Advanced Techniques For Healing Injuries

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This presentation .pdf from a USA Triathlon webinar by Ben Greenfield will teach the injured triathlete or triathlon coach how to go beyond the simple "ice it" principle of injury recovery, and incorporate technologies such as automated compression, nutrition supplementation, meal modification, physical therapy modalities, cold laser and other tactics used by professional sports teams, but underutilized by the general coaching and triathlete population.

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  • Thanks for all of this information on healing injuries. My mom is going through excruciating back pain and she has done all sorts of things from medicine to acupressure, and nothing seems to be working. I will tell her some of the ideas I read about in here to help her, so thanks again! http://www.elledgechiropractic.com
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Advanced Techniques For Healing Injuries

  1. 1. 1 Advanced Techniques for Faster Injury Recovery Ben Greenfield This webinar will teach the injured triathlete or triathlon coach how to go beyond the simple "ice it" principle of injury recovery, and incorporate technologies such as automated compression, nutrition supplementation, meal modification, physical therapy modalities, cold laser and other tactics used by professional sports teams, but underutilizied by the general coaching and triathlete population.
  2. 2. 2 Cumulative trauma disorder is the major injury problem in the workforce and the general population in this country. CTD is a group of injuries to the muscles, tendons, bones, blood vessels, fascia and/or nerves. CTD results from acute injury, repetitive injury, or a constant pressure/tension injury. All of which lead to what we term the cumulative injury cycle. The Cumulative Injury Cycle The cyclic nature of injury has been described for many years.
  3. 3. 3 Double Edged Sword The acute inflammatory response to tissue damage is of great value. By isolating the damaged area, mobilizing effector cells and molecules to the site, and — in the late stages — promoting healing, inflammation protects the body. Inflammation is the body’s first line of defense against injury and infection, but it’s a double-edged sword. An out-of-control inflammatory response can destroy healthy tissue and cause more damage than the original problem. Keeping it under control means the immune system must maintain a balance between fanning the flames of inflammation and cooling it down. Peter A. Ward (M.D. 1960, Residency 1963), the Medical School’s Godfrey D. Stobbe Professor of Pathology, has devoted his career to understanding the interactions among genes, cells and signaling molecules involved in this delicate balancing act. “When immune systems go awry, virtually without exception the problem begins with the triggering of a strong inflammatory response,” Ward says. “All autoimmune diseases — such as rheumatoid arthritis, psoriasis, lupus or multiple sclerosis — are diseases in which the inflammatory response is unregulated, excessive and out of control. So understanding the inflammatory system from A to Z will have huge applications in any number of diseases or clinical situations.”
  4. 4. 4 In This Presentation  Traditional Techniques  Newer “Fringe” Techniques  Nutritional Techniques
  5. 5. 5 Disclaimer These statements have not been evaluated by the FDA. No techniques or products on this presentation are being prescribed, and no techniques or products on this page are intended to diagnose, treat, prevent or cure disease. Please speak with your physician prior to trying anything I talk about.
  6. 6. 6 Traditional Techniques  RICE  Ultrasound  Electrostimulation  Massage  NSAID’s  Leeches
  7. 7. 7 #1: RICE  Acute Response  Methods?  Dixie Cups  Ace Bandages  Ice/peas/carrots  Chemical Ice?  Ice Baths Cryotherapy is the application of cold packs to an injured area. The goals of the therapy are to help reduce acute pain in addition to the swelling and muscle spasm often associated with injury. Cryotherapy is usually performed in the first 48-72 hours after the initial onset of injury. However, cryotherapy can also be used in chronic conditions when bouts of acute, inflammatory exacerpations take place.
  8. 8. 8 Wraps  coldoneinc.com  icewraps.net  thermotekusa.com  ACE
  9. 9. 9 GameReady  gameready.com
  10. 10. 10 Heat?  Post-acute period  Warm-up
  11. 11. 11 #2: Ultrasound  Sound waves --> vibration --> heat  Scar tissue break-up  Expense  Efficacy? Ultrasound has long been used to treat soft-tissue injuries. From tendonitis to bursitis to frozen joints and pulled muscles, ultrasound has been touted as the “miracle-machine” of physiotherapy. However, according to a study conducted at Ohio State University and reported in the International Journal of Sports Medicine, ultrasound may not do anything for musculoskeletal injuries.
  12. 12. 12 #3: Electrostimulation  Electrical current  Contraction --> heat/blood flow  Accuracy/pad placement  Not TENS  Frequency Specific Microcurrent  Combine with Ice Electro-Muscle Stimulation (EMS) is a unique form of electrical current that is administered at the site of an injury. The primary uses for this therapy is to help reduce pain and swelling while improving general muscle tone in the injured area. EMS can be used in conjunction with moist heat or ice therapy prior to chiropractic spinal adjustments. For example, there is one frequency that is only useful for shingles and herpes. In the shingles prodrome it eliminates the pain and prevents the blisters from breaking out. In herpes outbreaks it eliminates the pain and heals the blisters in hours with only a one hour treatment. This frequency combination is only good for this purpose and is not useful for anything else. We have not found anyone it does not work on or any other condition for which it is useful. The frequency to reduce inflammation reduces inflammation in a blinded animal study more effectively than any drug ever tested in this animal model. No other frequency reduced inflammation at all. The frequency specific effect is remarkable and reproducible. There are FDA restrictions on what we can say, report or claim as an effect of the use of microcurrent as a device for the treatment of any condition other than a general "treatment of pain" statement. Microcurrent instruments are all approved under the general class of "TENS" devices even though microcurrent is 1000 times less current than TENS.
  13. 13. 13 Home Units  Shopcompex.com  Globussht.com
  14. 14. 14 #4: Massage  Blood flow/relaxation  Adhesions/scar tissue  Practioners  Local sports clubs/teams  Angieslist.com  Ncttmb.org  Foam Roller/Stick National Certification Board for Therapeutic Massage and Bodywork ... Therapeutic sports massage is a type of massage technique that focuses on treating soft tissue aches, pain and injuries that are associated with recreational activities. Massage can reduce muscle stiffness and improve relaxation by reducing heart rate and blood pressure. While many athletes are convinced of the physical benefit of massage, research on its effectiveness is currently limited. Massage involves applying mechanical pressure to the soft tissues, and this is believed to result in improved muscle flexibility, increased range of motion in the joints, and decreased muscle stiffness. The pressure of massage may also improve blood flow during the massage and increase muscle temperature. Massage reduces heart rate, blood pressure and cortisol levels. Most people report a feeling of pure relaxation, reduced anxiety, and improved mood as a result. Athletes may indeed find an edge in these psychological benefits. On the other hand, very little scientific evidence supports claims that sports massage improves performance and prevents injury. A limited amount of research finds that post-exercise massage reduces the intensity of muscle soreness, but has no effect on the muscle functional loss (weakness, fatigue, decreases in strength, etc.) that often occurs after intense training or competition.
  15. 15. 15 #5: NSAID’s  Inhibit Prostaglandin/pain  Quick relief  Good for acute use  Problems  Inhibit healing long term  Gut/ulcer/stomach irritation  Liver/kidney toxicity  Topical NSAID’s? David Nieman, a well-regarded physiologist and director of the Human Performance Laboratory at the North Carolina Research Campus, was asked to study the affects of a 100-mile race on the affects of muscle and the immune systems of the participants. After looking at racers’ blood work, he determined that some of the ultramarathoners were supplying their own physiological stress, in tablet form. Those runners who’d popped over-the-counter ibuprofen pills before and during the race displayed significantly more inflammation and other markers of high immune system response afterward than the runners who hadn’t taken anti-inflammatories. The ibuprofen users also showed signs of mild kidney impairment and, both before and after the race, of low-level endotoxemia, a condition in which bacteria leak from the colon into the bloodstream. NSAIDs actually slowed the healing of injured muscles, tendons, ligament, and bones. “NSAIDs work by inhibiting the production of prostaglandins,”substances that are involved in pain and also in the creation of collagen, Warden says. Collagen is the building block of most tissues. So fewer prostaglandins mean less collagen, “which inhibits the healing of tissue and bone injuries,” Warden says, including the micro- tears and other trauma to muscles and tissues that can occur after any strenuous workout or race. The painkillers also blunt the body’s response to exercise at a deeper level. Normally, the stresses of exercise activate a particular molecular pathway that increases collagen, and leads, eventually, to creating denser bones and stronger tissues. If “you’re taking ibuprofen before every workout, you lessen this training response,” Warden says. Your bones don’t thicken and your tissues don’t strengthen as they should. They may be less able to withstand the next workout. In essence, the pills athletes take to reduce the chances that they’ll feel sore may increase the odds that they’ll wind up injured — and sore.
  16. 16. 16 “Fringe” Techniques  Cold Laser/Infrared  Vibration Therapy  Acupuncture  Magnets  Kinesiotape  Topicals
  17. 17. 17 #6: Cold Laser  Non-heat producing light laser  AKA infrared  Circulation/heat/cell function  Erchonia  Vetrolase.com  Coldlasertherapy.us When the body has an injury the cells are damaged and fail to function within normal parameters. Energies from the Cold Laser penetrate deeply into the skin and work by restoring normal cellular function. Cold Laser uses a non-heat producing light laser, which is locked at a specific wavelength that is optimal for treatment and can penetrate deeply into tissue. Cold Laser or Low Level Laser Therapy is emerging as a premiere therapeutic modality in the healing arts community. The biological effects of Low Level Laser Therapy have been shown to significantly accelerate and enhance the body's natural defense and repair abilities. By reducing inflammation as well as enhancing specific repair and healing processes, Low Level Laser Therapy has been proven to provide pain relief, reduce cell damage due to the injury and resulting loss of function. Low Level Laser Therapy enables the body to have a more rapid repair and stronger tissues once healed. Physiologic effects include improved metabolism, circulation and tissue healing. To treat top athletes in order to return them to competition at a much accelerated pace. If you remember, a few years ago, Lance Armstrong and the US Postal Service team were involved in quite a few bad wrecks, yet they were able to race the next day. According to Jeff Spencer, Armstrong's chiropractor who treated him with Cold Laser, if an injured athlete can get in for laser treatment within 2-3 hours of the injury, rehabilitation time can be cut in half. Biostimulation = more oxygen = more circulation= more healing potential = laser light exposure at certain wavelengths near 635nm stimulate cellular mitochondria (the energy generators) of our cells, to produce more ATP.
  18. 18. 18 #7: Vibration Therapy  Blood flow/hormonal response  Plates/platforms/handheld  Turbosonicusa.com  Vibeplate.com  Powerplate.com The sonic vertical movement of the plate stimulates the body’s natural “stretch reflex” which causes a spontaneous muscle contraction to instinctively stretch and contract: both movements occur at varying rates between 3-50 times per second. (3Hz to 50Hz) This movement produces mechanical oscillations with an average cycle length of about 40 msec, which is the time required to induce a natural monosynaptic stretching reflex in the respective muscle via the muscle spindle during one up and down vertical movement. The neuromuscular system reacts to this stimulation by a chain of rapid muscle contractions which result in entire-body vibration. Exercise causes the body to tire; rest allows the body to recover. By repeating this process, the body adjusts to the level of effort, resulting in an increase in physical performance. This phenomenon, called super-compensation, similarly occurs when training on the TurboSonic® platform. However, compared with traditional training methods, greater results are achieved and hormonal production is increased in much less time when training on the TurboSonic®. TurboSonic® comes standard with seven preset automatic program modes to provide a variety of treatment and workout options with multiple frequency and intensity variations per session. If different parameters are desired, the manual controls may be customized for effective patient treatment or personalized workout. Frequencies can be adjusted from 6Hz to 45Hz on the Deluxe model and 3Hz to 50Hz on the Premium model. Each model can adjust the amplitude from 0 to 100 to suit the user's condition. It is aware that vibration therapy exercises show increased body’s natural capabilities of healing itself improved cellular oxygen circulation, enhanced cellular fluid movement, assisted cellular waste movement, and stimulated cellular nutrient intake
  19. 19. 19 #8: Acupuncture  Blood flow/decreased inflammation/endorphins  Licensure important  Acufinder.com  www.aaaomonline.org Acupuncture involves the introduction of specialized needles into the skin at predetermined pressure points. The needles are constructed of very thin steel, of varying sizes. Each pressure point is a part of a larger, interconnected system of muscular and skin channels, which act as energy pathways, or meridians, throughout the body. Acupuncture is premised on the belief that the introduction of the needles to provide pressure at the appropriate points will enhance the release of the body's natural energy, the metaphysical energy force known as qi (or chi), which in turn assists in the restoration of proper blood flow, and a corresponding reduction in pain and increased health and recovery at the injured area. In essence, the therapy is designed to encourage the body to release its own natural recuperative powers. The needles are directed into the pressure point to a depth of approximately 1 in (2.5 cm). In a typical treatment, the needles will remain in position for between 20 and 40 minutes. Omoxibustion is a variant of the acupuncture application, in which heat is applied to the acupuncture points for the same purpose. Some states require that acupuncturists be licensed in order to perform treatment--check the Acupuncture Laws and Legislature page online (see Resources below). Make sure your therapist is properly licensed.
  20. 20. 20 #9: Magnets  Blood flow  Vessel constriction/dilation  Convenience  Pads/sleeves/wraps  “Nikken”  Magnetic Pulses  ONDAMED/biofeedback Of course, similar results can also be achieved by applying an ice pack and compression, but that's not always convenient. A magnet, of just the right power, could be carried in a school nurse's packet, or in an athletic trainer's bag, and always be available within seconds of an injury. But at this point no one knows just the right dosage, or in this case the necessary magnetic strength, to match up with which injury. One size won't fit all. Skalak said it would take a much stronger magnet, for example, to treat a thigh muscle than a sprain in the small finger. And, as he pointed out often during the interview, no one knows yet if it will work at all in humans. But Skalak sounds optimistic, based on many years of experience in a relatively narrow field. He is an expert on the smallest blood vessels in the body, ranging from five to 200 microns in diameter, or about one fifth of a millimeter. "These are very small blood vessels, and they are in all the tissues in your body," he said. "We like to think that's where the action is. That's where oxygen gets delivered, and it's where waste products get removed from your tissues. New research at the University of Virginia shows that there is at least some truth to the oft-cited claim that magnets can increase the flow of blood, thus providing more oxygen and nutrients to injured tissue. Researchers have shown that a mild magnetic field can cause the smallest blood vessels in the body to dilate or constrict, thus increasing the blood flow and suppressing inflammation, a critical factor in the healing process. "These small arterials can open and close because they have a layer of smooth muscle wrapped around them," he added. "They can increase their diameter, thus delivering more flow to a given tissue, and they can decrease the diameter, just like opening and closing a garden hose changes the flow of water.” When a magnetic field was applied to the paws of the lab rats, the vessels that had been dilated constricted, and the constricted vessels dilated, suggesting that the magnetic field "induced vessel relaxation in tissues with constrained blood supply, ultimately increasing blood flow." The mechanism is not fully understood, he added, but he suspects the magnetic field alters the flow of positively charged calcium ions that interact with the muscles around the small blood vessels, causing them to dilate or constrict. ONDAMED® works by using mild sound and accompanying magnetic pulses to stimulate the body at various frequencies. A medical practitioner monitors the response of the autonomic nervous system to these frequencies by noting changes in the pulse and informs the patient of findings, thus providing the information needed for biofeedback to occur. The identified stimulating sound and magnetic frequencies are then temporarily applied to identified areas while the patient relearns how to be in a healthier state. A key feature of ONDAMED is that relaxing frequencies are part of the re-education process. Many studies have shown that tension and stress reduce feelings of wellness and the addition of relaxing frequencies help re-establish the proper balance between the sympathetic nervous system and the parasympathetic nervous system.
  21. 21. 21 #10: Kinesiotape  Mimic skin elasticity  Lift skin from soft tissue  Blood flow/lymph drainage  Rocktape, Spidertech  Kinesiotaping.com Unlike traditional athletic tape which binds and doesn稚 stretch, certain forms of something called 徒inesiology tape� are engineered to mimic human skin, with the ability to stretch to up to 190% of original length but still retain 痴nap-back� or recovery. To achieve this, a weave in the tape will stretch in only one direction and the tension of the weave is engineered to mimic the same elasticity as skin. This means that the tape can lift the skin away from the soft tissue underneath the skin, thus promoting blood flow and lymph drainage. A kinesiology tape like this can also be used to stabilize muscles and joints that have been sprained or hurt. Unlike braces and sleeves that constrain and reduce blood flow, tape can provide support and stability while still allowing for increased blood flow, making it well suited to the repair of localized muscle groups.
  22. 22. 22 #11: Topical Anti- Inflammatories  Ingredients:  Arnica, magnesium, epsom salts, MSM, menthol, aloe vera  Pain relief, reduced bruising/swelling, blood flow  Brands:  Traumeel, Ancient Minerals, ActionWipes Arnica works by stimulating the activity of white blood cells which process congested blood, and by dispersing trapped fluids from joints and muscles and bumped and bruised tissue. It also has anti- inflammatory and anti-bacterial qualities and it is these that help to reduce pain and swelling as well as improving wound healing. Additionally, magnesium regulates calcium levels. As calcium works to contract muscles, magnesium relaxes the muscles, creating a state of balance. When the body contains excess calcium, deposits build up on the artery walls. With sufficient magnesium, those deposits disappear, clearing the arteries for increased cardiovascular health.
  23. 23. 23 Nutrition Techniques  Anti-Inflammatory Diet  Vitamin C  Proteolytic Enzymes  Fish Oil  Iron  BCAA’s  Phenocane  Glucosamine Chondroitin
  24. 24. 24 #12: Anti-Inflammatory Diet  Sugar --> acidity --> inflammation  Tips:  Avoid cereals/grains/sugars/nightshades/ processed fats  Eat dark skinned fruits/vegetables  Cold-water fish  Nuts  Green tea Pro-inflammatory foods will increase inflammation, increase your pain from the inflammation and may also raise your risk for chronic disease. Loading up on junk foods, high-fat meats, sugar and fast foods will increase inflammation in your body. This is partially due to the unhealthy fats used in preparing and processing these foods, especially trans fats and saturated fats. Processed meats such as lunch meats, hot dogs and sausages contain chemicals such as nitrites that are associated with increased inflammation and chronic disease. Saturated fats are also found in meats, dairy products and eggs. While all of these foods are important source of minerals and vitamins, you don't need the extra saturated fat. These foods also also contain fatty acids called arachidonic acid. While some arachidonic acid is essential for your health, too much arachidonic acid in the diet may make your inflammation worse. Be sure to choose low fat milk and cheese and lean cuts of meat, which will not promote inflammation. Diets high in sugar have also been associated with inflammation, obesity and chronic disease such as diabetes. Eliminate high sugar foods such as sodas, soft drinks, pastries, pre-sweetened cereals and candy. Another possible source of irritation comes from the nightshade family of plants. Whole fruits and vegetables are important to eat for their vitamins, minerals, and natural antioxidants. However some vegetables like potatoes, tomatoes, and eggplant may actually make pain from inflammation worse. These vegetables are part of the nightshade family of plants and contain a chemical alkaloid called solanine. Solanine can trigger pain in some people. While there isn't any formal research findings that back the claim about nightshade plants, some people believe they get relief from the symptoms of pain and inflammation. Diet is a key part of inflammation-fighting, and some foods have amazing anti- inflammatory properties. Here痴 the overview of a eating plan: -Avoid cereals and grains. Among the top culprits are breakfast cereals, non- sprouted bread, and pasta. Instead, choose gluten-free cereals, or whole grains like quinoa, amaranth, and millet. -Eat dark-skinned fruits and vegetables. Pomegranates, cherries, blueberries, plums, artichokes, spinach and broccoli are excellent. -Eat cold-water fish. Salmon and mackerel are best. -Drink green tea. Or take a green tea extract, like Thermofactor. -Eat nuts. Walnuts, almonds, pecans, pumpkin seeds, and flaxseeds are highly effective anti-inflammatories. Here is a sample daily meal plan that fights inflammation: -Breakfast: 1 cup cooked quinoa with handful of blueberries, 1 tablespoon almond butter and dollop of yogurt. Take glucosamine chondroitin prior to breakfast -Mid-morning snack: Plum, 1 cup unsweetened pomegranate juice, or handful of cherries. Include 1 handful of walnuts, pecans, or pumpkin seeds. -Lunch: Steamed broccoli with one baked sweet potato and 2 boiled eggs. -Mid- afternoon snack: One slice sprouted bread with goat cheese and avocado. -Dinner: Steamed spinach with salmon cooked in olive oil and seasoned with sea salt, cayenne and turmeric. -Dessert: 1/2 bar dark chocolate dipped in yogurt. -Post-Workout: take vitamin C, branched chain amino acids, and iron
  25. 25. 25 #13: Vitamin C  Collagen/connective tissue formation  Enzyme activity  Antioxidant  1-2g  Risk  Gut discomfort  Sugar Back in the 1940痴, during World War II, physicians began routinely giving their surgical patients 1000 mg of vitamin C daily for three days before surgery, followed by 100 mg of daily C during recovery. These docs reported in the British Journal of Surgery reported that wound disruption, or failure of wounds to heal properly, decreased by 76 per cent. They then found a a three- to six-fold increase in wound strength, reported in the New England Journal of Medicine, and then Russian researchers showed that surgical patients who supplement with Vitamin C are discharged from the hospital one to two days earlier, compared to individuals who receive no Vitamin C. This all makes perfect sense, since Vitamin C plays a critical role in collagen formation, and collagen is the primary component of connective tissue, and is essential for repair and healing. Vitamin C also increases the activity of enzymes critical to normal metabolism, works as an antioxidant that limits free- radical damage to tissues, and boosts the growth of fibroblasts and chondrocytes, which are cells that produce connective tissue fibers and cartilage. Sure, your gut might hurt a bit at 1000 mg of Vitamin C per day, but your wounds and injuries could certainly heal faster. Just do yourself a favor and don稚 get your C by chugging orange juice, since the OJ is high in acid-producing sugars that can actually retard recovery,
  26. 26. 26 #14: Proteolytic Enzymes  Trypsin/Chymotrypsin/Papain/Bromelain  Anti-inflammation, Protein digestion, Protein activation  Empty stomach  Examples  Wobenzymes  Recoverease  Pineapple/Papaya The inflammatory process starts when the body is assaulted in some manner. This can be tissue damage due to injury, such as twisting an ankle or being cut, or invasion by a foreign assailant, such as bacteria, viruses or—according to some sources—undigested food seeping from the digestive tract into the bloodstream. In most cases, the body responds instantly with a full frontal attack. A host of chemical compounds known as inflammatory mediators regulate the entire process. These include histamine, prostaglandins, kinins, leukotrienes and a group of plasma proteins making up the complement system. Their function is to choreograph the vascular and cellular effects of inflammation. Blood flow to the injured area increases, while blood flow away shuts down. Blood vessels become more permeable, fluid seeps into the tissues, and the capillaries become engorged. These events all result in three of the four cardinal signs of inflammation: swelling, redness and heat. How Do Proteolytic Enzymes Function? Enzymes work with the body’s innate mechanisms to promote healing and allow inflammation to progress naturally. They support the production of various cytokines, activate large proteins, such as alpha- 2-macroglobulins, and slow the clotting mechanism, which provokes a healthier healing response.
  27. 27. 27 #15: Fish Oil  High Omega 6:Omega 3  Eicosanoids  Prostaglandins/cytokines  Cell membrane/growth/delivery  Others  Flax/Hemp  Udo 3-6-9 omega 6 eicosanoids are pro inflammatory, omega 3 fats produce anti inflammatory eicosanoids f you want to avoid oils that have been exposed to this refining, bleaching, and deodorizing process, look for either cold-pressed or unrefined on a product’s label. Both terms mean that a mechanical process was used to extract the oil rather than chemicals. Udos: organic flax seed oil; organic sunflower seed oil; organic sesame seed oil; rice and oat germ oils; organic coconut oil; organic evening primrose oil; lecithin (guaranteed GMO-free); vitamin E; antioxidants (tocotrienols); and rosemary oil Nutrient interventions may provide benefit; specifically there is plausible biologic rationale for administering n-3 fatty acids (n-3 FAs) found in fish oil to patients with ALI, as n-3 FAs decrease formation of eicosanoid inflammatory mediators.
  28. 28. 28 #16: Iron  Ferritin/injury correlation  Hypoxia -> fatigue -> injury  Esp. for females  Risks  Stomach Upset  Toxicity  Meat, poultry, fish, eggs, dark veggies  Ferritin pyrophosphate Research at the Center for Sports Medicine in San Francisco examined 101 female high school runners were monitored over the course of a cross-country season, and found that runners who were injured had average ferritin levels that were about 40-per cent lower than those found in non-injured runners. The runners with the lowest ferritin concentrations had twice as many injuries as the runners with highest ferritin. What the heck does that have to do with Iron? Simply put, ferritin is your body痴 critical iron storage protein. The idea is that since iron is a key component of hemoglobin, the compound which carries oxygen to muscles and other tissues, it's possible that athletes with low ferritin have decreased oxygen delivery to tissues, become fatigued more easily during workouts and races, and then end up with exhausted muscles that are less able to stabilize and support the knees and ankles � which were incidentally the two primary sites of injury in the study above. Furthermore, Medicine and Science in Sports and Exercise suggests that low ferritin might also decrease the rate at which muscles and connective tissues are repaired, allowing minor injuries to mutate into major problems.
  29. 29. 29 #17: BCAA’s  Leucine, isoleucine, valine  Decreased inflammation/inflammatory markers  Examples:  Recoverease (also includes proteolytic enzymes)  Protein Powders  Methionine/cysteine/glutamine Theoretically, after digestion once protein is broken down into individual amino acids these amino acids can either be used to build new proteins or be burned as fuel to produce energy. If the athlete's diet is adequate in nutrition then the above "essential" amino acids will be used for protein synthesis which is optimal for advanced human performance. It should also be noted that essential amino acids are not produced in the body such as non-essential amino acids, but rather obtained through proper nutrition. For example, another study performed by Ohtani et al (29), a thorough before and after analysis concluded that markers for physical conditioning, fitness, and endurance greatly improved. In fact, only 2.2 g of the amino acid mixture three times a day significantly improved other physiological markers such as: red blood cell count, hemoglobin, hematocrit, serum albumin, fasting glucose, and a decrease in creatine phophokinase (p<0.05), suggesting increased hematopoiesis and glycogenesis, and rapid alleviation of muscle inflammation by the amino acid mixture. In addition to the BCAA痴, methionine, cysteine, and glutamine are three other beneficial amino acids for endurance athletes. The first two can stimulate production of glutathione, a powerful antioxidant that assists in recovery from intense exercise bouts, as well as supporting immune and liver function. Glutamine also helps to preserve and rebuild lean muscle tissue.
  30. 30. 30 #18: Phenocane  Ingredients:  Curcumin  Phenyalanine  Boswellia  Nattokinase  Alternative to NSAID’s Curcumin: Curcumin is a widely recognized anti-inflammatory. It has proven in studies to be as effective in reducing inflammation as cortisone. Curcuminoids: These are the sub particles that make up curcumin. Curcuminoids are the extremely potent, reduced parts taken from curcumin, which is reduced from the herb called turmeric. Curcuminoids have been found to be very powerful COX2 inhibitors and are the key ingredient of Phenocane Curcumin Plus. dl phenylalanine: Otherwise called DLPA. DLPA is a beneficial amino acid that is noted for helping the body maintain higher levels of serotonin. Serotonin is a hormone produced in the brain that promotes good feelings and has been proven to elevate mood, which then helps reduce feelings of pain. Boswellia: Boswellia is an herb that is also fairly well-known for its ability to inhibit COX2 in the body. It operates by a slightly different mechanism than curcuminoids, causing it to enhance and maximize the COX2 inhibiting activity of Phenocane Curcumin Plus. Nattokinase: This enzyme has been found to help reduce blood clots, thus, diminishing possible negative side effects from Phenocane as a COX2 inhibitor. Nattokinase is derived from the vegetable cheese called Natto, which is a popular soybean food in Japan.
  31. 31. 31 #19: Glucosamine Chondroitin  Components  Amino sugar/cartilage formation + repair  Carbohydrate/water retention, elasticity, enzyme inhibition  Risks  Blood pressure  Shellfish allergies  Efficacy?  Combine Proteolytic Enzymes  Example: Capraflex Glucosamine, an amino sugar, can promote the formation and repair of cartilage. Chondroitin, a carbohydrate, is a cartilage component that can promote water retention and elasticity and also inhibit the enzymes that break down cartilage. Both compounds are manufactured by the body, and completely necessary for proper joint lubrication and cartilage regeneration. Glucosamine and chondroitin all by themselves don稚 work too well. However, when combined with a cocktail of organic and natural ingredients, including traditional herbal and botanical joint support, collagens and minerals, the stuff gets magnified and works pretty damn well. Here are three vital components you need to look for in a glucosamine-chondroitin blend: -proteases, like bromelain, papain, amylase, lipase, cellulase and peptidase� -natural anti-inflammatories, like cherry juice, ginger, turmeric, white willow bark, feverfew or valerian� -a mineral blend, like calcium, magnesium, silica and l- carnitine�
  32. 32. 32 Example  IT Band  Preventive  Anti-inflammatory diet  Vitamin C/Fish Oil/Recoverease  Massage  Phase 1  Ice/Electrostimulation/Cold Laser  Phenocane + Capraflex  Topical Magnesium  Phase 2  Magnets/Acupuncture  Kinesiotape/Compression
  33. 33. 33 Additional Resources  BenGreenfieldFitness.com  Podcast #’s:  35, 39, 45, 53, 74, 90, 105, 108  Pacificfit.net  E-mail ben@bengreenfieldfitness.com

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