The term “Rx” comes from the original latin for “recipe”, or prescription. Though not prescriptive, here are some interesting things from the week. This includes a highlight from a conference I attended, Obama lifting weights, and answering a question I got about rehabbing a back injury.
Cool Science:
Saving baby brains with nanotechnology. This week I attended a conference on developmental brain injury. This includes any damage to the brain which occurs late in pregnancy, during childbirth or early in a child’s life. Though the causes are very varied and often difficult to predict, cerebral palsy (causing both movement and cognitive problems) is a common result. We have learned a huge deal about the mechanisms which cause cerebral palsy over the last few decades. However, we have made little progress with treatment. While many things appear to work in the lab, these treatments rarely work when trialed in humans. Rather than trying more of the same, it is almost certainly time to try something new. One stand-out aspect of the conference was data from a group that is using nanoparticles to target the injured brain. These particles, called dendrimers, can be tailored to carry almost any drug, but also not release the drug until they are inside the cell. This would potentially reduce the necessary dose of a drug, as well as any side-effects. The exact way that dendrimers enter cells isn’t known. Crucially, however, they appear to be selectively taken-up by cells in the damaged brain, with little effect on healthy cells. This could mean that treatments can be given to babies who are at risk of cerebral palsy, without the potential detrimental effects of treating the babies that were actually going to be OK without treatment. There are very few things we do in medicine that boast this benefit. Though trials of giving dendrimers to babies are probably still a reasonable way off, they are certainly one of the more promising therapies being discussed in this field at the moment. Read a review article here.
Chopping trees is manlier than playing soccer. A team of American anthropologists explored the effects of testosterone and behaviour by studying the Tsimane, an indigenous forager-horticulturalist society native to Bolivia. In Tsimane men, one hour of chopping trees (to plant food) boosted testosterone by nearly 50%. By comparison, an hour of competitive exercise (soccer) only produced a 30% increase. Importantly, the men of the Tsimane have lower levels of testosterone compared to Western males, but their testosterone levels don’t drop with age like ours do. The theory presented in this paper is that the benefits of testosterone follow different patterns in Western and hunter-gather populations. Unlike Westerners, the Tsimane work hard in old age, so their testosterone levels must remain stable throughout life. However, having consistently high testosterone can be detrimental - it requires a lot of energy, and can increase the risk of infection. Therefore, lower average levels of testosterone in Tsimane men are offset by boosts during food provision. The paper suggests that, in this population, the act of providing food boosts testosterone more than the act of being competitive (which is well known to boost testosterone in Westerners). However, I would argue that wielding an axe for an hour is going to boost testosterone more than playing soccer, much like lifting weights boosts testosterone more than running does. Either way, it is an interesting discussion on how testosterone affects our “fitness” in society. Consider chopping trees before your next Tinder date. Find the full article here.
Other interesting stuff:
Even Obama lifts weights. A “leaked” video from the gym of a Polish hotel shows Obama hitting the weights. Is it actually him? Who cares. Watch the leader of the free world getting his pump on, here or here.
30-day napping challenge! Social media has recently become over-run with 30-day squat/burpee/sit-up challenges, where you do more and more each day for a month. I obviously approve of anything that gets people moving more. However, challenges like this are often undertaken with no attention paid to more important things, like eating properly and sleeping more. I’ve previously written about how poor sleep can ruin your metabolism, cause over-eating, and increase your risk of dementia. Try this 30-day napping challenge from Authority Nutrition. It might even be better than 30 days of burpees:
http://dottotrot.com/2014/06/05/try-this-30-day-challenge-for-weight-loss/
Training:
This is a video of me deadlifting 210kg last weekend. It was the first time I’d tried anything nearly this heavy since injuring my back 6 months ago. I was subsequently asked what I did to rehab, so the basic ideas are listed below the video:
Cool Science:
Saving baby brains with nanotechnology. This week I attended a conference on developmental brain injury. This includes any damage to the brain which occurs late in pregnancy, during childbirth or early in a child’s life. Though the causes are very varied and often difficult to predict, cerebral palsy (causing both movement and cognitive problems) is a common result. We have learned a huge deal about the mechanisms which cause cerebral palsy over the last few decades. However, we have made little progress with treatment. While many things appear to work in the lab, these treatments rarely work when trialed in humans. Rather than trying more of the same, it is almost certainly time to try something new. One stand-out aspect of the conference was data from a group that is using nanoparticles to target the injured brain. These particles, called dendrimers, can be tailored to carry almost any drug, but also not release the drug until they are inside the cell. This would potentially reduce the necessary dose of a drug, as well as any side-effects. The exact way that dendrimers enter cells isn’t known. Crucially, however, they appear to be selectively taken-up by cells in the damaged brain, with little effect on healthy cells. This could mean that treatments can be given to babies who are at risk of cerebral palsy, without the potential detrimental effects of treating the babies that were actually going to be OK without treatment. There are very few things we do in medicine that boast this benefit. Though trials of giving dendrimers to babies are probably still a reasonable way off, they are certainly one of the more promising therapies being discussed in this field at the moment. Read a review article here.
Chopping trees is manlier than playing soccer. A team of American anthropologists explored the effects of testosterone and behaviour by studying the Tsimane, an indigenous forager-horticulturalist society native to Bolivia. In Tsimane men, one hour of chopping trees (to plant food) boosted testosterone by nearly 50%. By comparison, an hour of competitive exercise (soccer) only produced a 30% increase. Importantly, the men of the Tsimane have lower levels of testosterone compared to Western males, but their testosterone levels don’t drop with age like ours do. The theory presented in this paper is that the benefits of testosterone follow different patterns in Western and hunter-gather populations. Unlike Westerners, the Tsimane work hard in old age, so their testosterone levels must remain stable throughout life. However, having consistently high testosterone can be detrimental - it requires a lot of energy, and can increase the risk of infection. Therefore, lower average levels of testosterone in Tsimane men are offset by boosts during food provision. The paper suggests that, in this population, the act of providing food boosts testosterone more than the act of being competitive (which is well known to boost testosterone in Westerners). However, I would argue that wielding an axe for an hour is going to boost testosterone more than playing soccer, much like lifting weights boosts testosterone more than running does. Either way, it is an interesting discussion on how testosterone affects our “fitness” in society. Consider chopping trees before your next Tinder date. Find the full article here.
Other interesting stuff:
Even Obama lifts weights. A “leaked” video from the gym of a Polish hotel shows Obama hitting the weights. Is it actually him? Who cares. Watch the leader of the free world getting his pump on, here or here.
30-day napping challenge! Social media has recently become over-run with 30-day squat/burpee/sit-up challenges, where you do more and more each day for a month. I obviously approve of anything that gets people moving more. However, challenges like this are often undertaken with no attention paid to more important things, like eating properly and sleeping more. I’ve previously written about how poor sleep can ruin your metabolism, cause over-eating, and increase your risk of dementia. Try this 30-day napping challenge from Authority Nutrition. It might even be better than 30 days of burpees:
http://dottotrot.com/2014/06/05/try-this-30-day-challenge-for-weight-loss/
Training:
This is a video of me deadlifting 210kg last weekend. It was the first time I’d tried anything nearly this heavy since injuring my back 6 months ago. I was subsequently asked what I did to rehab, so the basic ideas are listed below the video:
The injury: Being a typical doctor, I didn’t see anybody about my injury, so I don’t know exactly what the problem was. However, from the mechanism (twisting lumbar spine under load) and pain, I think I potentially had good-going interspinal/intertransverse and quadratus lumborum muscle damage on the right side, though I can't rule out a problem within the spine itself.
Immediately post-injury: I stopped training. This may sound obvious, but I had a similar injury before and trained “through” it, ignoring the underlying problems. During this break from training, I worked a lot on shoulder, hip and thoracic spine mobility. A previous snowboarding injury and years of rowing meant that I wasn't loading my spine evenly when lifting heavy weights, and this is something I will always need to work on. Even fit, healthy people need to work on their mobility, particularly if they spend a lot of time sitting.
Starting again: Once the pain began to settle, I resumed training, but focussed on kettlebells. Double-kettlebell swings, cleans and front squats require an immense amount of spinal stabilisation. I did these in circuits lasting 15-20 minutes, but at a weight that I could only lift 5-10 times in one go, focusing on form. Here is an excellent article from physiotherapist Andrew Lock about using these kinds of movements to rehabilitate back injuries.
Train less: Years of training every day, or multiple times a day, in conjunction with a stressful job, was leaving me wide open to over-use injuries. I now train 3-4 times most weeks, and am stronger than I ever have been. Many people who are failing to meet their training goals could do with less rather than more.
Lifting again: I started doing heavy back and front squats every time I went to the gym. I worked mainly in sets of 5, adding weight every week. The mobility and strength required to do a controlled, full-depth front-squat translates really nicely to deadlifting. I would squat in front of a mirror, which allowed me to make sure that my hips were always level and even, often at the expense of adding more weight. I also added some movements like cable pull-throughs and good mornings to improve back, hip and glute strength. Finally, I had to make sure that my upper back was capable of holding on to a heavy weight, so I did a lot of pull-ups, rowing movements with dumb-bells and kettle-bells, as well as face-pulls and muscle snatches. Click links for examples.
I still have some way to go to fix my juries and mobility issues, but the above steps were a good start.
Starting again: Once the pain began to settle, I resumed training, but focussed on kettlebells. Double-kettlebell swings, cleans and front squats require an immense amount of spinal stabilisation. I did these in circuits lasting 15-20 minutes, but at a weight that I could only lift 5-10 times in one go, focusing on form. Here is an excellent article from physiotherapist Andrew Lock about using these kinds of movements to rehabilitate back injuries.
Train less: Years of training every day, or multiple times a day, in conjunction with a stressful job, was leaving me wide open to over-use injuries. I now train 3-4 times most weeks, and am stronger than I ever have been. Many people who are failing to meet their training goals could do with less rather than more.
Lifting again: I started doing heavy back and front squats every time I went to the gym. I worked mainly in sets of 5, adding weight every week. The mobility and strength required to do a controlled, full-depth front-squat translates really nicely to deadlifting. I would squat in front of a mirror, which allowed me to make sure that my hips were always level and even, often at the expense of adding more weight. I also added some movements like cable pull-throughs and good mornings to improve back, hip and glute strength. Finally, I had to make sure that my upper back was capable of holding on to a heavy weight, so I did a lot of pull-ups, rowing movements with dumb-bells and kettle-bells, as well as face-pulls and muscle snatches. Click links for examples.
I still have some way to go to fix my juries and mobility issues, but the above steps were a good start.