Fatigue Is Not a Risk Factor for ACL Injuries: Myth Buster Monday

Fatigue is Not a Risk Factor for ACL Injuries:Mythbuster Monday

Although I have torn my ACL twice, researched ACL injuries for 7 years and presented internationally regonized research on ACL risk reduction. Yet I still know very little about why ACL injuries occur.  However, every day we come a little closer and gain a better understanding the mechanism of this injury.

Although we don’t understand, the exact causes, we are able to identify risk factors for injury that predispose people to be at a. higher risk.  Although many risk factors are backed by research, some are complete misconceptions.  One of the most commonly argued risk factor is that fatigue puts us at greater risk for ACL injuries.  The argument is based around the idea that fatigue will alter our biomechanics in a negative manner. However, the research has shown that the changes we see in a fatigue state actually puts us at a lower risk.  In fact Hewett and Webster(two of the top ACL researchers in the world) foun d that fatigue cared us to demonstrate decreased forces, increased knee and hip flexion.  Each of these puts us at lower risk for injury.

Real world data also supports that fatigue is not a risk factor for ACL injuries.  There is no association between time of season or game qith increased risk of ACL injuries.  Infact a recent systematic review even showed 64% of  soccer ACL injuries happen in the first half of the game

Research

Are Antioxidants Negatively Affecting Your Training?

Are Antioxidants Negatively Affecting Your Training

First and Foremost we must start off with identifying what are Antioxidants? Antioxidants are compounds such as Vitamin C, E etc and have become incredibly popular in recent years, due to its ability to neutralize reactive oxygen species which are though to be responsible for being the root cause of many chronic disease including cancer, cardiovascular disease, neurodegeneration and aging.  Free radicals promote damage to our DNA, which may hinder our athletic performance.

So Tommy, How is taking something that may help prevent cancer, ageing and cardiovascular pulmonary disease a band thing?

When we workout, we generate free radicals. Oh no.  However, free radicals from exercise are good thing, since it triggers our body to build greater protection against physical stress.  When we take antioxidant supplementation , it can hinder our ability to adapt as body is not required to neutralize these free radicals.  Research has consistantly showns that chronic use of antioxidants supplementation with training will negatively affect performance. (How can we improve running performance)

Can Antioxidants ever improve performance?

Although when taken chronically, antioxidants hurt performance,  in short acute use it may actually improve performance.  This is due to the fact that it is able to help fend odd Reactive Oxygen Species that may hinder performance.  Thus, on race days, acute supplementation of antioxidants may be a valuable tool.

Research on this topic

“Increased oxidative stress during exercise results in the production of free radicals, which leads to muscle damage, fatigue, and impaired performance. Despite their negative effects on performance, free radicals may act as signaling molecules enhancing protection against greater physical stress. Current evidence suggests that antioxidant supplementation may impair these adaptations”

“Given that antioxidant supplements (e.g., vitamin E and C) tend to block anabolic signaling pathways, and thus, impair adaptations to resistance training, special caution should be taken with these supplements”

“Acute antioxidant supplementation has been shown to improve performance during high intensity exercise with short recovery intervals”

“With regard to the optimal timing of antioxidant consumption, much of the evidence is pointing towards an acute performance benefit but performance impairment when taken chronically.”

Should Patients Continue with a Wellness Plan Following The Completion of Physical Therapy?: MythBuster Monday

Physical Therapy is a catalyst for keeping people moving following an injury.  However, due to current limitations in the system, Physical Therapist are typically unable to fully correct the underlying causes of an individuals injuries. Under the current limitations Physical Therapy can serve as a powerful tool to lead people to long term health. This is where a quality wellness plan can become incredibly important in building upon the gains we have made during Physical Therapy.  If you are interested in my Wellness coaching options please reach out and we can set up a free consultation.

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Is Creatine Bad For Your Health? MythBuster Monday

For all of you that don’t want to read, The answer is if you are a healthy individual with properly functioning Kidneys and Livers, Creatine is extremely safe and effective.

History of Creatine

Creatine was first discovered in 1832, as a natural compound that plays an important role in cellular energy homeostasis. Creatine stores are used to provide energy in short explosive movements. Creatine along with our ATP serve as our instant fuel. Since this time it has become common place to use creatine to improve physical performance. In fact over $400 million worth of creatine is sold each and every year.

Over the last 30 years, creatine has been studied extensively and shown incredible results in both improving overall health and sports performance.

Creatine Improving Sports Performance

The International Society of Sports Nutrition put out a position stand that to into account an extensive accumulation of all the research on creatine and found these results.

“Creatine monohydrate is the most effective ergogenic nutritional supplement currently available to athletes with the intent of increasing high-intensity exercise capacity and lean body mass during training.” Here were some of the key take home points of this position stand.

  • Increase single and repetitive sprint performance
  • Increase work performed during sets of maximal effort muscle contractions
  • Increase muscle mass & strength adaptations during training
  • Enhance glycogen synthesis
  • Increase anaerobic threshold
  • Provide possible enhancement of aerobic capacity via greater shuttling of ATP from mitochondria
  • Increase in work capacity
  • Enhance recovery
  • Antioxidant effects
  • Increased Bone Mineral Density

Creatine’s Use in Disease States

I am not a medical doctor and am not offering any medical advice. I am only offering what research has discussed. Creatine has some interesting research that is going on regarding its effects in Neurodegenerative diseases. Neurodegenerative diseases are characterized by a progressive loss of function, and often death, of neurons. Below is the proposed mechanisms.

The theory that started the research in the usage of creatine as a treatment option is based around mitochondrial dysfunction and excess production of free radicals being two primary mechanisms driving the development of neurodegenerative diseases. Creatine supplementation increases the PCr pool which may facilitate improved mitochondrial functioning and more efficient ETC transfer.

In Animal studies creatine has shown positive results. However, these results have not carried over to human studies. This can be explained by decreased mitochondrial function being an important factor in several neurodegenerative diseases, but it is typically not the main factor. Creatine may not be used as the main treatment for any of these neurodegenerative diseases, however, it may still be a valuable part of treatment plans do to its many benefits including maintaining muscle mass and bone health, while also serving as an antioxidant.

Controversy around Creatine being Bad For You?

For years, creatine got a bad name. Thinking back on what I heard growing up, included “creatine is a steroid” “Creatine Only makes your muscle bigger because they fill them with water” and that you HAD to cycle creatine because it was bad for your “liver and Kidneys”.

As we talked about above creatine is not a steroid but instead a natural compound that plays an important role in cellular energy homeostasis. It affects energy production and distribution by being reverse phosphorylated to phosphocreatine. This ability gives us more work capacity while working out which allows us to achieve more #gains.

The second false narrative comes from the fact that creatine does cause your muscles to retain more water. Which is not a bad thing, we are made up mostly of water.

Finally, we get to creatine damaging our liver and kidneys. Since our liver naturally produces creatine, many worried too much would harm it. However, research has consistantly shown for HEALTHY individuals creatine is safe even for long term usage. For individuals with a history of liver issues they should be cautious and talk to their physician prior to taking creatine. For the kidneys, many thought it was bad because a common sign of kidney disease is elevated levels of creatinine, a byproduct of creatine, in the blood. This caused many people who were taking creatine to have false positives for kidney disease. However, the reason they were testing positive wasnt because their kidney was damaged but instead because they were taking more creatine thus having more creatinine by product. This is the same as if you eat alot of protein you would expect to have more amino acids in your blood.

Why I take creatine?

Creatine offers a tremendous amount of benefits for a very low price. On the physical side it increases work capacity, muscle mass, glycogen synthesis, sprint performance and enhances recovery. For my general health, it offer antioxidants to help fight off free radicals that come with my high stress highly active life style. Finally, there is research that shows while in sleep deprivation, creatine has shown to improve cognitive function. As a doctoral student, who loves to overextend himself with research, part time jobs, dog duty and running compass performance, sleep is usually the first thing i give up. So hopefully I get a little boost from my creatine.

I use Bulk Supplements for all of my supplements due to the high quality and insanely low prices. With Bulk supplements you arents paying for advertisements or labeling but instead just high quality products. You can get 200 servings of Creatine for ~$20 @bulksupplements when you use coupon code “COMPASS5OFF”.

References

Butts J, Jacobs B, Silvis M. Creatine Use in Sports. Sports Health. 2018;10(1):31-34. doi:10.1177/1941738117737248

Kreider, R.B., Kalman, D.S., Antonio, J. et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr 14, 18 (2017). https://doi.org/10.1186/s12970-017-0173-z

 Braissant O, et al. Creatine deficiency syndromes and the importance of creatine synthesis in the brain. Amino Acids. 2011;40(5):1315–24. 14. review

Wyss M, et al. Creatine and creatine kinase in health and disease–a bright future ahead? Subcell Biochem. 2007;46:309–34.   review

Beard E, Braissant O. Synthesis and transport of creatine in the CNS: importance for cerebral functions. J Neurochem. 2010;115(2):297–313 review 

Bender A, Klopstock T. Creatine for neuroprotection in neurodegenerative disease: end of story? Amino Acids. 2016;48(8):1929–40.

Should Patients Continue with a Wellness Plan Following The Completion of Physical Therapy?: MythBuster Monday

Physical Therapy is a catalyst for keeping people moving following an injury.  However, due to current limitations in the system, Physical Therapist are typically unable to fully correct the underlying causes of an individuals injuries. Under the current limitations Physical Therapy can serve as a powerful tool to lead people to long term health. This is where a quality wellness plan can become incredibly important in building upon the gains we have made during Physical Therapy.  If you are interested in my Wellness coaching options please reach out and we can set up a free consultation.

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