Sunday, April 11, 2021

How Fit Can You Get From Just Walking?

April 1, 2021


Walking is good for you, obviously. But can it whip you into shape?

By Graham Isador
Photo Illustration by C.J. Robinson


Four months ago my friend John Sharkman stepped on the scale and realized he was the heaviest he'd ever been. Sharkman—a former college football quarterback—was weighing in at 263 pounds, fifty pounds heavier than his time as an elite athlete. The realization that he'd jumped up to the size of a lineman was humbling, and he knew he needed to shed some weight. He asked me, his fitness journalist friend, to help. But the request came with quite a number of caveats: he didn't want to cut off certain food or alcohol, he didn't want to go to the gym, and he didn't want the whole process to feel that hard.

In the past, I've undertaken a number of successful fitness and fat loss challenges. I've taken all the pre-workout in the world, done thousands of kettlebell swings, gone paleo. But Sharkman's request got me thinking: What is the least amount of effort necessary for substantial weight loss? Can you get real results by just kind of messing around?

So in our group chat, Sharkman and a few other friends made a commitment to walking 10,000 steps a day and tracking our food. We aimed for about 2,000 calories. Sharkman dubbed the initiative Health Zone. After four months following those guidelines, my friend dropped 43 pounds. Collectively the group chat was down 105. Those are life-changing, infomercial-pitch numbers. Some caveats obviously apply: losing weight is hard, and keeping it off is even harder. Your mileage will almost certainly vary. But the whole experience made me wonder: just how fit can you get from just walking ?

"I think walking is probably the single most underutilized tool in health and wellness," says nutrition coach and personal trainer Jeremy Fernandes. According to Fernandes, the reason we rarely hear about walking as a major fitness tool—in the same conversations as stuff like yoga or expensive spinning bikes—is that people aren’t emotionally prepared for fitness to be easy. “Most people want to believe that working out and fat loss needs to be hard. If you need impossibly crushing workouts to get in better shape, then you’re not responsible when you fail,” he says. "But a basic program performed consistently—even a half-assed effort done consistently—can bring you a really long way, much further than going hardcore once in a while. "

It's not like walking is some secret. 10,000 steps is the default recommendation of some of the most popular fitness trackers on the market, and long walks have been a hidden weapon of superhero body transformations for ages. But until witnessing Sharkman undergo his transformation I didn't realize just how powerful just walking could be.

Of course, it's not the right tool for every goal. It won't get you over the finish line of a marathon. And if you want to achieve some sort of beach body, unless you already have some muscle mass, at a certain point simply getting leaner starts to have diminishing returns. That’s why celebrity trainer and champion bodybuilder Eren Legend is wary of signing off on walking as a solution for looking better naked.

"If you do cardio and you have a pear-shaped body, all that you can expect is to become a smaller pear," says Legend. “The only way to change your body composition, the shape and look of your body, is to perform a form of resistance-based training. That’s not to say that 10k steps is bad—if you’re regularly performing some type of physical activity your body is going to change. But is it the most efficient way? Some form of resistance training like weight lifting or sprints in addition to a nutrition plan will get you to your goals faster.”

Similarly, fitness tracker Whoop has given up on counting steps at all together. While most trackers and fitness apps count steps, the designers behind Whoop believe step count alone doesn't tell you enough, choosing instead to measure heart rate. Whoop's vice president of performance Kristen Holmes—a three-time field hockey all-American and one of the most successful coaches in Ivy League history—explained: “Simply counting steps doesn’t really tell you that much. All steps aren’t created equal.” A brisk walk is more beneficial than a slow walk. A jog might be more beneficial than that, she said. The company determined heart rate was the best way to tell you how hard those steps were working.

So if you're chasing high-level performance, single-digit body fat, or a bodybuilder physique, then relying solely on a ton of walking isn't the right move. But the reality is that most average people are pretty far from those goals, and focusing on the routines of really high performers my be doing more harm than good. In other words, expecting that you'll accomplish the training required for a movie star body when starting out a fitness routine is setting yourself up for disappointment. Walking a bunch, on the other hand, is something that is relatively simple to fit into your everyday life. The best fitness routine is always going to be the routine that you follow consistently. And I can vouch for the—unscientific, absolutely not peer-reviewed—results.

"Walking is something you're completely capable of starting right now," said Sharkman. "It sounds cheesy to say changing your life is that simple, but this definitely changed mine."

Sunday, April 4, 2021

Taking the Long View

March 27 2021

By Joe Powers and Ben May

Are We Courageous Enough to Create Our Own Future Now?

Walt Disney said: “Courage is the main quality of leadership.” Leadership in the fire and emergency services today defines the truth of his statement. Courage is one of the defining characteristics for every man and woman who takes the oath to serve and protect our citizens day and night. There is no nobler mission. But it’s not as easy as it was some years ago. We don’t mean “easy” in the challenges to do the job. That’s never been easy. It takes a special kind of person to be a firefighter–or any kind of first responder. It’s an extremely high bar in mental and physical ability and dexterity. The decision to lead firefighters and officers is the high ground of courage. It’s never easy to lead. It’s messy; sometimes we don’t know if we’ve made the right decision until years later. Today we are faced with every possible emergency facing our citizens and now are in the middle of a global pandemic. It seems like our services just keep expanding in the face of budget cuts and layoffs.

Shaping a New Future

Courage in leadership is defined by shaping the new future, maintaining traditional brand values, creating a foundation for sustainability through fostered innovation, and thinking differently to ensure tomorrow’s success. The fire service’s future relies on courageous leaders; however, the success of individual departments providing fire and emergency services hinges on the willingness of those leaders to step out, understand community needs, and begin to adapt now.

21st Century White Paper

The recent 21st Century Fire and Emergency Services White Paper from the Center for Public Safety Excellence is a blueprint for this adaptation. Released just a few months ago, the White Paper is one of the most comprehensive roadmaps for our service at exactly the right time. However, the future it describes is now. The actions it describes need to be taken now because our future is meeting us today. The 21st Century White Paper is exactly the kind of leadership so necessary for our profession and the safety of our citizens. It is visionary, strategic thinking grounded in the reality of the challenges we face with real solutions. This white paper should be a working document for every department’s strategic planning process.

A Change in the Wind

In the mid-2000s, the industry began a transformation. Little by little, fire department leaders across the United States started thinking differently and viewing their communities’ problems not in generalities but in specifics. Fire departments began to understand that, although fires are a high-risk problem, it is not the only risk experienced in the neighborhoods they serve. Today’s top fire departments hold the distinctions because their leaders stepped out of line, supported innovative thinking, and used their brand to build a foundation for long-term success in the community.

Community Risk Reduction

One of the key opportunities emerging from the 21St Century Fire and Emergency Services White Paper is the convergence of citizens’ needs for our service. The growth of community risk reduction (CRR) is the key that unlocks this opportunity for pinpoint service whether emergency or preventive, whether fire and rescue or some other agency that “we” bring into the equation. Incidentally, it’s a marketer’s dream. CRR begins with the brand: Fire Department or Fire and Rescue or Fire and Emergency Services.

In a recent conversation with one of our finest young chiefs, she mentioned how one of her challenges in bringing in new firefighters was the reality that only 7% of the job included actual firefighting. Yes, this is generally true, but we do not see this as a problem. It’s the evolution of our profession to an all-hazards mitigation service. Our heritage and history have served us well. It is rich in traditions as the stimulus for innovation, and CRR is that next step, with the White Paper to expand well beyond that.

Defining Risk and Creating a Point of Difference

The mindset of departments using models of CRR is different from all others, and rightfully so. The fundamentals of CRR drive departments to be different from all the others because the communities they serve are individual. Traditionally speaking, the fire service may provide some of the same services throughout the industry. However, we achieve the highest level of positive outcomes when we serve our residents with the programs and services most needed. We best serve our community best by first understanding risk.

It’s Not a Name Change

First and foremost, regarding CRR, let’s be on the same page. Throughout the industry, CRR may be one of the most misunderstood terms. For those leaders who understand CRR, there is long-term success in operations, community outcomes, and funding. For those who don’t understand it, CRR is simply a static name change and an unimpressive replacement for either “fire prevention” or the “fire marshal’s office.” What is the most significant risk to CRR? The lack of understanding by fire service leaders.

Opening the Firehouse Doors for a Transformative Model

CRR is not public education, fire code inspections, fire prevention, or more work for firefighters. It is a complete transformation to a model of risk assessments, prioritization, resource deployment, and evaluation. In the simplest of terms, CRR is all about opening the doors of our firehouses, looking into the neighborhoods, seeing the problems, then going out and helping to reduce the impacts of the biggest problems.


Understanding Enough to Tell the Story

In many cases, CRR uses firefighter perceptions, reliable data, and community insights to better understand the risk faced by residents and visitors. Collecting and studying the information create fantastic opportunities for fire service leaders to tell neighborhood-based stories. When fire departments can understand and articulate the unheard stories, they can use their trusted brand to impact communities positively, save lives, and write the organization’s future. This is where we start to see the opportunities of CRR in our departments. Telling the stories of an industrial area may drive changes to our training academy, the information we collect and share during preincident planning, and how command officers allocate emergency resources. Within a multi-family community, the stories may lead us to tailor curricula in that specific school district, improve on messaging during public events, and develop partnerships with social services to improve service delivery.

A Multidisciplinary Approach

CRR, depending on the neighborhood, may have elements of code enforcement and public education. However, true CRR is not fire prevention or kids wearing plastic fire helmets. CRR is community-specific services, programs, partnerships, and organizational changes to improve outcomes. CRR may impact physical fitness training and requirements where wildland and even high-rise risks occur. It may alter how company officers develop riding seat assignments or how home health care providers interact with their at-risk clients.

Is It Worth It? Yes, and Here’s How to Do It

CRR sounds like more work, right? Well … yes, and no. Creatively collecting information to tell the stories is an additional workload. However, as you begin to define the risks, the models of CRR drive increased efficiency and decreased organizational workload while doing more in the community. Although it sounds like a pipe dream, there are several benefits to CRR that most leaders don’t realize. By conducting a risk assessment and understanding the neighborhood stories, departments can better provide the risk-reduction activities communities need. However, CRR works the opposite way, too, by identifying what services communities don’t need–trimming citywide programs down to only those communities that require the services to increase efficiency and decrease workload. Also, providing the right services to the right community or population may reduce emergency response demand.

Dig Deeper to Understand the Real Risks in Your Community

What’s also important to understand is this: The first time you try to develop a risk assessment, you may not find the real story. Good risk assessments are the product of trials, innovations, evaluations, and perseverance. Risk assessments are not a one-and-done document you put on a shelf. Useful risk assessments use data, the Web, and even interviews to gather experiential data from firefighters, police officers, social works, and more. Evaluating progress can shed light on improvement opportunities and additional risk assessment elements to better tell the story.

It’s a Partnership that Can Work

Being everything for everybody is fiscally impossible, and–let’s be honest–the fire department doesn’t need to try to do it all. There are vast opportunities to partner with government and private organizations to improve communities. Linking up and communicating with social service and mental health resources may improve the holistic response to frequent 911 utilizers. Partnering with in-home health care, property maintenance, or meal-delivery services puts a number of advocates in homes, which the fire service cannot otherwise achieve. Even working with local schools and outlining their students’ specific risks can drive changes in morning announcements, lunchroom posters contents, and to-home messaging. There are so many capable organizations and people who can make a difference. Provide them with the information and let them do the job.

The “Fire” in “Fire Department”

As leaders, we have the responsibility to imbue young firefighters with the evolution of our profession and their responsibility as leaders to take it further. The brand equity and public loyalty are symbolized by the Maltese Cross, our uniforms, and our care–not just in time of need but in a comprehensive, interactive approach to safety and prevention with the citizens we protect in the middle. In our opinion, the name Fire and Rescue or Emergency Services is critical. Our citizens trust us in the way they know us. They know us first as the Fire Department, and it is an undisputed market and brand position.


Comprehensive Safety 24/7

In CRR, the Fire Department is leading and coordinating this comprehensive safety equation. That is marketing leverage from an unassailable position. It’s our responsibility to maintain that high ground of brand loyalty and equity. We do this daily in the specific actions with ourselves, the public, and the other agencies and professions we involve in CRR.

The fire service has the opportunity to capitalize on its brand and create a sustainable future through CRR. Risk-matched services, strategic partnerships, and continuous evaluation for improvement can drive outcomes to build our future through strengthening the fire department brand.

Courageous with CRR

Being courageous enough to intentionally instill CRR elements with the trusted brand of your fire department will put firefighters at the forefront of community change. Funding for your organization is no longer a government liability, as is seen in a traditional firefighting department; it’s an investment in intentional community change. Community investments that drive positive outcomes while reducing workload are a sustainable model for our industries’ future. The outcomes of CRR in one department cannot be duplicated in another. CRR requires leaders’ courage to step up and intentionally understand the communities served to tell the stories for successful outcomes.

Leading the Evolution of Our Future

The future of fire, emergency services, and comprehensive safety is in our hands if we have the courage to lead and shape it. Every fire officer, firefighter, and probie has the intelligence to embrace the shifting paradigm that includes the wellness of our citizens as well as their emergency needs. As the 21st Century White Paper notes: We will have specific data drawing a picture of the hazards and needs of every building, business, and family by jurisdiction and location. We are building a safe future for all our citizens with the fire service in the lead as the master builder.

Joe Powers is a 27-year veteran of the fire service and has a master’s degree in public administration and a bachelor’s degree in health sciences. He works with fire departments to improve operational response, reduce operational workload, and tie data to strategic decision making. Powers is the deputy chief of community risk reduction at the Charlottesville (VA) Fire Department.

Ben May is a board director of the Center for Excellence in Public Safety and recently retired global director of corporate alliances for the Walt Disney Company. He has been a marketing consultant to Fire Service Publications (IFSTA) of Oklahoma State University’s School of Fire Protection Technology, the U.S. Fire Administration, and metro fire departments across the country. He has a master’ degree with honors in international communication and Russian.

Wednesday, March 24, 2021

What’s the Minimum Dose of Training to Stay Fit?

A new review assesses what it takes to maintain endurance and strength when circumstances interfere with your usual training

by Alex Hutchinson, Mar 23, 2021


My college coach used to assign us a week of complete rest every November, after the conclusion of the cross-country season. But one of my teammates, an exercise science student, discovered the research of Robert Hickson, who did some classic studies in the early 1980s on maintaining fitness with reduced training. So, during our yearly week of sloth and bacchanalian revels, we would sneak out for two 30-minute bouts of hard running, hoping that would allow us to be both well-rested and still fit when we started training for indoor track.

Life as a grown-up is more complicated, and the reasons for temporarily reducing training are sometimes considerably more pressing—like a pandemic, say. But the question endures: what’s the smallest dose of training you can get away with temporarily while staying mostly fit? It’s particularly relevant for military personnel, whose ability to train while on deployment is often severely constrained, which is why a group of researchers at the United States Army Research Institute of Environmental Medicine, led by Barry Spiering, has just published an interesting review of the “minimum dose” literature in the Journal of Strength and Conditioning Research.

The review addresses three key training variables: frequency (how many days per week), volume (how long is your endurance workout, or how many sets and reps do you lift), and intensity (how hard or how heavy). It only includes studies in which the subjects reduced their training for at least four weeks, to distinguish it from research on tapering before big competitions—although some of the conclusions are similar. And it’s focused on athletic performance, not weight loss or health.

Maintain Your Endurance

The main conclusions about endurance are still based on those Hickson studies from the early 1980s, with a bit of confirmation from more recent studies. Hickson’s basic design was to put volunteers through ten weeks of fairly hellish training, involving six days a week of 40 minutes of cycling or running at intensities that reached 90 to 100 percent of max heart rate by the end. Then, for another 15 weeks, they reduced either the number of weekly sessions (to two or four), the duration of sessions (to 13 or 26 minutes), or the intensity of the sessions (to 61 to 67 percent or 82 to 87 percent of max heart rate).

Here’s the graph that got my college teammate so fired up, from Hickson’s 1981 study:

(Illustration: Medicine & Science in Sports & Exercise)

The vertical axis shows VO2 max, a measure of aerobic fitness. On the horizontal axis, you have baseline pre-training values on the left, for subjects who were recreationally active but untrained. After the ten-week period of hard six-day-a-week training, they’ve increased VO2 max by a very impressive 20 to 25 percent. Then, for the next 15 weeks, their VO2 max just stays at the new value, regardless of whether they drop down to only two or four days a week.

The overall conclusion of the new review, then, is that you can get away with as few as two sessions a week as long as you maintain volume and intensity of your workouts. But they caution that maintaining your VO2 max isn’t the same as maintaining your ability to perform long-duration endurance activities. Don’t expect to run your best marathon after a few months of twice-a-week training: your legs, if nothing else, won’t be able to handle it.

The picture was similar when Hickson’s volunteers reduced the duration of their training sessions to 13 or 26 minutes (i.e. reducing their baseline duration by one third or two thirds). Once again, VO2 max gains were preserved for 15 weeks. This study also included tests of short (~5-minute) and long (~2-hour) endurance. Short endurance was preserved in both groups, but the 13-minute group got worse in the two-hour test.

The third and final variable that Hickson manipulated was intensity—and here, finally, we get confirmation that training does matter. Dropping training intensity by a third (from 90 to 100 percent of max heart rate to 82-87 percent) led to declines in VO2 max and long endurance; dropping it by two-thirds (to 61 to 67 percent) wiped out most of the training gains. The takeaway: you can get away with training less often, or for shorter durations, but not with going easy.

There are a few important caveats here. Most notably, we’re drawing these conclusions based mostly on one specific, unusual, and probably unsustainable training protocol: hammering six days a week. If you have a more balanced training program that mixes hard and easy training, does it take more or less training to maintain fitness? It’s not obvious.

Also, the subjects in Hickson’s studies weren’t trained athletes or military personnel. If you’ve been training for years, you accrue some structural changes (a bigger heart and more extensive network of blood vessels, for example) that presumably take longer to fade away. Conversely, you probably reach a higher level of absolute fitness, which might fade away more quickly. One of the co-authors of the new review is Iñigo Mujika, a physiologist and coach at the University of the Basque Country in Spain who is among the world’s leading experts in tapering, in which athletes try to reduce their training enough to rest and recover for a few weeks without losing fitness before a big race. In tapering studies, athletes can reduce their training frequency by about 20 percent and their volume by 60 to 90 percent and maintain fitness as long as they keep their intensity high. That’s one good reality-check that suggests Hickson’s findings about the importance of intensity make sense.

Maintain Your Strength

The literature on resistance training is much more varied, which makes for a more complicated picture but hopefully more reliable conclusions. Surprisingly, the overall pattern turns out to be pretty similar to endurance training. You can reduce both the frequency and volume of workouts as long as you maintain the intensity, and you’ll preserve both maximum strength and muscle size for several months.

For exercise frequency, several studies find that even training just once a week is sufficient to maintain strength and muscle size. That fits with the conclusions of a study I wrote about recently that demonstrated impressive strength gains on a simple once-a-week routine. The exception is in older populations: for adults older than 60, there’s a bit of evidence that twice-a-week sessions are better at preserving muscle. There’s a similar picture for training volume: one set per exercise seems to be sufficient for younger populations, but older people may need two sets.

It’s worth noting that maintaining your existing strength is not the same as gaining strength: this review focuses on the minimum dose, not the optimaldose. Even in the broader strength training literature, there’s quite a bit of disagreement about how many sets or how many workouts per week it takes to fully max out your gains. But the basic finding here is that one set a week per exercise (or maybe a bit more for older adults) is probably enough to tread water for a while, as long as you don’t decrease how hard you lift. The review suggests aiming to approach failure by the end of each set, or at least to not decrease intensity compared to what you usually do.

In a perfect world, you’ll never need to apply any of this. But things happen, whether it’s related to work, travel, family, or global health. Over the years, as my own training has waxed and waned depending on the circumstances, the one non-negotiable element has remained a weekly tempo run—the spiritual descendant of those Hickson-inspired post-cross-country hammer sessions. It’s a shock to the system when my training has been patchy, but if that’s the minimum effective dose that ensures I never get truly out of shape, then I’m happy to swallow it.

For more Sweat Science, join me on Twitter and Facebook, sign up for the email newsletter, and check out my book Endure: Mind, Body, and the Curiously Elastic Limits of Human Performance.
Lead Photo: Mihajlo Ckovric/Stocksy

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Thursday, March 18, 2021

Brain’s ‘wiring insulation’ is one of the major factors of age-related brain deterioration

A new study led by the University of Portsmouth has identified that one of

the major factors of age-related brain deterioration is the loss of a substance

called myelin.

Myelin acts like the protective and insulating plastic casing around the

electrical wires of the brain - called axons. Myelin is essential for superfast

communication between nerve cells that lie behind the supercomputer

power of the human brain.

The loss of myelin results in cognitive decline and is central to several

neurodegenerative diseases, such as Multiple Sclerosis and Alzheimer’s

disease. This new study found that the cells that drive myelin repair become

less efficient as we age and identified a key gene that is most affected by

aging, which reduces the cell's ability to replace lost myelin.

The study, published this week in the journal Aging Cell, is part of  

an international collaboration led by Professor Arthur Butt at the University of

Portsmouth with Dr. Kasum Azim at the University of Dusseldorf in Germany,

together with Italian research groups of Professor Maria Pia Abbracchio in

Milan and Dr. Andrea Rivera in Padua.

Professor Butt said: “Everyone is familiar with the brain’s grey matter, but

very few know about the white matter, which comprises the insulated

electrical wires that connect all the different parts of our brains.

“A key feature of the aging brain is the progressive loss of white matter and

myelin, but the reasons behind these processes are largely unknown. The

brain cells that produce myelin - called oligodendrocytes – need to be

replaced throughout life by stem cells called oligodendrocyte precursors. If

this fails, then there is a loss of myelin and white matter, resulting in

devastating effects on brain function and cognitive decline. An exciting new

finding of our study is that we have uncovered one of the reasons that this

process is slowed down in the aging brain.”

By improving our understanding of aging brain stem cells, it gives

us a new target to help slow the progression of MS, and could have

important implications for future treatment.

Dr. Emma Gray, Assistant Director of Research at the MS Society

Dr. Rivera, lead author of the study while he was in the University of Portsmouth

and who is now a Fellow at the University of Padua, explained: “By

comparing the genome of a young mouse brain to that of a senile mouse, we

identified which processes are affected by aging. These very sophisticated

analysis allowed us to unravel the reasons why the replenishment of

oligodendrocytes and the myelin they produce is reduced in the aging

brain.

“We identified GPR17, the gene associated to these specific precursors, as

the most affected gene in the aging brain and that the loss of GPR17 is

associated to a reduced ability of these precursors to actively work to

replace the lost myelin.”

The work is still very much ongoing and has paved the way for new studies

on how to induce the ‘rejuvenation’ of oligodendrocyte precursor cells to

efficiently replenish lost white matter.

Dr. Azim of the University of Dusseldorf said: “This approach is promising for

targeting myelin loss in the aging brain and demyelination diseases,

including Multiple Sclerosis, Alzheimer’s disease and neuropsychiatric

disorders. Indeed, we have only touched the tip of the iceberg and future

investigation from our research groups aim to bring our findings into human

translational settings.”

The image shows myelin and specialized brain stem cells Oligodendrocyte

Progenitor Cells (OPCs) in the grey and white matter of the brain. 

The image depicts myelin (Cyan) and specialised brain stem cells Oligodendrocyte Progenitor Cells (OPCs) in the grey and white matter of the brain.
Credit: Dr. Andrea Rivera

Dr. Rivera performed the key experiments published in this study while at the

University of Portsmouth and he has been awarded the prestigious MSCA

Seal of Excellence @UniPD Fellowship to translate these findings and

investigate this further in the human brain, in collaboration with Professors

Raffele De Caro, Andrea Porzionato and Veronica Macchi at the Institute of

Human Anatomy of the University of Padua.

The study was funded by grants from the BBSRC and MRC to Professor Butt,

together with the UK and Italian MS Societies (to Professors Butt and

Abbracchio, respectively), and the Swiss National Funds Fellowship and

German Research Council (Dr. Azim). Dr. Andrea Rivera was supported by an

Anatomical Society Ph.D. Studentship (with Professor Butt), and the MSCA

Seal of Excellence @UniPD (Dr. Rivera).

Dr. Emma Gray, Assistant Director of Research at the MS Society, said: “MS

can be relentless and painful, and there are sadly still no treatments to stop

disability progression. We can see a future where no one has to worry about

MS getting worse but, for that to happen, we need to find ways to repair

damaged myelin. This research sheds light on why cells that drive myelin

repair becomes less efficient as we age, and we’re really proud to have helped

fund it. By improving our understanding of aging brain stem cells, it gives

us a new target to help slow the progression of MS, and could have

important implications for future treatment.”

Monday, March 15, 2021

The Enduring Mystery of Muscle Cramps? You’re not Alone - Alex Hutchinson

Any discussion of muscle cramps needs to start by revisiting retired baseball infielder Munenori Kawasaki’s detailed explanation of how he avoided a repeat of the cramp that had hobbled him the previous day.

Kawasaki: Monkey never cramps. Because a monkey eat every day banana. Two.

Interviewer: So how many did you have today?

Kawasaki: Three.

I love that interview so much that it pains me to cast doubt on his advice. It’s based on the traditional view of exercise-associated muscle cramps, which attributes them to dehydration and the loss of electrolytes like sodium and potassium (which bananas contain in abundance) from prolonged sweating. That theory dates back almost a century, and it remains dominant: a survey of 344 endurance athletes, published last year, found that 75 percent of them believed that taking extra sodium wards off muscle cramps.

The problem is that science keeps failing to back this theory up. Starting more than a decade ago, a series of studies have compared crampers with non-crampers at marathons, triathlons, and other endurance races and has failed to find any differences in the athletes’ hydration or electrolyte levels. Instead, a rival theory blaming cramps on “altered neuromuscular control” first proposed in the 1990s by Martin Schwellnus, a sports physician at the University of Cape Town in South Africa, has been gaining support. The basic idea: it’s a nerve problem that occurs in excessively fatigued muscles, essentially leaving a switch temporarily stuck in the on position.

But this theory, too, has a problem: unlike the electrolyte theory, it doesn’t give us an obvious solution or countermeasure to prevent cramps. The closest thing so far is a product called HotShot, a spicy drink developed by Flex Pharmaceuticals that triggers some of the same nerve receptors as pickle juice (long known as a folk cure for cramps) and hot peppers. There’s a bit of evidence from a HotShot-funded study published by Penn State researchers in 2017 that this jolt to the nerves makes your muscles a little more cramp-resistant and shortens the duration of cramps stimulated in the lab. But it’s hardly a panacea; even in that study, all the subjects still ended up cramping. Schwellnus himself warned that muscle cramps are a complex phenomenon with many different contributing factors, so we shouldn’t expect a simple solution.

What we’re left with is a search for factors we can control that might influence cramp risk. That’s the goal of a new study in the Journal of Strength and Conditioning Research from a research team at the University of Valencia and Jaume I University in Spain. It recruited 98 runners preparing for the Valencia Marathon, ran them through a series of tests before and after the race, and looked for differences between crampers and non-crampers. Some of the results were predictable, while others were surprising.

The good news, from the study’s perspective, is that 20 of the runners suffered muscle cramps during or immediately after the race. A total of 84 runners (72 men and 12 women) completed all the pre-and post-race testing, which means that 24 percent of them cramped, with similar rates in men and women. That’s roughly consistent with the stats from other races. Once again, urine and blood tests found no differences in dehydration or electrolyte levels before, during, or after the race.

Instead, the biggest difference was in the blood levels of creatine kinase and lactate dehydrogenase, both markers of muscle damage, which were significantly elevated immediately after the race and 24 hours later in the crampers. For example, day-after creatine kinase averaged 2,439 international units per liter. in the crampers compared to 1,167 in the non-crampers. This, too, is consistent with previous studies, suggesting that cramps occur in muscles that are fatigued to the point of damage.

The harder question is what predisposes some runners more than others to this kind of damage. One previous study suggested that crampers actually start the race with elevated muscle damage, perhaps because they didn’t back off their training enough. In this study, though, there was no sign of elevated muscle damage in the pre-race testing and no difference in the amount of time between the final training run and the start of the race.

In fact, most of the training variables the team assessed—the runners’ number of previous marathons, weekly training volume, and so on—were the same in both groups. Just one differed: 48 percent of the non-crampers reported regular lower-body resistance training compared with 25 percent of the crampers.

Another often discussed risk factor for cramps is pacing. A few previous studies have found that runners who end up cramping tend to have started the race more quickly compared to their eventual average pace, suggesting that they’re paying the price for overestimating their fitness. There’s a problem with this type of analysis, however: the cramp may cause the late-race slowdown rather than the other way around.

To get around this issue, the Valencia researchers brought all their subjects in for a VO2-max test prior to the marathon. This allowed them to assess their starting pace relative to their actual fitness instead of relative to their eventual finish time. Here’s what the average speed for each 5K segment looked like for the crampers (black circles) and non-crampers (white circles), as a fraction of speed at VO2 max:(Illustration: Journal of Strength and Conditioning Research)

There are no significant differences between the groups until after the 25K mark. If anything, the crampers started a little bit slower relative to their lab-measured fitness. This punctures the idea that cramps are a punishment for bad pacing. I apologize for any cramp-shaming I’ve done in the past: it wasn’t your fault after all. Unless you were neglecting your lower-body strength training, that is. The obvious news-you-can-use nugget from the new study is the apparent protective effect of resistance training. I got the same advice a few years ago from Juan Del Coso, the author of an earlier study that implicated muscle damage in late-race slowdowns: he suggested leg exercises such as squats with loads to up to 80 percent of max to protect your legs from damage.

But at this point, it’s probably worth recalling Schwellnus’s note of caution. People get cramps for all sorts of reasons, including underlying injury, disease, and medication side effects. The exercise-associated cramps you get during a running race may be influenced by some of these secondary factors. They may also be influenced by your genes: one of the best predictors of cramping is whether you’ve cramped in the past. And despite the paucity of evidence, it’s entirely possible that, in some people, traditional risk factors like dehydration or electrolyte depletion may play a role. So before I get too excited about squats as the new miracle cure, I’d like to see whether a few months of strength training actually reduces cramp risk in a randomized trial.

It’s tricky to get those sorts of studies funded, though—there’s no pharmaceutical money, no sports-drink money. So for now, if you’re struggling with recurring cramps, you’re left with trial and error. It’s worth giving strength training a shot (and not just for its cramp benefits). I’d be open to giving HotShot a try, too. And, hey, whatever the evidence says, I love bananas.

For more Sweat Science, join me on Twitter and Facebook, sign up for the email newsletter, and check out my book Endure: Mind, Body, and the Curiously Elastic Limits of Human Performance.

Saturday, February 27, 2021

In Case You’re Still Equivocating?

Vaccinations have been responsible for the demise of polio, smallpox, and a host of pandemic diseases. Presently, it’s not known if once vaccinated, can you still be a carrier. Clearly, people who are attracted to Public Safety jobs have tamped down their aversion to risk. But, it also implies that you’re not stupid. 

Big data has consistently shown the value of Western Medicine. Below is a table of risk for hospitalization and death by age groups. The Latin term Rez Ipsa loquitur (the thing speaks for itself) should do the trick. 




Friday, February 26, 2021