So today I wanted to talk to you about what I call the placeholder workout. It is pretty much what it sounds like. It is a VERY short workout that is designed to help prevent you from losing your progress.

What it's for: 
The placeholder workout is for those days that you'd normally miss the workout. Maybe you're stuck at work, maybe you're not feeling well, maybe the day got away from you and now you're beat tired. 

It is important to understand that it isn't going to make you stronger, it isn't going to move you closer to your goal. It will help prevent you from losing your progress. So, the purpose is to simply keep you from back sliding until you can do a proper workout. Typically, a placeholder workout can help maintain your progress for a day or two.
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As we close out the month of May there's a strong chance we are becoming more active outside. I have on more occasions than I can count heard people talk about how they only go to the gym after the spring/summer season has ended. While your programming could and in some cases should be changed, it is unlikely that it should stop or pause. It is a common notion to believe that exercise is exercise. However, this is NOT true. Let me explain.

Let's say you like to garden and do yard work. You work up a good sweat and at times even find yourself a little breathless from the activity. This is a great thing, as this means the heart is working harder and this work will result in improved cardiovascular fitness. Some of the muscles might even get worked hard enough to qualify as strength training. However, in many activities such as gardening, typically there are a handful of muscles that are used for the majority of the activities, leaving many other muscles untrained. This can cause muscular imbalances that lead to tendonitis. It may also impair flexibility and mobility over time.

The same point can be made of those in labor intensive jobs. I've heard many times, how they "don't need to exercise" because they get so much at work. Again, however upon further examination what you almost always find, is a handful of muscles that get used repeatedly and a bunch that do not get used at all.

The moral of the story is, a workout or fitness program does not need to necessarily train all muscle groups. It is important to take into consideration what you do for work and recreation, then tailor the workouts to address the muscles that need the exercise most, while also prioritizing the flexibility training to the muscles that get exercise the most. Taking such an approach will help reduce the risk of lower back pain, tendonitis, bursitis, and hernias.

An easy way to determine which muscles are likely getting all the exercise and the ones that are not receiving much is to look at the most commonly repeated tasks. If you find you perform a lot of bending over at the waist, you likely are training the lower back frequently. In this case you want to prioritize stretching the back and training the muscles on the opposite side of the body (abdominals). Let's say you find a majority of the tasks require pulling movements. In this case you want to prioritize stretching the lats, biceps and upper back, while training the pushing muscles (chest, triceps, anterior deltoid).  

Remember a balanced body is a healthy body. If the body is not healthy, there is an imbalance somewhere.

As the seasons change so does the environment and the ambient (surrounding) temperatures. In the north we experience dramatic seasonal swings and with the first really warm days typically we start seeing the first sun burns and we see increased occurrences of dehydration, and heat related illness. Dehydration is important because it can lead to heat exhaustion, heat stroke and in some cases can be fatal. However we can go overboard with the water consumption and develop hyponatremia. This condition caused by over consumption of water can also be fatal. So what to do?

Let’s talk about sweat! Sweat is a fun little substance our body makes to cool us down through the process of evaporation but also helps us expel toxins. There are some interesting things to know about sweat. For example:

• Sweat is more than water. It typically contains salt, potassium, calcium, magnesium (electrolytes) as well as some toxins i.e. lactate, ammonia, and urea
  
• Sweat rates change with acclimatization.
  
• Density and proportions of electrolytes and metabolites in sweat changes with acclimatization.
  
• The absence of sweat on a hot day is a sign of heat stroke
  
• Sweat is less effective at cooling us off as relative humidity rises (amount of water in the air as compared to the amount it can hold)
  
• Aired climates where humidity is low can allow the body to easily sweat and evaporate making cooling off more efficient but it can also allow the sweating to go unnoticed allowing us to dehydrate more quickly
  
  

Dehydration is typically defined as losing more water than you bring in but is best characterized by the body’s impairment to carry out normal bodily processes. This definition is not especially helpful to people so we will discuss identifying dehydration, as well how much you should be consuming. Keep in mind properly hydrating is not the only strategy to keeping people safe in the heat, however it is the one we will be focusing on today. 

Thirst is often the first noticed symptom of being dehydrated. That’s right… If you feel thirsty, you’re already dehydrated. Other early symptoms are: dry mouth, infrequent urination, low urine volume, and dark urine (although this is often chronic dehydration). When the body reaches 2% dehydration symptoms will likely include one or more of the following: fatigue, headache, nausea, dizziness, and impaired physical and cognitive performance. Dehydration is said to be severe and likely require medical intervention when body water loss reaches 10 or more percent, symptoms may include any of the symptoms above as well as: lack or reduction in sweating, sunken eyes, low blood pressure, fever, delirium, unconsciousness, dry skin, and increased heart rate. There are approximately 500,000 dehydration hospitalizations per year resulting in about 10,000 deaths.

As a general rule and under normal conditions we should consume water in a quantity that is approximately half our body weight in ounces.

An example of proper water consumption (again under normal conditions) can be illustrated as such: if you weigh 180 pounds you should drink about 90 ounces of water. If you are outside intermittently in the summer this amount of water intake will likely remain unchanged. Days you’re out in the heat for prolonged periods of time the  water intake will need to increase. 

Hydration in a hot environment is different from standard hydration as sweat rates increase. The CDC recommends 24-32 ounces of water per hour in a hot environment. If you want a more precise recommendation you can perform the following experiment. Assuming we are starting in a hydrated state, begin by weighing yourself without clothes on. Get dressed then enter the hot environment and perform physical activity at about the intensity you normally would (and make sure someone knows you’re doing this). Do this for 1 hour. Return back to where you weighed yourself. Take your clothes off and re-weigh yourself (this is important because your clothes will absorb sweat). You will likely see a weight loss of 1-2 pounds. Unfortunately this is not fat weight. It’s water weight. Now you know how much water per hour you need to consume in order to maintain your hydration.

It is important to point out that one can over hydrate. If we consume too much water we can develop hyponatremia which can be fatal. Hyponatremia is a condition where too much water has been consumed and the electrolyte fluid ratios are thrown out of balance. Electrolytes such as salt, potassium, and calcium are important to transferring electrical signals in the body. If our electrolytes are diluted our body can’t function properly and in severe cases can shut down completely, resulting in death.

This condition can be easily avoided by ensuring you consume enough electrolytes throughout the day. In most cases the electrolytes we get in our everyday meals are adequate. In severe heat  it may be advisable to lightly salt your food and/or alternate between electrolyte/sports drinks and water. It is unlikely you need every drink to be an electrolyte/sports drink so don’t go overboard. Be aware that typically electrolyte/sport drinks are high in sugar. One popular approach is to drink one electrolyte/sport drink for every two drinks of water. If you do this you will likely have the appropriate electrolytes to function optimally and have nothing to worry about. 

The role of acclimatization and its impact on hydration and heat borne illnesses can not be overstated. It takes the human body approximately 10 days of working in the heat to acclimatize completely. When acclimatization is complete you’ll notice earlier onset of sweat in the hot environment, increased sweat volume (amount), slowing of the heart rate (initially heat will cause a boost in heart rate), and a less noticeable reduction in electrolyte loss in sweat. It is also highly advisable to acclimate to the heat slowly. For example, an easy and safe way to acclimate is to spend 20% of your waking hours in the heat, then increase it by 20% each day. By day 5 you will have spent all your waking hours in the heat. You won’t be completely acclimated but you will be well on your way.

Lastly, a note on heat exhaustion and heat stroke. Neither of these conditions are a laughing matter. If either of these are suspected, seek medical attention immediately. Below are the symptoms and actions to take:

• Heat Exhaustion symptoms: headache, nausea, dizziness, weakness, irritability, thirst, heavy sweating, increased body temperature, decreased/ceased urination
  
  • Action: Get to a hospital/call 911, remove unnecessary articles of clothing, sip water, use cold compress or moisten skin (arms, legs, neck, face, forehead etc
    

Heat Stroke symptoms: slurred speech, confusion, hot/dry skin or profuse sweating, high body temperature, seizure, coma/loss of consciousness
Action: Call 911, remove outer clothing, ice bath/soak in cold water, wet wash clothes, 

Dehydration and heat borne illnesses are easily preventable by ensuring that you acclimatize properly, consume adequate water and electrolytes and that you are prepared for the environment to which you’ll be exposed. Remember as a general rule you should consume approximately half your body weight in ounces in water under normal conditions. When in a hot environment you will likely need 24-32 ounces each hour. If you feel thirsty you’re already dehydrated. You should expect about 10 days to fully acclimate to the heat. Be aware of the symptoms of dehydration and heat borne illness and take action quickly if you’re presented with symptoms, especially if you’re in a hot environment.

I very commonly hear the phrase “I have bad knees”. Typically this phrase is used to describe pain someone experiences in their knees when performing certain activities. When I think of bad knees I think of the actual issues that create pain… not the pain itself. Why not the pain itself? Because pain does not necessarily indicate an injury or damage. Pain is an alarm. The question is, what is the alarm telling us? Pain can be an indication of fatigue, it can be an indication of damage occurring or has occurred (injuring vs injured), it can be an indication of irritation or malfunction.

We can liken pain to the gauge lights on the dashboard of our car. Perhaps we’re driving and the check engine light comes on. This tells us there’s something that requires our attention so we go and get it checked. It may just be letting us know we need to change the spark plugs. However, there could be a larger issue. Figuring out what it’s telling us is crucial to prevent potentially harming the motor permanently. If we ignore the light, whatever the issue is will likely get worse. This issue may also put strain on other areas of the vehicle and cause other mechanical issues. Pain is the same way. It is our check engine light. It could be a muscle imbalance, a knot (adhesion) or trigger point or it could be something more serious. However we need to investigate it to know.

When someone tells me they have bad knees, I encourage them to tell me more about it.I like to know if they have been diagnosed with a condition, or if they have spoken to a physician or sports medicine professional and any outcome that resulted. I ask them to describe the pain to me, when they notice it most and any protocols they may use to resolve it. I ask these questions because depending on the answers it may not be “bad knees” as much as it is tight tissue, a muscle imbalance or a trigger point.

Let’s talk about tight tissue. What does this mean? Well it is not uncommon when we are in certain postures for a prolonged period of time that our muscles and fascia (collagen based tissue fibers running throughout the body) become stiff. Someone might for example, find that after a long car ride when they first get out and move around they are experiencing some pain in the knee. They may also then find when they move around or stretch a bit the pain begins to reduce. However when the tissue becomes especially tight it’ll start creating little nodules. We call these adhesions, more commonly called knots. In this case when you get out of the car you may find that moving around does not resolve the issue and you just continually feel knee pain. Sometimes stretching is enough to pull the tissue apart, sometimes massaging or foam rolling the area prior to stretching is required. 

Returning to knee pain as an example, let’s say for example, you find knee dominant movements (i.e. squats, lunges etc) consistently cause pain. You may have an actual knee problem but you may be dealing with a muscular imbalance. A muscular imbalance is when one muscle on one side of the joint is tight (also referred to as chronically shortened) and the muscle on the opposite side of the joint is overly lax (also referred to as chronically lengthened). An imbalance can cause pain because muscles apply tension to joints. If they didn’t human movement couldn’t occur. When there is an imbalance the tension applied to the joint is applied incorrectly causing the joint to move in a way it was not intended. This isn’t an injury… not yet. It is the malfunction that will lead to an injury if left uncorrected. I like to use the hinge on the door analogy. When a hinge on a door is on correctly the door swings open and closed seamlessly. We don’t even think about the hinges when we’re using the door. However if the hinge gets bent or is on crooked, the door squeaks. You can hear it each time you open the door and you notice the sound and may notice it coming from the hinge. If you correct the placements of the hinge and rehang the door the problem will be solved and you likely won’t give it another thought. If the hinge is left alone, over time you’ll notice that squeaking will get louder and louder until eventually the hinge or one of its connections breaks. Our joints are the same way. If we have a muscular imbalance we may notice pain. Each time you use the joint for certain activities you’ll feel it… over time you may notice the pain becomes worse. If left unchecked something will “break”. 

Treatment for a muscular imbalance typically involves some massage/foam rolling, stretching and various exercises. Over time and with consistency you’ll notice the pain will become less and may eventually disappear altogether. It won’t happen overnight as the muscles have been trained into these postures and improper movements for a long time. So while you can treat the tight and lax muscles you also have to be careful to treat the movement or static postures you’ve been performing that created them. Over time your central nervous system will become retrained (this is called motor learning) and the problem will disappear. 

These are controversial and debate among physicians and researchers continue. However the logic is sound and looks a little something like this. A trigger point is where an activated motor neuron is connected to a knot. The difference between a regular knot and a trigger point is found in how pain is expressed.

If you press on a knot you will feel pain in the area of the knot. If you press on a trigger point you will experience pain radiating to another area of the body. Ever dealt with a knot on your upper back and when pressure is applied you feel it in the temple? That’s an example of a trigger point. Again trigger points are not injuries, but they are malfunctions. These trigger points and knots if left unchecked will continue to pester you with pain and muscle tightness. This can lead to altered body movements, increased sitting and various other pain avoidance activities. Over time our central nervous system will learn and make these movement deviations second nature leading to muscular imbalances. 

As you may have noticed there is a relationship between muscular imbalances, trigger points,  muscle adhesions, and pain. Our natural response is to avoid pain but we better serve ourselves if we get to the bottom of the pain and address it. If we do not and we just accept we have a bad knee or bad back etc and avoid certain exercises, or movements we may be doing so prematurely and causing more harm than good. If we identify what’s causing the pain we can quickly figure out if there are movements that should be avoided, or if it’s something that can be resolved. Good resources for identifying pain are professionals such as an exercise professional, massage therapist, or sports medicine/medical professional. If an avoidance of pain strategy is your strategy and you’ve not identified the cause of pain, you will likely find more and more movements trigger pain. This will likely progress until an actual injury occurs, making the interventions to fix the problem more difficult, painful, costly and time consuming than if it was simply resolved at the beginning. Remember if we don’t make time to maintain our health now, we will be forced to make time for our illness later.

The first non-calorie roadblock to explore is your sleep. One might think that less sleep means you burn more calories because we burn more calories awake than asleep. However, sleep plays a large role in our hormones and hormones play a large role in our waking metabolism. If we do not get enough quality sleep our hormones will be out of balance which will cause our body to not burn as many calories during our waking hours, resulting in less calories burned overall for the day. 
The most common reasons people don’t get the proper amount of quality sleep is timing and ability. Timing is usually due to not getting into bed before they’re tired. Often people wait until they’re tired to go to bed. On the surface that makes sense. However that is a flawed thought process because if you continue to stimulate your mind you’ll likely be tired long before you realize it. You’ll even get a “second wind”... we don’t want a second wind. That just results in less quality sleep later. Often we are amazed at how quickly we’ll feel tired once we’ve turned off all our devices and climbed into bed. 

It is recommended to turn all blue light/technology off an hour before bed. If that doesn't seem doable and you feel you need to turn the tv on when you climb into bed, that's still better than waiting until you feel tired.  Likely once you lay down and get comfortable you’ll find yourself nodding off mere minutes after you do so. The moral of the story is identify the amount of sleep you want to get, and begin preparing for bed an hour beforehand regardless whether you’re tired or not. 

Another common reason people do not get enough quality sleep is they have a hard time falling asleep or have a hard time sleeping well. Exercise helps with this and there are a number of supplements that can help as well. You might look for something that contains substances such as melatonin, valerian, chamomile etc. If something natural does not work, consider speaking to your primary care provider because the consequences for accepting poor sleep go far beyond weight loss. Decreased sleep is associated with a dramatic increase in dementia as we age. It is associated with heart disease, and many other chronic diseases. So if you’re getting into bed but unable to get quality sleep, make this a priority. 

If you’re not sure if you’re getting enough quality sleep a good test is to lay down and close your eyes. Be sure to set an alarm. If you’re easily falling asleep that is a strong indicator you’re not getting enough. That being said, you may find taking a regular nap a good solution to the sleep challenge. You don’t necessarily have to get all the quality sleep at night. If you find you can only sleep well for six hours but are able to easily fall asleep for a nap, then do that. Again, I know it takes time and everyone is so busy, but if you don’t make time for your wellness today, you’ll be forced to make time for your sickness tomorrow. 

The second non-calorie roadblock is gut health. In our digestive system is where the majority of our lymphatic tissue resides. Lymphatic tissue is largely responsible for the efficiency of our immune system. Therefore a healthy gut will likely result in you getting sick less. However, there is also a relationship with our digestive system and our ability to lose weight. Over the course of the last 10 years the body of scientific evidence now shows those with a healthy gut i.e. lower intestinal inflammation, greater bacteria diversity and permeability, are able to lose weight more effectively on the same level of calorie restriction than those whose gut health is not as strong.
Things that influence gut health are of course, hormones, and nutrition. A diet high in saturated fat, refined carbs and sugars promotes inflammation. A diet containing fermented foods such as sauerkraut, yogurt, cottage cheese and fiber (fruits and vegetables) promotes improved health, lowers inflammation and promotes diverse healthy bacteria. So if you’re sticking to a 1200 calorie diet and struggling to lose weight but ignoring things like vegetables and fermented foods you may want to revisit your food choices as it may be less the calories getting in the way and more the health of your gut.

The third non-calorie roadblock is lean tissue. Primarily what we mean by lean tissue is bone and muscle. Something I have seen many times is someone losing weight through diet alone. They continue to reduce what they eat to lose weight. Sometimes you have to adjust your calories down as you lose weight, no doubt about it. However, if you’re not doing resistance training you’ll find you’ll be reducing your calories, further and further. The reason is the speed of our metabolism is largely determined by the amount of lean tissue we have. Think about a car, the bigger V8 motors consume much more gas than the 4 cylinder motors right? Of course they do because bigger motors require more energy. Lean tissues are the motors of our body. If we do not perform resistance training we lose lean tissue when we diet. The reason for this can be found in our evolution. The human body adapts to stress. If we go back in our history we spent thousands of years being hunters and gatherers and lived in a time when people commonly missed meals, and endured the stresses of going hungry for long periods of time. This stress caused the body to adapt to such food shortages through processes of slowing down the metabolism. Lean tissue is not advantageous to preventing hunger as it burns calories even at rest. Therefore if there is no stress on the muscles the body has adapted to get rid of it. However if there is stress on the muscles the body has adapted to maintain and build the muscle, as well as then metabolizing fat to meet the energy shortage. So it is important to perform resistance exercise when dieting as it signals to the brain that “we need” this muscle which ensures your metabolism stays high even in the state of food reduction. If you’re not performing resistance training at least twice a week there is a good chance your metabolism is slowing down and you’ll have to continue to reduce your calories to a miserably low level.

Understand this is just three roadblocks. As mentioned in the beginning of the article a food sensitivity or a medication/medical condition may also be interfering. However even if that is the case, there’s a good chance that addressing the three roadblocks above can still help. You may have noticed that the three roadblocks when addressed won’t just help you lose weight, they’ll help you stay healthy, strong and sharp. If our gut is healthy, our sleep is good, and our muscles trained, we are going to feel better, and look better. If we feel and look better we live better and can be better for those we love and for the activities in life we enjoy.