Wednesday, October 17, 2018

Zone, Keto, Paleo and Deflame

Comparing lower carbohydrate and Ketogenic type eating plans
This post will explain the general process of nutrient assimilation and the various drawbacks
following a “traditional food pyramid” or “my plate” diets recommended by the FDA vs. a low
carbohydrate diet proposed by a multitude of researchers. While these low carb researchers have
found slight variations in their diets or eating styles, there are a great many similarities found as well.

Barry Sears’ “Enter the Zone” diet, David Seamen’s “Deflame diet”, the Ketogenic diet and of
course Loren Cordain’s “Paleo” diet, all contend that lowering carbohydrate intake can alleviate
medical conditions like type two diabetes, chronic inflammatory disorders, nonalcoholic fatty liver
disease, hypertension, fat free mass (FFM) and coronary artery disease.

It is my hope that you as the reader gain appreciation of how our meal choices affect our overall health, body image, satiety, energy level and even lab levels.  Armed with this new information you may change your views of certain foods dramatically.

          In analyzing the effects of various low carbohydrate eating plans, including but not limited to the ketogenic diet, we must first discuss metabolism.  Metabolism is a chemical process in which the body receives nutrition.  This assimilation of nutrients results in the delivery of macro and micro nutrients to the individual cells, so that cellular metabolism can occur.  This process provides energy in the form of ATP, building blocks for muscles (amino acids), the materials needed for the framework of the body (collagen, bone minerals) as well as the walls of each individual cell (fatty acids).
Metabolic processes
          The first step in carbohydrate metabolism is glycolysis, this chemical reaction allows the body to utilize the simple sugars (glucose) or store them.  The body utilizes a glucose in a variety of ways.  It’s used as a primary source of energy for our movements (glycolysis, Krebs cycle and electron transport chain), and energy source for brain cell function (exclusively). When taken in excess, it’s combined to form glycogen(glycogenesis), during that process insulin is released and the liver later stores the glycogen in the fatty cells.
Fat metabolism occurs if there’s a lack of available carbohydrates to metabolize.  There are a variety of reasons this may occur; fasting, a low carbohydrate diet and untreated diseases like diabetes.  The result of fat catabolism is glycerol and fatty acids, but we should keep in mind that high insulin levels inhibit fat catabolism.  Nevertheless, the body synthesizes enzymes called lipases, and maintains the ability to catabolize fat in the correct environment.  Fat catabolism is similar to carbohydrate catabolism, energy production from fat also occurs in the mitochondria via the citric acid cycle & the electron transport chain.  To break down the fatty acid chains, the body utilizes a process called beta-oxidation, which cleaves the long fatty acid chain groups and converts them to usable segments.
Protein metabolism the least plentiful source of energy in the traditional “food pyramid”.  The traditional role of protein consumption is anabolism, which is responsible for synthesizing the proteins and needed for our soft tissues.  The body can produce various proteins (and amino acids), but a select few several amino acids must be consumed (essential amino acids). Therefore, but all not only is protein essential to a diet it can also serve both; as a source of energy, and a source of building blocks.
Lower carbohydrate eating plans

In Barry Sears is Enter the Zone diet, a 40:30:30 caloric intake ratio is utilized (Carbohydrate: Fat: Protein).  Dr. Sears contends that foods that have lower amounts of sugar or “lower glycemic index” foods allow for less fluctuations of insulin levels.  This in turn lowers cravings as well as improving wellbeing through reduction in inflammatory responses.  Like most diets, the zone diet is dependent on the individual’s metabolic requirements. BMR is the rate of caloric expenditure for an individual per day and is reliant upon the individual’s fat free mass (FFM)(Sears, 1995.).  The FDA’s recommendation for protein is .38 g/lb. FFM, while Dr. Sears calls for .7 to 1g/lb. This makes it a higher protein diet.  The amount of fat in this plan is determined by the caloric intake, and that in turn is reliant on the BRM (Sears, 1995.). The amount of fat in this diet is also higher than FDA recommendation of 10% (Total Fat, 2018.). Dr. Sears’ work has been heavily scrutinized, and the results of his eating plan has had have been impactful on improving FFM (Ebbling, 2007.; Fontani, 2005.; Skoy, 1999.) Dr. Sears also reported that his plan had positive implications regarding cholesterol and cardiovascular profile factors. The Zone diet is also been found to improve fasting glucose levels for type II diabetics (Hamdy, 2008.). As mentioned before, the mechanism in the zone diet is to limit foods to lean meats, some unsaturated fats and most importantly fibrous or low glycemic carbohydrates. The increase in protein results in a positive nitrogen balance (only protein contains nitrogen versus fat and carbohydrates) and an anabolic state. The lack of carbohydrates also induces the body to metabolize the fat and protein taken in. Metabolizing fatty acids leads to a slight ketogenic state. The lack of insulin fluctuations is the reason someone following a Zone type system would feel satiated, as a spike in insulin has a reactive dip shortly after (Hyman, 2018) and this dip is why your body craves another meal.
The brain also has a part to play in how we react to food. There is a concept involving anorexigenic responses, which are triggered by a high fat diet, and promote satiety (fullness). The hypothalamus controls these types of responses and Resveratrol (a natural polyphenol that promotes anorexigenic responses) is present in high protein eating programs (Drummen, 2018.; Safahani, 2017.).

Dr. Seamen’s DeFlame is another diet or eating system that calls for a reduction in starchy carbohydrates. The focus is to replace “pro-inflammatory” starchy carbohydrates with “anti-inflammatory” fibrous carbohydrates and replace trans fats with unsaturated fats.  The mechanism Dr. Seamen describes is one where glucose causes a hyperglycemic state, combined with trans fats, resulting in the bacteria in the gut to release endotoxins. These endotoxins have a detrimental effect on cells causing them to release inflammatory chemicals. The end result is chronic inflammation that can cause and contribute to a variety of maladies (Seamen, 2002. ; Totsch, 2015.). The net effect of the DeFlame diet is a de-facto ketogenic state (mild compared to strict Ketogenic plans). While Dr. Seamen’s aim is to reduce inflammation, he also alters the metabolic pathways at the same time, resulting in an anabolic effect. The de flame diet also was shown to decrease fatty liver disease and type II diabetes, which has been consistent with the variety of lower carbohydrate type eating programs (Pérez-Guisado, 2011. ;  Khondkaryan, 2018.; Drummen, 2018.).
The Paleo diet is yet another eating program that calls upon ketosis and fatty acid catabolism by harkening back to our paleolithic roots. This plan features many ieterations, so a range of protein intake is available.  By avoiding starchy, low glycemic index and processed food, while placing an emphasis on fibrous foods and animal products (excluding dairy), the individual can maintain a ketogenic state. The Paleo diet’s main theme is to not consume any food that wouldn’t have available to our ancestors and to “mimic the pre-agricultural time”, to when we were hunter-gatherers (Cordain, 2018.). This program has no guidelines, making it more of a philosophy than a structured program. A study conducted by Pastore et al. found that after only a 4-month trial on the Paleo diet, the subjects (who had prior hypercholesteremia) had significantly lowered total cholesterol and triglycerides, and even improved FFM (2015).

The Ketogenic eating plan features fat metabolism more than any other program. This plan is best used for lowering the amount of insulin and is not ideal for long term usage as it has been found to raise lipoprotein content (Kwiterovich, 2003). This plan should be supervised and performed for specific medical outcomes in question (Klara, 2017.). Its lower levels of carbohydrates increase some stress hormones (cortisol) and decrease anabolic hormones like testosterone, and lower anabolism in athletes due to the lowered protein content could be an issue (Miller, 2017.). Fat loading has also been found to be inferior to carbohydrate loading for athletic endeavors as a mode of event preparation (Zajac, 2014.).
The following chart outlines the various carb restricted eating plans and the benefits and drawbacks of each, it also outlines the macronutrient break down and the effect of some of the lab values.
While the metaphor “many roads lead to Rome” applies here, the mode of eating program you utilize does not seem to have a major bearing on your FFM, cholesterol profile (excluding Ketogenic) or satiety, so long as you adhere to the major guidelines outlined by these various authors. These programs are here as tools, allowing the individual to maintain a healthy frame, feel satiated and ensure that their lab work will be within normal limits.  In making our meal selections, we are deciding what effect we are having on our bodies and lives

Comparison of the various low carbohydrate plans (Keto and Paleo, 2018).

Enter the Zone
Macronutrient breakdown
Carbs: 5-10%
Fat: 60-80
Protein: 20-30
Can fluctuate between a Keto and Paleo
Carbs: 40%
Fat: 30%
Protein: 30%
Carbs: 10-15%
Fat: 55-75%
Protein: 15-30%
Avoid Carbohydrates; Burn fats in lieu of carbs
Avoid processed or refined sugars, grains and trans fat
Avoid high glycemic index foods, balance macro’s
Avoid post agricultural period products (dairy, refined sugars, grains)
increased FFM, improved satiety
increased FFM, improved satiety
Increased FFM, improved satiety
Increased FFM,
Improved satiety
Decreased athletic performance
No limitations due to no guidelines, expense
Lab value impact
Lower insulin levels, Lower testosterone, increased inflammation, higher lipoproteins
Lower insulin levels, decreased inflammation, lower cholesterol/heart disease
Lower insulin levels, lower inflammation, lower cholesterol/heart disease
Lower insulin levels, lower inflammation, lower cholesterol/heart disease

Cordain, Loren. “The Paleo Diet Premise |Reduce Risk of Chronic Disease | Dr. Cordain.” The Paleo Diet™, 2018,
Drummen, Mathijs, et al. “Dietary Protein and Energy Balance in Relation to Obesity and Co-Morbidities.” Frontiers in Endocrinology, vol. 9, 2018, doi:10.3389/fendo.2018.00443.
Ebbeling, C. B., Leidig, M. M., Feldman, H. A., Lovesky, M. M., & Ludwig, D. S. (2007). Effects of a Low–Glycemic Load vs Low-Fat Diet in Obese Young Adults. Jama, 297(19), 2092. doi:10.1001/jama.297.19.2092
Fontani, G., Corradeschi, F., Felici, A., Alfatti, F., Bugarini, R., Fiaschi, A. I., . . . Berra, B. (2005). Blood profiles, body fat and mood state in healthy subjects on different diets supplemented with Omega-3 polyunsaturated fatty acids. European Journal of Clinical Investigation, 35(8), 499-507. doi:10.1111/j.1365-2362.2005.01540.x
Hamdy, O., & Carver, C. (2008). The why WAIT program: Improving clinical outcomes through weight management in type 2 diabetes. Current Diabetes Reports, 8(5), 413-420. doi:10.1007/s11892-008-0071-5
Hyman, M. (2012). The blood sugar solution: The ultrahealthy program for losing weight, preventing disease, and feeling great now! New York, NY: Little, Brown and.
Khondkaryan, L., Margaryan, S., Poghosyan, D., & Manukyan, G. (2018). Impaired Inflammatory Response to LPS in Type 2 Diabetes Mellitus. International Journal of Inflammation, 2018, 1-6. doi:10.1155/2018/2157434
Pastore, Robert L., et al. “Paleolithic Nutrition Improves Plasma Lipid Concentrations of Hypercholesterolemic Adults to a Greater Extent than Traditional Heart-Healthy Dietary Recommendations.” Nutrition Research, vol. 35, no. 6, 2015, pp. 474–479., doi:10.1016/j.nutres.2015.05.002.
Pérez-Guisado, J., & Muñoz-Serrano, A. (2011). The Effect of the Spanish Ketogenic Mediterranean Diet on Nonalcoholic Fatty Liver Disease: A Pilot Study. Journal of Medicinal Food, 14(7-8), 677-680. doi:10.1089/jmf.2011.0075
Seaman, D. R. (2002). The diet-induced proinflammatory state:. Journal of Manipulative and Physiological Therapeutics, 25(3), 168-179. doi:10.1067/mmt.2002.122324
Safahani, Maryam, et al. “Resveratrol Promotes the Arcuate Nucleus Architecture Remodeling to Produce More Anorexigenic Neurons in High-Fat-Diet–Fed Mice.” Nutrition, vol. 50, 2018, pp. 49–59., doi:10.1016/j.nut.2017.10.019.
Sears, B., & Lawren, B. (1995). Enter the Zone. New York, NY: Regan Books.
Skov, A., Toubro, S., Rønn, B., Holm, L., & Astrup, A. (1999). Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity. International Journal of Obesity, 23(5), 528-536. doi:10.1038/sj.ijo.0800867
Totsch, S. K., Waite, M. E., & Sorge, R. E. (2015). Dietary Influence on Pain via the Immune System. Progress in Molecular Biology and Translational Science Molecular and Cell Biology of Pain, 435-469. doi:10.1016/bs.pmbts.2014.11.013
Zajac, A., Poprzecki, S., Maszczyk, A., Czuba, M., Michalczyk, M., & Zydek, G. (2014). The Effects of a Ketogenic Diet on Exercise Metabolism and Physical Performance in Off-Road Cyclists. Nutrients, 6(7), 2493-2508. doi:10.3390/nu6072493

Thursday, October 26, 2017

What's posture got to do with it? Everything!

Does our posture affect what happens when we exercise?
This is the first in a multi part series, today we will discuss the detrimental effects of postural faults in the upper body and next time we will address the lower body. In exercise as well as in normal day to day movement, there is a complex interaction between how we move and how much we move.  Most commonly how well or poorly we move is reflected in our capacity to move.  If we move well we can move a lot, and conversely if we move with altered movement patterns, it can be less efficient, detrimental and many times pathological.

Postural faults are not your fault..well not entirely.

One of the most common thing we see in our office is poor posture, but why?  Believe it or not, it's the way we have evolved vs. our current environment.  Over 30,000 years of recorded history, man has been active.  Farming for vegetables, chasing or hunting for prey, it was not easy or sedentary type existence. Fast forward to the 21st century and we no longer need to hoe the field or track migratory prey over long distances. Our bodies were designed to move and perform tasks crucial to survival. Those tasks formed a balanced frame because the tasks were diverse.  Not so much anymore.. For those who want to know more about primitive patterns, how we analyze it and how we get back to healthy movement click here for a power point presentation I created for fitness professionals.

We live in a flexion based society and most of us contribute to it in almost every aspect.. even when we weight train. 

It's no secret that we as a society have become not only complacent but we're also stuck in the seated position for much too long. We spend more and more time at the work desk, and even more in the car and when all that is over we go to the gym and sit in all of these Precor and Hammer strength machines some more. All of this concentrates the work that we do in the front of our bodies; overdeveloping the front half, and making it dominant.  The result is your posture collapsing forward.  In essence we are feeding the poor posture with something we are told is good for us.  Exercise is good for us, but much more so when it's done correctly and not reinforcing postural faults.

Don't worry Doc, I train back day too..
I'm ashamed to say I fell victim to this one too way back when, most think that training your lats with pulling type exercise will balance your posture, but it does not. The Latissimus doesn't balance out the chest/pecs the middle and lower trapezius and rhomboids do. This thought process contributes to this Upper Crossed Syndrome which is widespread and an underlying factor in so many musculo-skeletal issues.
The chest has taken over and pulled the shoulders forward

A healthy balance or the muscles that move us forward and backwards in the upper body

The Lats(back) has taken over and rotated the shoulders in

Take into account the previous discussed predisposition (the front of us taking over) and we quickly see that our workouts can be contributing to a myriad of pathological processes including but not limited to;

  • Arthritis in the neck (cervical degeneration)
  • Pinched nerve in the shoulder (thoracic outlet syndrome)
  • Pinched nerve in the neck(cervical radiculitis) 
  • Tendinitis in the biceps
  • Shoulder Bursitis(sub-acromial bursitis)
  • Shoulder impingement 
  • Rotator cuff syndrome or tear
  • Upper back spasms(thoralgia)
  • Headaches
As a matter of fact, you don't even need to exercise for the above problems to occur if you have the rounded shoulder syndrome. This is why it's important to have good movement patterns before starting any exercise program. If we can begin with correct fundamental movement exercises, you need to be able to perform these movements (without bad mechanics) before you start an exercise program.  These movements are;
  • Upper body push(push up, plank)
  • Upper body pull(TRX pull up, pull up)
  • Squat
  • Hip hinge or Deadlift
  • Lunge
  • Twist (rotation or anti-rotation)
Many feel like these exercises are too hard, or they have bad knees etc., but the truth is that a good fitness professional knows how to scale these exercises to make them possible for everyone. I wrote a terrific post about exercises that incorporate may of these movements here.

Balance; the key to so many things
You're not pulling this off without some good shoulder stabilizers
The head needs to be balance on top of the shoulders or the muscles that support it will become tight, it's like balancing a 10 lb bowling ball on top of the body. If you don't have the right leverage it gets ugly..FAST  The same holds true for the shoulder, the shoulder blade provides platform of the shoulder.  If that base cannot hold it's stability it's difficult and dangerous to try and lift objects without overwhelming the stabilizing muscles. It's those instances where you start to see the rotator cuff tears AC joint separations and bursitis. 

You want the gym? You can't handle the gym!

For as big as the fitness industry is, there is very little cohesion and even less standardization.  There are commonly competing ideologies and ideals (crossfit vs. NSCA), and there is no central authoritarian agency, no standards of progressing .  The truth is that we learned or were taught these fundamental movements in our youth(primitive patterns), however we may not of mastered them or we have forgotten them.  In fitness there is very little "vetting". We go out and perform exercises because the trainer said so or we see everyone else doing them, seldom asking why?  The truth is that there is a process that you need to follow that will dramatically increase the chances of a successful exercise routine.  You need to be able to pass movements benchmarks before graduating to the next level. After all, your routine is worthless if you are too injured to perform it and studies show that most exercise enthusiast will not return following a major injury. Tune in next time when we discuss the lower body imbalances and the pitfalls associated with them before we start on what needs to be done to prevent these types of problems.

Today we provided principles, so you can adapt your own protocols, don't hesitate to contact us with questions. 
Please let us know you visited our blog by liking, commenting & sharing.

Dr. Serafim is a Rehabilitation and a Strength and Conditioning Specialist. He lives and works in the Exton PA area and has devoted himself to furthering his understanding of movement related disorders. He teaches continuing education and operates a private practice. More information can be found at and feel free to like us at our facebook page.

Thursday, May 4, 2017

Keys to recovery; don't let soreness hold up the next workout! Part 2; Recovery workouts and techniques.

Part II of the Consistency series
You will never be successful in your workout if you cannot stay consistent and manage soreness and injury..
As discussed in part one found here, the amount of success reaching your fitness goals means making sure you can string together enough workouts. As we said in our last post; consistency is key!!! 

There are many things that can get in the way of a consistent routine.  For those new to my blog, I use sports science to prevent the number one way of loosing your consistency.. Injury!  But injury alone does not hinder our progress.  Travel, work obligations, family obligations and delayed onset muscle soreness(DOMS) from the previous workout all conspire against results.
Finding exercises that fit your time and lifestyle (discussed in this post) can take care of the when and where. Preventing injuries can really get your routine on a roll(discussed hereherehere and here,), but will you be giving that next workout your best?  
The Commandments of weight training;
For success in any workout program it has to adhere to the principles of training: specificity, overload, rest, adaptation and reversibility. These are the basics "commandments" of exercise, and for your next workout to really be effective, the second "commandment": overload must be adhered to (really all of them do).  Today we will cover overload and rest. Specificity should be prescribed by your fitness pro, and it should be derived from a needs analysis. 
Reversibility is the process in which you loose your gains (rate of 1/3 you gained them).

Overload: Human's can't register a 10% difference

You can progress your workout or "overload" it a number of different ways, slight changes are sure fire ways of "upping the ante".
  1. Increase the working weight,
  2. Increase the repetitions,
  3. Increase the time under tension, 
  4. Increase the number of sets  
  5. Increase the intensity(decrease rest time)
You're either moving towards me or away from me. 
As you can see, there needs to be a progression to really force adaptations to training and ultimately progress in to a stronger, leaner and better athlete. It's widely known that if your sets, reps, weights are decreasing you are most likely over-training. The amount of overload will be largely dependent on how recovered you feel. The take home message is that; if you are not progressing you are regressing!  So lets get to what has been proven and what has been reported by athletes to help. 

Rest speaks to recovering, the more you do to recover, the less rest you need. The following factors will speed up the process and lessen the chance of injury overall.
Active Recovery
This concept is basically about getting the blood pumping to the body and the sore muscle groups in question. What the research is showing is that it's better to perform a light, low intensity workout as opposed to just completely resting.  One study documented the lactate clearance was improved when performing related activity either after an event or in between sets. The intensity was at 30 % the original(1).  Another study noted that adding the active recovery also improved psychological recovery by adding relaxation(2). A third study showed a decrease in overall lactate levels in athletes who added recovery workouts and massage on rest days(3).  Excellent examples of Active recovery workouts on rest days include but are not limited to:
  • light kettle bell work (swings, halo's, dead-lifts, windmills)
  • Battle ropes
  • Jump rope
  • Cardio (rowing, treadmill, walking, elliptical)

This one would seem to be a slam dunk right? Stretch a sore muscle. Yet much of the available research tells us the contrary is true. There is little benefit to stretching to relieve muscle soreness.  Which makes the next subject a bit more confusing(4,5,6).  Please do not completely abandon stretching, it's still has some merits!

Many automatically infer that Yoga is about stretching, when in reality, there is a strong body stabilizing/strengthening effect, an affect on breathing/oxygenation as well as a calming effect. Another reason it would seem beneficial is that it's a low load long duration activity, much like our active recovery. If recovery workouts are beneficial, then adding extra oxygen to metabolize lactate and increasing circulation are the way to go(7).

This modality has been around and has obvious benefits, while there is plenty of studies, it's been used and commented on so many times, that there's no need to expand much further(8). Many athletes come in to our office on a maintenence basis to make sure they are at peak performance.  Athletes all the way up to the professional level do the same. 

Common Sense
Some exercise enthusiast may be a little too aggressive when starting a program, if you soreness lasts more that 7 days, consult your doctor(not your exercise professional).  In cases of excessively long periods of soreness consider a more gradual increase in any of the "overload" factors. The body cannot register a difference of 10%, so that is always a good starting point. Remember the greatest ability is AVAIL-ABILITY, you aren't getting stronger if you can't get off the couch. 
We will cover some of the other principles in a third installment of Key's to recovery.

The take home message is that the traditional approaches many take just don't work. Research shows that light activity in between sets and workout are the best way to make sure your moving to live and living to move!

Today we provided principles, so you can adapt your own protocols, don't hesitate to contact us with questions. 
Please let us know you visited our blog by liking, commenting & sharing.

Dr. Serafim is a Rehabilitation and a Strength and Conditioning Specialist. He lives and works in the Exton PA area and has devoted himself to furthering his understanding of movement related disorders. He teaches continuing education and operates a private practice. More information can be found at and feel free to like us at our facebook page.

(1) Effects of active recovery on plasma lactate and anaerobic power following repeated intensive exercise. Ahmaidi S, Granier P, Taoutaou Z, Mercier J, Dubouchaud H, Prefaut C. Medicine & Science in Sports & Exercise. 1996 Apr;28(4):450-6. PMID: 8778550

(2) Effect of incorporating low intensity exercise into the recovery period after a rugby match. M Suzuki, T Umeda, S Nakaji, T Shimoyama, T Mashiko, and K Sugawara, British Journal of Sports Medicine, 2004 38: 436-440.

(3) Blood Lactate Removal Using Combined Massage and Active Recovery. Micklewright, D P. 1; Beneke, R FACSM 1; Gladwell, V 1; Sellens, M H. Medicine & Science in Sports & Exercise. 35(5) Supplement 1:S317, May 2003.
(4) Lund, H., Vestergaard-Poulsen, P., Kanstrup, I., & Sejrsen, P. (1998). The effect of passive stretchng on delayed onset muscle soreness , and other detrimental effects following eccentric exercise. Scandinavian Journal of Medicine & Science in Sports8, 216–221.
(5) Herbert, R., de Noronha, M., & Kamper, S. (2011). Stretching to prevent or reduce muscle soreness after exercise. Cochrane Database of Systematic Reviews, Issue 7, CD004577. doi:10.1002/14651858.CD004577.pub3
(6) Cheung, K., Hume, P., & Maxwell, L. (2003). Delayed onset muscle soreness: treatment strategies and performance factors. Sports Medicine33(2), 145–164.
(7)Boyle, C., Sayers, S., Jensen, B., Headley, S., & Manos, T. (2004). The effects of yoga training and a single bout of yoga on delayed onset muscle soreness in the lower extremity. The Journal of Strength & Conditioning Research18(4), 723–729.
(8)Training, Journal Of Athletic. Effects of Massage on Delayed-Onset Muscle Soreness, Swelling, and Recovery of Muscle Function (n.d.): n. pag. Web.
Part III of the Consistency series

What you're missing: The Commandments of exercise.
Essential advice for putting together a successful workout program and smashing through the plateaus when your workout becomes stagnant.

It sure looks like cross-fit in some ways

In parts one and two we covered some of the issues that can interfere with consistency as well as went over the "Commandments of training".  In this final installment we will finish talking about the essential concepts of exercise so you can train smart and "MOVE TO LIVE & LIVE TO MOVE"

In review the basic tenets are  overload, restadaptation, specificity and reversibility.  We covered the first two last time so lets get to the rest.

Specificity: You reap what you sow
Anyone want to guess what Micheal Johnson's adaptations were?

If you sprint, you develop big quads.  If you work with your hands, you develop big forearms.  Humans are adaptable creatures, almost everything we are exposed to eventually we adapt to. Whether it's a hot bath or a loud room at a party or concert, what your initially exposed to eventually becomes "background noise".  Fitness training is no different, it shapes and molds each one of us (activity dependent), and if done enough, it becomes a bit routine. The S.A.I.D. principle (a common rehab/fitness concept) states exactly that, we specifically adapt to the imposed demands placed upon us; it's the reason the stone masons forearms are so big and strong or the Kenyan marathoner who seems built for what he does.  In fact the Kenyan IS built for what he does, and is the work of many generations and demands imposed.  These individuals commonly have crossed large desert distances for generations and have become efficient at doing so.
Here's a thought;  If this is true, why do we train our high school pitchers in the weight room? We're training them to be slow and plodding, a pitcher's biggest need is speed!  

The perfect marathon machine crafted over generations
Adaptation: It goes both ways...
The body's ability to learn, adapt and improve allows us greater ability, but it also causes our progress to plateau.  Doing the same exercise or activity week in week numbs the physiologic response that is responsible for muscle growth, hormonal adaptations and the enzymatic changes that gives us better endurance (better 02 delivery, improved energy systems).  If it ain't broke don't fix it does not apply in regards to adaptation, while it makes things easier for us, it also makes us comfortable.  In fitness we need to be challenged and constantly pushed.

The point of diminishing returns..
When your're a regular at the gym you see the same people doing the same thing, day in and day out.  Many look the same the always do (and still not at their ideal).  Why isn't their hard work paying off with success?  It's a fact of sports science that if you have been doing a certain type of training for long enough, that you are losing out on gains in strength and weight loss.  I'm a personal example of this, and when I became informed and changed my ways, I was rewarded with less injuries, a leaner physique and a stronger body. I now try and share that knowledge, check out some of these great techniques with a trainer that knows WHY and HOW to do it properly. 

Shocking the system.. it's called Periodization
The process of changing what you do every few months is called periodization, professional athletes do it,  so you should most likely be doing it as well. There are many different reasons to change up what you are doing. It cuts down on injuries by giving some of you body parts and tissues a rest.  In professional sports it's broken down in to seasons;
Preseason- sports specific skills training, improve cardio vascular endurance
In-season-maintenance of strength, manage injuries, light cardio 
Postseason/Off-season-add muscle mass, increase speed, manage injuries
Each period has specific goals and is geared to addressing what may have developed in the period before. While most, if any of us are not professional athletes, they are the gold standard that should be followed.  This set-up can be adapted to any type of athlete or exercise enthusiast.
We can adapt the season analogy defining what the pro's want to accomplish in each period and relate it to someone who wants a great physique. 
Diet down-Getting ready for your Activity or season(bathing suit weather)
Maintain-Keep the weight off while still enjoying life(bike, kayak,watersports)
Get strong-take advantage of additional calories of the holidays to increase muscle mass
Get fast- begin to shed extra weight and improve cardio vascular system

Reversibility: Fear not!
The concept of reversibility is one we can all sympathize with, it's the idea that our gains made through exercise are lost at a rate of 3:1.  In other words If we worked out for one month it would take our body three months to loose or "forget" the benefits that came with said exercise program.  But like adaptation, it goes both ways!  The concept also states that the de-trained athlete will quickly recover the lost gains due to inactivity vs. someone who was completely uninitiated.  So, while it's true that if you don't use it you loose it, it's also true that after you loose it it's easier to get it back compared to someone who never had it to start.  To avoid reversal of gains simply perform one set to complete fatigue of each body part once a week!

To summarize this series, here are some do's and don'ts;
Do Increase you weight, reps, time or sets 10% consistently
Do Get your vitamins from whole foods and stay hydrated
Don't Drink alcohol if you're trying to get in  better shape
Do address post muscle workout soreness with active recovery techniques
Don't get stuck doing the same routine for longer than 4 months
Do exercise the target muscle to fatigue
Don't completely stop, if need be maintain with one set a week
Do train in a specific manner if you are an athlete with specific needs (i.e. baseball pitcher)
Don't just sit there, I just gave you the road map, now get out there and Live to move and move to live!

 Today we provided principles, so you can adapt your own protocols, don't hesitate to contact us with questions. 
Please let us know you visited our blog by liking, commenting & sharing.

Dr. Serafim is a Rehabilitation and a Strength and Conditioning Specialist. He lives and works in the Exton PA area and has devoted himself to furthering his understanding of movement related disorders. He teaches continuing education and operates a private practice. More information can be found at and feel free to like us at our facebook page.


Tuesday, January 10, 2017

Get the best of the past and the future with these intense full body blasting tools

In today's world  everything old is new again-retro fashion, paleo diets and now fitness. To help understand why some of these exercise techniques may be right for you, it's best to examine what and who they can benefit.
Each system has its roots in the fitness industry evolution, most are combinations of several systems. It seems some of the conventional wisdom we heard when we were young like "sit up straight" or "eat your vegetables" were actually time proven wisdom. Here's a picture of President Truman's gym; note the rings, medicine balls and gym mat. This was state of art at the time, but let's look at the rings and what that has come of it since then.
The following exercises will get you ready for a traditional gym based routine, they will also make you better at the fundamental movements.  Those movements make you better at the things you need to do on a day in day out basis.
Suspension training is nothing new, high school gymnasiums included climbing ropes and rings in simpler times. TRX is a regressed form of gymnastic training.  Bodyweight training is always functional (click here to learn more about functional training), since you have to control the weight you're using which trains your stabilizer muscles, allowing to avoid overuse and ballistic injuries. TRX also allows for some great stretching activities. does a great job putting together just a few of the stretching activities that can be performed.
Who's it good for? Suspension training is excellent for the beginner who cannot handle their full bodyweight in compound movements like the squat, push up and pull up.  As you get stronger (which should occur in the first 9-12 weeks) you continue to progress your training by moving foot or hand position into a more weight bearing position. TRX coerces  you to brace your core promoting "stiffness" and forces you to integrate your core in your basic movements.  
Low back pain patients would greatly benefit from this type of program after rehab that would include addressing  mobility and pain issues. This work out is a great example of a local muscle endurance "military" type work out. It builds capacity, allowing you to work harder for longer.  It's a great segue to a hypertrophy "bodybuilding" workout, since you should be able to perform compound movements correctly before you start adding weight to your moves.

TRX, the ultimate "road warrior" getting in shape and staying in shape takes consistency(read more about it here).  TRX is light  weights and supremely portable for the home gym or busy traveling professional. It comes with a door anchor that can be used virtually anywhere. 

Medicine and Smash Balls
We have been working with balls ever since cave man threw his first boulder at a saber tooth. Medicine ball training started with Persian wrestlers and later with ancient Greek healers. They got the name "medicine" balls because they served as functional correctives for people with injuries and sickness.  The point with tossing or smashing activities are to use your legs and core to develop the power in the toss.  Too many times athletes striking motion, be it kicking or throwing, are DETACHED from their core. This dynamic causes a "leak" in energy in the athletes kinetic chain (movement chain). An excellent example was mentioned in this post that mentioned MLB pro. pitcher Tim Lincecum
Who is it good for? Everyone could benefit from Medicine/Smash balls but high school, college and pro athletes have the most to gain. They can provide a local muscle endurance(military training) type work out or a plyometric type workout. Both types could be used for recovery, endurance or calorie burning. 
Working with balls you can enhance several different movement planes of the muscular system
One of the high level trainers I look up to Todd Durkin,  is training Darren Sproles here with smash balls in the diagonal plane lift.  Drew Brees is working out of the triple flexion position in the background.  Todd works with MLB pitchers and NFL athletes, he rarely trains just one movement plane,  and is one of the best trainers anywhere. 

Floor gliders have infinite variation
Floor Gliders/Ab Wheels
Ab wheels have been around for many years, they provide excellent core activation, and tie the core into pectoral and deltoid movements.  They also target some of our accessory stabilizers and promote functional stability. There's upper and lower limb variations such as this "mountain climber" variant.  This type of exercise it great to work in to a rehab protocol or a high intensity interval workout. From shoulder syndromes to weak lower back/cores, these simple yet effective tools are much harder than you would imagine.  The also burn a TON of calories given their nature( whole body activation).  
Core Flyte just released their V2 glider/stability trainer and they also have a variety of exercise routines on their website at  Here is a split squat with the trailing foot on V2 glider.
Who's it good for?  Again, everyone would benefit from some linkage from core to extremities.  These are also compact and light weight so the travelling athlete could make really great use of them for maintenance.  They can promote both scapular(shoulder blade) and lumbar(low back) stability, just where you need it the most!

By mixing in some of these tools your body will be stronger, more resilient and more stable.  The more you repeat your routine the less successful it will be.  Tune in next time when we discuss programming your exercise routing like the Pro's. 

 Today we provided principles, so you can adapt your own protocols, don't hesitate to contact us with questions. 
Please let us know you visited our blog by liking, commenting & sharing.

Dr. Serafim is a Rehabilitation and a Strength and Conditioning Specialist. He lives and works in the Exton PA area and has devoted himself to furthering his understanding of movement related disorders. He teaches continuing education and operates a private practice. More information can be found at and feel free to like us at our facebook page.