February 23, 2011
Episode # 134 from https://bengreenfieldfitness.com/2011/02/episode-134-how-active-release-technique-can-help-your-body-feel-better/
Introduction: In this Podcast, Active Release Technique, nitro-glycerine for injuries, low volume weight training, does it matter if you burn fat or carbohydrate during a workout?, Raynaud’s syndrome, Epsom salts, weight training soreness, asthma remedies, is sugar-free gum healthy?, lap band surgery.
Welcome back to the Ben Greenfield Fitness Podcast. This is Ben and I’m recording today’s episode in Spandex. That’s right, I’m wearing my bicycling uniform because I’m going on a bike ride today & sometimes the best way to get my butt out the door to exercise is to actually dress like I’m gonna do it. So, in today’s podcast, I have an interview with Dr. Kevin Christy about something called active release technique which many of you may know as ART. It’s an interesting interview about a technique that’s really useful for improving or helping with injuries & also for assisting with performance. We also got our Listener Q & A and few special announcements, so, let’s jump right in to this week’s content.
If you’re over at BenGreenfieldFitness.com this week, you may have seen the posts about breakfast specifically my question to you about what confuses you about breakfast, because, it does seem to be one of the more confusing meals of the day. For example for weight loss, do you eat breakfast, do you not need it? For carbohydrates, fats & protein do you include all 3? Do you only do carbs? Do you just have some fruits? The idea about breakfast & the influence that it can have on the rest of the day is something that’s pretty important and so, I’ve put up that post. I’d love to hear your comments about what confuses you about breakfast & in upcoming posts, I’m gonna be answering your questions. So be sure to heed over to BenGreenfieldFitness.com & pipe in on the conversation there. Speaking of the conversation, tons of Q & A and conversations about fitness, fat loss & nutrition happening over at the Ben Greenfield Fitness facebook page. Just go to http://www.facebook.com/bgfitness to check that out and get in on some things that you really don’t see over at BenGreenfieldFitness.com. And then finally, for those of you out there who are interested in advertising on the blog over at BenGreenfieldFitness.com, just shoot me an e-mail or just go to the show notes for this episode, Episode # 134 & there is an advertising information sheet there. So, let’s go ahead & get on to this week’s content.
Listener Q & A:
If you have a question for the Podcast you can call toll free to 8772099439 or if you’re international, you can Skype to username pacificfit. You can also use the free Ben Greenfield Fitness iPhone app & ask a question by pushing Ask Ben button that’s there on iPhone app & by the way, android people, the android app does come out next week; it’s just finishing up its beta-testing. It will be available to you for free next week. And then finally, you can of course use the Ask Ben form which is on the show notes for any of these podcasts over at BenGreenfieldFitness.com. And the first question comes from Backy.
Backy says : Have you ever heard of using a nitro-glycerine patch for healing injuries? What would be the potential side effects? Do you think it would be effective for my friend who has a nagging Achilles injury?
Ben : Well, nitro-glycerine patch is pretty interesting. The idea behind them is that they’re suppose to regulate the nitric oxide levels delivered to an area and potentially improve healing by increasing some of the nutrient in the oxygen delivery – A nitric oxide being something that can improve the diameter of the blood vessel that’s actually feeding an area. However, all of the studies that have been done on the active ingredient of these nitro-glycerine patches which is specifically something called glycerol tri-nitrate have not found that there is any additional benefit of using a nitro-glycerine patch over any of the standard treatments for things like tendinosis or things like Achilles, tendonitis. Not only was it found to be ineffective over standard treatments but there’s not any evidence that these nitro-glycerine patches actually do affect the enzymes responsible for increasing nitric oxide production. So ultimately, unless the sports medicine clinic that your friend is going to has some new cutting-edge research that I haven’t seen, there’s not a lot of evidence that these patches or going to help out too much so, they may want to think twice about what their doing. Now, they do now have a patch that actually delivers a non- steroidal anti-inflammatory drug, specifically into an injured tissue area. So, whereas I’ve never been a huge fan of encouraging people to take something like ibuprofen or Advil in the past just because of the damage that it can do to the gastrointestinal tract. They do have a patch now that is a prescription-based patch that you apply to an area that delivers the same drugs locally that’s bypassing the stomach and you end up with less of the stuff in your blood stream. So, that’s something that I would consider over & above a nitro-glycerine patch. The next question is from Mike Trinkle.
Mike : What do you think of low volume, high intensity weight training?
Ben : I’ve seen a website that goes to great lengths, explaining that performing extra sets beyond the light warm up & one heavy set yield only 0- 5% more muscle growth. I like the short time commitment but I’d like to do a wider variety of exercise with fewer sets if I can get decent results. When we’re talking about muscle growth, the most important component to consider is the actual time under tension that the muscle is exposed to. So for example, during a workout, you generally want to get about a 150-200 seconds of time under tension for the muscle group that you want to grow. And when you’re doing just 1 set, it has to be a very long set to complete failure or it needs to be multiple sets of shorter reps in order to amass that time under tension for the muscle. Now doing multiple sets for a muscle mentally, a lot of time is easier than doing just one set to total fatigue for a muscle. So for example, doing 5 sets of 10 biceps curl for the bicep is a lot of times much easier & more feasible for the average person than doing one set of 50 bicep curls. And that’s the idea between splitting things into multiple sets. So, the idea behind this low volume weight training is that you really don’t need to do much in terms of an additional set, but most of the research on this was done over a decade ago. And since then research has shown that you do need multiple sets or that high amount of time under tension for a muscle to really optimize muscle growth and hypertrophy compared to a single set. When I say hypertrophy, that’s just basically muscle growth, specifically the muscle cells & muscle fibers in the area that you want to work. Now, when would doing 1 set be appropriate? For example if you wanted to just increase your power or you just wanted to increase your strength and you didn’t want to actually put on muscle, that’s where doing a single, kind of high intensity set like 1 set of 8 reps of a super heavy bench press would come in handy. But if you’re just looking for muscle growth, multiple sets are going to be effective & most of the research that’s on the website link that you send over to me is pretty outdated when it comes to this stuff. And you’re going to find that most body builders pretty much any individual who’s wanting to get a muscle to grow larger, is doing a lot more than just 1 single set with the caveat that if they are doing a single set, it’s usually a high reps, we’re talking like 40,50,60 reps. So, next question is from Lorna.
Lorna says : Why does it matter, whether I burn fat or carbohydrate during my workout. I thought that if I am at a chloric deficit at the end of the day, fat will be used for energy, giving me body fat lose. Whether I burn carbohydrate or fat, a deficit will mean fat stores are reducing when it all balances out. Will it not?
Ben : Well, you’re right Lorna in that at the end of the day; really the total amount of calories that you’ve burnt is most important. However, you also need to consider your limited time in getting the most efficiency out of your workout. So, if you take 2 people and you put them side by side and you tell 1 person to walk on the treadmill for an hour at a low fat burning intensity, say like 50% intensity. They are going to burn a high percentage of fat during that workout. They’re not gonna burn many calories but they’re going to burn a high percentage of fat. Furthermore, their heart rate isn’t getting very high & they’re not going to be breathing that hard so there won’t be a real big metabolic or hormonal response to that long easy walk on the treadmill. If you take another person & you tell them to do eight 2-minute sprints on the treadmill, each separated by 2 minutes of easy recovery walking, that person is going to get a very high heart rate during that workout. They’re going to be breathing very hard; they’re going to increase the number of hormones and the metabolic response to that workout. So, they’re burning a lot more calories even after the workout is done. And even though they’re going to primarily be burning carbohydrate during the workout because the workout is performed at a high intensity and your body uses carbohydrate when you work out at a high intensity, the overall number of calories that they burn will be similar or greater than that easy 1-hour walk on the treadmill. So, what it comes down to is they’re going to get more bang for their buck & they’re going to lose weight more quickly in a shorter period of time that the person who’s doing the easy fat burning cardio. The other thing to consider is that a lot of times, even if you are working out in like, a fat burning zone, you’re still not burning as much fat as the person who’s working out hard. And the reason for that is this: if you’re working out hard and you’re burning like say, 800 calories an hour, you’re gonna be burning a lot of carbohydrate because you’re working out hard. You might be burning say, 70% carbohydrate, so you’re only burning 30% fat but that’s 30% of 800 calories. Now, if you go out & do something easy, say like you’re working out at 300 calories an hour, you might be burning 50 or 60% fat but 50 or 60% fat of 300 calories is still a lot less fat than 30% fat of 800 calories. So, you need to think about the total calorie burned in addition to the overall fat percentage. And what it comes down to is that in most cases, you’re going to lose weight more quickly if you’re working out at an exercise intensity that makes you breath hard and makes your muscles burn and kind of my 3 pillars of fat loss that I talked about in last week’s top 10 fat loss secrets that I released over at BenGreenfieldFitness.com is that you’re number 1 priority for fat loss should be weight training, your number 2 priority for fat loss should be cardiovascular interval training and your number 3 lap-out loss, should be easy slow cardio. So, hopefully that helps out with your question. Another question from Laura, well, she has a 2-part question.
Laura : Are there homeopathic or home remedies for Raynaud’s phenomenon?
Ben : For those of you who don’t know what Raynaud’s phenomenon is, is it’s basically a disorder that causes a discoloration of the fingers and the toes; they usually get kind of reddish and a little bit purple and many times, they have areas of very low blood delivery. So, you basically get very sensitive to cold temperature. And for example, you go out for a run, you know, your friends might be able to run with no gloves on or some thin gloves on and you got to wear thick mittens because your hands or your feet get cold so easily. That’s just because there’s not enough blood going to the area to actually heat the area. So, when you have this issue, obviously one thing you can do is just try to keep blood flowing as much as possible. So, when you’re in the cold, you can basically try to wiggle and move your toes and fingers as much as possible and if that doesn’t work, you can do like windmill motions with you arms and your legs just to try and get more blood into the area. You can massage your hands and your feet, that’ll help with blood flow quite a bit as well. Sometimes, Raynaud’s comes on in, basically what would be termed an attack, to where you’ll be fine and then all of a sudden you’ll get really cold, that’s where doing things like the arms swinging and massaging an area, it can help to improve blood flow. As far as natural remedies or supplements that you could take, 3 of the top herbal supplements when it comes to blood flow and assisting with temperature regulation in the extremities are gingko biloba and ginger is another, and then rosemary is also a kind of traditional circulatory tunic to support healthy circulation. So, you could supplement with any of those and the other thing that’s shown promise for Raynaud’s is biofeedback and basically, biofeedback is actually training the body to have less of what’s called a sympathetic nervous system response that can kind of shut off the blood flow to the area. And so, it shuts downs your responses to stress, it reduces the closure of those blood vessels and that you get more blood flow and that’s more heat to your extremities. So, biofeedback is a deal where you’re going to go into a biofeedback practitioner, typically you’re hooked up to a computer and some equipment that’s monitoring your physiological, your biological response to stress and then through a series of sessions, you’ll learn how to consciously reduce your stress response and something like that can be useful for a variety of conditions but it’s something to try out once. And then the second part of your question is “what do you think of Epsom salt as a source of magnesium?” Well, in an Epsom salt, typically the type of magnesium you’re going to find in Epsom salt that you would add to, say like a bath, would be a magnesium sulphate. It is definitely a great source for soothing muscles, for assisting with relaxation compared to oral supplementation with a few hundred milligrams of magnesium citrate, with just typically the type of magnesium that I recommend people supplement orally with. You’re not going to get as much absorption from like an Epsom salt bath but you will get quite a bit of magnesium exposure and a lot of the benefits of magnesium. Don’t get your bath too warm; that can actually decrease the absorption if you take a warm bath. I believe it’s over 103, would be what you’d want to avoid, but you can definitely use an Epsom salt. If you want to get an even higher percentage of magnesium in salts bath, use just magnesium flakes and you can get magnesium flakes, there’s 1 company called ancient minerals that makes real good magnesium flakes that you can try. I’ll put a link to it in the show notes but that’s actually what I use. I don’t soak in Epsom salt, I soak in magnesium flakes and I noticed that I typically feel a lot better after using that Epsom salt when it comes to soreness or relaxation but ultimately, it is a good supplement or way to get your magnesium in, although I wouldn’t completely neglect taking oral magnesium as well. Our next question is calling question from Jeff.
Jeff : Hey, what’s up Ben this is Jeff from Tampa. I have a question for your awesome show. Alright I’m sold, I know I need to do resistance training, I’m an endurance athlete, basically runner-cyclist, and every time I get started with weight training, I go in, I do some dumb bells just kind of doing a little bit of circuit training. I always get stiff and achy and sore after the first & second time. I just give up and I just hate this so, can you give me some tips on how to get started with resistance training so I’ll stick with it? Thanks, Ben, I appreciate you man. Bye.
Ben : So, that’s one of the top reasons people drop out of a weight training program early is the soreness because there’s lots of muscle tearing that occurs when you’re weight training. Weight training and running are 2 of the top activities that cause a lot of that muscle soreness and those are 2 of the top activities that people tend to hate or avoid doing. What I would recommend is that you start with just 2 days a week of weight training if you’re going full body, and go closer to 4 days if you’re splitting it up and doing like upper body 1 day, lower body another day and then another upper body, lower body session. Now, what I would really recommend that you do is go listen to the first 5 episodes of my get fit guy podcast. And in those first 5 episodes, I really lay out pretty much everything that you would need to get started with weight training. Now, I’m gonna put a link to that podcast and these are really short episodes. You could get through the first 5 episodes in 30 minutes, but I’ll put a link to those and for those of you listening in the week this podcast come out, be sure to check BenGreenfieldFitness.com on Friday because I’m going to list the top 10 episodes that have ever appeared over at that get fit guy podcast so that you can listen to some of the more popular and more helpful podcast that are available over there. So, definitely listen to that podcast, don’t overdo it and of course, include your recovery protocols when you start weight training. It doesn’t seem like you would make this much of a difference, but something as simple as getting your protein in after you finished and throwing in some branched-chain amino acids or some proteolytic enzymes, something like a recover-ease supplement after you finished weight training, can make a huge difference in your soreness. So, listen to those get fit guy episodes, those are going to go into a lot of detail about how to get started with weight training.
Ralph : I have a hard time running and have been told I have athlete induced asthma. I’ve been told this because I have hard time breathing during exercise and it sounds like wheezing. Is there anything that I can do to help with this?
Ben : Well, this is something, it’s not super common but it does happen in people who exercise. You don’t have any asthma at all and then they get an asthma attack or they had a lot of trouble breathing as soon as they begin exercise. And the idea behind this is that, it’s believed that people who get exercise induced asthma are more sensitive to changes in temperature or the humidity of the air. So, when you’re sitting around doing nothing at all, a lot of times you’re breathing through your nose and your nose actually starts to warm and humidify and cleanse all that air that you’re inhaling. And once you start exercising, you start breathing through your mouth and then the air that hits your lungs isn’t warm, it’s cold, it’s not as humidified, it’s drier and the contrast between the warm air that’s in your lungs and that cold air that your inhaling can trigger an attack. So what happens is your airways start to swell and typically, you’ll produce a lot of mucus as well and all the swelling and the mucus blocks the airways and it makes it more difficult for you to exhale or to push air out of your lungs, so it can feel like you’re having a very hard time breathing. My wife has had to deal with this before and to a certain extent, learning how to control your breathing seems to help her a little bit, specifically she does yoga which teaches a deep diaphragmatic breathing and it also helps you to relax as you focus on your breathing. So, that can be one thing that’s very useful to try, but the other thing you may want to look into is one of those power breather devices which can also improve the strength of your inspiratory & expiratory muscles. With the idea being that, if you do start to go into bronco spasm, you would at least have a little bit more to fight against it with so to speak. Now you may actually need to go and get a bronchodilator. And this would be one of those steroidal-based inhalers that you use when you feel a spasm starting to come on and that will open up the airways and kind of reverse that spasm. If that’s something that you don’t want to do or you don’t want to use a steroidal inhaler, you can try natural remedies. I mean, they’re out there; oregano is one, for example, that was mentioned on this show before, when I conducted an interview on somebody about oregano and the many uses of that. You can listen to that interview at BenGreenfieldFitness.com/oregano. Other things that people will use are like, some of the curry extracts or curcumin extracts like a turmeric mixed in water or tea, like an herbal tea, local raw honey traditionally used for like allergies, pollen allergies things like that. That’s something that some people have used before for exercise-induced asthma. There are just a ton of natural remedies out there. One of the things that I have, is written by Carolyn Dean called “The Future Help Now” encyclopaedia, and it’s basically this awesome database of searchable herbs and supplements and natural remedies that can be used for conditions like this. So, I could fill up an entire hour of podcasting just with what’s in there on, asthma for example. I’ll put a link to her encyclopaedia in the show notes but I actually have a copy in my computer and I’ll open it up and press search and find and I can read up on a lot of this stuff; really easily with that encyclopaedia that she wrote so, very useful to have on hand. I’ll put a link to that in the show notes to this episode, Episode #134. Now, a lot of times there’s something called vocal cord dysfunction that exercise induced asthma or folks who have exercise induced asthma or have been diagnosed with exercise induced asthma or actually misdiagnosed and they actually have a vocal cord dysfunction. That’s something that can be fixed through therapy, through, kind of like a breathing and vocal therapy. You may want to look into vocal cord dysfunction and somebody in your area who may be able to help you out with that. You also want to make sure you avoid stark contrast in temperature and humidity when you’re exercising. Don’t go straight from your house or your office out into the cold area exercise. Gradually warm up or just avoid the cold altogether and stay indoors when those stark temperature contrasts exist or if you have to exercise in the cold, wear a scarf or some type of covering over your mouth so that it warms and humidifies the air just a little bit in the same way that your nasal passages might. But those are some things we look into; I’m not a doctor but I would definitely check to make sure that you don’t have vocal cord dysfunction. Look into some natural remedies; get your inspiratory and expiratory muscles stronger; consider a bronchodilator and also, watch the stark changes in temperature.
Kat : Do you know of any potentially harmful effects of chewing sugar free gum?
Ben : I think a lot of us don’t really know exactly what’s in our gum but if we analyze it, most gum today has 5 things in it. It’s got this gum base which is the part that’s kind of left in your mouth while your chewing; it has some type of sugar, either just regular sugar or else a sugar substitute like an aspartame, a sugar alcohol, sorbitol, xylitol etc; usually has some type of wax-based softener in there. Typically, in addition to the sugar, some type of flavouring in there which is usually an artificial chemical flavor and occasionally, you’ll get like real peppermint extract in a good gum and then a lot of times, the gum has artificial colours added to it so it just looks a lot nicer, like a red or white. So, in terms of the actual ingredients, if you pull gum of the shelves, like if you take like a peppermint excel gum and pull it off the shelf, the ingredients are maltitol, gum base, sorbitol, glycerine, gum, Arabic, natural and artificial flavours, mannitol, aspartame, artificial colour, acesulfame potassium, and carnauba wax. So, the first ingredient there’s maltitol – that’s a sugar alcohol. In most cases, there’s not enough of it in the gum to cause diarrhea or gas or bloating, but if you’re chewing lots of gum during the day, and any of the ingredients in the gum end with O-L indicate that they’re sugar alcohol, it may cause a lot of gas and bloating. So that’s something to think about. I’m not really against sugar alcohols that much, the fact that they can cause that gas and bloating because they’re just not digested all that well. The gum base, typically, is made up of some type of elastomer; they’ll use usually like a calcium carbonate as a filler; some of them will use like a talc as a filler, and the percentages of those are going to change based off of the type of gum that you’re chewing, like a bubble gum versus a regular gum. An elastomer is typically like a natural latex or a synthetic rubber, which is basically what the very first gum was, just rubber off the rubber tree. The resin that’s in there provides a body or a strength to the gum and usually, that’s derived from like a turpentine or a rosin, which is from a tree. Typically, there’s a wax, like a paraffin wax or a microcrystalline wax in there. A lot of times, they’ll put fats in there to plasticize the rubbery stuff that you chew on, and that typically comes from a hydrogenated vegetable oil. They put an emulsifier in there and that just basically, helps keep the gum moist; usually that’s lecithin or the other one that they’ll use is a glycerol monostearate; they’ll put a filler in there, again, to kind of give the gum a little bit more texture, and typically, that’s a calcium carbonate and sometimes, to prevent the gum from oxidizing, they’ll use an anti-oxidant in there, typically BHT is one of the more common ones and BHT stands for butylated hydroxytoluene and it’s basically an organic compound, you’ll find it in cosmetics pharmaceuticals; it’s used in petroleum products like jet fuel as well; they even embalm dead people in it so, lots of things going on there in that excel gum. The other things that I talked about, the glycerine, that’s just a syrupy liquid that’s chemically-produced; you can buy them in water and fat, and something vegetarians or vegans might want to think about is that usually, it’s coming from an animal source, the fat in that, and it’s just used to basically, to plasticize the gum. Gum arabic is typically going to come from the acacia tree – it’s a hardened sap taken from a couple different species of the acacia tree, and artificial flavours, they can come from anything. I read the US Code of Regulations on natural flavours a few weeks ago; I’ll give it to you again here. It’s the essential oil essence or extractive protein hydrosilate, distillate or any product of roasting, heating or enzymolysis, which contains the constituents derived from a spiced fruit juice, vegetable juice, edible yeast herb, bark bud, root leaf or any other edible portion of a plant, meat, fermentation products of flavouring rather than nutritional so, pretty much anything on the face of the planet could be used as a natural of artificial flavouring. The colours that they’ll use in there just vary – they’ll use the reds, the yellows, the blues, the typical stuff that you’d see in sodas and drinks, same stuff they’ve used in gum. The aspartame that you’ll find in most gum, that’s an amino acid; it’s not a naturally-occurring amino acid but it’s broken down in your body into aspartic acid, phenylalanine and methanol, and you can add further into formaldehyde, formic acid and a couple other compounds. People get head aches and intestinal cramping from aspartame, there’s kind of arguments that go back and forth about whether it’s a neurotoxin, but I’m pretty careful with that, as well as the acesulfame potassium for a lot of the same reasons. The wax that’s used in gum is taken from the leaves of a palm tree and it’s mostly just a bunch of fatty alcohols and fatty acids, same stuff they used in like car waxes or shoe polish or cosmetics. So, really though, all of these stuff is just in trace amounts in gum, so it sounds really bad when you hear about it all once, but it’s not something to worry you have to worry about if you’re like popping a couple pieces of gum in the afternoon to keep your appetite satiated. However, I personally, because I chew a lot of gum, I go for a natural gum; I use Spry and it’s really just like a natural peppermint oil extract with a little bit of xylitol, which is like a sugar alcohol added. It’s likely that chewing a couple pieces of, like the excel peppermint that I just got done talking about, is not going to hurt you that much but if you’re a chronic gum chewer, using it a lot to control your appetite, chewing gum all day long, you may benefit from going for a more natural gum source, but I think a lot of people just pop gum thinking that it’s so small that it couldn’t do any damage. Probably true, unless you’re chewing a ton of gum, like getting up there in the range of like 4-8 pieces per day, that’s when you’d want to start thinking about, maybe chewing out some stuff that might not be bad for you. So, last question; this question’s from Ryan.
Ryan : I recently read an article about lap band surgery and complications that are occurring with lap band surgery. I’d like your thoughts on this.
Ben : And Ryan sent me a link about people who were dying after getting lap band surgery. So, lap band surgery has nothing to do with music or bands – it’s basically this adjustable band that’s put around the upper part of your stomach, so it makes your stomach into the shape of basically like an hour glass, so it really slows how quickly food moves into the stomach – you feel fuller after eating less, and it’s a little less invasive than like getting your stomach stapled or removing a part of your stomach, and it’s also designed so that it can be inflated or deflated with minimal surgery to allow more or less food in, as the case may be. And so with that narrowed opening to the stomach, it can actually make it really hard to digest some foods, and if you don’t thoroughly chew your food, you’ll end up getting a lot of discomfort and if people are used to just mauling down their food, and then they get lap band surgery, they’re really not going to be in a happy place. I don’t know how these people died, but it’s likely that the complications to the surgery were not from them not chewing enough food, which just would’ve cause some gastric distress but more likely related to, I’m guessing some type of infection or error that occurred with the surgery. So lap band surgery, when performed in the right way, is not super dangerous (as long as there’s no hospital or physician errors involved) but, I’m not a huge fan of surgeries to control weight. However, if you simply cannot control your appetite, a lap band surgery is one of the less invasive surgeries that you could get; I’m totally against it, but I would definitely research the hospital or the physician who’s going to be doing the surgery on you because it’s very likely that most of these people had died from infections, not from anything related to the actual lap band or the physiological effects of the lap band itself. So, always something to think about when it comes to surgery; there’s tons of different surgeries you could get when it comes to controlling appetite – you can remove a part of your stomach, you can get a staple and you can bypass the stomach, but lap band is probably one of the safer, less invasive ones. So, those are all the questions and next, we are to move in to the interface technique with Kevin Christy after this special message.
Ben : Hey folks, Ben Greenfield here and, I get a lot of questions from you guys about different types of treatments and rehab protocols or ways to deal with injuries or biomechanical issues that may or may not be main stream. Today, I have a chiropractic physician and certified strength conditioning specialist on the call and his name is Dr. Kevin Christy, and Kevin is certified in something called Active Release Technique, as well as Active Release Technique biomechanics and well, he has lots of experience in many other areas of rehab and chiropractic issues. Today, we’re going to focus on ART; for those of you who don’t know what ART is, Kevin’s going to be explaining that and he’s going to be going into detail about how it’s actually used in athletes and the general population to really help increase range of motion, deal with injuries and do everything else that he’ll talk about today, so Kevin, thank you for coming on the call.
Kevin : My pleasure.
Ben : And of course, naturally, the first question is can you describe ART to us?
Kevin : Yeah, definitely! ART or active release technique is a motion-based soft tissue treatment, so one of the biggest difference that people always, our tissues in the body, the difference between this and say, other forms of the tissue work or massage and really, the active component is very important so, a lot of times, the patient and as well as the practitioner is moving quite a bit as we do and generally speaking, we’re trying to shorten a muscle or ligament tendon, get a contact on there and then release that, and by doing that, you’re going to lunge the muscle in such to release it and break up your scarred tissues, maybe your trigger points, it’s used in things of that nature and we’ll try to, as you said, increase range of motion. Blood flow back to the area, that’s a big part of the sealing. It reduces some of the pain symptoms and really try and increase the function of the muscles, so that’s in a short paragraph, that’s active release technique. A lot of people will describe it as a revolver, and so it’s not like you’re laying there and you’re getting worked on, it’s comfortable. We have a purpose in mind and so, when you’re getting the treatment done, you definitely can feel it but it’s not too much; it’s not overbearing but most people describe it as it would hurt.
Ben : When I first had ART performed on me, it was at an iron man triathlon and a lot of times, you’ll see you guys, your ART practitioners at iron man triathlon events and I’ve seen that a few half iron man events as well, and for me, the first time that I got ART was when I was dealing with some low back and some sacroiliac issues and I wanted to go see you guys prior to the race, kind of for me, it was a last ditch effort. I saw you guys over there and it ended up actually freeing up my back quite a bit and decreasing a lot of the tightness that I would usually experience during something like an iron man event, but I really didn’t know what to expect when I went in and sat there, and for people listening in who may want to be in a better boat than me and know what they’re getting into if they decide they’re going to go see an ART specialist, can you walk us through what a typical treatment might be? Like, can you make-up a fake issue and walk us through how you’d actually work on something like that, like what a typical session would look like?
Kevin : Yeah, definitely and, from my standpoint, I find ART biomechanics as what we can do, in which you mentioned, there’s a decent amount of providers out there that also has that, and they don’t know surely how to have the biomechanics to do video taping and such but a lot of times, in evaluation, let’s say a chronic hamstring strain; you’re going to do a lot of different things with that and you got that upper hamstring tendonitis, as some people would call it, and it’s kind of a misnomer, but you come in, you’ve had this for a while, bothers them when they run or maybe when they sit and such. One of the great things that the active release technique, besides that manual therapy aspect of it, is the diagnostic aspect of it and so, we’re really trying to figure out why it’s happening; obviously, our goal is to get rid of the pain but we also need to really think about why you’re having that and you knew that thing will just be a long system that’s going off, and there’s some altered biomechanics, neither could be other things like running form but I’m not a running technique guy, but there’re other things that can cause it but we really need to figure out the real biomechanical cause of it so, not only do we come up with a diagnosis to help you that you got a hamstring insertional tendonitis. Now, we figure out that with the tissue palpation, ART has really trained us to understand the texture of the muscle and tendons and ligaments and see, “okay, there’s an adhesion here or this is a little bit functional here” and really, take a part of the different aspects of the hamstring into the glutes, the ad doctors as well, so neither really know all the muscle glutes that are functioning during running, and if we say running, the only most we triathletes, we also, obviously, take into consideration swimming and cycling movements as well, but from there, we also need to take into consideration some functional testing that we do; we need to see how the glutes are functioning, so they’re doing some things like hip extension tests to see how it’s firing or the glute’s on time; lot of times, what we see when we have someone lying on there stomach and we palpate the hamstring glutes and the low back, and we have to perform a hip extension motion which is obviously very important in running and in walking, we’ll see that the hamstring and the low back dominate the textures and they won’t even make it out firing much at all, or they’re firing late and I say that because I’ve had professional athletes where you touch them, you get the most muscular glutes that you can possibly have and if they’re okay that they’re going to have strong glutes. Yes, but the firing of it is off, so it’s just a little bit late and their hamstring dominant, and it’s the same way with anybody else, any other patient that belongs, perform that hip extension during running, actually overusing that hamstring, not getting enough of the main player which is the glute, and so, we need to figure that out and a lot of times, we see opposite hip flexor tightness and a lot of times, they’ve tighten there, typically sitting too much but if you have a hamstring strain on say, your left and then you also want to check the right side hip flexor, because imagine, if that is tight and then you try to have a little bit of a stride length because the hip flexor is tight, it’s not going to allow the opposite leg to really swing forward because of that hip flexor causing the tightness there, and so we check things like that; obviously, that big one named topical stability, which now say sudden improper core stability, saying it’s close to be more of hip extension and running and also, single-leg stands and such, but improper core stability, that hamstring will actually substitute and acting as a stabilizer, and have a tough time also to recover. Overtime, it will affect things in there with the hamstring and say “okay, let’s just try to stabilize your pelvis, like they’re going to ask me to do hip extension not knowing, it’s hard to do both things consistently without causing some type of overused strength and you really need put together the puzzle of why that hamstring is doing that, and so, that…
Ben : So, this is why, for example, with like – I remember this and in the times that I’ve been to ART since then, people have me move and walk and jog and just stand there and watch me quite a bit before they even touch my body.
Kevin : I understand, and that’s part of their way of saying “visually, is there any compensations going on?” and that’s a big part of what we do. In our practices, if you’re in a situation like, if you said an iron man, you can’t really bust out the video camera and video tape it and put it on a computer in slow motion, but in a clinical setting, that’s what we do – try to figure out, is there anything we can see when you’re running and walking that’s going to show some sort of physical imitation, that might put overuse strain on that hamstring, and that’s just 1 example of how a hamstring issue can happen and how this, you know, you can get any type of injury and there’s usually a series of events or dysfunction that can lead to that and with the ART, if they really keep up with the certification and really honing on the biomechanics, that’s really what separated this, is really trying to paint an entire picture of the injury and sort of this, a lot of times when people go to a doctor and they get the diagnosis, they get 4-6 weeks of rest and they get a little bit of rest called standing sets, and that’s all they really get, maybe some medication and everything like that and it helps with their pain levels possibly, but they never were given a reason why they have it and a solution to prevent it from happening again, 6 months to a year down the road.
Ben : Right! So basically, the way that I understand it is you’re taking various muscles and attachments and manually pinning them or holding them down then moving the muscle to a range of motion. Is that really elementary description or what am I missing there?
Kevin : Well, I can give you the exact one because ART is patented so to do pan, then they have to be different in a way, and what we do and what we’re trained to do is we applied tension to the structure, not necessarily pressure, and it’s typically a thumb contact, just depending on the area that the body that we’re working on because we could use our fingers, typically, to get a thumb contact and we apply tension and we don’t have a lot of slide on the skin, so like we’re in a massage, it might be a lot of slide or some other forms, cross-friction massage and that would be a slide; there’s no slide so we put tension with no slide, we get right on to the adhesion in a long and truthful fashion of the muscle fibers, and then from there, we get it in a shortened position, contact without tension and no slide, and then we get a full length of the other muscles, and typically, we try to have the patient do it actively, so they’re actually doing the movement. Sometimes, depending on pain levels, tolerance or the structure, we might passively do it in forms, so we might grab their leg and go into, let’s say, hamstring stretch as we got a contact on there, whereas a lot of times, it’s actively done.
Ben : Gotcha!
Kevin : So it’s pretty much, the descriptive terms of ART, as far as what we’re doing.
Ben : Yeah! After a session, I’ve felt sometimes like I’ve just finished lifting weights because I’m moving various muscles through a range of motion, sometimes 10 times and I’ve noticed that the ART practitioners, a lot of times, tends to be sweating and grunting quite a bit too, so it is a very active form of treatment, both from the practitioners’ stand point and the person receiving the ART too, it seems.
Kevin : Yeah, definitely; I mean, that’s why there’s not a lot of chiropractors doing it and a lot of physical therapists doing it because it can be pretty casting on us, but it’s worthwhile in the end.
Ben : Right! Does someone typically see an ART practitioner want it, something that you’ll go back to for repeated sessions?
Kevin : Well, yeah. Obviously, I think the difference depending on the injury, the promiscuity of it that someone had it for a year, or it’s just been a week, there’s only been a difference treating plants. I usually tell my patients is that, let’s look anywhere between 2 and 8 digits, depending on certain things and how you respond, I mean, everybody’s different; I’ve never been a big fan of sitting up an exact treatment plan, full of patience to get everybody going to respond differently, some time of that look. We’re looking for a linear progression of reduced pain, increased function and as long as we’re getting that, we’re doing well and if we hit the long, up to 2 digits, we may have to look at a different angles but if I haven’t gotten progress, an insignificant progress, in a 6-8-digit mark, then we might need to look at something else because not everything, as I cure on, if there’s anybody that tells you that you’re going to get a 100% results, they’re lying to you but, we love to see a total resolution when one visits and does happen, there’s no doubt about that. I’m just a little cautious to give that as well, as a serious treatment plans if one visits because there’s just so many different factors and in my practice, there’s a little bit more to it than just ART so, a lot of times, I wait to do some other functional and video taping until some of the pain levels are down because some times, there’s a lot of pain that can fog your testing and your video taping because they are in pain, so you can’t get a true picture of what’s going on with them. And then, we also give a lot of corrective stretching exercises that we need to do, but with the active release technique, we’re definitely looking at reduced visit and that’s ultimately, our goal.
Ben : Gotcha! Now, are there certain things that ART shouldn’t be used for, in terms of soft tissue injuries or issues?
Kevin : Yeah, I mean, as soon as it stopped to, obviously, I get a lot of people who come in and they want to race or they’ve been running for a while and they’re a novice and such and the first thing, if you got some foot and ankle stuff or sin stuff, you got to do a lot of stretch fractures because obviously, stretch fractures, we’re not treating that; that’s more of a red situation and needs to be addressed such and an ART, that would be definitely contraindicated, but most soft tissue regions or adhesions or theories and things, ART could be a very big component to it. Now, it’s not the NLBL to every injury, that is soft tissue related, but if there’s usually, multiple stretch-ons are a great 1-2-3, and they got to take a serious, whole, an Achilles rupture, a calf rupture, things like that; there’s going to have to be a period of time where there’s rest and ice and some of those basic principles and where going to get on there manually. If there’s a significant bruising, we got to go right or go around the areas and things and so, I had a guy come in a couple days ago with, about a grade sheet cast, really swollen, really bruised and things like that could really put it through a lot of range of motion, so that can always be a limited thing in the range of motion issue, so they can’t move it at all. Obviously, it’s going to be hard to do active release technique if they can’t move their structures, so there are some of the contraindications to it, among superb, if you’re dealing with some special populations, I’d go into a whole host of things like diabetes and all these different things that you might see at the clinic and technically, a person with a really bad diabetic soreness, they’re not going to be active runners and such, and will go into all those different things.
Ben : Gotcha, okay. So, when you’re doing ART or someone’s going to see an ART, what thing should they be looking for in terms of certificates or flag if they’re wanting to?
Kevin : Okay! Actually, that is funny; I’ve had that question with Adders seminar with Dr. Leigh E who was talking; he’s the developer of ART and we’re at a big injury expo thing and it was full of FARTs, and he goes “where are the fake active release technique providers?” So, he calls them the F-A-R-T, and I’m saying that because we do have to keep up a certification every year, so I have to give out every year, to a different one, to keep up my certification, and there are people that were ART providers and you can only call yourself an ART provider if you can do keep up with your certification, and so they haven’t kept up with it for a few years, so they might not have gone to a seminar in 5 years and while they still say they do ART but technically, they can’t promote it; they can’t put it on their website, they can’t do things like that so, it’s something to look out for. Also, as far as certification, there’s a bunch of different levels of it but, if you’ve got a lower leg injury and as long as you’re in the ART provider list, on ActiveRelease.com, and as long as that provider has the certification for that and it’s broken down into upper extremity, lower extremity, spine and there’s biomechanics, nerve entrapments, master’s course, there’s a few other things out there that they have, but as long as they’re certified in your injury area – if you’ve got shin splints and they’ve got lower extremity, then fine. You got dysfunctional limbs, they got upper extremity, then it’s fine that the person that you want to seek out at that point, if you’re looking for the ART. So just make sure they have the certification or qualifications for your issue, and then there’s other things on top of it that you might want to look for if you want to get video taped or the biomechanics certification just means that I went through a certification to learn how to understand the biomechanics of the body, video taping; we were the ones that go to the iron man events, we have the treatment tents and things like that so, if you are an iron man, there’s actually an iron man provider listing which I’m on, and that means that we’ve gone people processed and gone to the iron man events, so those are different things I’m looking forward to but, at a minimum, just make sure that they’re certified in the body part region that your injury is in, and you should be in good hands, and there’s no guarantee for that obviously, but that’d be the best way to go.
Ben : Gotcha! Well, 1 last question for you. We get a lot of people, probably the most common injury that people, especially right into this show with, is problems with the IT bands, specifically like tightness, IT bands friction syndrome, pain on the outside of the knee, pain, kind of up, in the outside of the hip from the IT band; if some were going to go see an ART practitioner for IT band friction syndrome, what would they need to expect in terms of what would be done with them at the session?
Kevin : Okay! Yeah, IT band obviously, is everybody runners’ nightmare. As a practitioner, we don’t like to see our patients get it because it is a little bit of an actual crime but, going to an ART provider with this, typically, the ART structures that they will work on, is obviously IT band; we really try to strip that and lengthen it because it’s typically a tightening of that, just suddenly, that can cause it to rub. There’s a little bony prominence on the outside part of the knee, and the IT band which makes it unique, is that it comes out from the hip, the chia-fill muscle comes all the way down, the tendons are a lot longer than the actual muscle that it comes from, which is rare, and then it crosses the knee joint, and when it gets a little bit tight and then you flex that knee from 0-30 degrees, that’s when you rub, can cause some frictioning over that bony prominence and you get the overtime, the inflammation there, then it shields like someone’s going to stab you with a knife on the outside of your leg, that’s what it is, the inflammation response to that friction. Well, typical structures that need to be addressed, and this is going to cost heavily, typically, is obviously the IT band, so they’ll probably work from the attachment point from below the knee joint all the way up into the hip; they’re not getting up to the hip, they’re going to be brought down because you definitely got to get up into that chia cell. Typically, the chia cell muscle is becoming tight because the gluteus media is in the glutes arc, functioning right to stabilize that hip during 1-leg stands, which is running – you’re going to go from 1 leg to 1 leg, and so you really got to make sure that we get rid of any of the heathens or trigger points in those areas to correct the function of that muscle, but vastus lateralis, which part of the quadriceps which is on the outside part of the knee and it kind of blends into where the IT band is, that tends to become tight. Then the VMO muscle, when the VMO is also part of the quadriceps, which is more on the inside part of the knee, that muscle actually, kind of, becomes weak but if there’s adhesions in there, it’s going to be hard for that to activate properly, and so you’re going to get a little bit of a vitello tracking issue there with the tightness on the outside and the weakness on the inside, so you’re going to make sure that’s addressed, and then I always recommend on getting to the hamstring part, specially the lateralis aspect, I wanted to see how that’s going there and making sure that things are alright with that, but those are, at a minimum note, the basic structures that should be worked on from an ART standpoint, as long as there’s dysfunction there, you can always go to the rectus femoris as well, which is another part of the quad that’ll become tight on people. Another structure that people forget about, sometimes, is the hip flexors – regarding this, you need to make sure that’s going well but you know, which runs on the side part of your low back, that’s 1 that you want to be addressed. And then, there’s a more of your direct muscles and in it directly, you need to test things like, you got to check the flamenco function; a lot of times, if their positions were back, that’s going to cause some probably issues with the IT band because you might get a medial inward migration of the knee, which you’re going to put a stretch on the IT band, and if they got really flexed, then that’s going to cause some infra-rotation to the tibia, the lower leg bone, that will also put a stretch on the IT bands, so those are all things that really need to be addressed as well. Leg length issues, and analysis from an ART standpoint, there’s not a lot we’re going to do with leg length issue, but you need to address it with other avenues of tear as well so, expect some soreness when you do get the IT band treated; you’re going to find some of these hot spots along the IT band that is causing dysfunction and ART providers are going to get on there and really try to break those up so, sometimes, treatment for the IT band goes past that – a good hurt into a more of a hurt, and just understand that and it’s just a process, but typically, a little bit of dilative tear for the inflammation area, your eyes, maybe your modalities and structures try to decrease that, and then the ART providers are going to try and correct the structures that are causing it.
Ben : Cool. Well Kevin, that was very informative and for listeners who are listening in, who are down in Florida area, that’s where you’re at right?
Kevin : Yeah, definitely. We’re in South Florida, Brookstone in the Fort Lauderdale plantation area.
Ben : Cool! Alright folks so, if you have questions or comments, remember, you can go to the show notes for this episode and leave them there. Kevin, thanks for coming on.
Kevin : My pleasure, thank you very much.
Ben : Alright folks, until next time. This is Ben Greenfield and Kevin Christy, signing out from BenGreenfieldFitness.com.
Ben : Well folks, that’s going to wrap it up for this week. Be sure to visit the show notes to this podcast, podcast # 134, where you can check out everything that I talked about, including the oil of a regina, the baff flakes, the Future Health Now encyclopaedia, links to my breakfast post and more on that, and everything else that I’ve discussed, so be sure to go over to BenGreenfieldFitness.com and to iTunes and leave the show a ranking, it really helps out with our iTunes popularity. So until next time, this is Ben Greenfield signing out, from BenGreenfieldFitness.com.