Integrative Approaches to Optimum Performance

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Integrative Approaches to Optimum Performance

• Geoff Lecovin M.S., D.C., N.D., L.Ac., CSCS

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Geoff Lecovin, DC, ND, L.Ac, CSCS

• In private practice for over 18 years
• Chiropractor (1990)
• Naturopathic Physician and Acupuncturist (1994)
• Certified Strength Conditioning Specialist
  (NSCA, 2005)
• Corrective Exercise Specialist (NASM, 2006)
• Performance Enhancement Specialist (NASM, 2006)

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Integrative Components of Optimum Performance
Psychological
Biochemical
Structural
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Psychological(visualization and Intention)

• When you visualize yourself performing an
  activity, you are in turn physiologically
  creating neural patterns in your brain, just as
  if you had physically performed the action.
• These patterns are similar to small tracks
  engraved in the brain cells from physically
  rehearsing an activity
• Mental imagery is intended to train our
  minds and create the neural patterns in our brain
  to teach our neuromusculoskeletal system to do
  exactly what we want it to do.
• Ultimately, an athlete can enhance their
  performance physically by simply mentally
  practicing the activity.
• The more emotion and intention, the more
  effective the results

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Effects of Visualization on the Free-throw
Performance of Basketball Players." University
of Chicago

• Athletes were tested to determine their
  free-throw proficiency and then randomly assigned
  to one of three experimental groups.
• The first went to the gym every day for one hour
  and practiced throwing free throws.
• The second group also went to the gym, but
  instead of physically practicing, they lay down
  and simply visualized themselves successfully
  shooting.
• The third group did nothing
• At the end of 30 days, the three groups were
  re-tested
• The players who hadn't practiced at all showed no
  improvement in performance and many exhibited a
  drop. Those who had physically practiced one hour
  each day showed a performance increase of 24
  percent.
• The visualization group, by merely imagining
  themselves successfully shooting free throws,
  improved 23 percent

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Stress and the Mind-Body Connection

• Repressed Conscious or Unconscious Emotions
• Abnormal Autonomic Activity (Sympathetic)
• Reduced Local Circulation of Blood
• Mild Oxygen Deprivation
• Muscle Pain
• Nerve pain/Numbness/Tingling/Weakness
• Tendon Pain
• DECREASED PERFORMANCE

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Biochemical

• Diet
• Supplementation

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A Balanced Approach to Diet

• Focus on fueling the body with nutrients that
  provide energy for exercise rather than on
  calorie restriction.
• Optimize nutrients
• Shift balance of omega-3omega-6 fats
• Change carbohydrate sources to fruits and
  vegetables
• Incorporate lean protein sources with every meal
  and snack
• All calories are not created equal

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The Healthy Plate
Corn Peas Potatoes Pumpkin Squash Sweet
potatoes Whole grains Yams

Asparagus Broccoli Cabbage Carrots DGLV Green
beans Peppers Tomatoes
Beans lentils Beef (grassfed) Cottage
cheese Eggs Fish Nuts nut butters Poultry
pork (lean) Tempeh tofu
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The Power of Color

• RED (anthocyanins, lycopenes)- strawberries,
  cranberries, raspberries, cherries, grapes,
  beets, peppers, water melon, pomegranates,
  apples, onions, pink grapefruit
• ORANGE-YELLOW (beta carotene, lutein,
  zeaxanthin)- carrots, sweet potatoes, yellow
  potatoes, orange, mangoes, cantaloupe, pumpkin,
  squash, apricots, corn, banana, turmeric, ginger
• GREEN (beta carotene, lutein)- spinach, chard,
  kale, avocado, asparagus, artichokes, broccoli.
  Brussels sprouts, cabbage, green tea
• BLUE-PURPLE (anthocyanins)- blueberries,
  blackberries, grapes, red wine, eggplant
• WHITE- garlic, onion, cauliflower
• BLACK/BROWN- Coffee, dark chocolate, nuts
• The Color Code. James A. Joseph, Ph.D., Daniel A.
  Nadeau, M.D., Anne Underwood

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General Macronutrient Guidelines

• CHO- 40-55
• PRO- 25-30 (1-2 g/kg body weight)
• FAT- 25-30
• Base macronutrient intake upon type of
  exercise/sport, goals, mood and energy level

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Fats

• Eat more monounsaturated omega 3s
• -avocado, olive, fish, flax, walnuts, wild game,
  DGLV
• Limit saturated fat
• - beef, butter, cheese, egg yolks
• Avoid/eliminate trans fat
• - margarine, partially hydrogenated oils
• Eating healthy fats is essential for weight
  loss, general health, fitness and a fat-burning
  metabolism

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Omega 3Omega 6

• Omega 3 fish, flaxseed, walnuts, canola, DGLV,
  grassfed beef
• Omega 6 soybean oil, safflower oil, corn oil,
  other polyunsaturated vegetable and seed oils
• Imbalances between omega 3omega 6 increases
  inflammation, thereby increasing risk for
  inflammatory diseases such as CHD, stroke,
  autoimmune problems, eczema, RA, etc.

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What About Carbs?

• Glycemic Index (GI) measures the rise in blood
  sugar triggered by a specific number of
  carbohydrates of that food. The higher the
  number, the greater the blood sugar response.
• Glycemic Load (GL) indicates how much of a
  carbohydrate is in a serving of a particular
  food.
• Choosing foods with a low GL is beneficial
  for weight loss and overall health

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The Influence of Hormones

• When you eat, what you eat and how you exercise
  affects which hormones are released

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The Influence of Hormones

• Catabolic- glucagon, epinephrine, norepinephrine,
  cortisol
• Anabolic- testosterone, growth hormone, IGF-1,
  insulin

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How food intake affects hormonal response

• Insulin (lipogenic and anabolic) Lowers blood
  sugar, raises triglycerides and shuttles AAs and
  other nutrients into muscles
• Glucagon (lipolytic and catabolic) Raises blood
  sugar and breaks down fat and protein for energy
• CHO triggers insulin
• Protein triggers glucagon
• Fat is neutral

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Nutrient Timing

• Critical for
• Immune function
• Recovery and repair
• Reducing body fat
• Increasing/maintaining energy
• Nutrient Timing The Future of Sports
  Nutrition by John Ivy Robert Portman Basic
  Health Publications (February 20, 2004)

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Energy Phase

• Carbohydrate/protein supplement 30 minutes before
  working out1. Maintains immune function
• 2. Stops rise in cortisol
• 3. Sets stage for faster post-workout recovery
• 4. Spares muscle glycogen and protein
• 5. Minimizes muscle damage
• e.g. 20 g high glycemic CHO, 5-6 g whey protein,
  electrolyte/vitamin formula (C, E, Na, K, Mg)

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Anabolic Phase

• CHO/Protein within 45 minutes after exercising to
  optimize insulin response and repair muscle
• 1. Shifts metabolism from catabolic to anabolic
  state
• 2. Speeds up elimination of waste by increasing
  muscle blood flow
• 3. Replenishes glycogen stores
• 4. Initiates tissue repair and reduces muscle
  damage
• 5. Bolsters immune system and sets stage for
  muscle growth

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Growth Phase

• The 18-24 hr period after exercise during which
  the majority of muscle and strength gains occur.
• 1. Consume CHO/PRO 2 hr after exercise
• 2. Eat high protein diet and high protein/low
  glycemic CHO snacks (depending upon goals e.g.
  body building, weight gain/loss etc.)

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Ergogenic Aids

• Creatinetake 3 to 6 grams daily (for higher
  intensity events and body building)
• Whey protein- consume pre and post workout
• Physique athletes have a higher
  proteincarb ratio than performance athletes
• Caffeine 5 mg caffeine per kg of body weight
  (drip65-100 mg/cup 2 oz espresso about 100mg).
  Ingest caffeine about 3 - 4 hours before the
  competition. Caffeine mobilizes fat stores and
  encourages working muscles to use fat as a fuel.
  This delays the depletion of muscle glycogen and
  allows for a prolongation of exercise. Also
  lowers RPE.
• Glutamine several grams post-workout during
  times of very intense training
• Vitaminstake a multivitamin (with iron for
  menstruating females) daily
• Sports drinks/Carbohydrate gels see next slides
• EFA'seat fish 2 to 3 times per week or take 2 to
  4 grams of EPA and DHA daily
• BCAA (Leucine, Isoleucine , Valine)
• Quercetin- 250-500 mg 15 minutes before meals
  three times per day
• CoQ10- 300mg daily
• Green/black Tea- 2-8 cups daily
• Fresh fruit and vegetables (Phytochemicals)
• Water

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Sport Drinks

• Best for- endurance athletes who exercise for
  more than an hour at a time
• What to look for- 6-9 CHO (divide grams of CHO
  per serving by the milliliters of drink per
  serving and multiply by 100)
• gt9- GI distress
• lt5- not enough to fuel muscles
• Home made- mix 9 tsp sugar, 1/8 tsp salt and the
  juice of 1 lemon.
• Dose- Take 5-12 ounces every 15-20 minutes

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Carbohydrate Gels

• Best for- endurance athletes who exercise for
  more than an hour at a time
• What to look for- 70-100 calories and 17-25, CHO.
  
• Dose- 1-2 gels per hour (30-60g CHO). Take with
  8 oz water to enhance digestion
• Good food sources- Honey sticks (1 tsp/25
  calories). Take 2-3 sticks per ½ hour

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Structure

• Identify musculoskeletal dysfunction
• Treatment (e.g. trigger point acupuncture, soft
  tissue release, joint manipulation
• Optimizing the kinetic chain through corrective
  exercise
• Exercise- core, strength hypertrophy, power

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Kinetic Chain
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5 Kinetic Chain Checkpoints

• Feet- Straight ahead with neutral ankle position
• Knees- straight ahead in line with 2nd and 3rd
  toes
• Hips- neutral spine and abdominal drawn in
• Shoulders- in line with center of hip joint
• Head- center of ear in line with center of
  shoulder

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Optimum Alignment

• Alignment of the musculoskeletal system allowing
  posture to be balanced with center of gravity
• Ability of the neuromuscular system to perform
  functional tasks with the least amount of energy
  and stress on the kinetic chain

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Ideal Posture

• Optimum muscle length-tension relationships at
  which a muscles are capable of developing maximal
  tension

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Muscle Imbalance
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Dysfunction

• Altered reciprocal inhibition- a tight muscle
  causes decreased neural drive to its functional
  antagonist
• Synergistis dominance- compensation of
  synergistic muscles in order to maintain force
  production
• Myofascial dysfunction (trigger points)
• Arthrokinematic dysfunction- joint dysfunction
  affecting the surrounding muscles
• Faulty movement patterns

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Dysfunction Leads to

• Altered neuromuscular control
• Tissue fatigue
• Injury and impaired performance

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Causes of Muscle Imbalances

• Postural stress
• Pattern overload
• Repetitive movement
• Lack of core stability
• Lack of neuromuscular efficiency

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PATTERNS OF DYSFUNCTION

• When a chain reaction evolves in which some
  muscles shorten and others weaken, in
  predictable patterns of imbalance (Janda)
• Upper crossed syndrome
• Lower crossed syndrome

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Cumulative Injury Cycle
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STRUCTURAL CAUSES OF PAIN

• Trigger Points
• Muscle shortening
• Altered joint mechanics
• Abherant motion
• Pathology

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MYOFASCIAL TRIGGER POINTS

• 1.Small circumscribed hyperirritable foci in
  muscles and fascia
• 2. Begins with a muscle strain
• 3. Site of sensitized nerves, increased
  metabolism and reduced circulation

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TRIGGER POINT SYMPTOMS

• 1. Local or referred pain
• 2. Pain with muscle contraction
• 3. Muscle stiffness and restricted joint motion
• 4. Muscle weakness
• 5. Paresthesia and numbness
• 6. Proprioceptive disturbance
• 7. Autonomic dysfunction

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Trigger Points Can Compromise

• Flexability
• Balance
• Strength
• Power
• Speed
• Agility

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PERPETUATING FACTORS

• Mechanical Stresses
• Nutritional/Dietary factors
• Metabolic and Endocrine Inadequacies
• Psychological factors
• Chronic Infection
• Other (allergy, sleep, improper breathing,
  dehydration, smoking, caffeine, medications,
  visceral disease)

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TREATMENT

• 1. Release muscle shortening and deactivate
  trigger points- trigger point acupuncture, soft
  tissue and joint manipulation
• 2. Corrective exercise
• 3. Prevention- core, strength, power exercises
• 4. Diet/Nutrition
• 5. Lifestyle modification

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DRY NEEDLING(Intramuscular Stimulation)

• Insertion of an Acupuncture needle according to
  neuroanatomical concepts

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THE EFFECTS OF DRY NEEDLING

• Strengthen Tendons Ligaments by inducing local
  inflammatory reactions (PDGF, Fibroblasts,
  collagen)
• Stimulates stretch sensitive GTO Muscle
  Spindles
• Mechanical disruption
• Treat Overactive Motor Points
• Provides Blood Growth Factors which can disrupt
  microscars
• Alters Neural Control via neurotransmitters,
  endorphins and inhibitory mechanisms
• Stimulates Reflex Mechanisms e.g. spinal,
  sympathetic and circulatory

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SOFT TISSUE RELEASE TECHNIQUE (Taws)

• Specific contact is made on the muscle
• Traction is applied to the tissue in order to
  trap the lesion
• The muscle is moved either actively or passively
  through the line of injury
• The stretch is held for 1-2 seconds
• Repetitions are done in different positions and
  planes of motion (8-10 times)

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EFFECTS OF SOFT TISSUE RELEASE

• 1. STR stretches and softens scar
  tissue/adhesions
• 2. Pain input messages to limbic system are
  reprogrammed
• 3. Muscle length, flexability and memory are
  regained

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Adjunctive Therapy

• Hydrotherapy- hot, cold and contrast
• Kinesiotaping
• Supplements Bromelain, C/Bioflavonoids, Cal/Mag,
  DMSO, Glucosamine, MSM, Fish oil, Biofreeze
• Exercise

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OPT Exercise Model (NASM)
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Functional Exercise(NASM)

• Multiplanar (sagittal, transverse, frontal)
• Involves acceleration, deceleration and
  stabilization
• Multiple speeds
• Varying body positions
• Optimum alignment

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Integrative Exercise(NASM)

• Kinetic chain Assessment
• Flexibilty
• Core stabilization
• Balance
• Speed and agility
• Resistance
• Power
• Cardiorespiratory
• Supportive nutrition
• Recovery and regeneration

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Periodization

• Planned changes in training programs to
  facilitate steady improvements by manipulating
  volume and intensity
• Five Stages
• Anatomical adaptation- general conditioning
• Hypertrophy
• Strength
• Maximal strength/power
• Skill

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Anabolic Hormones and Exercise

• Growth Hormone
• Testosterone
• IGF-1
• Insulin

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Hormonally Intelligent Exercise

• Short rest- 30 sec or less
• Multiple sets- 4 plus
• 6-12 repetitions
• Intensity 65 or more
• Large muscle groups (compound exercises- squat,
  deadlift, lunge, push, pull, twist)
• keep blood sugar levels balanced with pre/post
  nutrition
• Anaerobic (EPOC- excess post exercise oxygen
  consumption)

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Stabilisation(NASM)

• Correct imbalances that could lead to injury or
  correct injuries that prevent exercise or cause
  dysfunction

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Corrective Exercise Protocol

• Inhibit
• Lengthen
• Activate
• Integrate

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Stretching Continuum

• Static (autogenic inhibition)- passively taking a
  muscle to a point of tension for 20 seconds
• Active (reciprocal inhibition)- using agonists
  and synergists to dynamically move the joint into
  a range of motion. Typically 10 reps of 2 seconds
• Dynamic- uses the force production of a muscle
  and the bodys momentum to take a joint through
  full available range of motion. Used as
  pre-activity warm-up

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Strength and Conditioning Journal Vol. 24, No.
6, pp. 3337.Should Static Stretching Be Used
During a Warm-Up for Strength and Power
Activities?

• The objective of stretching in a warm-up is to
  achieve a short-term increase in the ROM at a
  joint or to induce muscle relaxation and
  therefore decrease the stiffness of the
  muscle-tendon system
• Substantial evidence is now available to state
  that static stretching can impair strength and
  power performance
• Instead, rehearsal of the skill about to be
  performed, at gradually increasing intensities,
  culminating in some efforts that are equal to or
  greater than the expected competition intensity.
  This type of dynamic warm-up serves to activate
  or recruit the specific muscle fibers and neural
  pathways required to achieve optimum
  neuromuscular performance

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Summary

• Balanced diet with power foods and
  phytonutrients
• Full-body workouts 2-3x/week, including core,
  flexibility, strength and power
• High intensity interval training 2x/week
• Low-intensity activities 1-2x/week
• Dont stress the small stuff
• Get adequate sleep