June 2020

Intelligent effort and safety are the most important considerations when trying to stimulate positive physical change. The human body, left to its own devices, is very resistant to change and will usually do what it can to maintain the status quo, unless a significant stimulus is introduced. Many gym rats and weightlifting enthusiasts try to make up for a lack of exercise intensity (momentary effort) by increasing exercise volume and frequency, which frequently leads to overtraining, injury, and greater risk for illness due to overtaxing the immune system. There are a great many so-called "advanced training techniques" that have been used in gyms for decades by athletes and bodybuilders; most of them are pointless and provide very little benefit. A couple of techniques that do have some merit are pre and post exhaustion movements. How effective are they, and how frequently should they be used? Let's take a closer look.

A pre-exhaustion involves performing a single joint exercise immediately before a multiple joint exercise for the purpose of more deeply inroads (fatiguing) the larger or primary musculature. Often, the smallest muscle group in a compound movement becomes a limiting factor in terms of getting the most effective inroad. A good example of this is the Leg Press. The prime mover in the Leg Press is the glutes, but often the quadriceps fatigue before the glutes can be thoroughly inroaded. While the quadriceps is a strong and powerful muscle group, the glutes are even larger and stronger. However, by performing the Abduction exercise before the Leg Press, you can more deeply fatigue the glutes and achieve a more effective exercise stimulus. Pre-exhaustion can be beneficial if used sparingly and strategically, and is more feasible when used in certain combinations, such as Abduction/Leg Press or Pullover/Pulldown. We often have clients perform the Leg Curl exercise first in the exercise order just before the Leg Press. In some ways this could possibly be considered a pre-exhaustion, but not really. We do this more to target the hamstrings effectively, but the hamstrings are not a prime mover in the Leg Press. Also, performing a knee flexion exercise (Leg Curl) before performing a knee extension exercise (Leg Press) allows us to thoroughly warm up and lubricate the knee joint. This is beneficial for all clients, but especially those with knee issues.

A post-exhaustion entails performing a single joint movement after a multiple joint movement. Ostensibly, this is to more deeply fatigue a smaller muscle that may get overlooked in a larger exercise. A good example of this would be to perform a bicep curl right after doing a Pulldown or Compound Row exercise. Performing post-exhaustion can make your muscles feel more "pumped", i.e., engorged with blood, similar to doing pushups prior to going to the beach. Many bodybuilders strive to achieve this feeling because it feels good and gives them a sense of accomplishment. Post-exhaustion can also be very effective for correcting a muscular imbalance or helping to rehabilitate an injury, such as performing the External Rotation exercise for the small rotator cuff muscles after doing the Overhead Press. Speaking of the Overhead Press, in addition to the major muscles of the shoulder it also involves the posterior (rear) part of the neck, so performing a Cervical Extension exercise after the Overhead Press could be considered a pos-exhaustion for the neck musculature. Strong neck muscles are important for everyone, in order to prevent injury and improve posture.

It is very easy to take pre- and post-exhaustion too far, in my opinion. Exercise volume is like a dosage of medication; both have a narrow therapeutic window. Recovery ability can be fragile, especially if one is active outside of their Total Results workouts, so exercise frequency, volume, and intensity need to be regulated to avoid overtraining. Post-exhaustion is largely unnecessary, since it further weakens the already weak link in compound exercises. The slow movement speed and precise turnaround technique of the Total Results exercise protocol enable us to target the intended musculature much more thoroughly, so performing a pre-exhaustion is not required in most cases. Even Ken Hutchins (founder of our exercise protocol) wrote a chapter in the Super Slow Technical Manual titled "Where Pre-Exhaustion Went Awry." During Hutchins' time at Nautilus, his boss Arthur Jones became increasingly intrigued by the concept of pre-exhaustion, and had several Nautilus machines built to more efficiently accomplish this. After Hutchins left Nautilus and further refined our exercise protocol, he came to understand the dangers of too much exercise volume and largely moved away from the concept of pre- and post exhaustion.

In order to achieve optimal results, you need a balanced exercise protocol and routine that will stimulate positive change without damaging the body in the process. That's where Total Results comes in. We have studied exercise history, equipment design, anatomy and physiology, concepts of motor learning, and nutrition for nearly twenty years, and we will customize our selection and sequence of exercises to help you succeed without getting injured. Get Total Results today.

When an injury, inflammation, or physical ailment occurs in the human body, most people's first instinct is to rest or do nothing, in hope that the problem gets better on its own. Most family physicians will probably give the same advice, and may even prescribe an anti-inflammatory medication. Unfortunately, this does not get to the root of the problem; it only treats the symptom. Most doctors know very little about what constitutes true muscle-strengthening exercise, so they usually prescribe rest, or at most, a gentle walking program. In some cases, the doctor will recommend physical therapy.

Traditional physical therapy often focuses on the wrong things. It incorporates modalities that provide minimal benefit, while checking off all the boxes accepted by the insurance company. A lot of time is dedicated to electrical stimulation, stretching, icing, and so-called "functional movements' which provide little benefit (and some of this can be done at home). Physical therapy focuses on restoring normal range of motion (which is important), but it doesn't place a premium on increasing strength; the connection between strength, range of motion, and functionality seems to be missed. When strength training is performed, it is usually performed in a haphazard fashion, without any consideration for speed of movement, change of direction, body alignment and positioning, or progression. Weight and repetitions are selected arbitrarily. Is this really the best way to rehabilitate an existing injury or protect yourself from being injured in the future?

There is a better way: Total Results exercise. The body is fairly resistant to change, and it needs a very good reason to adapt. The same is true for rehabilitating an injury. When an injury occurs, there is a loss of strength in the muscle(s) affected, or in the muscles surrounding that affected joint. When there is a loss of strength, there is also a loss of function. You must work to build strength in order to improve and restore function. What is needed is a stimulus. You must cross a stimulus threshold in order for the body to adapt; performing 30 repetitions with 5 pounds of resistance won't do it. The resistance should be meaningful enough so you reach momentary muscular fatigue in proper form within 1 � to 3 minutes of elapsed time.

If you have suffered an injury, avoiding exercise is the worst thing you can do. If you do nothing to strengthen the affected muscle/joint, the problem will be exacerbated due to greater atrophy. This leads to a further decrease in function. We often see this scenario with people who have suffered a back injury. Some of it is psychological; a person is told by his doctor or physical therapist not to perform a certain exercise, and the person becomes fearful of suffering another injury. No physical activity is without risk, but properly performed exercise is as safe as taking a walk. Tim has had two herniated discs in his lower back for many years, and even though he occasionally deals with back pain he performs the Lumbar Extension exercise every week in his workouts. Keep in mind that when I say "aggressive" therapy it should not be misconstrued as unsafe. Just the opposite. We utilize a very slow movement speed (ten seconds in each direction) with careful and precise turnarounds (change of direction) while closely monitoring the client for form discrepancies. Even though we are working very intensely, the most intense repetitions (those toward the end of the exercise) are actually the safest because we have weakened the musculature to the point where their capacity to produce injurious force is significantly lessened. Range of motion is certainly important; utilizing our slow movement speed in a pain-free range of motion will increase functionality and also enhance your flexibility without performing additional stretching.

Total Results exercise is true therapy for improving strength, restoring muscular function, and reducing pain, in addition to addressing the needs of the cardiovascular and metabolic systems. We often make modifications to our exercise methodology by using Timed Static Contractions, negative-only protocol, manual resistance, or even adjusting your range of motion to avoid further joint irritation, but the key is to work intensely and intelligently. Client feedback is very important, and we take the time to educate our clients about the process and help them to differentiate between injurious pain and exertional muscular discomfort. We have almost twenty years of experience in helping clients to restore function and get more out of life. If you or someone you know needs help in rehabilitating an injury, we would be happy to schedule an initial consultation. Get Total Results.

Most people are aware of the restrictions that have been placed on business owners as a result of the Covid-19 situation. Our facility was forced to shut down for two months, due to fear over the spread of the virus. Unfortunately, our facility (with its unique exercise philosophy) was lumped with all other run-of-the-mill gyms. The phrase "social distancing" entered the lexicon earlier this year, and will probably be with us for the foreseeable future. What many people, except for Total Results clients, may fail to understand is that we have been practicing social distancing for nearly 20 years!

Environment:

When you first walk into our exercise studio, you will notice that it is impeccably clean. This is what every Total Results client expects and deserves. You won't find trash, towels, or empty water bottles on the floor. We wipe down the equipment after every appointment; this includes seats, pads, movement arm handles, and seat belts. The studio temperature is kept between 65 and 70 degrees, to prevent overheating that can negatively impact your workout performance. An intense workout such as ours is best performed in a cool and well-ventilated environment, and we have fans stationed near each piece of equipment. There is a dehumidifier present in our studio, but we have not been using it. We recently learned that if the humidity is kept too low, germs and other airborne particles stay in the air longer. The ideal humidity level is between 40 and 60 percent.

Instruction:

As an instructor, it is important for me to maintain a respectful distance from the client during a session, not only to make the client comfortable so that they can give a maximum effort, but also so that I can monitor form and make corrections, observe joints, and check body alignment and positioning. This is something that we have always done, but we have been giving just a little more distance when possible. Our studio has two exercise rooms connected by a long hallway, so we can technically have two sessions going at the same time without clients (or instructors) getting in each other's way. In order to alleviate concerns, we are initially only allowing one client in the studio at a time; this way you have total privacy! In Virginia, masks are currently required to be worn in enclosed public places, such as stores and shops; however, the governor's executive order does not require a mask to be worn during exercise. We do not require that clients wear masks during their workout. It can actually make it harder to breathe during the workout and increase your risk for getting dizzy or lightheaded. However, if clients feel more comfortable wearing a mask, they are welcome to do so.

Conclusion:

Exercise is best performed in a clinically controlled environment, under the supervision of an educated instructor. You know exactly what you're getting at Total Results: a safe, comprehensive, and scientifically-based exercise program performed on biomechanically-engineered and well-maintained equipment. Our studio is cleaner and safer to be in than a hospital or doctor's office. If you have been working out at another gym that isn't currently open, or if you don't feel comfortable being in a crowded or unsanitary environment, give us a try. We would be happy to get you scheduled for an initial consultation to learn about our philosophy. We look forward to working with you!

SARS-COV2 has been a tragedy for a small and specific portion of both the global and local population. People at risk include those over 80 years old (80% of SARS-COV2 deaths in my county have been people over 80 years old), people in Nursing Home facilities (almost 2/3 of SARS-COV2 deaths in Virginia) , and of course those with Diabetes, Heart Disease, or other confounding health issues (up to 99% of SARS-COV2 deaths across the globe). For those high-risk categories of people who have died from SARS-COV2, we have failed. Lockdowns did not work. Masks and social distancing were implemented very early in Nursing homes but did nothing to stop the Virus from hitting those populations. The science and public health strategy clearly needs to change and improve significantly. Still, according to CDC's best estimate, 98.7% of SARS-COV2 patients over 65 years old will survive.

On the other hand, we have also failed the younger and healthier population. If you are under age 65 (like 90% of my county population), according to the CDC, your chances of surviving if you contract SARS-COV2 are greater than 99.9%, and you are not very likely to contract SARS-COV2 in the first place: https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html. The vast majority of the population are simply not at risk of dying from SARS-COV2. Yet, government mandated quarantines and shutdowns have taken place in many states and countries. Business, schools, churches, and even health care facilities have been prevented from fully operating.

What effect did all these shutdowns have on SARS-COV2? Very little. In fact, those communities, states, and countries which had the strictest quarantine orders actually suffered higher per capita SARS-COV2 deaths (Note: this correlation does not necessarily imply causation). Despite recent massive public protests in places like Minneapolis, SARS-COV2 Hospitalization rates have continued dropped significantly: Minneapolis Hospitalization Rates. Places like Sweden that never locked down and states like Georgia that reopened early have also experienced a drop in hospitalizations and deaths from SARS-COV2. Unnecessary Lockdowns. It seems as if no amount of preventative measures at either end of the spectrum had any effect on the spread and reduction of SARS-COV2 hospitalizations and deaths.

However, the economic, social and healthcare crisis brought about by the forced shutdowns in the U.S. and around the globe will bring suffering and death orders of magnitude above the number of people lost to SARS-COV2. Below are just a few examples:

According to a study at Johns Hopkins School of Public Health, there could be an additional 253,000-1,157,000 childhood deaths in low-income and middle-income countries "resulting from the potential disruption of health systems and decreased access to food": https://www.sciencedirect.com/science/article/pii/S2214109X20302291

According to UNICEF, an additional 130 million people are expected to suffer food insecurity: https://www.sciencedirect.com/science/article/pii/S2214109X2030228X

According to the Hopkins Bloomberg School of Public Health, 80 million children under 1 are at risk of contracting deadly, vaccine-preventable diseases due to disrupted global vaccination programs for diseases such as polio and measles, which could result in 6000 infant deaths per day.

There is a surge in the United States and Canada in lethal overdoses, attributed in part to the SARS-COV2 lockdowns: https://www.newsday.com/news/health/coronavirus/fatal-drug-overdose-coronavirus-long-island-1.45066205, https://www.cbc.ca/news/canada/british-columbia/overdose-deaths-bc-1.5607792

According to a World Health Organization (WHO) survey of 115 countries, "more than half (53%) of the countries surveyed have partially or completely disrupted services for hypertension treatment; 49% for treatment for diabetes and diabetes-related complications; 42% for cancer treatment, and 31% for cardiovascular emergencies." https://www.who.int/news-room/detail/01-06-2020-covid-19-significantly-impacts-health-services-for-noncommunicable-diseases

In addition to economic ruin for many, this is a health crisis of epic proportions. Millions of untimely deaths will occur due to disease, starvation, suicide and more. We have not seen this reversal of global health outcomes since World War II.

What can you, as an individual do to fight this global catastrophe in the making? The cat is out of the bag, so to speak. It is going to be a difficult time. What we can do is act locally and every small action we take can improve this terrible situation:

-Be healthy - take every chance to improve your own health. Eat a healthy whole food diet. Sleep 8 hours. Lift weights once or twice per week. Get some Vitamin D through sunshine. Reduce or eliminate junk food and excess alcohol. Stop smoking. Do not become susceptible to SARS-COV2 or other viruses or diseases. Keep your immune system strong so you do not become a health care statistic.

-Donate to local or national charities. Your local food pantries are a great place to start. Over 40 million Americans have lost their jobs, and many are going hungry through no fault of their own. Regardless of your circumstances, there are others nearby who are worse off than you.

-Get healthcare when you need it. Do not delay your Cancer screenings. Up to 300,000 additional cancer deaths could occur due to lack of screenings in the U.S. alone. Get your heart checked. Do not be afraid to go to the doctor or hospital. I have been to Johns Hopkins Cancer Center several times during this pandemic and by all accounts it is running safely and very efficiently.

-Go beyond the media headlines and clickbait. Do your own research on SARS-COV2 and any other health issue. Go directly to the sources of health studies and news (ex. CDC, WHO, Schools of Public Health, individual doctors and scientists, resources like Medlineplus and Pubmed). A good local SARS-COV2 resource for me has been https://www.vdh.virginia.gov/coronavirus/ It will be well worth your extra time. At this point, if anyone believes anything they see or hear in any mass media at face value, they are foolish and are part of the problem. Educate yourself and those around you.

The reaction by governments around the globe to the SARS-COV2 pandemic has been a catastrophe. Trillions of monetary units have been printed. Supply chains have collapsed. Millions are going hungry. Previously controlled diseases are resurfacing. Healthcare has been crippled. Countless poor souls will die. Please do your small part to counter this devastation and suffering.

If you are a Total Results client or have previously read our blog posts, you know that our exercise program is an important aid in fat loss, but that nutritional selection and portion control are the most critical factors. Watch television for five minutes, and after the obligatory commercials for one medication or another, you'll probably see an advertisement for a weight loss or nutritional program. There are a lot of different nutritional approaches, and while many of them work (some of them only for the short term), there is a lot of misinformation out there. With so many foods available in the typical grocery store, what is the best way to shop and to eat?

Most grocery stores have a similar layout. The perimeter of the stores house the produce section, the dairy section, beef and poultry area section, and the seafood section. Stick to this perimeter area; that's where the food with the highest nutritional content is located. While the bakery is also usually on the perimeter of the store, I wouldn't recommend stopping by there too frequently.

Now take a look at what is offered in the interior aisles. That's where you will typically find your sugary beverages and snacks, breads, and cereals. These are areas to largely avoid.

Taking this shopping approach will save you money in the long run and get you in and out of the store more quickly, as the perimeter tends to be less crowded than the interior aisles.

Now that we have an idea of where in the store to get our food, which foods should we select? We recommend selecting single-ingredient, whole foods, and relying as little as possible on packaged food. If a food has a lot of ingredients on the package that you can't pronounce, you don't need it. It's also a good idea to consume a larger percentage of your diet in the form of healthy fats. Great sources of fat include meat, fish, eggs, butter, olive oil, avocado, and nuts.

Fat is not the bogeyman that we have been brainwashed into believing over the past fifty years, and consumption of dietary fat does not make you fat. While it is true that one gram of fat has 9 calories (compared to 4 calories each for a gram of protein and a gram of carbohydrate), those that consume a large portion of their calories from saturated fat tend to eat fewer calories overall. This is because fat satiates you and makes you no longer feel hungry. In fact, fat and protein are much more satiating than most carbohydrate based foods. Hunger is a signal that your body is craving nutrients; once you are no longer hungry the body has had its nutritional needs met. If you were to eat a meal rich in processed carbohydrates and sugar, it will take much longer for you to feel satiated, because you are consuming far fewer essential nutrients, and you'll probably feel hungry again in less than two hours. You should not feel the need to eat every couple of hours if you are eating the right foods.

Consuming adequate protein is absolutely necessary. It is essential for facilitating tissue repair, particularly for the muscles. Select organic whenever possible, and go with grass-fed over corn-fed. Tim talked about a lot of this in his last blog post, so I'll try not to be repetitive, but grass-fed beef has an even greater nutritional value than either chicken or pork. Salmon and other types of fish are a great source of protein (and fat), and will help you regulate your Omega-3 and Omega-6 fatty acid levels to prevent systemic inflammation which can lead to a greater risk for the diseases of modern civilization (diabetes, cancer, heart disease, etc.).

The vast majority of your carbohydrates should come from fruits and vegetables. If fat loss is your goal I would recommend avoiding fruits with a higher sugar content, such as apples and bananas. Salads are low in calories, but high in vitamins and other nutrients. This is why you often feel very satisfied after eating a salad, especially if you add in a little olive oil and vinegar for flavor. Remember, there are essential amino acids (proteins) and essential fatty acids, but there is no such thing as essential carbohydrates. Your body is capable of getting glucose without consuming it, through a process called gluconeogenesis. This is why ketogenic diets are very effective.

Finally, try to limit your portion sizes to no bigger than the palm of your hand, and eat until you are no longer hungry. If you do this in conjunction with regularly performing intermittent fasting (limiting your feeding windows to between 6-10 hours per day), you will generally consume fewer total calories, boost your immune system, increase your metabolism, sleep better, and feel more alert and productive.

These guidelines will help you stay healthier, aid in fat loss, maintain your insulin sensitivity, ward off chronic disease, and give you the biggest bang for your buck as far as your grocery bill is concerned. It will also help you get the most out of your exercise experience. At Total Results, we are committed to your health and helping you maximize your genetic blueprint. Start the transformation today.