Monday, July 26th, 2010
I’ll cut right to the chase: I’ve torn my meniscus. The meniscus is the cartilage that acts as a shock-absorber in your knee, also preventing bones from rubbing on one another. It’s a pretty common whoopsie, and it’s likely that mine has been there for a while, I just made it extra mad by Warrior Dash-ing, taking on an “extreme” (per its name) lifting program, and starting up with running again. What’s just as common is the knee-jerk response (pun totally intended!) to have arthroscopic surgery, especially here in the United States. So common, that while it’s still a surgical procedure to repair or remove all or part of the meniscus, it’s still often lightly referred to as a “treatment” in the biz. Um… If you have to knock me out cold with anesthesia for something, it’s beyond a “treatment”. I just had a facial two weeks ago, I know the difference.
I’m sure most reading this already have an inkling that I’m not a fan of surgery. This is mostly true. I’m all about it for life-saving procedures. For less critical situations, I want more facts first. Being a chiropractor married to a physical therapist makes me both the best and worst patient ever for an orthopedist. The whole reason we stopped in to one the other week was because we were sure from our own analysis that something was wrong IN my joint, such as some torn cartilage, but we weren’t sure what exactly. After a 70 minute wait, some quick xrays, and about 10 minutes of the doctor’s assistant ruling out things we already had on our own, the doctor came in and spent a grand total of 90 seconds with me (tops) to say “torn meniscus, MRI to confirm, surgery will fix it no problem”. Well, 60 of those seconds were for that, the other 30 were spent on some snarky remarks about chiropractors and PTs, but that’s another rant…
I did schedule the MRI for a week later, but, after reasoning that it was not worth having one just for curiosity’s sake, I canceled. You see, I’d already decided I would not have surgery. Not just yet, anyhow. I’ve read enough stuff (see referenced articles at bottom for some examples) to know that, while having torn cartilage predisposes me to osteoarthritis, surgical repair of it does not improve that. Likewise, short-term (1 year) post-op recovery is particularly unsuccessful in females, through an as yet unknown mechanism. As a doctor, I’ve been around a lot of sloppy knees, many of which have had repairs to either the ACL (anterior cruciate ligament) and/or the meniscus. Throw into the mix my husband’s personal (he’s had 2 meniscectomies, 1 repair and he’s not a fan) and professional experience, and a recent random $.02 from a medical doctor that was decidedly anti (would you believe my GYN was discussing his torn meniscus with me during my pelvic exam? LOL), my own intellect-plus-intuition was confirmed and I decided I didn’t need a mugshot of my own meniscus. Probably best that I don’t know exactly what’s up, thus setting mental limitations on what I can achieve on my own. On that note, the orthopedist did mention that he believes I’ve been pretty much fine for so long because of all of the muscle in my legs. Score! It definitely added to my resolve to see what else I could achieve to on my own to support my knee for the time being.
So, what’s on deck? Well, my in-house PT has me on some specific exercises and modified ADLs (activities of daily living—example: I have to walk down the stairs one step at a time, injured leg leading. It takes forever!), and he performs this cool low grade joint mobilization on my knee that makes it feel so much better for a good bit. I’m on ice after activity and a therapeutic dose of ibuprofen for the short-term as we tackle the swelling and inflammation. Large amounts of glucosamine are in play as I build up my reserves of joint tissue making compounds, and sleep is an even higher priority these days. Acupuncture and massage will continue to play a role. The former because I know it’s capable of healing me on many, many levels as a whole person, not just as a knee with a person attached to it. The latter to keep trigger point development in surrounding tissues at bay while my knee is so sloppy. I’m so inspired and intrigued by meditation and guided imagery for healing, I’m investigating some programs for that now. I wear a knee brace. The compression feels good and I’m less gimpy after a lengthy stint of sitting. But, really, it’s mostly there to remind me not to be a jackass, especially while exercising. I don’t run, lift (with my legs), or jump, and I avoid bending my knees past 90 degrees. For example, while yoga is on the menu, my instructor knows to make sure I don’t fold up my knee during child’s pose, so I modify with a ton of blankets or stay on all-4s with something under my knees. I’ll admit it, I got depressed quickly. This is a BIG change for me, activity-wise. So I made a list of what I CAN do to make myself feel better. Here tiz: yoga, swimming, deep water aqua aerobics, NordicTrack, pilates, upper body lifting, biking, elliptical. (The cardio machines are not much of a consolation, but I have caught up on some reading.) Anyhow, I’ve learned to really like some of that stuff and my weight has held pretty steady, so I’m happy for now. Beyond that, everyone I work with is in the know, so I’m less tempted to demonstrate things that might make me regret having done so later in the day when my knee is barking.
Not only is my PT really smart, he's exceptionally handsome! 
What’s my point in telling you all of this? I’m not that unusual, for starters. This sort of thing happens all of the time, to people with fewer resources of information regarding alternatives. People like me are the ideal study subjects, in fact, because we are not professional athletes who are worth so much on the field, it’s considered a bad career move to not get duct-taped, spit-polished, and shined up until the next injury. Likewise, we are not children who might develop improperly if not repaired quickly. We are also active. Sedentary folks, especially those with other factors working against them, such as extreme obesity, are less likely to be studied too. So the information I have gathered showing that surgery does not provide an increase in favorable outcomes (ex. Pain reduction, decreased arthritis incidence, better functioning) is completely relevant to me. Finally, surgery will always be there. Once we re-evaluate my progress in 6 weeks, we’ll alter the plan, if needed. That plan may include surgery. Or the surgical option may play out years from now. Who knows? But I’m smart enough to know that if the knee being so dysfunctional starts to affect surrounding joints badly (ex. hip, lumbar spine), and surgery could correct that situation, then “duh”. Right now, the “duh” would be not trying to rehabilitate sans surgery.
The over-riding theme for the post is: Do your homework. We’re in a “patch ‘em up” society, especially in America. Get second and third opinions until you feel good about whatever decision you make. Know what you’re willing to do. Seek the advice of a variety of practitioners. Regarding ACL and meniscus repairs in those with formerly healthy knees, did you know that outcomes were equal between patients who had surgery + rehab as compared to patients who had rehab only? And that no study on those same knee surgeries in particular has been able to demonstrate a more favorable outcome for those receiving surgery? Kinda makes me think my husband should be making as much as an orthopedist! Especially when you consider the time involved with one versus the other. Nevertheless, check things out. It’s YOUR body. YOU’RE the boss of it. Always make informed decisions regarding the care and maintenance of it. And be flexible enough that, when new information and technology is available to you, YOU can change your mind. A win-win.
http://www.sciencedaily.com/releases/2010/06/100629081630.htm
http://www.sciencedaily.com/releases/2010/07/100722075224.htm
Monday, May 3rd, 2010
Athletes like to self-diagnose. And one of the most common conclusions they like to draw is: “I must be overtraining”, regarding anything from wanting to eat their shoes out of increased hunger to doing a faceplant on their keyboard at work—at, like, 10:00a when they started at 9:00a—to black toenails (wouldn’t that be a fun OPI nail polish color? Called “When’s Your Next Race?”). While still misunderstood, if overtraining were the problem, it’s more likely that the athlete wouldn’t have the energy to label the phenomenon, or they’d be too immersed in ennui to care. So what’s really going on?
For most elite and non-elite-but-kickin’-it-regularly athletes, overdoing it in any way is fairly self-limiting. You really kill it in training for a week or two, over and above the norm, and you find yourself banging down some extra chow and power napping your way to renewal. I remember losing it at one point in training a couple of years ago and Dr. Jodi prescribed “2 starches and a nap”. LOL (PS She’s always right.) Honestly, most athletes will kill it in training for one to two days before the inherent wisdom to nap/chow kicks in and they’re good to go. All the same, things can (and do) go wrong sometimes.
Let’s define overtraining and then move off of it. (It’s not as common as you think) The theory about what it is exactly has been batted around since the late 1950s. We haven’t been able to give it a tight definition, but what overtraining is as its core has stuck: central nervous system (CNS) overload leading to aberrant functioning. “Overtraining is an imbalance between training and recovery, exercise and exercise capacity, stress and stress tolerance.” (see reference) What’s shifted most is the symptoms associated with overtraining. We used to look for restless behavior, which is considered the sympathetic form of overtraining. (Meaning: It affects the sympathetic—fight or flight—branch of your autonomic—think “automatic”–nervous system. It does not refer to your coach and friends feeling sorry for you. BWAHAHAHA! Sorry…) Nowadays we look more for signs of phlegmatic (LOVE that word) behavior, such as lethargy and lack of desire, and sometimes inability to perform. This would be the parasympathetic form (other autonomic branch), and is more common in endurance athletes. All of us active nuts have felt this on some level at some point, I’m sure. But for it to be defined as “overtraining” it has to be pretty profound first of all, but it also takes lot of time to occur (CNS accumulation) and a lot of time to recover from it. Think weeks or months. In other words, a turbo nap, a massage, and an extra helping of yams isn’t going to cut it. In all seriousness, you’re looking at deep physiological disturbances in hormones, blood chemistry, and things like “nocturnal urinary catecholamine excretion”. Well beyond soreness, stiffness, fatigue, and questioning why you do your sport.
Fortunately, what’s happening in most cases is called “overreaching”. Aren’t you so glad it was given a name? Now we can self-diagnose more accurately! Anyhow, overreaching is basically short term overtraining (STO) for, say, a few days to 2 weeks, 3 tops. Better yet, controlled overreaching is STO on purpose, and it is used by coaches and trainers all of the time. The key is the planned and orchestrated recovery that goes along with it for a week or so after the overreaching period. Overreaching has many of the same symptoms of overtraining, just not as many and not as severe. You’re not totally debilitated by them, that is. And with the planned/controlled aspect, you’re expecting the symptoms on some level, so it’s less traumatic. Rather than the complete staleness caused by overtraining, you’ll experience a period of “brief competitive incompetence”. (This term cracks me up. Like, “It was a shame. Ethel just up and rode the race backwards. Must’ve been the brief competitive incompetence created by not recovering adequately from her overreaching.”)
Anyhow, did you catch the word “recovery” there in the last paragraph? I’ve heard Jodi say “You’re not overtraining, you’re underrecovering” enough to know that long-term training success depends on how you recover from short-term overreaching bouts. This can be applied to all of life, by the way, not just endurance sport training. And it’s very individual—not just sport to sport, but athlete to athlete—such as with which type of rest and nutrition you’ll repair and recuperate best. Stay tuned for more on how to put that into play with the MP4 Team!
In fact, we are hosting a call tomorrow night at 8 pm on recovery. If you would like more information on the call or want to attend, sign up on the right hand side above and we’ll send you an email with the details or keep checking the facebook fan page for more info. Like our last two calls, it will be fun, informative and full of solutions that you can implement right away.
Reference:
Overtraining in endurance athletes: a brief review
LEHMANN, MANFRED; FOSTER, CARL; KEUL, JOSEPH
1993, The American College of Sports Medicine.
Thursday, April 29th, 2010
I just recently attended a conference on restoration and recovery. At MP4, this is a big part of our mantra. See, you want to train like the pros do by working out really hard, mimicking the amount of volume they do and/or doing as many events as they do and so on. But you’re missing out on one of their major training secrets: structured rest.
Many pro athletes do not work anywhere near as much as you do. Most of them are sponsored so that they do not have to work. This makes all the difference in the world. Not having the obligation of a 9 to 5 means that when they rest (albeit as short as it may seem), it really is a rest.
I enjoyed the conference because for one, it’s always nice to rub elbows with other coaches and two, there was a nice eclectic mix of presenters there so you got a nice mix of information from all different backgrounds. For instance:
Basically, they ran some athletes into the ground during a long weekend event. Let’s call it a tournament. Then they measured the athletes’ ability to recover through bodily markers (such as CK markers in the muscle). The study showed that the athletes’ bodies had recovered long before (almost 36 hours) their minds had perceived this to have happened. So if you had asked that athlete if they felt recovered from the past weekend event, they would say no to you, that they felt lethargic and lacked all will but their body will tell you that they are ready to go.
This got me to thinking…(get nervous, this is never good for anybody) how much of that is our own programming (in other words you think you should feel tired so you are) and how much of that is a real phenomenon (like our brains need recovery, too)? If someone had told Suzie Psycho that her body was recovered before they asked her, would her answer have been any different? This is good stuff because at least 90% of the game is mental and if your body/brain connection is more than just “positive” thinking, someone needs to get on that now with a rest protocol. They need to ask the athlete at 12 hours, 24 hours, 36 hours and then 48. Then they need to do the same thing but tell them they are recovered. See if it is any different. This was not lost on anybody at the conference. You had a few questions and some fervent writing because this can make a break a team that may be in a tournament of 5 games or on a playoff track with a bunch of events that are happening in a row.
I enjoyed hearing more about the latest research, but I also liked that I now need a guinea pig to run into the floor…Kas, where are you?
Stay tuned for more…hehe
Monday, March 15th, 2010
While I’m usually sweating it out over technical stuff for a responsible and informative blogpost, today I’m speaking straight from the heart. With maybe a little technical stuff thrown in here and there, we’ll see. But, really, I laid the groundwork last week with my post on the Central Governor Theory and discussion of the Central Nervous System. If you haven’t had the pleasure, we took a look at the fact that you have one Central Nervous System that some theorize is governed even more centrally by an inborn system that checks us physically when it feels we need it. Athletes, particularly elite ones, may have experienced this phenomenon when trying to will their bodies farther-faster-longer to no avail.
Where's my podium?
What I’d like to toss on the table is that this concept could easily be extrapolated to the mental and emotional, not just applied to the physical. I mean, after all, we only get one CNS that runs the whole show—body, mind, and spirit. Without getting too woo-woo, let’s just all agree that separating the mind from the body isn’t going to happen because it’s all brain-based ultimately, yes? Cool. Anyhow, what’s got me waxing philosophic (and probably esoteric and spastic at the same time) is my own struggle with a blend of physical, emotional, and mental trauma that pretty much has me spinning my wheels. And I thought maybe I wasn’t alone.
Half of the title for this post is a quote stolen from some former colleagues who used it as a tagline for their sport chiropractic practice: Life is an athletic event. True it is. We would find over and over again that physical injury resulted time and again from what is termed “an abrupt change in training”. You can apply that concept to anything—whether it’s a high level hurdler suddenly trying to change their technique and straining a muscle in the process, to a harried soccer mom quickly reaching over the front seat of her car to grab her child’s left-behind gym bag only to upset her rotator cuff. The point behind this is that, no matter how conditioned you are physically, a change is a change is a change. And an abrupt one can = trauma, assuming no proper dynamic warm-up and no prior movement rehearsal. I think this easily translates to losing it over a non-physical situation for which you have inadequate preparation or no prior experience from which to draw.
The second part of the title alludes to the concept of overtraining. Wikipedia defines it as “…a physical, behavioral and emotional condition that occurs when the volume and intensity of an individual’s exercise exceeds their recovery capacity. They cease making progress, and can even begin to lose strength and fitness.” Um, is it just me, or has anyone else experienced the same sort of sensation outside of training for an athletic event? The sensation of “exceeding their recovery capacity” resulting in a “physical, behavioral and emotional condition”. A “bonk”, in other words. Don’t raise your hand. If you’re in the throes of something like this right now, you may be too spent to do that anyhow.
So now that I’ve explained the post title ad nauseam, you’ll be able to feel me on my recent life experience. And how I’ve been bonking all over the place. If you’ve been following our posts, by now you know that I’m pretty much o-v-e-r-over it with this AC joint (shoulder) sprain. It’s way better, but it still takes almost nothing when testing the waters to tick something off in that quadrant of my body. For most of you reading this post on THIS site, forced inactivity due to a frustrating injury would be enough to put you over the edge. Wait, I’m not done. My husband recently started a new job. He really likes it and all, but he’s in the training phase of it and he has to put in several hours of work every day…after work. If it’s not that, he’s catching up on his doctorate coursework so that he can complete that degree by this August. If you passed Health and Human Sexuality class in high school, you might be able to put it together that the fact that we are trying to race the clock and start a family (I’ll be 40 this year and, according to modern medical testing, my baby maker is out of business) is…er…extra challenging with us not even being in the same part of the house most of the time. Wait, I’m still not done. Maybe it’s the 40-what-the-heck-is-my-body-doing-these-days thing, but my snowball-prone brain has decided to wad all of this up into what feels like a full-blown midlife crisis. Because amidst chiropractic appointments for the injury and peeing on ovulation test strips and keeping up with dust bunnies and the rest of daily life, I’m now also consumed with “What do I want to be? How do I want to shape my career? Where do we want to live?” The oddest part about all of that is that in spite of girding my loins up over coffee each morning, telling myself “Okay, new day. Knock it off. Let’s get on with things”, I find myself less efficient with time running out on me constantly. Contrast this with the fact that just a couple of years ago I was competing in a sport that required a TON of preparation, time, and self-absorption while I (fairly) successfully juggled about 15 hours more work per week while keeping the house free of health department violations, and… well, I’m confused. I’m bonking. I’m bonking at the athletic event of “life”.
Writing last week’s post about the Central Governor Theory really got me thinking about the fact that, if we can’t separate mind, body, emotion, and spirit, why wouldn’t we experience a forced “time out”, like it or not, conscious or not, with an overload to any combination of those components of ourselves? Likewise, if an athlete is at threshold in one or more of those areas outside of the physical one, couldn’t it then negatively affect physical performance, just like physical overload—or, “overtraining”—can affect mental and emotional status? I say yes. And I’ve witnessed it for years with patients and friends. In fact, I’m excellent in a crisis. As long as it’s someone else’s crisis, that is. So I’ve objectively pieced these things together before. But it sure is a more meaningful learning experience when it’s a life-bonk all of your own, complete with the inability to make decisions, compartmentalize, draw on logic, or adequately manage your time. As the acupuncturist said to me Monday “Your chi is out of balance. You have too much yang. You must bring in more yin”. Folks, she was telling me to chill the heck out, adding that I wouldn’t heal any components of “me” until I got balanced. I wasn’t about to argue with someone who had me nearly-naked and face down on a table while tapping needles into my shoulder, back, butt, and feet. Harking back again to the Central Governor, the inner “Check please!” switch in my Central Nervous System—not being able to separate my physical injury from my mental strain from my emotional turmoil—is likely shutting me down on some level, as is reflected in my behaviors, such as getting less done, less well, with relatively more time at my disposal. (More time with which to fail. Yay. LOL) Assuming I remember to do things the first place.
Anybody but me?
My life story
Before this becomes too much of an all-about-me rant (or did it already?), I’d like you to consider this a friendly little slap, like Cher did in the movie “Moonstruck” saying “Snap out of it!”, in case you’re dazed and confused about why you’re bonking (aka. failing) in one part of your life in spite of spot-on efforts. It might not be that part of your life, but one of the other inseparable, intertwined parts of you-glorious-you that all feed into the same command central. I’ll let you figure that out because, whether you know it or not, you know yourself best. I find this self-knowledge to be especially true with health and fitness nuts, actually. And while you do that, I’m going to go get my husband to have a meeting over our daytimers, then re-read Kas’s post about using injury timeouts wisely, and then start perusing meditation programs before I don’t know my yin from my yang anymore.
Monday, March 8th, 2010
By Heather Morgan
True confession: Right now I’m sitting here typing merely out of fear that Kas will show up out of nowhere and slap me around for a blogpost on the Central Nervous System (CNS). If you’ve been reading our posts, and more so the comments, you know what I’m talking about. Why so resistant? I’m not, actually, but… um… the CNS is not a small topic, even when you shave it down to the effect of physical activity on it. Nevertheless, there is a theory worth discussing that, while borne of the relationship of athletic pursuits and exhaustion, brings up some interesting points about why our bods call it quits—even if we’re not exactly doing anything obviously taxing with them.
Let’s start here. The CNS. You get one of them. And it tells everything you have everything it’s supposed to do. Its importance is evidenced by the fact that its components—the brain and spinal cord—are encased in thick dura (think: the toughest leather ever), then housed in hard bone (your skull and spine). Personally, I think it’s super cool, which might explain the fact that I’m a chiropractor. And if you’ve ever had any doubt that the mind and body are 100% connected at all times, or if you’ve ever found yourself poo-pooing the very expression “body-mind connection”, dismissing it as earthy-crunchy mumbo jumbo, you ought to rethink that just based upon the anatomy. I mean, you don’t have to go off and start wearing over-sized tunics and layers of beads while waving crystals around and burning incense, but you should definitely give the CNS some respect for being the great brain-body integrator that it is.
Is it me, or are her eyes really far apart?
Way back in 1922, a scientist named Archibald Hill (doesn’t that name just scream “geek”?) first proposed the idea that there’s a central governor within the nervous system, protecting our vital organs (brain, heart, etc) from anoxia (lack of oxygen) during exercise. Anyone who’s ever rented a moving truck with a speed governor to protect you from going too fast gets the concept already. Somewhere along the line his theory lost favor to other ones attributing mechanical muscle failure to inadequate oxygen supply to the muscles, muscle fuel depletion, or lactic acid build up. Such is the way of the science world. Fast forward to the late 90’s and researcher Tim Noakes—also a long-distance runner which had to give him some street cred—resurrects and expounds on the Central Governor Theory. Noakes’ research demonstrates that during exercise the brain is constantly adjusting muscular power output according to data it’s receiving from all over the body, allowing exertion to continue only as it considers safe. Even more interestingly, there is evidence that these data assessments and calculations factor in prior exercise experience, the knowledge of the duration of that exercise bout, and the body’s current metabolic state.
Before I go on, I have to point out how neato-keen that is. I picture this Central Governor (CG) as some little politician-looking person–navy suit and all–sitting in the brain in front of a jillion or so screens of graphs and data and flickering calculations. The CG is constantly instant messaging areas of the body, saying things like: “Fire it up, time to sprint” or “Whoa, slow it down. I don’t care how badly this person thinks they want to win”. Factoring in more, such as prior experience, they send out messages such as: “I know what we did last time, but we had more reserves left than I thought, so we can go harder this time” or “This machine is usually capable of this, but it has a head cold, so let’s tone it down some”. I’m way over-simplifying physiology (per usual), but for me the image helps to reinforce the fact that it is indeed a mind over matter concept being brought forth here.
Getting back more into the science a bit, the Central Governor Theory attempts to reverse the thinking that fatigue comes from the periphery inward. Rather, according to Noakes et al., fatigue is more of a suggestion to the muscles from the brain once the CG decides that, in order to have some energy reserves left in the muscles for a true emergency, and to make sure the brain and heart have plenty of oxygen, things need to slow down a bit. Furthermore, research findings show that, even when going all-out, athletes do not ever recruit all muscle fibers or use up all muscle glycogen stores. Noakes et al. explain that fatigue sensations, then, are less physical than they are emotional. That the burning “I can’t go on” distress signals from your limbs are created by the brain to keep you from complete exhaustion, or even from hurting yourself seriously. So basically your brain bonks, not your bod, if you will. On purpose, no less! Are you a fan of interval training? The positive performance effect of those sorts of exercise bouts has conventionally been explained as the muscles getting better at storing energy or using oxygen in order to combat fatigue. Noakes, however, would say that this sort of training teaches the Central Governor that the body can survive and withstand harder and harder workloads.
Oh boy. Can't. Go. Anymore.
If we can step away from the athletic perspective for a minute, I like that this concept could be used to explain how sufferers of chronic fatigue or fibromyalgia experience extreme fatigue while at rest. Again, we have one CNS dealing with all of our body parts and processes—physical, mental, emotional, physiological. If we have some systemic issue that is struggling for balance 24/7, wouldn’t it stand to reason that there is some sort of Central Governor purposely keeping us relatively physically still in order to focus hormonal and metabolic activity toward more critical processes? I’m nursing a shoulder injury right now. Once it calmed down enough for me to fall asleep and stay asleep, all I wanted to do was—you guessed it—sleep. Was that because I wasn’t able to train like I was and therefore was less energetic because I wasn’t getting that zippity-doo-dah effect from my regular routine? Not likely. From personal and professional experience, I’d say it was that my CNS (or the governor of it) was shutting things down so that some important repair work could take place. And just about all of us can relate to how absolutely physically exhausting it can be to weather an emotional upheaval such as a death or loss, no matter how physically conditioned we are. Even something happy can do this given enough emotional involvement and output. “It was the weirdest thing. Sally Sue has been blowing her long runs out of the water, but throwing that baby shower just took her out for the rest of the afternoon.”
Before we get all wrapped up in a great sounding theory, there’s no lack of controversy surrounding it. For one, the idea that the Central Governor is protective, and out of our conscious control in order to be so, flies in the face of events where elite athletes have clearly had “physiological catastrophes” during events. Anyone remember Gabriela Andersen-Schiess, the 1984 Olympic marathoner staggering into the stadium, waving medical help away, and somehow eventually crossing the finish line? It was painful to watch her, much less be her. Was her Central Governor on a coffee break? Likewise, there are many in the field of exercise physiology who can provide explanations with regard to oxygen exchange, heart rate, stroke volume, and all that jazz, while dismissing Hill and Noakes’ idea that it’s all a carefully calculated concert orchestrated by the brain to maintain homeostasis.
What’s the ultimate truth of it? Heck if I know. If you sat on me, hooked my nostrils, and yanked my head back in an effort to get a response, first I’d ask if you learned that from Kas (heh heh), then I’d probably give some non-committal answer about how the theories of different exercise physiology camps didn’t have to be mutually exclusive or something. But I’d do it with a leaning toward the Central Governor Theory. And it’s not just because I think my Wizard of Oz-like image of it all is so cute. It also feeds my own concept of something greater (and hard to explain) running this marvelously complex show of chemicals and electricity and tissue that I go through life in. And before I get way too deep there, it also explains a lot to me about how patients of mine have experienced the healing process—good or bad—depending on how compliant they were, what was going on in their personal lives, and so forth. Many factors, yet only one CNS at our disposal. Seems like something should be governing all of that. What do you think?
References:
http://jeb.biologists.org/cgi/content/abstract/204/18/3225 (a Noakes study)
http://en.wikipedia.org/wiki/Central_governor (pretty easy read, good look at the controversy, see references at the bottom for more Noakes studies if interested)
