If Vitamin D weren't critically important to optimal body function, this wouldn't be the case. According to Dr. Holick, Vitamin D deficiency/insufficiency is our most common health problem, yet very little attention is given to it by most of the medical establishment. In fact, many doctors don't include Vitamin D tests as part of a standard panel. The solutions presented in this book are straightforward, simple to implement, and are cost-effective (sunshine is free!). Don't be misled by what Dr. Holick calls the "sunphobes"; sensible and responsible sun exposure will not increase your risk for skin cancer. In fact, there is evidence to suggest that Vitamin D deficiency can put you at even greater risk for melanoma. There is a reason why we often feel a sense of peace and calm after spending some time in the sun; because it's good for us! Eat well, supplement, and spend some time in the sun. You'll be surprised at how quickly your mood, energy level, and health start to improve.