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8 Reasons Why You’re Sore–#8–Deloading

One of the most common complaints I get from new trainees (most often these come from middle aged men who are just now getting back into strength training) is that of being sore all of the time.  Many people associate muscular soreness with getting a good workout or getting results.  However, the research does not necessarily support this thought process.  Muscles tend to get sore anytime a new stimulus is introduced (new exercise, activity, etc), but this should typically subside within 2-3 weeks of starting the activity.  Anytime a new exercise is introduced, it is expected that some level of soreness will occur.  However, a good program will actually have an introduction phase where weight and volume are intentionally reduced in order to avoid excessive soreness, as this can negatively impact future workouts.  If you are chronically sore beyond the initial 2-3 weeks of starting a strength training program, there are eight areas that you may need to pay attention to.

Jeff Tirrell, CSCS, CSFC, Pn1

#8–Deloading

Deloading is a term used to describe an intentional period of time (usually 1-2 weeks) where intensity and/or volume are reduced in training.  In some cases, no training at all is performed (though this is probably not optimal, unless you are injured).  In my experience, this is usually not an issue with the majority of clients.  Most people end up missing time at the gym due to illness, work, kid’s activities, vacation, etc.  If you happen to be somebody that is highly dedicated to your training and don’t ever miss any period longer than a week in the gym, then a scheduled deloading period may be needed.  I usually recommend reducing training volume by 40-60%, and intensity by 10-20%.  In practice for a one week deload, this would look something like this:

Normal Week                                                                                     Deload Week

45 total weekly training sets of all exercises                                      24 total weekly training sets

e.g. squats: 200lbs lifted                                                                     squats: 160-180lbs lifted

If you don’t ever miss time in the gym in a 12 month period, I would recommend the following deload schedule for people who train 3, 4, or 5 times per week.  As mentioned earlier, training more than 5 times per week is likely not feasible for most adults, and less than 3 doesn’t warrant a deload period.

3 days per week: deload for 1 week, 1 time each year

4 days per week: deload for 1 week, 2 times each year

5 days per week: deloa for 1 week, 3 times each year

 

8 Reasons Why You’re Sore–#7–Program Hopping

One of the most common complaints I get from new trainees (most often these come from middle aged men who are just now getting back into strength training) is that of being sore all of the time.  Many people associate muscular soreness with getting a good workout or getting results.  However, the research does not necessarily support this thought process.  Muscles tend to get sore anytime a new stimulus is introduced (new exercise, activity, etc), but this should typically subside within 2-3 weeks of starting the activity.  Anytime a new exercise is introduced, it is expected that some level of soreness will occur.  However, a good program will actually have an introduction phase where weight and volume are intentionally reduced in order to avoid excessive soreness, as this can negatively impact future workouts.  If you are chronically sore beyond the initial 2-3 weeks of starting a strength training program, there are eight areas that you may need to pay attention to.

Jeff Tirrell, CSCS, CSFC, Pn1

#7-Program Hopping

As stated initially, any new exercise or activity added to a program will produce a novel stimulus that will almost always lead to some level of soreness.  Many individuals change their workout every day and never give themselves a chance to adapt.  Many people enjoy the feeling of being sore as they associate that with progress.  However, when you look at research, most of the gains in lean body mass actually occur 2-4 weeks into training after the majority of initial soreness has subsided.  It should be remembered that strength training is a skill.  It must be practiced.  It is recommended that the majority of your exercise selection remain basically the same for at least 3 weeks.  Workouts can be varied by the number of sets, reps, weight lifted, or time to completion.  After 3-12 weeks with a given exercise, you can switch it out if you are bored or no longer able to progress the aforementioned variables.

8 Reasons Why You’re Sore–#6–Training Frequency

One of the most common complaints I get from new trainees (most often these come from middle aged men who are just now getting back into strength training) is that of being sore all of the time.  Many people associate muscular soreness with getting a good workout or getting results.  However, the research does not necessarily support this thought process.  Muscles tend to get sore anytime a new stimulus is introduced (new exercise, activity, etc), but this should typically subside within 2-3 weeks of starting the activity.  Anytime a new exercise is introduced, it is expected that some level of soreness will occur.  However, a good program will actually have an introduction phase where weight and volume are intentionally reduced in order to avoid excessive soreness, as this can negatively impact future workouts.  If you are chronically sore beyond the initial 2-3 weeks of starting a strength training program, there are eight areas that you may need to pay attention to.

Jeff Tirrell, CSCS, CSFC, Pn1

#6-Training Frequency

The cold hard truth is that when we are younger, we recover quicker.  I remember when I first started training in 1998 (8th grade), I would train 6 days per week for 90-120 minutes.  I got bigger, stronger, and rarely felt overtrained.  There was a time in the summer my junior and senior year where I would train 6 days per week, and on 3 of those days. I would actually lift 2 separate times accounting for roughly 12 hours of training each week.  Even at this time, I still made great progress.  It wasn’t until my sophomore year of college that my 6 day per week plan was just more than my body could keep up with.  I scaled things back to 5x/week and did just fine again.  Once I started having kids and sleep got limited, the stress of providing for a family became real and I had to scale back to 4 days per week.  I find that most adult clients over the age of 40 can only tolerate 3-4 days per week.  There’s nothing that says you can’t train back to back days.  However, if you are always sore, and don’t feel that you’ve recovered, you may need to give yourself some extra days for recovery.

 

8 Reasons Why You’re Sore–#5 Training Volume

One of the most common complaints I get from new trainees (most often these come from middle aged men who are just now getting back into strength training) is that of being sore all of the time.  Many people associate muscular soreness with getting a good workout or getting results.  However, the research does not necessarily support this thought process.  Muscles tend to get sore anytime a new stimulus is introduced (new exercise, activity, etc), but this should typically subside within 2-3 weeks of starting the activity.  Anytime a new exercise is introduced, it is expected that some level of soreness will occur.  However, a good program will actually have an introduction phase where weight and volume are intentionally reduced in order to avoid excessive soreness, as this can negatively impact future workouts.  If you are chronically sore beyond the initial 2-3 weeks of starting a strength training program, there are eight areas that you may need to pay attention to.

Jeff Tirrell, CSCS, CSFC, Pn1

#5-Training Volume

When referring to training volume, we are typically talking about one of two things.  Total number of sets performed in a given session, week, or month is one way to look to volume.  Another way to look at volume is as volume load.  Volume load is calculated as weight lifted x sets x reps.  So, if you lifted 100 pounds for 3 sets of 10 reps, your volume would be 3 sets, but your volume load would be 3000lbs (100 x 3 x 10).  Simply looking at volume (total sets performed) is a better way to compare different individual’s workloads.  Volume load is very relative depending on an individual’s training background, strength, etc.  If training volume gets too high, then you may be outworking what your body is capable of recovering from.  I find that most adult clients over the age of 40 struggle to handle more than 24 total sets in a single session or more than 72 sets in a given week.  There are some who can handle more than this, and some who struggle to recover from volumes half of this.  When increasing volume, it can be helpful to look at volume load for an individual and try not to increase by more than 5-10% in a given week.

8 Reasons Why You’re Sore–#4 Carbohydrates

One of the most common complaints I get from new trainees (most often these come from middle aged men who are just now getting back into strength training) is that of being sore all of the time.  Many people associate muscular soreness with getting a good workout or getting results.  However, the research does not necessarily support this thought process.  Muscles tend to get sore anytime a new stimulus is introduced (new exercise, activity, etc), but this should typically subside within 2-3 weeks of starting the activity.  Anytime a new exercise is introduced, it is expected that some level of soreness will occur.  However, a good program will actually have an introduction phase where weight and volume are intentionally reduced in order to avoid excessive soreness, as this can negatively impact future workouts.  If you are chronically sore beyond the initial 2-3 weeks of starting a strength training program, there are eight areas that you may need to pay attention to.

Jeff Tirrell, CSCS, CSFC, Pn1

#4–Carbohydrates

Carbohydrates are the primary nutrients that drive insulin secretion.  Insulin is an anabolic hormone that drives protein and fat into cells where these nutrients are used to repair tissue.  Though there are other pathways that do allow protein and fat to make their way into the cell, they are not as quick or efficient.  Carbohydrates are also stored as glycogen in the muscles, which is the body’s preferred fuel source at higher intensity exercise levels.  Carbohydrate levels can vary greatly depending on activity levels, goals, and training frequency.  Most people will operate best on a minimum carbohydrate intake of 100 grams per day.  Ideally, these are coming primarily from fruits, vegetables, potatoes, rice, beans, and whole grains.

8 Reasons Why You’re Sore–#3 Protein

One of the most common complaints I get from new trainees (most often these come from middle aged men who are just now getting back into strength training) is that of being sore all of the time.  Many people associate muscular soreness with getting a good workout or getting results.  However, the research does not necessarily support this thought process.  Muscles tend to get sore anytime a new stimulus is introduced (new exercise, activity, etc), but this should typically subside within 2-3 weeks of starting the activity.  Anytime a new exercise is introduced, it is expected that some level of soreness will occur.  However, a good program will actually have an introduction phase where weight and volume are intentionally reduced in order to avoid excessive soreness, as this can negatively impact future workouts.  If you are chronically sore beyond the initial 2-3 weeks of starting a strength training program, there are eight areas that you may need to pay attention to.

Jeff Tirrell, CSCS, CSFC, Pn1

#3–Protein

Protein is responsible for making up at least part of every structure in all humans.  It is responsible for the repair of muscles, tendons, ligaments, and organs.  Protein is most commonly found in animal products such as meats, eggs, and dairy.  Despite popular belief, vegetarian dairy substitutes (such as almond milk) tend to be a poor source of protein.  Soy and pea along with a variety of vegetable-based protein powders are the best bet for vegans to increase protein intake.  For optimal recovery, protein intakes should range from 0.62 grams per pound of bodyweight up to 1 gram per pound of body weight.  For very lean individuals who are very active or trying to lose body fat, amounts may need to be even higher.  Protein intakes of up to 2 grams per pound of bodyweight have been studied and found to be safe in healthy individuals.

8 Reasons Why You’re Sore–#2 Hydration

One of the most common complaints I get from new trainees (most often these come from middle aged men who are just now getting back into strength training) is that of being sore all of the time.  Many people associate muscular soreness with getting a good workout or getting results.  However, the research does not necessarily support this thought process.  Muscles tend to get sore anytime a new stimulus is introduced (new exercise, activity, etc), but this should typically subside within 2-3 weeks of starting the activity.  Anytime a new exercise is introduced, it is expected that some level of soreness will occur.  However, a good program will actually have an introduction phase where weight and volume are intentionally reduced in order to avoid excessive soreness, as this can negatively impact future workouts.  If you are chronically sore beyond the initial 2-3 weeks of starting a strength training program, there are eight areas that you may need to pay attention to.

Jeff Tirrell, CSCS, CSFC, Pn1

#2–Hydration

Hydration or water intake is probably one of the easiest ways to improve health, recovery, and performance.  For most people in the general population, we want to focus on calorie free fluid with minimum caffeine (this means water).  Water acts as a solvent, transporter, catalyst, lubricant, temperature regulator, mineral source, and assists in anabolic processes.  Water helps bring nutrients to cells and removes waste.  It is used in the production of proteins and glycogen, helps facilitate and speed up many chemical reactions (many wouldn’t occur without it.  It also lubricates joints and acts as a shock absorber for our eyes and the spine.  Water intake should range from 1 Liter per 1000 calories consumed (need to know your caloric consumption) up to ½ ounce per pound of bodyweight.  In very hot or humid conditions or when activity is very high, larger amounts may be needed.

8 Reasons Why You’re Sore–#1: Sleep

One of the most common complaints I get from new trainees (most often these come from middle aged men who are just now getting back into strength training) is that of being sore all of the time.  Many people associate muscular soreness with getting a good workout or getting results.  However, the research does not necessarily support this thought process.  Muscles tend to get sore anytime a new stimulus is introduced (new exercise, activity, etc), but this should typically subside within 2-3 weeks of starting the activity.  Anytime a new exercise is introduced, it is expected that some level of soreness will occur.  However, a good program will actually have an introduction phase where weight and volume are intentionally reduced in order to avoid excessive soreness, as this can negatively impact future workouts.  If you are chronically sore beyond the initial 2-3 weeks of starting a strength training program, there are eight areas that you may need to pay attention to.

Jeff Tirrell, CSCS, CSFC, Pn1

#1–Sleep

Sleep is one of the most neglected areas of health, fitness, and recovery.  It can have some of the most dramatic impacts on improving any of these areas, but can also be one of the most difficult areas to improve. We only have 24 hours in a day and we must divide this time between sleeping, eating, work, family/social time, leisure activities, and training.  Your priorities will dictate which areas you spend the most time on.  One thing that is often overlooked however, is that increased sleep (both quantity and quality) can help in many of these areas.  It has been shown that better sleep improves cognitive function (better function at work), makes you more efficient, improves mood (better for friends and family), improves hormonal profiles (better for health), and improves performance and recovery.  If you struggle to get enough sleep, try to set a better schedule for yourself to allow for earlier bedtime and/or a later wake time.  If you struggle with sleep quality, try to establish better sleep hygiene practices.  Common recommendations are to sleep 7-9 hours per night (kids need more like 9-12 hours/night).  However, some research suggests that hard training individuals may need 9-10 hours of sleep for optimal results.

You Have A Social Media Disease

There Is No App for Thumb Pain

Your thumb is made up of an intricate system of tendons that enable very precise movement.  The joints of a thumb are fairly small and yet we are able to produce an amazing amount of force with this single digit.  In this age of all things digital, the modern American thumb has been subjected to greater workloads.  Problems with thumb pain, numbness, and limited function are becoming more common complaints in physical therapy.  I have some suggestions on how to manage pain and limit the damage and embarrassment of excessive social media thumb exposures.

Thumb Tendon Troubles

Dr. De Quervain was the first to clinically described thumb tendonopathy, and we call thumb tedonosis De Quervain Syndrome.   The test for De Quervain Syndrome was created by a clinician with an equally odd name and it is called the Finkelstein test.  Place your thumb in the palm of your hand.  Make a fist with the finger around the thumb.  Hold the wrist in neutral and then deviate the wrist toward the pinkie finger.  If you feel pain it is a positive Finkelstein test.

Resolution of thumb tendonopathy pain happens quickly when you give in to the symptoms of pain and modify your activities.  Rest the thumb tendons by using your fingers instead of your thumb on that smart phone.  Avoid fitness activities that put stress on the thumb.  Lifting in front of the body with the palms facing inward is often the lift that new mothers perform and develop painful thumb tendons.  Early on in the pain onset, icing is often helpful.  In physical therapy, we are successful with soft tissue mobilization, ultrasound, and manual therapy.  A gauntlet type thumb splint you wear at night is an unattractive but provides aviable position of rest for severely aggravated thumb tendons.

The Numb Thumb

Irritation of the median nerve in the carpal tunnel of the wrist will create thumb, second, and third finger numbness and pain.  An injury of the recurrent median nerve in the front of the palm will produce numbness in the thumb and limited strength during thumb opposition–thumb to pinkie finger.  Patients with neural irritation often develop numbness, weakness, and then pain.  The pain often wakes them from sleep and disrupts hand function.

Once again, you will resolve a numb thumb with rest.  Once neural irritation gets fired up, it takes longer to resolve than an aggravated tendon.  Giving in to the numbness and resting the hands will produce better results if you start early.  Two weeks of avoiding the aggravating hand activity produces good results.  Night splints for the wrist and thumb are often helpful.  A carpal tunnel release is a common surgical alternative that takes pressure off the median nerve.

Gumbie Thumb Beware

Every joint has a certain degree of stability and certain degree of mobility.  Our spine, knees, hips, shoulders, and elbows must move enough to produce motion but not so much that they fall apart.  The amount of movement in our joints is largely an inherited characteristic–you can blame Mom and Dad.  The person at the extreme end of the scale (“double jointed”) needs to take certain precautions with their thumbs.

The Beighton Score is a popular screening technique for joint hypermobility.  It has been around for thirty years and is used in research all around the world.  The scoring is based on eight passive range of motion assessments and one active range of motion assessment.  One point is assigned for each of the following.

A pinkie finger that can be passively bent backward more than 90 degrees.

A thumb that can be pulled down to the front of the forearm.

Elbows that passively hyperextend to 10 degrees.

Knees that passively hyperextend to 10 degrees.

The subject can place the palms on the floor during a straight leg, forward bend.

Researchers disagree on the score that should be a threshold for concern about systemic joint hypermobility.  I have found that fitness clients and physical therapy patients that score a 5/9 or higher require modification of their training programs.  It is not uncommon to encounter physical therapy patients that have a Beighton Score of 9/9.  Hypermobile individuals need to take more precautions when they perform repetitive tasks such as texting on a smart phone.

Kimberly Salt wrote an excellent article on social media induced thumb pain in the May 19, 2018 issue of the New York Times.  Take a minute and read, Me and My Numb Thumb: A Tale of Tech, Texts and Tendons.

Michael S. O’Hara, PT, OCS, CSCS

Remember What You Wrote

Things I’ll Do Differently When I’m Old

Steven Petrow of the New York Times wrote a great article, Things I’ll Do Differently When I’m Old.  As a physical therapist that has guided thousands of 60 year plus individuals through the rehabilitation process, I have some suggestions.

I will work with a professional on developing a sustainable fitness program.  The preventative against age related physical decline is a program of exercise.  Consistent exercise reduces fall risk and maintains independence.  No other modality has a greater impact on health.  Blood sugar levels, respiratory capacity, mental health, and cardiac fitness all respond favorably to exercise.  Do not be a fitness “do it yourselfer”.  Older, deconditioned, and previously injured individuals get much better results when under the direction of a qualified professional.   One way or the other, you are going to spend time and money on your health.  Spend it up front–you will be much happier.

I will not let pain linger. Pain is not a “normal part of aging”.  Chronic pain alters brain chemistry and destroys healthy movement patterns.  Left untreated, pain has the capacity to weaken and spread damage to joints not involved with the initial pain provocation. See a physical therapist and find out what you can do to resolve pain issues before they become chronic.

I will exercise caution with medications that have an effect on the central nervous system.  Many older people take multiple medications that impact brain neurochemistry.  More brain real estate is devoted to movement than reading, writing, and arithmetic.  A steady diet of pain medications, sleeping pills, and anti-depressants takes a toll on coordination, balance, and the ability to safely get around town.  Add in a cocktail or three and you have a dangerous combination.

I will make a sustained effort to recover from any and all physical challenges.   As we travel through our senior years, most of us will experience a health setback that requires rehabilitation.  Full recovery of strength, mobility, and function takes eight to twelve months.  Many physical therapy patients stop all rehab efforts way too soon.  More of the rehabilitation battle is being fought in isolation as reimbursement for physical therapy care is shrinking.  You may be done with formal physical therapy in four weeks, but you need to continue with a restorative exercise program for much longer.

I will not get fat.  Physical therapy patients that are overweight have much more difficulty recovering from an injury or a challenge to their health.  Sarcopenia is the medical name given to age related loss of muscle mass.  Adding extra fat onto a body that is losing muscle creates an environment that makes movement more difficult and pain more prevalent.

I will listen and answer all questions from my health care provider to the best of my ability.  The answers we get from the patient are the clues that lead us to the proper care.  We need to know how your pain / symptom behaves and the effect it has on your life.  Please do not omit any information that you feel is not important or unrelated to your condition.  Do not lie about any aspect of your functional status, medications, mental health, etc…  Your therapist, doctor, or physician assistant cannot help if we do not have all of the information.

I will plan ahead.  In my dealings with older physical therapy patients, these are the three things that make life easier for both the patient and their families.  Do what you can to manage these issues while you are healthy and clear headed.

  1. Have a Will with end of life directives.
  2. Insurance coverage that reduces the expense of long-term care.
  3. Pre-planned funeral services and insurance

Michael S. O’Hara, PT, OCS, CSCS

Read the NY Times article here: https://www.nytimes.com/2017/12/05/well/family/thing-ill-do-differently-when-im-old.html?_r=0

 

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