I was just checking in on how Maximum Strength is doing over at Amazon, and came across the following five-star customer review. As the reviewer notes, sometimes you need to get outside your comfort zone - both in training and in life - to get to where you want to be.
"This book is a must-read. I heard a lot of hype about this book before purchasing, and I'm glad I finally bought it. I did the entire 4 month routine and honestly, my body feels better than it ever has in the past."I was used to the traditional bodybuilding bodypart split of chest on Monday, legs on Tuesday, Arms on Wednesday, etc etc. For years, I just accepted that this was the way to train your body. I just dealt with back pain and shoulder pain as part of the "price of working out." Doing 5 exercises for your back in one day, and 5 exercises for your shoulders in one day is the absolute wrong way to train your body, unless you are an actual bodybuilder, but for the average fitness enthusiast, that just doesn't apply."Eric's book outlines splitting your routines into upper body days and lower body days. The routines are easy to follow. Full detailed pictures, and explanations. One of the most important things he advocates is varying the rep range each week within the 4 week routine. You probably never have done any exercise of 8 sets of 2 reps or 10 sets of 3 reps. You have to keep in mind Eric is a Strength & Conditioning Coach with the goal of getting you stronger. I was hesitant, but you have to open your mind and try it."My body feels stronger, and more balanced. There are a few non-traditional exercises that you probably have never heard of, or are hesitant to try out. My advice would be to do everything in the book to a T. It works. You may be reluctant to do so much deadlifting and squatting. You may have never hear of scapular push ups, walls slides, face pulls, or behind the neck band pull aparts. Open your mind. Follow the routines exactly and you will be glad you did. I know I am. Your body will feel so much stronger, more balanced, and your posture improves. I hope this doesn't sound like a 3 a.m info-mercial testimonial for the latest fitness product, because it's not. I'm a Certified Personal Trainer and a Certified Gym Rat who has been lifting for 11 years. Open your mind, try the routines, follow to a T. Your body will thank you."Click Here to Purchase Maximum Strength.
Free Teleseminar Series at SportsRehabExpert.com
I just wanted to give you all a heads-up on a great audio series - Sports Rehab to Sports Performance - that Joe Heiler has pulled together. I'll was interviewed on Friday, and Joe's also chatted will Mike Boyle, Gray Cook, Kyle Kiesel, Stuart McGill, Phil Plisky, Brett Jones, and Charlie Weingroff. The entire interview series is COMPLETELY FREE and begins airing later tomorrow night. You can get more information HERE.
Also, don't forget that the third annual Mike Boyle Strength & Conditioning Winter Seminar is fast approaching. For more information, click here.
Snowy Sunday Sentiments
Yesterday, in an email exchange I was having with some guys who are really "in the know" in the world of baseball pitching, one of them commented that pitchers need to start thinking more along the lines of training like Troy Polamalu of the Pittsburgh Steelers. In other words, less external loading, more pure-body weight drills, and a big focus on reactive ability (plyometrics drills, for the lay population).
I'll be the first to recognize Polamalu's accomplishments on the field - including an interception return for a touchdown yesterday. And, I admit that I don't know much about his training philosophy aside from what I have seen in 3-4 minute YouTube and NFL clips. So, I guess you could say that my point of contention is with what some folks take from viewing these clips, as was the case with this email exchange. So, I'll be very clear that I'm not criticizing the Sportslab philosophy; I'd love to buy these guys lunch and pick their brains, in fact.
However, I've got two cents to add - or maybe even three our four cents, depending on how poorly the American dollar is doing nowadays. I'm writing this on a snowy day in Massachusetts and I've got a little bit of extra time on my hands (a rarity during the baseball off-season for me).
I think that it is wrong to assume that weight training is unnecessary and plyometrics are sufficient for injury prevention and performance enhancement in pitchers. This is a common belief held among a large body of pitching coaches that I feel really needs to be addressed.
The fundamental problem I see is that a system that relies extensively on training elastic qualities. Or, in the terminology I like to use, it teaches an athlete to be more "spring," making better use of elastic energy from the tendons. This works best in an athlete who is largely static, or has a solid base of muscular strength.
Who would be a static athlete? Well, one example would be an athlete who gained a lot of strength in the previous four years...say, Troy Polamalu. He was a first-round draft pick out of USC, known for a good program under strength and conditioning coach Chris Carlisle. They've packed lots of muscle and strength on loads of high school guys over the years, no doubt. Polamalu may not realize it, but those four years of USC training probably set him up for the positive results he's seeing in this program - especially when you compare him to a good chunk of the NFL that now uses machine-based HIT training because they're afraid of weight-room injuries.
Basically, for the most part, only the freaky athletes make it to the "big dance" in football, so the S&C coach is responsibly for not hurting them. It's not much different in the world of baseball - but we're dealing with a MORE TRAINED population in the first place.
I'm sure that many of you have read Moneyball (and if you haven't, you should). One thing that they touch on over and over again is that high school draft picks don't pan out as well as college draft picks.
Sure, it has to do with facing better hitters and maturing another four years psychologically. However, one factor that nobody ever touches on is that these college draft picks have another four years of strength and conditioning under their belt in most cases. It may not be baseball-specific in many cases, but I would definitely argue that it's better than nothing. Strength goes a long way, but physiologically and psychologically.
And, that's what I want you to think about until my next newsletter comes out - when I'll get a bit more to the science of all this, and how it's been demonstrated in professional baseball.
New Blog ContentRandom Friday ThoughtsHow to Make an Exercise TougherAnother CP Intern on the Road to DieselFrozen Ankles, Ugly Squatting
Until next time, train hard and have fun.
EC
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used by Cressey Performance Pitchers after they Throw!
In this week's "The Biggest Loser made me want to stab my eye out with a hot poker" moment, I watched what appeared to be a 1,742-pound woman attempt to do an inverted row. It was an admirable attempt, for sure, but I'm sorry to say that in all my years of coaching and writing strength and conditioning programs, I've can think of fewer than 20 females who have ever been able to perform a single good inverted row.
This isn't a knock on women; it's just that they, on average, have markedly less strength than men in the upper body. And, more importantly, the inverted row is a more advanced strength exercise than people realize - so that strength discrepancy will be more readily apparent.
As a frame of reference, here is what a good inverted row looks like:
As you can see, the chin stays tucked to keep the cervical spine (neck) in line with the rest of the body. Without that forward head posture, you're getting just the kind of scapular retraction you want. Speaking of scapular retraction, you'll also notice that the chest is going ALL THE WAY up to the bar.
There are three compensation patterns that you'll come across. To protect the innocent, I won't post videos, but rest assured that if you did a quick YouTube search for "inverted row," you'd quickly come across example of the following:
1. The Ceiling Humper: This individual will give a little tug of elbow flexion and scapular retraction to get about halfway up, and then he/she will violently thrust the crotch to the heavens. In some circles, this individual is known as "The Fish." Regardless, it isn't pretty.
2. The Scared Cat: This individual basically does a curl - including curling the wrists in - so that there is essentially everything occurring except scapular retraction. In the process, they get to the top - but in that top position, they are rounded up in a ball like - you guessed it - a scared cat. There is, however, a delightful chin protrusion/forward head posture that makes that individual believe that the movement actually took place. Unfortunately, it didn't - and this effort, too, isn't pretty.
3. The Half-Asser: This individual is the lazy cousin of the Ceiling Humper and Scared Cat. He can be found around dudes who do half pull-ups, pop their collars, and live in their parents' basements. Very simply, he (or she, for that mattter) only goes halfway up - but usually still insists on using the feet-on-the-box set-up (the most advanced progression).
Sadly, the acronym IRA was already taken, so Inverted Rows Anonymous could never get off the ground - and these issues persist. I suspect that we're looking at a $47 million government stimulus package to remedy the issue. And, as our new commander-in-chief has stated, "things are going to get worse before they get better," be prepared to observe this inverted row ignorance for quite some time before it's addressed.
For a host of better scapular stabilization exercises, check out Optimal Shoulder Performance.
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No blog yesterday; things were kind of crazy around CP, and I did a 14-hour day that began with dropping Pete off at the airport at 6:15. The good news is that it allowed me to stockpile some content for today's random thoughts.
1. For this week's music selection, I got a little inspiration from one of Cressey Performance's newest clients. Here's a little old-school flavor for you:
2. Speaking of that new client, I guess you could say that the cat is out of the bag.
Rumor has it that this guy can pitch a little bit.
3. Here is a great review of Maximum Strength. I've been so busy lately that I actually forgot I'd published a book about six months ago and probably ought to mention it here and there! Click here to pick up a copy.
4. As I've written before, I'm not a fan of Vitamin Water - but I will say that I love article!
5. Apparently, George the Lobster is the talk of my hometown (Kennebunk/Kennebunkport, ME). They're freeing this 140-year-old , 20-pound lobster on the beach up there this weekend. It was a strategic move to release him in January, as it reduces the likelihood that George will be scared back into captivity by the socially-awkward males tourists on the beach in their lime green Speedos.
Oh, and on a semi-related note, I could eat an entire 20-pound lobster in one sitting and then be hungry 15 minutes later. Lobster alone never fills me up; I'm a surf and turf guy. Us Maine guys are spoiled brats like that.
6. For those who missed it, I had an article published late last week at T-Nation; check it out:
The Right Way to Stretch the Pecs
7. After a holiday hiatus, I got back on track with my newsletter this week. Newsletter 138 focuses on the misunderstood role of the rhomboids.
8. I got asked the other day why I cue folks to keep the chin tucked during squatting and deadlifting variations. Shoulder geek that I am - and even though it's just the tip of the iceberg - I gave the following perspective:
Cervical extension = levator scapulae shortness
Levator scapulae shortness = scapular anterior tilt and insufficient upward rotation
Scapular anterior tilt and reduced upward rotation = unhappy shoulder
Additionally, you've got the extensor reflex - which Mike Robertson covered quite nicely HERE.
Have a great weekend, everyone.
This is a random post, but it came about in light of our recent switch to a new hosting company, plus the reorganization of the site. In this drawn-out, mind-numbing, baldness-inducing process, I came to realize that a lot of my better writing has slipped into an internet black hole - or at the very least, the EricCressey.com archives. So, with that in mind, over the next few weeks, I'm going to reincarnate some of my old material.
Waiting to Reach ThresholdBack Squats and Overhead ThrowersThe Best Thing I've Seen All Year
And, if you're looking for sites that I visit nearly every day, I'll be posting some recommendations, too. Today, though, I want to give you a heads-up on a great audio series - Sports Rehab to Sports Performance - that Joe Heiler has pulled together. I'll be interviewed, as will Mike Boyle, Gray Cook, Kyle Kiesel, Stuart McGill, Phil Plisky, Brett Jones, and Charlie Weingroff. The entire interview series is COMPLETELY FREE, and you can get more information HERE.
I'll follow this up with future installments.
Q: I attended the baseball strength training clinic you gave in Long Island. I have a question for you about push-ups for pitchers. I am using push-ups with all player, and one of the parents has been concerned that push-ups are not good for pitchers. I was wondering if you could help me explain why push-ups are good for pitchers.
A: No problem. The two big "players" in scapular dysfunction are lower trapezius and serratus anterior. These muscles work in conjunction with the upper trapezius to upwardly rotate the scapula, which allows for safe overhead movements. Research has shown that baseball pitchers have less scapular upward rotation compared with position players and non-athletes - so it's definitely an adaptive change that we need to work to address.
Push-ups (when done correctly) can be useful for activating the serratus anterior, and as a closed-chain exercise, it has proprioceptive benefits at the shoulder girdle. Plus, you get a considerable effect in terms of core stability training, as you're resisting the effects of gravity in the "plank" position where the lumbar spine wants to slip into extension.
That said, if you're dealing with high school athletes, I'll warn you that over 90% of them (in my experience) need to be coached on how to do a push-up correctly. It isn't as simple as "just do this," as most of them will resort to incorrect technique. With a good pushup, the upper arms should be tucked to a 45-degree angle to the torso, and the athlete should actively "pull" himself down to the bottom position with the scapular retractors. The hips shouldn't sag, and there shouldn't be a forward head posture. Essentially, the chest - not the chin or hips - should get to the ground first.
I got to talking with an athletic trainer at a recent seminar, and we were discussing how people really don't understand how the rhomboids work.
You see, the rhomboids typically get lumped right in with the trapezius complex as scapular retractors - and that's correct, but not exhaustive enough to illustrate my point. What you want to observe is the line of pull of the rhomboids:
What you'll see if that this line of pull is quite similar to that of the upper trapezius and levator scapulae muscles, both of which "hike" the scapula up. In reality, the goal with any rowing exercise should be to get the lower trapezius firing as much as possible, as its line of pull depresses the scapula as it retracts - and the muscle is involved upward rotation, which is essential for safe overhead movements.
Note how the line of pull of the trapezius changes as you go superior (top) to inferior (bottom).
As such, you want to make sure that you get your shoulder blades back and down as you do your rowing movements. Here's an example of what a bad seated cable row, where the scapulae are retracted, but ride up, leading to upper trap, levator scapulae, and rhomboid recruitment.
Much of this comes because of the backward lean, but it's also possible to have it when in the right torso position.
If you are someone with shoulder issues, you'll be surprised at what some general massage work on the rhomboids will do to alleviate your discomfort. We know that working on pectoralis minor and levator scapulae will quickly yield results, but rhomboids falls into the same category, as (like these two muscles) they're involved in downwardly rotating the scapulae.
Click here to purchase the most comprehensive shoulder resource available today: Optimal Shoulder Performance - From Rehabilitation to High Performance.Sign up Today for our FREE newsletter and receive a deadlift technique video!
We're a few days late with this post, as I was in Washington, D.C. from Thursday through Saturday for the Professional Baseball Athletic Trainers Society Team Medicine conference.
1. Metallica's the music choice of the day. Can you really go wrong with a band that's this badass with a drummer who used to be a junior tennis prodigy?
2. To start off, I want to congratulate Cressey Performance athlete Mark Hogan on becoming the first ever football scholarship athlete at Georgia St, a new program that will begin play in 2010.
3. It never ceases to amaze me how many people still haven't grasped the concept of "N=1." Maybe I have a skewed perspective on the importance of a big sample size because of my time in the research world? Perfect example: I get an email from a powerlifter who had shoulder problems for years, and they *magically* disappear when he takes a step back from benching (presumably in terrible form) in favor of doing dips and handstand push-ups. So, obviously, the logical line of reasoning is that everyone with shoulder problems is only a few hundred dips and handstand push-ups away from shoulder bliss and an altogether utopian society where the glenohumeral Tinkerbell sprinkles fairy dust on labrum tears and bicipital tendinosis to make things allllllllllll better. Seriously, it's just logic.
4. I'm sure I'll get a few email follow-ups to #3 from those interested to know if I have any mythological treatments for knee, elbow, and ankle pain. For those, I recommend duct tape and a glue gun. Lower backs, on the other hand, respond best to Indian rain dances. It's true. Four separate individuals (coincidentally, all of them went by the name "Professor N=1") told me so.
5. On a less cynical note, I had an article published at T-Nation on Tuesday. Check it out: The Right Way to Stretch the Pecs.
6. As you may have already noticed, we're still working out some kinks in the site - particularly the Articles and Baseball Content pages. I promise; we're getting closer!
7. A few weeks ago, I gave you a heads-up on one Cressey Performance athlete (Shawn Haviland) who has a blog. It turns out that another one has a good one rolling along, and he deserves some love, too. Check out Will Inman (Padres system pitcher) at WilliamInman.com. Good content, but if he calls me a trainer one more time, he's going to be pushing the sled until the cows come home.
Just a quick one this week. Have a great weekend.
Of all the lousy things that can happen, this has to be one of the worst. Imagine...You've just completed the most successful bulking cycle of your life, adding twenty pounds of mass; you're on top of the world. Now, all you have to do is train properly and eat plentifully in order to solidify your gains. With your knowledge of diet and training, it should be a snap. Then everything hits the fan...
Your girlfriend is so proud of you for making such great gains and transforming your physique that she can't keep her hands off of you. The day before, she had shared a soda with a friend who had just come from the gym. That friend had taken a sip from the water fountain at the gym and accidentally touched her lips to the spout. Ten minutes earlier, that skanky "human sweat gland" guy who spends five hours on the elliptical cross trainer each day had just made out with that same water fountain. That morning, he had kissed his wife goodbye before leaving for his job at the DMV. That wife is the teacher of a kindergarten class. Incidentally, that class happened to be riddled with the flu, and some kid had blown chunks all over her nice new blouse the day before. Sure she cleaned it up, but she still wound up with the flu. Thanks to this incredibly unlikely downward spiral, you are now home sick from work, pitying yourself as you watch the same episode of Sportscenter eight times in a row. All the while, you're thinking about how you would much rather be deadlifting like a madman and showing off your gains at the gym!
Unfortunately, you cannot go back in time to prevent yourself from coming down with the flu. Although it may be beneficial to look back and figure out if there was anything you could have done to strengthen your immune system (avoiding overtraining, paying attention to post-workout nutrition, taking certain supplements, getting plenty of sleep, etc.), you need to focus on the task at hand: beating the flu! You see, bodybuilders, powerlifters, and other athletes have to take into account how sickness affects performance and physical appearance, whereas normal folks just worry about "getting rid of their sniffles."
Before we get to the specifics, though, I should mention that the term "flu" that we so often use is short for influenza. Influenza (also known as Grippe or Grip) is really only one of several common kinds of viral respiratory infections. Also including on this list are the common cold (upper respiratory infection or acute coryza), pharyngitis, laryngitis, tracheobronchitis, and viral pneumonia (1). Regardless of the clear differences in the nuts and bolts of each infection, they are generally all lumped together and called the flu by the general public. While this oversimplification is erroneous, the human immune system must be strong to prevent and in many cases overcome any type of infection. And, if you're anything like me, you detest the idea of getting loaded up on medications, sugary cough syrups, and lozenges just because your nose is running faster than a sprinter with a rocket up his butt. All that being said, let's get to work on finding a universal approach to maintaining your gains and getting back to optimal health as soon as possible.
Diet
Proper diet seems like a no-brainer, right? One would think so, but I'm constantly amazed at how people vehemently adhere to this primitive urge that tells them to stuff themselves full of crap foods just because they feel like crap! These crap foods are usually "comfort" foods: Mom's cookies, white toast with cinnamon, sugar, and butter, hot chocolate, a whole gallon of ice cream?. These foods may have made you feel better as a kid when they were used to take your mind off the "boo-boo" on your knee, but they'll only make thing worse when you are a sick adult. They might make you feel all warm and toasty on the inside, but they'll quickly make you soft and fluffy on the outside if you overindulge.
So what should you eat and what should you avoid? For starters, remember that total calories are of foremost importance. Don't fall into the trap of dropping calories too low out of fear of gaining fat while "on the shelf." Instead, it's important to assume the mindset of maintaining the status quo physique-wise while bringing the immune system up to par. If you gain a little fat, don't sweat it. Remember, it's a lot easier to shed a little fat than it is to regain a few pounds of lost muscle. In reaching your daily caloric goal, as usual, spread your intake out over six smaller meals. Maintenance caloric intake is highly variable, so rather than multiplying your body weight by a certain number to find your target, base your intake on slightly below (100-150 calories) what you would take in on a normal rest day. This decrease should account for the extra time spent on the couch or in bed.
Specific macronutrient recommendations are also of little value in this instance due to individual variations in terms of carb tolerance. As such, adhere to your typical macronutrient ratios with the only exception being a slight reduction in carb intake to compensate for the diminutive calorie reduction and reduced training effect. Furthermore, make sure that you keep protein high (1-1.5g/lb lean body mass) in order to remain in positive nitrogen balance and stop muscle protein catabolism in its tracks. From all our cutting cycles, we're all well aware that protein needs increase during times of stress, and sickness is certainly one of those times. In a study of critically ill children in hypermetabolic and catabolic states, researchers found that a higher protein intake was associated with positive nitrogen balance, whereas a low intake (with total calories held constant) led to a continued state of negative nitrogen balance and muscle protein catabolism (2). A big steak probably won't sound too appealing when you're sick, though, so low carb protein powders (such as Xtreme Ultra Peptide), cottage cheese, omelets, and other "easy to get down" protein sources might turn out to be your best friends.
Next, only consume low-glycemic carbs. When you're sick, your body isn't primed for sucking up simple sugars like it is when you've just completed a training session. So, the typical bodybuilding "no-no" foods should be even more off-limits than usual. Your best bet is to focus carb intake early in the day when muscle cells are most receptive to storing glycogen.
Keep fats (especially healthy fats) up as well - possibly at the expense of carbohydrates. In the aforementioned study of critically ill children, fat was used preferentially for oxidation. Meanwhile, a high carbohydrate intake was associated with lipogenesis (fat formation) and decreased fat oxidation (2). Thirty percent of total calories is a good figure in order to support endogenous testosterone and overall energy levels (as fat is the primary source of energy at rest). Your body will be forming plenty of new immune cells as you fight off sickness, and fatty acids constitute an important component of each new cell membrane. Therefore, in order to give the body the best raw materials available, make sure that you're getting plenty of omega-3 fatty acids.
However, don't fall into the trap of overdoing the omega-3s or fat in general; very high fat diets are associated with impaired lymphocyte (one of the five kinds of leukocytes, or white blood cells) function (3). Furthermore, while fish oil has proven effective in enhancing immune function in certain clinical situations (e.g. rheumatoid arthritis, ulcerative colitis) and in animals, studies of healthy humans are yet to yield consistently favorable results to substantiate the claim that omega-3s enhance immunity (4). As such, there does not appear to be any greater benefit (at least not yet) to increasing omega-3 PUFA intake during times of sickness. Simply stick to your normal intake levels, relying on healthy sources such as fish oil and flaxseed oil for your supplemental fat intake.
The last dietary concern that warrants mention is water intake. You might think that because you aren't training, you don't need to worry much about pushing the H2O- big mistake. The body loses a significant amount of fluids each day independent of training. We're constantly losing water as we dissipate heat through our skin and in our breathing without even knowing it. Factor in increased mucus production, the sweating that may be associated with a fever, the fact that your body is constantly constructing new cells (especially during sickness), not to mention your higher protein intake, and you can begin to realize the importance of really emphasizing water intake. Shoot for at least one gallon (preferably more) of water daily.
All these considerations in mind, I highly recommend you pick up a copy of Precision Nutrition from Dr. John Berardi. His information is fantastic, highly effective, and presented in a user-friendly format.
Supplementation
First and foremost, be sure to get a flu shot each fall. The optimal time to do so is mid-September through November, as it takes at least a week for the shot to really kick into protective-mode. If you need proof that the influenza vaccine is worth the fee (if you even have to pay for it), look no further than a study conducted on a Brazilian airline company's employees. As I'm sure you can imagine, flight attendants and those in related roles are a population segment that is extremely susceptible to the flu due to their interactions with so many customers (often in confined spaces). Prior to flu season, each of 813 employees received either an influenza vaccination or a placebo. Seven months later, the employees who had received the vaccines showed 39.5% fewer episodes of flu-like illness than the placebo. Additionally, the vaccine group was absent from work due to sickness 26% less often than the placebo group (5). From a weight-training standpoint, that 26% corresponds to a lot of missed training sessions. In addition to the flu shot and your regular multivitamin, you should definitely include the following:
Vitamin C
Vitamin C (ascorbic acid) is the first immune-booster that comes to mind. A vital component of every cell in the human body, ascorbic acid is perhaps most notably found in high concentrations in leukocytes (white blood cells). The leukocytes are constantly being produced in the bone marrow as safeguards against bad stuff like cottage cheese gone sour, reruns of those obnoxious Subway commercials with Jared, curling in the squat rack, and, oh yeah, infections. During infection, in order to prevent oxidative damage, the vitamin C within the leukocytes is used up faster than a post-training shaker bottle full of Relentless (4)! Thus, it should come as no surprise that reduced leukocyte vitamin C levels are associated with less than optimal immune function. (6) In the worst vitamin C deficit scenario, scurvy, the immune response is entirely inadequate (and sometimes nonexistent) in each of the many components of the immune system. In fact, overall vitamin C status is often measured via an assessment of levels in the leukocytes (4).
In terms of preventative supplementation, a true consensus has not yet been met regarding the efficacy of vitamin C in reducing the occurrence of common colds. Several respected studies have found that Vitamin C supplementation is of little value in preventing the common cold (7), whereas others have reported decreased incidences of reported common cold infection among individuals who received large doses of a vitamin C supplement (8,9). However, other studies have verified the assertions that supplementation with vitamin C improves several aspects of the human immune response, effecting positive changes in proliferation and/or function of in three of the five types of leukocytes: lymphocytes, neutrophils, and monocytes (10-16).
Adequate vitamin C status is often defined as "a circulating pool of 1500mg" (7). Due to the fact that water-soluble vitamins like vitamin C are not stored by the body as well as fat-soluble vitamins, ascorbic acid must be continuously replenished through diet and supplementation. Doses of up to 10g per day have been used in numerous studies without serious toxicity symptoms. The side effects of such high consumption may include diarrhea and, in serious cases, kidney stones or urate crystals (due to increased uric acid release in the urine). Antonio and Stout state that these risks have "been greatly overstated" (7). Based on the available literature, I recommend 2-2.5g of supplemental vitamin C daily during normal training conditions and 4-5g daily during flu-like symptoms and times increased of training stress. Also, be sure to spread your intake throughout the day in 500mg doses. Dosages of 500mg are proven to increase cellular ascorbic acid absorption by up to 40%, whereas dosages greater do not increase this absorption (17).
Vitamin E
Perhaps as important as vitamin C is Vitamin E, which works synergistically with selenium in tissues to reduce lipid membrane damage by reactive oxygen species (ROS) during infections (4). Vitamin E has proven effective in improving various parameters of the immune function, including enhanced lymphocyte production, improved antibody response to vaccine, reduced pulmonary viral titers (a measure of virus prevalence in respiratory infections), and "preventing an influenza-mediated decrease in food intake and weight loss" (18-20). No decrease in food intake? Maybe that steak won't sound so bad after all!
All that being said, even the slightest deficiency in vitamin E can easily compromise one's immune response. And, the current RDA of 30 IU is barely adequate in preventing deficiency in sedentary, normally healthy individuals, let alone in athletes, the elderly, and the sick and diseased. Granted, one may derive a considerable amount of vitamin E from diet alone, but in order to receive sufficient vitamin E to attain an enhanced immune benefit, one must supplement in excess of the RDA (especially on low-fat diets). Vitamin E is recognized as one of the least toxic vitamins, although one may experience some minor symptoms (nausea, diarrhea, muscle weakness) with very high dosages (7,21). As such, 800-1200 IU throughout the year (regardless of whether you're sick or healthy) is an optimal approach.
Glutamine
Glutamine is well known as the most abundant amino acid in the human body (including both the plasma and tissue pool). In fact, the intramuscular free amino acid pool is more than 60% glutamine, and the glutamine in skeletal muscle accounts for about 90% of the body's total glutamine pool. Although over 40% of the body's glutamine is devoted to fueling the GI tract, this amino acid also plays a role in the functioning of many other parts of the body, including the liver, brain, muscles (duh!), hair follicles, kidneys, and - you guessed it - the immune system (7,22-24). Adequate levels of glutamine are necessary to ensure optimal proliferation and function of lymphocytes, macrophages, and neutrophils (25,26).
Traditionally, because the body can synthesize glutamine endogenously (mostly in the muscle tissue), it has been classified as a nonessential amino acid. However, this classification is made under the assumption that the body is not enduring a stressful physiologic trauma such as sickness (23). Many researchers have now begun to classify glutamine as a conditionally essential amino acid during times of sickness, infection, and malnutrition. Because glutamine is a crucial substrate for a variety of metabolic processes, it is only logical that the body requires increased amounts of the amino acid during infection in order to "bolster" the immune system while maintaining normal physiological functioning (24,26).
Unfortunately, as you can see in many cancer patients, the body's response to infection, injury, and stress is protein catabolism. Initially, plasma glutamine levels are depleted. Next, in order to sustain its metabolic processes and replenish plasma glutamine levels, the body takes glutamine from skeletal muscle. Normally, this isn't a problem, as skeletal muscle glutamine synthesis matches glutamine release. However, during times of stress, there is a problem: numerous organs, including the liver and bowel, show marked increases in glutamine uptake during infection. These increases, in combination with the needs of the immune system, GI tract, and the regular metabolic processes, cause glutamine release from skeletal muscle to exceed glutamine synthesis. In fact, skeletal muscle glutamine release may double during infection (23,27). In summary, during infection:
1. Glutamine use increases
2. Glutamine supply decreases
3. A concentration gradient across the muscle cell membrane cannot be reached (23)
4. Your beloved quad sweep becomes fuel for your GI tract and, essentially, your body's lunch.
Think about it for a second: when you're sick, is your body going to care more about ensuring appropriate internal organ functioning or maintaining sleeve-splitting biceps? Luckily, numerous studies have proven that exogenous glutamine can help to: maintain positive nitrogen balance (and glutamine levels in skeletal muscle), increase plasma glutamine levels, prevent decreases in ribosomal concentrations, improve muscle protein synthesis rates, and enhance immune function (through such mechanisms as encouraged lymphocyte proliferation) (7, 28-32). Also, let's not forget that glutamine?s "immunoenhancing" effects make it an effective year-round, recovery-promoting supplement (albeit in smaller doses) for hard training athletes who are more susceptible to infection, especially during and shortly after periods of intensive training (7,33,34). Glutamine supplementation is also associated with increased plasma GH concentration, which may also assist in immunity (7,35). During illness, shoot for 0.35-0.4g glutamine per kg body weight, and spread your intake out throughout the day in 3-5g doses. Based on the published clinical studies and for absorbability reasons, I recommend glutamine peptides. L-glutamine (free form), however, tastes better, generally costs less, and will also yield favorable results. Personally, I'll stick with peptides, but it's your call; just make sure to get it in you in some form!
Zinc
Although most people primarily associate zinc with growth and development, this trace mineral also plays a crucial role in proper immune function. A deficiency of zinc relates to diminished immune response, including low T- and B-cell (the two broad categories of lymphocytes) counts in bone marrow due to decreased proliferation, and reduced antibody production (just to name a few). In some mice, only thirty days of inadequate zinc intake caused an 80% reduction in immune capacity. As such, it should come as no surprise that zinc deficiencies are prevalent in numerous immune system-stressing chronic illnesses, including HIV, renal disease, and alcoholism (4,36).
While the complications of zinc deficiency are well established, studies on the benefits of zinc supplementation in enhancing immune function have yielded mixed, but mostly favorable results. Numerous studies have found that zinc supplementation initiated upon the onset of a cold or upper respiratory tract infection decreases the sickness' duration and severity (7,37-39). In a study of twenty burn victims, fewer pulmonary infection rates and shorter hospital stays were observed in patients who received a trace mineral supplement that included zinc (40). Meanwhile, zinc supplementation in long distance runners prevented the typical increase in reactive oxidative species normally seen with endurance activity (41).
In terms of preventative supplementation, researchers found that of 609 school children that were given either a zinc supplement or a placebo, those who supplemented with zinc had 45% fewer acute lower respiratory infections over the 120-day study (42). If you take nothing else from all these studies, at least walk away from this article cognizant of how important sufficient intake is, especially for athletes (who are more likely to be deficient than the general population). While high-dose supplementation can actually lead to immunosuppression, moderate supplementation throughout the year with slightly increased dosages beginning at the onset of flu- or cold-like symptoms is an effective and safe supplementation approach (7). During sickness, take at least 25mg zinc (but not more than 100mg) per day. An optimal approach would be to get this supplemental intake in the form of a ZMA supplement, as it will enable you to meet your zinc needs while increasing anabolic hormone levels, improving recovery, and promoting deep, restful sleep.
Miscellaneous: the other stuff
Here are a few other supplements that are often thrown into the immunity discussion, but will probably not be worthwhile additions to your immune effort:
Vitamin A (preformed vitamin A is known as beta-carotene): Although vitamin A is of unquestionable importance to proper immune functioning, there is no definitive evidence to suggest that supplemental vitamin A offers additional benefits over normal dietary intake, especially in those with already adequate status. Excessive vitamin A intakes have been associated with suppression of T- and B-cell function, thus causing a greater susceptibility to infection. Toxicity can also become an issue with higher intakes. Vitamin A deficiency is very uncommon in wealthier nations. As such, if you feel that you need to get more beta-carotene than you diet alone provides, make sure to select a multivitamin with at least 5000 micrograms (4,7).
Echinacea: Although a few studies have emerged that show slightly (and relatively insignificantly) shorter respiratory tract infection durations in patients treated with echinacea, most have demonstrated that the herbal product has little or no effect on preventing and treating sickness. This uncertainty is complicated by the fact that there are nine species of the plant, different parts (leaves, stem, roots, flowers) of the plant can be used, and different forms are available (e.g. powder, liquid extract, capsule). Essentially, even if echinacea was definitively proven effective, an argument would still exist over which species, form, and delivery produces the best results. At this point, there is not enough evidence to recommend echinacea as a worthy supplement (7,43-45).
Arginine: This nonessential amino acid has shown promise in improving immune response and wound healing via improved lymphocyte production in individuals with compromised health status. Other studies, however, have shown that arginine supplementation is of no benefit in attempting to enhance the immune response, especially in healthy individuals (7). Given that some clinical trials use upwards of 20g L-arginine per day (mostly without appreciable immunity-related results), forty capsules per day seems like far too risky an investment even if you enjoy being a human guinea pig. Then again, even if you do decide to give arginine a try, be careful; excessive intakes can actually blunt the immune response (46).
Lifestyle/Training
An adequate amount of sleep during sickness is of the utmost importance. The old "8-hours at night" recommendation still holds true...as a minimum. You should also be shooting for a nap or two during the day. It seems like a no-brainer to say that you shouldn't be training when you're sick, but I'm constantly amazed at how many people still go the gym in spite of their wheezing, sore throats, and aches. Before you stumble off the couch and over to your local gym, ask yourself if your body could really recover from a heavy training session if it hasn't even recovered from the flu. The answer should be a resounding "NO!" If it isn't, maybe it will help to think about how your decision to go train will impact others; you'll probably make half the people in the gym sick just like the "human sweat gland" did to you. Stay home, if not for your own sake, then for the sake of everyone else who enjoys his or her health and visits to the gym. Get over the flu and then get back to the gym!
Conclusion
There you have it: a comprehensive approach to getting back to the gym as soon as possible. To recap:
1. No comfort foods
2. Maintenance calories (factoring in reduced activity level)
3. Normal protein intake
4. Slightly reduced carb intake, consisting of low GI carbs only
5. Normal healthy fat intake
6. Regular Multivitamin
7. 4-5g vitamin C in 500mg doses throughout the day
8. 800-1200 IU vitamin E in 400 IU doses throughout the day
9. 0.35-0.4g glutamine peptides/kg body weight in 3-5g doses throughout the day
10. ZMA supplement (or zinc equivalent providing 25-100mg/day)
11. No training until symptoms are gone
12. R&R
It might not sound as appetizing or heart-warming as a bowl of chicken soup, but it beats Nyquil...
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Stretches to maintain length of both the pectoralis major and pectoralis minor are really important — especially in the weight-training population, where Mondays, Wednesdays, and Fridays are declared national bench press holidays in all 52 weeks of the year. Simply put, everyone presses too much and pulls too little.
However, what few people (including Mike and I, circa 2004) realize is that in the process of stretching out the pecs (particularly pectoralis major) in this fashion, you run the risk of irritating the anterior shoulder capsule, particularly if the shoulder blades aren't stabilized. As the picture below shows, the attachment point of the pectoralis major is further down the humerus.
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