DrGeoffLecovin.com

Whether you’re a professional athlete or avid recreational sports enthusiast, preventing injuries and having that competitive edge are two things that athletes strive for.

Many of my patients want to know what they eat or do for performance enhancement.

There numerous training styles, formulas and nutritional supplements claiming to offer athletes the winning edge. Some work, while many do not.

This week’s blog outlines an evidence based performance enhancement and injury prevention approach used by the Phoenix Sun’s that has been proven to work.

Assessment

Starting with an assessment is essential as it helps to identify postural distortion patterns (movement impairments) that affect the Kinetic Chain (Human Movement System).

An assessment helps to evaluate:

1.  Length tension relationships in myofascial structures (i.e. the resting length of soft tissues for optimal force production)
2. Joint function (i.e. optimal movement of joints, which can also affect muscle strength)
3. Nervous system function (i.e. the proper timing and coordination of  movements around joints)

Optimum function of the of the neuro-musculo-skeletal system results in optimum neuromuscular efficiency- the ability of the Human Movement System to produce force concentrically, reduce force eccentrically and dynamically stabilize isometrically in all planes of motion.

Athletes who demonstrate optimum neuromuscular efficiency perform better and have fewer injuries.

The Overhead Squat Assessment is an evidenced based tool that can identify dysfunctional movement patterns:

The Overhead Squat:

Stand facing a full-length mirror with your feet shoulder-width apart and pointed straight ahead and your arms raised overhead. Squat three times. Hold the pose at the lowest point in your third squat and take note of your body position at the checkpoints. Perform the movement again and have someone watch from the side and behind.

Common movement distortions include:

1. Feet turn out or flatten

2. Heels rise

3. Knees moves in or out

4. Shoulders elevate and/or arms fall forward

5. Low back shifts to one side, arches, rounds or there is excessive forward lean of the torso

Because of the interrelationship of the Kinetic chain (Human Movement System), distorted movements at one anatomical area will affect the entire chain. For example, lack of mobility at the ankle joint will result in compensation at the knees. Because the knees require stability, this could result in knee pain and dysfunction. The knees will compensate to allow more movement e.g. turn in or out, placing abnormal tension on muscles that attach to the pelvis and lumbar spine. The lumbar spine will compensate by an increase in the lordotic curve, causing an anterior pelvic tilt. This results in tension on the latissimus dorsi muscle which connects the low back to the shoulder. A tight latissimus dorsi muscle will alter the alignment and motion in the shoulder, potentially leading to shoulder pain and forward head carriage. At the top end of the chain, forward head carriage can lead to neck pain, headaches and other chronic painful conditions in the upper extremities.

The Overhead Squat Assessment gives us clues as to where to look. This assessment should be followed up with:

1. Range of motions testing
2. Manual Muscles testing

Once overactive and underactive muscles as well as joint dysfunction are identified, then a specific corrective plan can be created for the athlete consisting of:

1. Inhibiting tight muscles with manual therapies and self myofascial release
2. Lengthening muscles with stretching
3. Activating weak muscles with manual therapies and corrective exercises
4. Integrating dynamic movement to reeducate efficient movements of the entire Kinetic Chain  with functional exercises
5. Optimum Performance Training (OPT) consisting of 3 blocks:
   1. Stability
   2. Strength
   3. Power

Integrating: flexibility, core, balance, reactive training, speed, agility, quickness, resistance and cardiorespiratory exercises

*Performing Self-Myofascial Release with a Foam Roller is an extremely effective warm up tool prior to an event as well as recovery after an event to reduce post-exercise soreness.

What about eating for performance?

The Basics:

Carbohydrates, proteins and fats provide the energy necessary to maintain body functions at rest and during activity as well as provide energy for recovery and repair.

Carbohydrates primarily come from vegetables, fruits, legumes and grains. Carbohydrates can be classified according to how they affect one’s blood sugar. A high glycemic carbohydrate (e.g. refined cereal, Gatorade) will lead to a rapid increase in blood sugar whereas a low glycemic carbohydrate (e.g. nuts, legumes, sweet potatoes, oats) has more of a stabilizing effect on blood sugar. Carbohydrates are responsible for energy, fat metabolism and sparing muscle protein. The type of carbohydrates an athlete should consume depends on the energy requirement of the sport (i.e. aerobic or anaerobic).

Protein is found both in animals, grains and plants. Animal proteins are classified as being “complete” and as such are optimal in terms of repair and recovery. Protein functions as part of our immune system, hormones and fuel when muscle glycogen (carbohydrate) is depleted. Protein is especially important for repair as well as stabilizing blood sugar levels. It is not a preferred source of energy.

Fats or lipids, are found in both and animals and plants. They are classified according to their chemical make-up or degree of saturation. Fat is the most energy dense nutrient. It is an ideal fuel source for lower intensity or endurance activities. Other functions include: nerve transmission, vitamin transport and organ cushioning. Research shows that optimum health can be achieved by a diet higher in omega 3 fats e.g. cold water fish and monounsaturated fats such as olive oil. I recommend using extra virgin olive oil for salad dressing and low heat cooking and walnut, almond or coconut oil for moderate heat cooking. Avoiding Trans fats and partially hydrogenated oils is important for general health. In my observation, many popular snacks contain a combination of these bad fats, sugar and artificial ingredients, which are poor choices for recovery and repair and are major causes of obesity and other chronic health conditions.

In general, it is recommended that athletes consume approximately 55% carbohydrates, 30% fat and 15% protein of their total caloric intake (not including physique athletes, who require a different combination in order to achieve that defined look).

The healthy plate is a good guideline for major meals:

Recommendations:

1.    Emphasize whole foods (preferably local, seasonal and if possible organic)

2.     Pre-exercise nutrition should be 4-6 hours before practice/game and should consist primarily of low glycemic sources. If a game is in the early morning, then dinner the prior night should meet these criteria. Pre-exercise nutrition is important for maximizing glycogen (carbohydrate) storage in muscle. An additional snack is recommended 30-60 minutes prior to the practice/game

3.     Moderate-high glycemic foods should be consumed every 20 minutes during exercise to reduce muscle protein breakdown.

4.     Moderate-high glycemic foods are also the foods of choice after exercise and should be consumed within 30 minutes after a practice/game in order to minimize muscle catabolism (breakdown) and maintain anabolic state. This helps to support recovery and immune function

5.     A post exercise meal 1-2 hours after practice/game should consist primarily of low glycemic sources

6.     Stay hydrated throughout the day and especially before/during/after games and practices. For activities under 90 minutes, water is the best choice. Vitamin drinks and other colorful concoctions are superfluous and in my opinion not healthy due to the artificial ingredients. Coconut water is a healthy option for electrolyte replacement and hydration

7.     Sleep 8-9 hours per night

Example of Pre-exercise meal:

*Dinner the night before- enriched Barilla pasta with turkey meat sauce a mixed salad. Oatmeal/Berry crisp for desert

*Breakfast that morning- Oatmeal with nuts, raisins, berries and cinnamon. Smoothie (Unsweetened Almond milk/whey protein-15g/1/2 banana/1 tbsp almond butter/1/2 cup berries)

Example of Pre-exercise snack:

*Nut butter and honey on multi-grain bread or sliced apple

*Smoothie (see above)

*Cheese and high fiber crackers

Example of what to eat during a practice/game:

*Blend 8 oz orange juice or dark apple juice with ½ banana 1 scoop whey protein and water (16 oz total). This should be consumed during breaks and at half time. This should not replace water

*Coconut water

Example of immediate post-exercise nutrition:

*Nut butter and honey or mozzarella cheese sandwich on high fiber bread e.g. Dave’s killer bread and a piece of fruit.

Example of post exercise meal:

*Brown rice, beans, chicken, guacamole and salsa

*Pasta with meat sauce and a salad

*Tuna or turkey sandwich with veggies and 1 fruit

The above recommendations do not take into consideration food sensitivities or intolerances that are unique to each athlete, nor are they recommended for physique oriented athletes who require a different percentage of carbohydrates, proteins and fats (see prior paleo post).

Look in any fitness magazine and you will be bombarded with advertisements for supplements making claims to give you more energy, make you stronger or help you put on lean body mass.

The fact is, no supplement can replace:

1. An evidenced based exercise program
2. A balanced diet, with an emphasis on anti-inflammatory foods
3. Adequate rest and recovery

I.    An evidenced based exercise program- The NASM OPT Model

OPT is the acronym for Optimum Performance Training.  It is an evidence based training model that integrates all forms of training:

•             Flexibility

•             Cardiorespiratory

•             Core training

•             Balance training

•             Reactive training (power)

•             Speed, agility, quickness

•             Resistance

By following the OPT model, a person can systematically progress towards any goal, be it general conditioning, weight loss, strength and muscles gain or performance. They can also achieve optimum levels of physiologic, physical and performance adaptations.

OPT is divided into 3 building blocks and 5 phases:           

Block 1:  Stabilization (phase 1- stabilization endurance):  The focus is on endurance, joint stability, flexibility, postural control and neuromuscular efficiency

Block 2:  Strength (phase 2-stabilization strength; phase 3- hypertrophy and phase-4- maximum strength): The emphasis is to maintain stabilization endurance, while increasing strength. This block can be progressed to include increasing muscles size (hypertrophy) and/or maximal strength (lifting heavy loads).

Block 3: Power (Phase 5-power): The power phase focuses on the rate of force production, i.e. how quickly a muscle can generate force. Power training is also known as plyometrics. There is a quick powerful movement involving an eccentric contraction, followed immediately by an explosive concentric contraction.

How to use the OPT Model

Designing an individualized, systematic, integrated fitness program is accomplished by having an understanding of an individual’s goals, needs and abilities.

This is done through a comprehensive fitness assessment, which is comprised of both subjective and objective information.

Subjective information includes: general medical history, occupation, lifestyle and personal information.

Objective information includes: physiologic assessments, body composition testing, cardiorespiratory assessments, static and dynamic postural assessments and performance assessments.

Acute Variables:             

**Tempo-  The speed at which each repetition is performed. The first number is the eccentric contraction (lengthening); the second number is the isometric contraction (dynamic stabilization); the third number is the concentric contraction (shortening).

***Volume – Amount of training performed within a specific time period

****Load – Amount of weight

II. A balanced diet, with an emphasis on anti-inflammatory foods

People are always looking for that “magic pill”. What if I told you that every time you eat, you could be on the road to becoming stronger, faster, more muscular or leaner and that your food could be that “magic pill”?

When you exercise, there is tissue damage and inflammation. It is through the repair process that your body makes adaptation and progression towards your goals.

One of the primary factors affecting your ability to heal is your diet.  The key nutrients for optimum healing are:

1. Unprocessed Carbohydrates- vegetables, fruits, whole grains, beans and lentils
2. Proteins- eggs, yogurt, fish, poultry, grass fed beef, wild game and soy
3. Fats- extra virgin olive oil, omega 3’s (fish, flax and walnuts), coconut oil, raw nuts and seeds
4. Vitamins and minerals (as found in the foods above)
5. Phytonutrients  (pigmented plant based chemicals with anti-inflammatory and other health benefits).

The power of color:

Phytonutrients are substances in plants which promote health in three important ways:

(1)Acting as powerful antioxidants

(2) Reducing inflammation

(3) Detoxification

Free radicals are unstable molecules that can damage our cells, leading to heart disease, cancer, cataracts, premature aging and a variety of other conditions.

Antioxidants have the power to dramatically decrease the damage caused by free radicals in our bodies, thereby decreasing our risk for disease.

Red

Many bright red fruits and vegetables, such as raspberries, cranberries, tomatoes, cherries, red peppers, red grapes, beets, red onions and pomegranates contain phytochemicals such as anthocyanins, lycopenes and/or carotenoids, which are potent  antioxidants.

Orange-Yellow

Carrots, sweet potatoes, yellow potatoes, pumpkins, squash, apricots, bananas, oranges, mangoes and cantaloupe all contain carotenoids, which are potent antioxidants. Other orange-yellow foods offer additional healing properties, such as yellow corn (good for eye health) and turmeric (effective for treating and/or preventing inflammatory conditions such as arthritis and cancer).

Green

Green vegetables, especially spinach, avocados, asparagus, artichokes, broccoli, kale, Brussels sprouts, cabbage, watercress and green tea are packed with chlorophyll, beta-carotene and/or lutein, all powerful antioxidants. These foods are also good for skin health and most contain significant amounts of fiber, which is important for heart and digestive health, reducing cholesterol and preventing colon cancer.

Purple

Black berries, blueberries, concord grapes, raisins, eggplant, plums and red wine all contain anthocyanins, another heavy-hitting antioxidant that guards against heart disease and cancer, and helps to lower cholesterol.

Brown

Cocoa, coffee and tea contain high concentrations of antioxidants with numerous benefits.

Spices and herbs also have potent anti-inflammatory properties, e.g. Cinnamon, pepper, oregano, thyme, rosemary, parsley, basil, garlic, onion, ginger.

Sample Meal Plan:

BREAKFAST:

• 3-4 oz salmon
• ½ cup slow-cooked oatmeal with ¼ cup blueberries and cinnamon
• 1 tbsp raw almonds
• Green tea, water or coffee

SNACK:

• Plain Greek Style  yogurt with berries and ¼ cup raw nuts

LUNCH:

• 4-6 oz Tuna or poultry
• Romaine, arugula or spinach salad (dress with lemon juice, olive oil and dill)
• Green tea or water

SNACK:

• Carrots, celery, red pepper with hummus or guacamole

DINNER:

• 6-8 oz filet of sole, cod or snapper
• 8 stir fried Brussels sprouts with garlic
• Romaine, arugula or spinach  salad with raw walnuts, carrots and radishes ( dress with olive oil, garlic, Dijon mustard,  lemon juice and ½ tsp honey or maple syrup)

SNACK:

• SMOOTHIE: (Fresh fruit, almond or coconut milk, whey protein powder-15-20 g, 1 tbsp. flaxseed oil)

III.                Adequate rest and recovery

Exercise results in muscle tissue breakdown, the depletion of energy stores and fluid loss. Recovery allows the body to replenish energy stores and repair damaged tissues. Without sufficient time to repair and replenish, the body will continue to breakdown.

Sleep Deprivation is another factor that can hinder sports performance by resulting in subtle changes in hormone levels, particularly those related to stress, muscle recovery and mood.

Chronic sleep deprivation has been shown to increase levels of the stress hormone cortisol, decrease activity of human growth hormone and decrease glycogen synthesis.

There is also a link between sleep deprivation, decreased aerobic endurance and increased ratings of perceived exertion.

What Supplements can help you to become stronger, faster and more muscular?

My emphasis is on whole foods, evidence based exercise, stress management and adequate rest and recovery. If you have mastered these, then you can consider the following supplements, which are supported by research as being efficacious cost-effective ergogenic supplements:

1. Whey Protein (to meet extra protein needs)
2. Creatine Monohydrate
3. Beta Alanine
4. Caffeine
5. Multiple Vitamin/Mineral (with iron for menstruating females)
6. Fish Oil

Remember, balancing exercise, diet, hydration, rest and recovery is the key to becoming stronger, faster and more muscular.