Last September, I was put in touch with Dr. Rick Cohen, and we hit it off right away. In addition to being a knowledgeable and super-qualified physician, Rick is also a baseball fan and performance geek just like me (I knew he was legit when I met him for the first time and he was rocking some Vibram Five Fingers shoes!). Rick's enthusiasm and forward-thinking mindset is absolutely contagious and has gotten his company, Bioletics, off to a great start.
Just to get a feel for what he does (and while remaining unbiased), I had my fiancee go through a series of performance testing they do (outlined below) and the entire process was fantastic. One of the glaring issues discovered was low vitamin D, which has since been addressed. Just two months prior to our work with Rick, I'd encouraged her to ask her primary care physician to check her vitamin D levels at a routine physical. The physician's response was "No. You're not post-menopausal." The take-home message from this quick story is that not all physicians have all the information (or even a small fraction of the information, as Vitamin D plays countless roles in the body other than bone metabolism).
Since forward-thinking physicians are few and far between, it's sometimes a challenge to find someone good in your area - and that's where a guy like Rick and his company can come in to help out. I highly recommend Bioletics - to the point that I wanted to get Rick on-board for an interview to share some of his great information. So, without further ado, Dr. Rick Cohen.
EC: Thanks for taking the time for an interview, Dr. Cohen. Please fill us in a bit about your background, what you're doing at Bioletics, and where the idea for the business really emerged.
RC: My pleasure.
It actually all started in your neck of the woods in Massachusetts. I had a medical practice with a focus on nutrition, athletic performance and aging there for over ten years. At the time, I was very dissatisfied with the assessment options available in the medical field. So, I developed a few of my own that could be done at-home with either a saliva or urine sample or a finger stick blood spot.
After moving to Bend, Oregon last year, I became involved in screening some of the girls on my daughter's track team for iron deficiency and bone health. We also looked at vitamin D, which is a critical nutrient for both bone health and overall athletic performance.
When the results came in, it turned out that 95% of the runners low in iron. Additionally, 80% of the team was vitamin D deficient and more than 50% were mineral imbalanced. After adding amino acid and recovery hormone panels to the screen, I repeated it with several local elite athletes. Again, the results were shocking: not a single athlete was healthy from a biological standpoint.
At this point, it was pretty obvious that there was a need to turn the entire concept of human performance testing inside-out. For years we've been obsessed with peripheral performance measurements-heart rates, VO2 levels and power output. But the idea of looking inside an athlete's body has been completely overlooked.
Giving athletes the ability to assess their unique, physiological needs represents a paradigm shift in athletic performance. Despite all the marketing hype in the sports supplement industry, there's no such thing as a one-size-fits-all formula for improving your athletic performance.
As athletes, our basic, biological needs are all very different. We would never think of buying a bike, a baseball bat, or a pair of running shoes without trying them on or out for size. Why do we use nutritional supplements-protein powders, recovery drinks and vitamins-without knowing if they are a good fit for us?
EC: Now, let's talk about some of the specific things you guys can test. I've been a big vitamin D guy for years now, and I know that's one of your core tests. What are you seeing thus far?
RC: Optimizing your level of vitamin D3 is the single most important thing you can do for your health and well-being-and quite possibly your performance. Interestingly enough, vitamin D isn't really a vitamin at all. It's a hormone manufactured by your skin during critical periods of sun exposure.
Vitamin D is both a key building block and a cellular activator of almost every physical process. It regulates more than 2,000 of the 30,000 human genes. It's an essential part of the endocrine system, as it controls several of the adrenal hormones, growth of cells, and production of enzymes. It's a powerful immune booster that provides a front-line defense against colds and flu as well as cancer and autoimmune disease.
Vitamin D is essential for optimum athletic performance, as it contributes to muscular strength and recovery while controlling physical reaction time, balance and coordination.
So far, almost every athlete we have tested has had sub-optimal levels of vitamin D (less than 50 ng/ml) except for one professional triathlete who trains in the sun in Australia all year. Many athletes have been extremely low-under 25ng/ml.
Unless you can train outside year-round and/or make a conscious effort to get mid-day sun exposure; it is almost impossible to restore vitamin D to an optimal level-between 60 and 80 ng/ml-without supplementation. When supplementing, the best results have come from the use of a sublingual vitamin D3 spray. Gel caps, tablets and liquids are less effective.
The most important thing to remember is that your vitamin D level needs to be assessed and monitored. You can't just take a random dose of vitamin D3 and expect to get results. Bioletics offers an at-home finger stick assessment that is virtually pain-free; it takes only two minutes and two drops of blood to complete.
EC: Now, how about iron? It's traditionally been a huge issue for female endurance athletes, but are you seeing it as much in females who aren't on that level of training volume?
RC: Yes. We learned this is a huge issue, especially among teenage girls. In general, low iron is a problem among menstruating women because they lose blood every month. With teenage girls, the issue is compounded by the fact that their diets tend to be lower in calories, red meat and protein-all of which are critical for obtaining adequate iron.
Iron is critical for athletic performance, as it carries oxygen in the red blood cells from the lungs to the muscles. Severe iron loss results in a reduction of red blood cells (a condition known as anemia). What most athletes are not aware of is that you do not have to be anemic to be suffering from low iron. The most common signs of iron deficiency are fatigue, irritability, poor performance and slow recovery.
Another important point to stress is that while the assessment of red blood cell count, hemoglobin, hematocrit and serum iron are needed to diagnose anemia, these are not sensitive indicators when it comes to assessing deficiencies in iron stores-the supply of iron that's actually available for the body to use. The iron-binding protein, ferritin, is a much more reliable marker of functional iron stores. We like to see levels of ferritin in females between 40 and 70 ng/ml.
EC: How about men? Is too much iron a common finding?
RC: Good question.
In men, we are much more concerned with excessive iron than with low iron. This is because men do not bleed regularly and also tend to eat more red meat and calories than women.
The problem with too much iron is that it can create free radical damage in the body. Just as iron in metal rusts, it has a similar action in your body. Fortunately, your body has natural antioxidants to protect against the free radicals created by iron. But when levels get too high, it can become a problem. As we get older, excessive iron levels can play a role in the development of heart disease, cancer and immune disorders.
Excessive iron is linked to a genetic variation in iron absorption rates. Hemochromatosis is a genetic disorder where the body absorbs iron too readily and iron stores can get tens or even hundreds of times higher than normal and cause severe organ damage. While the full blown disorder is relatively rare, many people have lesser variants which cause gradual accumulation of iron over time. The second cause is dietary-we take in too much iron by eating iron-fortified foods like breakfast cereals and breads.
Just as with vitamin D, it is necessary to know your iron levels before you begin to take any kind of iron supplement. The restorative dose of iron is generally 36mg daily while the maintenance dose for those with a history of low iron is 18mg daily. Taking a restorative dose without knowing a benchmark can push iron levels too high. Playing it safe and taking a maintenance dose may not be enough.
Ideal levels of ferritin in men are between 70 and 100 ng/ml. If your levels are higher than that, it is important NOT to take any iron supplements or eat iron-fortified foods.
We have seen iron levels in the upper 100s and low 200s in younger male athletes. For these men, we recommended they monitor the levels every few years and to consider donating blood twice a year. This will not only keep their iron levels from climbing, but will greatly help those in need.
Part 2 of this interview with Rick will run tomorrow, but in the meantime, I've asked with Rick to arrange for a special discount for EricCressey.com readers only. If you head over to www.Bioletics.com and enter the coupon code ECCPP25 at checkout, you'll receive $25 off the cost of your initial basic or complete panel.
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A few tips on items to check out this week:
5 Sneaky Tricks to Triple Fat Loss Results - This is a 27-page report from Joel Marion that he's made available for free for the next three days. It's got some good stuff in there, and it's also pretty darn entertaining!
ACL Graft Options: Allograft or Autograft - Here's a great blog post from Mike Reinold highlighting the research on different graft options for ACL reconstructions as well as their clinical significance. I liked it so much that I actually posted a comment on it outlining my perspective as a strength and conditioning coach.
I've got a great interview lined up for this week, and Part 1 will run tomorrow. Be sure to check back for it!
Tomorrow is marathon day here in Boston. On one hand, it's a great day in our city, as loads of money is raised for charity and quite a few high level, well-prepared athletes come to town to compete for a Boston Marathon crow.
Unfortunately, it's also a day when hip replacements become reality and 140-pound dudes in shorty-short shorts instantly become Johnny Brassballs so that they can fight through pain (and runner's diarrhea) to complete a 26.2 biomechanical nightmare that is the exercise equivalent of taking a 1983 Chevy Cavilier out for the Daytona 500. The Boston Globe ran a feature today that noted, "Each year for the past three years, about 1,000 qualifiers received medical deferments, allowing them to postpone their eligibility to run until the next year. As of last week, about 600 of the nearly 27,000 people registered to run tomorrow had sought deferments, and the organizers expected that number could double."
Out of the Running
The thing that I think frustrates me the most about this scenario is that all the modalities listed as "treatments" are really just band-aids on a ruptured aorta. They talk about oral NSAIDs, cortisone shots, ice, massage, knee straps, surgery, physical therapy - all REACTIVE modalities. People wait for issues to reach threshold and only then do they start to perceive them as problematic. And, there will never, ever, ever, ever, ever be any modality that will overcome a dysfunctional runner with a completely warped perception of reality a few weeks out from an event so physically demanding that it actually killed the first guy ever to do it.
So, with this year's marathon upon us, I'm going to make a plea to the (few?) marathoners out there who actually read this: start preparing on Tuesday for next year's event if you plan to run it. Be a regular athlete before you try to become an elite athlete. Don't run to get fit; get fit to run.
Four-month training programs are a load of B.S.; nobody became elite at anything in four months. Instead, put in a legitimate year of strength training, flexibility training, (energy systems) cross-training, sprint work, threshold work, and solid nutrition BEFORE you start running any longer. You'll feel like a million bucks and blow this year's time out of the water.
Confucius said that "The journey of a thousand miles begins with a single step." So, here's Step 1. Get a foam roller and start doing this series every day:
1. Yesterday was tax day. And, since you're all probably feeling like Uncle Sam took a dump in your favorite shoes on the taxes front, this uplifting video couldn't be more appropriate to kick things off.
2. Yesterday also marked the end of the introductory offer on our new Optimal Shoulder Performance DVD set. Some of our more noteworthy customers of these DVDs sold to the likes of President Obama, Amelia Earhart, Spongebob Squarepants, and King Tut. Okay, they really didn't buy any - but they might have if you blog readers had told all your friends about this fantastic resource to spread the word. The take-home point is that you should feel poor and guilty the day after April 15. Thanks for nothing. Let's move on.
3. Just when I thought nobody could beat me down more than Uncle Sam yesterday, I realized that Tony had written this month's staff training program, and I went through one of the most brutal training sessions in Cressey Performance history. Here's a little taste:
A1) Bench Press Clusters: 4 x (4x2) - 10s
A2) (160-lb/hand) Farmer's Walk: 4x90yds (on last set, it was walk as far as you could go...I went 135 yards)
Frankly, this first pairing was enough to get a 25% attrition rate from our training crew (man down!) - but there was actually more:
B1) Wide Pronated Grip Seated Cable Rows: 3x10
B2) 1-arm, 1-leg DB RDL: 3x8/side
C1) Standing DB Military Press: 3x8
C2) Slideboard Bodysaw: 3x10
And, last but not least:
D) Side-Lying External Rotations: 2x8/side
I'm not sure why, but it really made me angry to do these external rotations at the end of all this brutality. It was almost like Tony was rubbing it in our faces that we weren't quite done, even though the hard stuff was over. So, just as a statement, I did 2x10/side instead and then suplexed Tony off the loading dock...just because (okay, not really; Uncle Sam suplexed him off the loading dock).
4. While I don't really "commute" anymore because our new house is so close to the facility, I do have a pretty good audio book rolling in the car right now: Switch: How to Change Things When Change is Hard.
It was written by Chip and Dan Heath (who also wrote Made to Stick, a book I absolutely loved and highly recommended in the past). The Heath brothers go into detail on the important factors that determine whether or not attempts at change will be successful, highlighting some profound examples from everything from the business world to nutritional practices with newborns in Southeast Asia. What I like the most is that they relate everything back to principles that are directly applicable to everything in my "world:" training and nutrition practices, managing employees, and running a business. It's definitely worth a read. Check it out HERE.
5. This point is going to make today's blog interactive, as I need some feedback. My one responsibility on the wedding planning front is to decide where we go on our honeymoon (tough job, I know). I know I've got readers all over the world who have been to some cool places, so let's hear some recommendations in the comments section below. We're an active couple and want to honeymoon where we can hike, exercise, etc. instead of just sitting around drinking tequila. As of right now, I'm leaning toward the Riviera Maya, but am open to suggestions - except Iceland. This guy convinced me otherwise:
Just a friendly reminder that the introductory price of $97 on Optimal Shoulder Performance: From Rehabilitation to High Performance ends tonight at midnight - when the price goes up by $30. This DVD set has been getting some awesome feedback, so don't miss out on this last chance to get it at a an awesome value:
www.ShoulderPerformance.com
"Mike and Eric do an incredible job of making sense out of complex information and research without watering it down a bit. I not only left the seminar with a better understanding of the functional work that all the muscles of the shoulders do, but also with plenty of new tools to put into my own program along with the knowledge to know when and why to use them. It was worth every penny, which I'm sure comes as no surprise to anyone fortunate enough to have learned from these guys previously."
Jon Hudak MS, CSCS
Assistant Strength and Conditioning Coach - Rensselaer Polytechnic Institute
With the recent release of Mike Reinold and my Optimal Shoulder Performance DVD Set, I thought it'd be a good time to list of a few more reasons to pick up a copy of this thorough resource.
1. The presentations in this DVD set not only outline the differences in shoulder conditions among ordinary lifting populations, sedentary folks, and overhead throwing athletes - but it also outlines different ways to manage these individuals.
2. When you consider annual salaries and signing bonuses, collectively, Mike and I manage over $1 billion in professional baseball shoulders annually. If that doesn't put your shoulder programs to the test, nothing will.
(just signed a 4-year, $68 million contract....Beckett, not Mike - sorry, Mike)
3. My second presentation of the day - Training the Injured Shoulder During- and Post-Rehabilitation - discusses what folks with different shoulder conditions CAN do in the weight room in spite of their shoulder issues. This makes OSP a great resource for personal trainers, strength and conditioning coaches, and fitness enthusiasts concerned with maintaining a training effect without exacerbating shoulder symptoms.
4. You'll put down your blanky and stop demanding a MRI for everything, because my first presentation of the day will demonstrate that diagnostic imaging like MRIs and x-rays are just one piece of a diagnostic puzzle that should include specific movement evaluations.
5. You'll learn why the term "shoulder tendinitis" is usually a load of crap.
6. As you probably know, the Red Sox and Yankees don't get along too well.
So, when a Red Sox staff member gives a talk so good that a Yankees organization staff member shows him some love, that's a pretty good feather in your product's cap:
"I attended this seminar with high hopes of learning more about the 'baseball shoulder' from two different approaches of the sports medicine and performance community. This seminar not only exceeded my expectations, but more importantly, took 'one huge leap' toward bridging the gap between two different communities (physical therapy/athletic training and strength and conditioning) that have the same common goal: to get athletes on the field of play and keep them there. These two highly-intelligent leaders of their respective fields have a great sense of evidence-influenced practice, and maybe more importantly, have an innate ability to readily and effectively communicate their knowledge. Thanks to Eric and Mike, this seminar was momentous in the on-going mission of creating a 'common language' for those working in the performance-based fields. I encourage any and all members of the performance fields to invest in the DVDs of this seminar and attend any seminar Mike and Eric put on. I promise you will learn something valuable every single time you have the opportunity to listen to either of them because they are constantly learning, studying, and changing - all great signs of any leader of any field."
Scott DiFrancesco, ATC, CSCS
Minor League Athletic Trainer - New York Yankees
7. You'll learn how to screen for congenital laxity and modify shoulder training in its presence.
8. Both Mike and I have been featured in The Boston Globe and The Boston Herald for our unique training methods. Check these two examples out:
This Joint is Jumping (Mike)
Custom Body Shop (Eric)
9. These DVDs will make you realize that true symmetry in the human body is likely a complete myth, particularly in the context of throwing shoulders.
10. You'll learn the most effective rotator cuff exercises, some of which I guarantee you won't have seen before - so they'll also keep your training "fresh."
11. Mike was formerly the Facility Director of Champion Sports Medicine and the Coordinator of Rehabilitative Research & Clinical Education at the American Sports Medicine Institute in Birmingham, AL. That means he rehabbed a lot of big time athletes and did a lot of big-time research. I, on the other hand, am best known for my charming wit, ravishingly good looks, and entertaining personality.
12. You'll appreciate that simply repositioning the scapula can dramatically impact rotator cuff function to enable you to achieve personal bests you never thought were possible on 1-rep max rotator cuff exercises:
Okay, maybe there won't be any 1RMs featured, but we will talk about the importance of scapular positioning with respect to cuff function.
13. You'll learn about the different types of impingement, how to test for each, and how to manage these issues both in the context of rehabilitation and training around them.
This guest blog comes from current Cressey Performance Intern, Chris Pothier.
When Eric asked me to present on the topic of stealing second base, I thought "Easy, how hard could this be?" Little did I know that I was entering the ultimate battle royal of baseball movement techniques. One side says the cross-over step is the 'end all be all," while the directional step folks insist that their style is far superior. Who is right and who is wrong?
With research and countless hours watching Grey's Anatomy clips of guys stealing bases on YouTube...I came to one rather unusual conclusion. Now, I have not coached thousands, hundreds or even a hand full of players' base stealing technique, or written an E-Book on the "how to." Rather, I was asked a question and I've researched and have placed my own opinion on the matter. You can agree or disagree with me; I won't lose sleep either way.
Here is a run-down on both techniques; both share the same 3-points on set-up technique:
1. Feet slightly wider than shoulders, keeping a positive shin angle back to either base.
2. Knees flexed 110-120 degrees with shoulders over toes to keep weight on balls of feet.
3. Hands out in front of hips, creating a shorter distance the arms have to travel and a shot lever arm which allows for faster positioning of the arms.
Cross-Over Step
1. Driving that left leg across your body, towards second base, landing slightly in front of your right.
2. As you rotate your torso, you square up to second base with your hips at the same time driving that left leg to full extension, creating your power. Left arm drives with cross-over step, followed by a quick right arm drive to initiate arm/leg synchronization.
3. Left arm drives with cross-over step, followed by a quick right arm drive to initiate arm/leg synchronization.
Directional Step
1. First step, initiate drive with left leg, to get hips and shoulders over right (power) foot.
2. Then externally rotate and step back 6-8" with right leg.
3. At this point, left knee drive towards chest, right arm drive, positive angles on both shins, toes toward second base, ankles dorsiflexed and torso square to second base.
4. Drive to full extension in right leg with left arm drive.
I've realized we could sit here and argue that the cross-over step doesn't allow you to clear your right leg with your left foot since you don't rotate first, or you waste time stepping backward with your right foot in the directional step. That's not the purpose here. Research from Reed et al, showed over two steps, the directional step resulted in significantly greater distance traveled, however it took significantly more total time than the cross over step, which covered less distance but quicker in two steps. This shows nearly identical velocities and there is no advantage over the other. On the other hand, a study by Ostarello et al tested three start methods and at all six timing stations; set at different distances, the cross over step was quicker (note from EC: we teach the crossover step to all beginners, but never interfere with guys who have been doing the directional step for an extended period of time, especially if they have had good success with it).
In my opinion, and I like to look at the bigger picture, there are too many variables that play into base stealing to pin one way against the other. You have to consider everything that goes into base stealing: lead, reading the pitcher, pitcher's deception, reaction time, individual speed/power, sliding technique , catcher's pop time, etc.
Here are some stats;
Jacoby Ellsbury- Career 129 SB; 70 SB 2009; 3 full seasons; Directional Step
Ichiro Suzuki-Career 342 SB; high of 56; 9 full seasons; Cross-Over step
In conclusion, if you have been directional stepping for six years, don't change. If you are just learning a technique, try both, go with what feels more comfortable and what can be coached easily. Base stealing is an art that takes mastering many small components to be successful. It's like saying who is better looking: Megan Fox or Jessica Alba...........exactly.
For more information or to contact Chris, check out his blog.
Related PostsProper Sprinting Warm-upsPreseason Precautions for Baseball
Just a quick heads-up on where some of the Cressey Performance minor league guys are winding up to start the season. If you're in their neck of the woods, get out and show 'em some love at your local ballpark.
Tim Kiely - (Little Rock) Arkansas (Angels AA) - Opening Day Starter Tonight
Jim Fuller - Savannah (Mets Low A)
Chad Rodgers - Myrtle Beach (Braves High A)
Will Inman - Portland (Oregon - Padres AAA)
Tim Collins - (Manchester) New Hampshire (Blue Jays AA)
Steffan Wilson - Huntsville (Alabama - Brewers AA)
Steve Cishek - Jupiter (Florida - Marlins High A)
Cory Riordan - Tulsa (Rockies AA)
Anthony Seratelli - Northwest Arkansas (Royals AA)
Kevin Pucetas - Fresno (Giants AAA) - Opening Day Starter Tonight
Shawn Haviland - Stockton (California - A's High A) - Opening Day Starter Tonight
Benji Johnson - Mississippi Braves (AA)
Craig Albernaz - Durham Bulls (Rays AAA)
Chad Jenkins - Lansing Lugnuts (Blue Jays Low A)
Kevin Nolan - Lansing Lugnuts (Blue Jays Low A)
We also have quite a few younger guys in extended spring training who will be assigned to short-season teams in a few months - or (hopefully) play their way up to A-ball teams.
Good luck, guys!
