INERTIA: A Therapist's Thoughts

Kate Pollock, our registered dietician provided this info for our clinic.  I thought it was very informative and useful. I get questions about this kind of stuff all the time so I thought I would share it!

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Proper dietary intake for two to three days prior to exercise can affect performance!!! Proper hydration in the two to three days BEFORE exercise is ESSENTIAL!  Drink an extra 4-8 cups (32-64oz) of fluid the 2 days before strenuous exercise — especially if you are a heavy sweater.    

During the 3 to 4 hours before event/strenuous exercise (IDEAL TIMING):

• 200-300g carbohydrates; 800-1200kcal
• Sufficient fluids (at least 2-3 cups (16-24oz) of fluid)      
• Example: 2c Frosted Mini-Wheats with 2c milk, 1 large banana and 2c grape juice (259g)   

During the 2-hours before:

• At least 2-3 cups (16-24oz) of fluid
• 1 gram carbohydrate per pound of body weight (about 100-250g carbs; 400-1000kcal)
• Example: 1 large baked potato, 1c corn, 4oz chicken breast, and 2c lemonade (149g) 

 

During the 1-hour before (keeps you from getting hungry):    

• -SUFFICIENT FLUIDS – 1-2 cups (8-16oz) of fluid
• Moderate complex carbohydrates (50-125g)
• Relatively low in fat (<20g – especially saturated fat) and fiber (<10g; fat & fiber delay gastric emptying)
• Moderate in protein (10-25g; red meat is especially difficult to digest)
• 0.5 grams carbohydrates per pound of body weight (about 50-125g carbs; 200-500 kcal)
• Example: Yogurt-covered granola bar with 1c low fat chocolate milk and 1 large apple (82g)  

5-10 minutes before:

• 1-2 cups (8-16oz) of fluid
• Simple sugars are OK (if consumed alone, should only be consumed a short amount of time before exercise to avoid insulin spike)
• Example: Sports Drinks or 100% fruit juice

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Thanks for the great info Kate!

In my next post, I plan to discuss the new "rocker bottom" shoes that you are starting to see more of. I'm getting quite a few questions about those as well. If you have specific questions or info about them I'd like to hear it. 

The emerging popularity of the Wii Fit gaming system over the past year has brought about the question as to whether such a system actually has a therapeutic application or not. I have only played with one once and found it to be quite challenging, especially the balance components. Based on my limited experience, my conclusion is that the Wii could provided a real improvement in functional balance.

I can now offer a more definitive answer thanks to a research article recently published in the January 2010 issue of Journal of Orthopedic & Sports Physical Therapy.  The article is titled, "Effects of a Wobble Board-Based Therapeutic Exergaming System for Balance Training on Dynamic Postural Stability and Intrinsic Motivation Levels."   

The idea of the study was to determine if such video game-based balance activities would improve a patient's willingness to perform such tasks at home and thus yield the desired improved balance.  Essentially the end result was that exercise-based video games that incorporate balance, like the Wii Fit board, did yield an improvement in dynamic postural stability. Even better, the subjects had more fun while doing it!!   

Carrie Truebenbach provided the following response to a reader's question,

"I am not especially familiar with this shoe yet. That being said, it is a "shoe" with minimal to no cushion. For most people this style of footwear (mimicking barefoot running) would be difficult to adjust to, as the majority of runners (85 percent) are heel strikers to some degree. This pattern of gait is facilitated by the typical styles of shoes, including running shoes that we wear daily. To tolerate a shoe such as the Five Fingers, without getting injured, your running style would need to be very neutral and efficient — even if you were wearing it for competition only.  So I would likely not recommend this style of footwear for many runners ..." 

Thanks Carrie!

The new year may have you focused on some new fitness goals. To help achieve your goals, it is important, if not imperative, to use the right equipment. A fundamental piece of exercise equipment is the proper shoe. At the Sports Medicine Center we treat many athletes with lower body injuries related to exercise and sporting activities. Unfortunately in the recipe for overuse injury, one key problem tends to be the wrong footwear. So how does one go about finding the right running shoe?

To begin with, consider the right shoe a small investment, knowing that the right investment will reap big rewards. Purchasing shoes at a local running specialty store, or online site is important. Name brand shoes from department stores and discount retailers are often composed of slightly different materials than those of the same brands sold by running-specialty retailers. The economy version running shoes, found at discount and department stores, are often made of slightly different materials that are typically less durable. So, if you are committed to getting the most of your shoe investment, and your fitness goals, do yourself a favor and seek the optimal shoe for you.

And how does one know what is the best shoe amongst the hundreds of styles, colors, and comfort-guaranteed gizmos that compose a running shoe? Well, fortunately, all of the bells and whistles really boil down to three or four basic running shoe styles that each company then individualizes. These styles include: neutral cushioned shoes (for the lightweight performance runner); stability shoes (beneficial for most runners); and motion control styles (for the low-arched, flexible foot, or heavier runner).

Depending on your level of experience, there are a number of ways to make an informed decision. Certainly the Internet can offer loads of information regarding shoe styles and even how to help determine your running style. But ultimately, receiving individualized attention to your needs and foot type is best. Local running shoe stores can be helpful and offer a variety of brands for you to try. But for expert advice in these decisions, consider pursuing an evaluation and shoe wear prescription here at the Sports Medicine Center’s Runners’ Clinic. This experience will provide you insight into your lower body posture and alignment, foot type, and basic information about your running style. This is the type of information that can optimize your shoe purchase and give you a strong start for achieving your 2010 fitness goals.

For more information about the Froedtert Sports Medicine Center’s Runners’ Clinic visit our site or call 414-805-8602.

Information submitted and provided by Carrie Truebenbach, MSPT.  Thank you, Carrie!

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The following are comments received for this blog post:

What are your thoughts on the new Five Fingers shoes made by Vibram? I'm thinking about getting a pair but worry about the lack of cushion.

- Steve P.

I received this information from my collegue, Kathryn Pollack, and thought it would be good to pass along. Kathryn is the Sports Medicine Dietitian at the Froedtert & The Medical College of Wisconsin Sports Medicine Center and wanted to pass along this excellent information regarding supplements. Thanks, Kate, for the info!!

Vitamin D is often called “the sunshine vitamin.” And although you can consume foods that contain Vitamin D to help increase the amount circulating in your system, it is almost impossible to consume enough Vitamin D in your diet without a supplement. Your body makes the majority of the Vitamin D circulating in your system when UVB rays hit your skin. Many factors can affect the effects of UVB rays on your skin …

• Low UVB exposure and therefore low Vitamin D levels are often a result of:
  
  • Latitude (above 35 degrees)
  • Season (usually highest exposure in summer; lowest in winter)
  • Time of day
  • Melanin in skin (darker skinned individuals may need 10 times the exposure than lighter skinned individuals)
  • Use of sunblock / sunscreen
  • Age
  • Clothing or coverings over face and body
• Benefits of adequate Vitamin D levels:
  
  • Maximal calcium absorption in the gut to prevent bone loss
  • Adequate bone growth
  • Reduction of inflammation
  • Healthy immune function – especially helpful in reducing the risk of respiratory infections
  • Help cells develop properly to decrease the risk of cancer
  • Athletes should be ESPECIALLY concerned as adequate Vitamin D levels are associated with increased speed in running and cycling, increased cardiovascular and muscular endurance and increased choice reaction time!
  
  
• How do I know if I am Vitamin D deficient?
  
  • Your doctor should test your 25(OH)D or 25-hydroxy-vitamin D levels
  • The results are usually measured in ng/mL
  
  
• What’s enough?
  
  • <20 ng/mL = deficient
  • 21-31ng/mL = insufficient
  • >32 to 100ng/mL = “optimal”
  • Some studies show that the “ideal” level for athletes should be >50 ng/mL
    
• What can you do if your levels are below “optimal”???
  
  • See a Dietitian!!!
  • Based on your lab results a dietitian can recommend a dose and a Vitamin D3 supplement
  
  
• Can’t I just get Vitamin D from the foods I eat?
  
  • Unfortunately, unless you are consuming large amounts of cod liver oil everyday you probably are not consuming enough Vitamin D from only the foods you eat
  
  
• How much Vitamin D will I have to take?
  
  • In May of 2010, the Institute of Medicine will release new Vitamin D recommendations
  • More than likely at least 800-1000IU (or as much as 2000IU) of Vitamin D will be recommended to maintain healthy Vitamin D levels (much more will be recommended if you are found to be deficient)

For more information on sports nutrition, contact Kate Pollack, RD CD at 414-805-7461.