It’s autumn in North Carolina, which can only mean three things: spectacular sunlit leaf color, a distinct uptick in latte consumption, and NCAA college sports in full swing.
I get the privilege of working with several Division I college sports programs, most notably my graduate school alma mater: the University of North Carolina at Greensboro. I’ve been feeling the Spartan love this week with lots of outcall sports massages in the athletic training room, and working with these talented young people never fails to keep me on my toes.
The Internet Age has given athletic people vast resources to learn more about sports, nutrition, physiology, training, and therapies. On the whole, I am impressed that the availability of knowledge seems to help my massage clients to be well-informed and discriminating consumers of information. People who participate in sports at a high level view their bodies as tools — their vehicles for recreation and competition. This insight frequently leads them to constantly seek and evaluate information that will improve their performance, health, and experience. It also means they ask practitioners a lot of questions.
It’s easy to view “why?” as a challenge: a threat to authority and credibility. But forcing myself to dig deep into the body of knowledge through the incredibly effective (and sometimes incredibly annoying) Socratic method makes me a better practitioner and helps me build a reputation among my clients that I am a trustworthy source of information. The college students I work with ask questions that often catch me off guard, and the exercise of thinking analytically and critically to construct a thoughtful answer is often a missing ingredient in massage education.
Let’s apply it to a common instruction massage therapists give to clients following a bodywork session: “Be sure to drink plenty of water after your massage.”
The pat answer many of us learn in massage school is “to help flush out metabolic waste.” But what does that mean, and most importantly, is it a rigorous and factual response to the physiologic processes at work?
To be thorough and deductive in crafting an answer, consider all the pertinent facts. Massage therapy has a demonstrable effect on blood and lymphatic circulation, because the mechanical manipulation of soft tissues introduces heat and pressure, which creates a mild inflammatory response. The body’s response to topical heat is rapid dispersal by dilating capillaries in the tissue, which decreases blood pressure because of decreased vascular resistance. To maintain homeostasis, the body responds to the drop in blood pressure by adjusting fluid uptake in the blood stream and changing heart rate to stabilize blood pressure. One important role the circulatory system performs is transportation of the surplus substances of metabolism and energy production and expenditure to the kidneys to be excreted from the body. An example is the process of converting protein into energy: the leftover substances include ammonia, urea, and uric acid, which are toxic if they remain in the body. Massage is not directly shown to release metabolic waste from soft tissues under study conditions, but in consideration of the peripheral responses to massage, appropriate hydration supports homeostatic processes to promote optimal muscle function and recovery. Most importantly: with the exception of a few conditions such as hyponatremia (abnormally low electrolyte dilution), drinking water is an appropriate recommendation for overall health an wellness; the risks are vanishingly small, and the potential benefits are great.
For many clients, this explanation goes in to way too much physiology detail. However, I think as a therapist, it is important to understand the complete picture and to be able to articulate it accessibly and intelligently. It establishes credibility and develops the ability to think critically and scientifically about the therapeutic intention of our work. It also helps me to be better able to talk about the effects and benefits of massage to other medical providers, which has made a huge impact on building my client base and becoming regarded as a skilled practitioner, able to get into a variety of unique opportunities as a massage therapist. For me, it’s simply not enough to regurgitate pat answers; I am voraciously curious and keeping current on research helps me to continuously refine my methods and understanding.
If you are a consumer of massage therapy, I encourage you to ask your therapist questions about what he or she is doing and effects on the body. I think most therapists are like me — we get really excited when clients show an interest in our specialty and we want to share with you information that can positively impact your health, wellness, and understanding of your body. Learning about physiology and anatomy in school was like getting an owner’s manual to my body and I love sharing that feeling of empowerment through knowledge with my clients. I don’t think it’s appropriate to try to test therapists’ knowledge with “trap” questions, but to approach your therapist as a resource to broaden your understanding of health, wellness, and activity. Additionally, most massage therapists maintain an extensive referral network of other allied healthcare professionals, so even if we can’t directly answer your questions, we can almost certainly direct you to another expert who can.
Do you have a burning question about massage therapy, or are you a practitioner who has encountered great questions from your clients? Shout out below!
First, a disclaimer: this post is going to be a self-congratulatory/self-flagellating exercise in navel gazing, although I hope not entirely devoid of insights. If that’s not your thing (and it’s totally cool if it isn’t!), it’s probably best to skip over this one. I promise to get back to bicycle racing soon. Without further delay, I present my latest Soigneur’s Diary entry.
This is a really flippant, privileged, entitled-white-girl-from-the-suburbs thing to say, but rings true: I’m not used to not being good at things.
I’m a little bit on the type-A side in that respect. I tend to pick up new things pretty easily — new sports (with the notable exception of inline skating), artistic pursuits, academic skills, clinical skills, using technology, and so forth. I try to embrace the “see one, do one, teach one” approach to learning and it generally serves me well. I take pride in mastery of processes and making meaningful contributions through my work. I learn best when I can take a methodical approach and clearly see how all the moving pieces fit together.
So it’s absolutely driving me crazy that I’m not a great soigneur already. I feel like I have about 1 out of every 10 days of total competence versus completely screwing up and getting in the way. There are a few things I’m doing very well, like therapeutic massage and first aid management, but it seems like such a small percentage of the job. It’s the part that the director rarely sees, which really shouldn’t matter — performing my job expertly is its own reward and if I’m doing it right, my part should be relatively invisible as athletes recover from racing and heal from injury easily and rapidly. I would never presume to take credit for their achievements, but I am keenly aware that poor clinical reasoning on my part will inevitably impact them negatively.
But that’s the tip of the iceberg; the other 90% of unseen lurking mass is the part that consistently trips me up and makes me feel foolish at best and incompetently negligent at worst. Part of the challenge is the rest of the job should be more or less invisible too: the best soigneurs get noticed by going unnoticed. Everything is immaculately prepared and arranged when it needs to happen without question or hesitation. All the details are managed to make a perfectly smooth big picture. All this is done without the expectation of thanks; at the end of the day, the things that matter are that the riders are cared for, and the rest of the staff is happy and never inconvenienced by a task left incomplete.
I am working so hard to get to that point. I had a long phone conversation with my mentor yesterday, who likened my situation to being thrown into battle on the front lines without basic training. (I have a hard enough time justifying a career in something as “trivial” as sports to my Quaker Meeting; the military metaphor might be enough to get my Friend card revoked!) It does feel a bit like that sometimes, but I think of it more like a counter-terrorism squad: people only notice the superb work they do when they let that one-in-a-million slip through the cracks and horrors ensue. (I’ve been watching Homeland in my spare time before bed; ugh, my Quaker card is definitely in serious jeopardy now). Obviously, forgetting a chair or mislabeling a supply box doesn’t have quite as serious repercussions, but it shows that I’m not performing at the high standards to which I hold myself. I feel like 5 months of doing this job should be enough time to achieve proficiency; I mean, seriously, sure there’s the sports medicine bit, but mostly I wash vans and fill bottles and make sandwiches. How hard can it be?
I’m not a dumb person. I’m comfortable solving calculus-based biomechanics problems, I know all the bones in the human hand and nerves in the brachial plexus, I play half a dozen musical instruments, I got a perfect score on a section of the GRE, I can still recite the first canto of Dante’s Inferno in Italian that I memorized in college (which is probably why I have trouble remembering phone numbers). I’m a serial enthusiast and when I get really excited and into a particular topic, I read everything I can get my hands on to amass a near-encyclopedic knowledge about it (my mom sometimes calls me Cliff Clavin and I don’t think it’s a compliment). Emotional and social intelligence…maybe not so much. I have a hard time fitting in and perceiving social cues. I get so excited about successfully navigating a social interaction when I meet a new person that I invariably immediately forget their name. I don’t have a strong personality, and I think that causes me to come off as aloof, shy, and boring. In reality, I usually just have no idea what to say. I don’t think of myself as particularly cute, funny, or interesting, so I tend to discount and discredit the qualities and contributions I bring to the table. I am less shy than just painfully introverted, and I recharge with alone time and spending one-on-one time with close friends. I expend so much energy trying to be liked that I make myself wholly unlikeable. I’ve come to grips with the realization that I’m kind of weird and have weird interests, but I lack the confidence to fully own my weirdness and instead fall firmly into the awkward zone. I haven’t really found my people, so I make up for my difficulty forming friendships by throwing myself into work and dramatically overthinking everything. It’s pretty exhausting, actually.
I’m a worrier. I was in therapy specifically for aviophobia last year, and I realized that air travel was hardly the only time I experienced overwhelming anxiety. The psychologist I worked with appealed to my academic tendencies and gave me an array of articles and chapters to read about how the brain processes threat. Fear is hardwired into the prefrontal cortex “lizard brain” as an important survival tactic. When we receive a sensory stimulus like a sabertooth tiger crouching in the grass, an ancient programmed circuitry fires into action, engaging the sympathetic nervous system to divert all energy to escaping the danger. It is an evolutionary advantage for the brain to perceive a threat where none exists — if we assume that every rustle in the grass is a tiger, we are more likely to survive rather than if we incorrectly identify the rustle in the grass as just the wind when a tiger is ready to pounce. This tendency toward hypervigilance is the reason our species has been able to survive, proliferate, and evolve. It also causes an awful lot of problems in the modern world. When the amygdala receives signals that a threat is present, it floods the blood stream with stress hormones that activate the sympathetic nervous system, stopping metabolic processes and heightening sensory input to prepare the body to face or flee from danger. When a specific, discernable threat is present in the environment (the tiger, to continue the example), the system functions as designed. When there is not a threat readily identifiable, the amygdala looks for other environmental cues that could signal danger, and even cues within the body such as elevated heart rate and respiration. A panic attack is, in essence, crippling fear of fear itself. We then spin “what if” stories that have no actual basis in reality, taking us out of the moment to exist in an imaginary realm of fear and dread. Even though the conscious mind knows it isn’t real, the prefrontal cortex has no way of differentiating and responds to the imagined fear stimulus just as if it were a tangible threat.
My biggest fear is shame, and I am tremendously good at inducing it in a variety of situations. I think this is true for most people, and definitely for me: if I’m given a list of a hundred things I do well and one area in need of improvement, I obsess about the shortcoming and discount all the proficiencies. I dwell on my goof-ups and allow them to overshadow my talents. I walk around like a puppy that’s just been beaten with a newspaper, afraid that my coworkers are going to yell at me the way I am mentally berating myself (usually they don’t, but I live in terror of their disapproval). I parked a van in the wrong place yesterday and I spent the rest of the day in a funk when one of the other staff pointed out my error in an effort to help. It’s an attractive quality, no?
It’s also absurdly unproductive, and I know it is. My guilt and fear that I will never measure up is probably my biggest obstacle to competence. How do I possibly ask others to put their confidence in me, when I lack confidence in my own abilities?
While I was bemoaning my plight to my endlessly indulgent mentor, my mother sent me a TED talk that spoke to the heart of the matter.
In the video, researcher-storyteller Brené Brown explores the link between vulnerability, authenticity, shame, and courage — spoiler alert: she finds that the ability to embrace imperfection and celebrate shortfalls with successes alike is at the core of successfully finding fulfillment in all our relationships and endeavors. Yikes. The very idea makes my throat tight with the first inklings of panic. Wouldn’t putting my vulnerability on display counteract all the effort and energy I put into appearing like a pillar of confidence and strength?
Writing this post to go in the public sphere is my first step toward a healthier exploration of vulnerability. I don’t have to turn into a scared child to accept the fact that I will fail in life, sometimes often, hopefully not too spectacularly, and that’s ok.
My mentor had some great advice that is already helping me to feel more secure about my abilities. His first piece was to stop assuming logical leaps and to be more pedantic about questioning each procedural step. I love this approach; I learn best when I read the directions completely before assembling an appliance, so I have a thorough understanding of the process timeline from start to finish, and a discernable checklist of items that assure the task has been completed correctly. He told me to let go of my concern that people will judge me for insisting on a detailed explanation of mundane things, because an excellent end product at the expense of taking a little more time with the process is better than struggling as I go without a clear vision. The same concept applies to the challenge of dealing with cultural differences that I face with working in Europe — it is always preferable to spend more time hammering out details ahead of time than to assume we’re all on the same page because I don’t want to take up anybody’s time.
He implored me to do one thing at a time. Multitasking is the enemy of process. In science, the most important part of experimentation is the ability to repeat the exact conditions that will achieve a specific end result. Adding too many variables invites error. Accomplish each task completely before moving on to the next, and focus on the task at hand instead of allowing my attention to wander to the next one. Keeping a physical checklist is helpful for me in this area, because it’s one fewer thing to juggle in my mind as I learn a new skill. A slightly slower, more deliberate process is always preferable to hurried neglect.
As I establish processes that achieve satisfactory results, he encouraged me to allow those to become as instinctive as my sports medicine practice has become. He is the only director I have worked with who has actually seen me in action doing sports massage and first aid, and he commented that I am so comfortable in my element that a complex maneuver looks as intuitive and natural as getting out of a chair and walking across a room. I find it a little ironic that I am struggling to make setting out chairs and mixing sports drink as easy a task as performing a physical evaluation for knee pathologies. On the other hand, it’s good to remember that the hard medical part that many soigneurs spend years mastering is already more or less second nature for me.
One piece of advice that struck me at first as a little counter-intuitive was to apologize less. I have always tended to show profuse contrition over even relatively minor offenses, or those that are not even really my fault but I appeared in the wrong place at the wrong time. He told me to quit taking ownership and responsibility for things that are out of my control — not to be an excuse-maker, but also not to saddle myself with the burden of every mishap. Sincerity comes less from expression guilt and more from the actions taken to not let the same mistake happen again, and that’s what’s really meaningful to other people.
He instructed me to let mistakes go immediately. Every time I allow some part of my mind to linger in the past and obsess about a mistake, I am diverting attention from the task at hand and making another mistake more likely. It is always more productive, and often safer, to take a lesson and whisk away the rest. Mistakes in and of themselves have no value — the value comes from learning to approach the situation differently next time for a successful outcome.
Finally, he cautioned me against comparing myself to others. This is a pretty tall order, as I tend to evaluate the world around me through judgment rather than perception. There was a beautiful blonde Australian soigneur here this spring who was also a first-timer, and I was in awe of her skill. She was such a natural at every part of the job, and her extroverted effervescence and gregarious personality endeared her to the rest of the staff quickly in a way I admired and even envied. I have come to realize that she made just as many mistakes as me, but the biggest difference in her approach was her ability to laugh it off and hop right back on the horse. She seemed a lot less stressed than I feel most of the time, and I think her resilience was a huge part of that. I have been racking my brain for ways to develop the same resilience myself; it hadn’t occurred to me that perhaps it already exists within me and was waiting to be tapped.
I cash in another night feeling just a little better about my work today than I did yesterday. I gave a director a bad driving direction today, and I forgot that I had promised a rider to change his wound dressing when another director asked me to make a gas station run for diesel in the van. I didn’t let go quite soon enough on a water bottle feed and the rider knocked it out of my hand. But nobody died. We even won our race. And I am coming to realize that today was a job well done, even if it wasn’t a job done perfectly. And that’s ok.
It’s a pleasantly steamy early summer evening in North Carolina and I’m enjoying a glass of wine on my porch and watching the fireflies dance in my yard. The relaxation and leisure of my life in this moment makes my life in Europe the last couple months seem like a dream. But I loved the thinly veiled chaos of my work in Europe as much or more than the luxurious Sunday afternoon nap earlier today.
To bring this blog back up to speed, we have to go all the way back to the Koga Ronde Zuid-Oost Friesland in the middle of May, a one-day interclub road race in the beautiful verdant farmland and pristinely groomed villages near Appelscha, Netherlands. We had all gotten a few days to recover from the Peace Race and legs were primed, injuries nearly healed. This was a new race on the calendar, and a dream-race for staff — spectacularly comfortable nearby accommodations (with an equally spectacular breakfast buffet), a non-UCI race with no caravan and no designated feed zones on the course, minimal gear, food, and prep necessary. Our seven-man team lined up with the directive of racing forward, getting at least one rider in every breakaway move, communicating with one another, and staying out of trouble. Easy enough.
Once the riders were off, the director, mechanic, and I made our way back to the team car and proceeded to the first point in the race for open feeding, a picturesque tree-lined lane just after a section of pavé. These were not the helter-skelter cobblestones of Paris-Roubaix, but had enough of a crest in the middle to scrape against the undercarriage plate on the team car (which had been installed before Paris-Roubaix for that very reason). Coming off the first stretch of pavé, our smallest, lightest rider who was crushing cobbles for his first time ever streaked off the front of the peloton like a rocket. We knew already that we were in for a show.
We wended our way through the course circuitously and managed to feed the riders at 4 different places before feeding was closed. By the 3rd time we passed out bottles, a dozen or so riders had broken off the front, including 4 of our team. They were doing exactly as their director had instructed: racing forward, being conservative but appropriately aggressive, taking the race in exactly the direction they desired. After the last open feeding, we proceeded back to the finish line. Our director reported that the Dutch race organizer had actually expressed that he wanted the Americans to win, that it would be good for the sport. This attitude is wholly unprecedented in European racing; American riders have almost always been viewed as relatively unwelcome outsiders.
We waited at the finish line, getting bits and pieces of race reporting in Dutch that bode well for our team. I left my cooler bag of water and soda at the end of the barricades, strapped a podium bag with a fresh kit, wet wipes, and recovery mix to my back, and staked out a good position to get some photo ops. Soon we heard that a single rider had broken away off the front, and it was indeed our incredible time trial master who performed so spectacularly at the Peace Race. Minutes later, the race radio reported that two more riders had broken away while the fourth remaining USA rider blocked to let them ride. We realized we were about to see something incredibly special: a 1-2-3 podium sweep team victory.
It was breathtaking to see, made even more special from the Dutch race organizers and fans who said things like “magnificent!” The riders had truly raced forward, communicated with one another, and put on one heck of a race. Even at relatively small races like this, outstanding performances are widely recognized and not quickly forgotten — every other race I attended with the juniors team, someone mentioned the 1-2-3 podium sweep in Friesland.
After that, the team was on cloud nine. I had made a nice selection of sandwiches and race food goodies the night before, and had stopped at a roadside stand in Germany to buy several cartons of field-fresh strawberries as a special treat. Their excitement and satisfaction was as palpable as it was infectious; being part of the staff behind a big team win is almost as exciting as being out there on the road.
The next day we headed back out to the small Dutch village Lieshout, home to the Bavaria brewery, for an inter-club circuit race — something of a cross between a Belgian-style kermesse and an American-style criterium. The course was surprisingly challenging: hot and sunny with paver brick road surface, lots of turns and chicanes, and several raised roundabouts in corners. The juniors completed 65 kilometers, which is too short to permit or necessitate feeding, giving the staff a break and me a chance to indulge one of my other passions: race photography.
It was a heated race with an early two-man break by one of our riders and his trade team teammate from Hot Tubes Development, which the pack brought back until a bigger bunch got away and stayed away. It ended with a bunch sprint in which another of our riders gave it his all for a hard-fought 2nd, and our 4th podium in 2 days!
The team had such an outstanding, intense weekend that I got permission from their director to take them on a field trip to the nearby city of Maastricht, capital of Limburg with ancient roots dating back to Roman times. Today Maastricht is known for its vibrant city center shopping and dining district, with several beautiful churches and medieval structures still intact. Most of the riders had already visited on other trips, but it was the first trip for several of them, as it was for me. It was a great opportunity to have a nice lunch away from home base or racing with the guys, and to turn them loose while I did a little shopping and sightseeing.
The next day I had to fetch two more riders from the airport in Brussels, one of whom would join us for the upcoming Three Days of Axel race and the other who would ride Axel for his trade team, Hot Tubes Development, and join the USA team later in the season. After a nasty taste of Brussels traffic (some of the worst in the world; I got charlie horses in my legs in my sleep for days after riding the clutch for so long!) we packed up a truck and took the group to Zeeland, on the Dutch coast, to get a first taste of cobblestones and to deliver a couple riders to Hot Tubes.
It was really neat to see such a large group of the best juniors in the United States in the same place at once. (If the one in the middle looks a little old to be a junior, that’s because he is our intrepid program director, William Innes). Cobblestones, sometimes called pavé, are a classic hallmark of northern European racing and riders who handle them with speed and agility forever have their careers defined by their excellence in “cobble crushing.” Nearly all of the famous spring classics feature sections of cobblestones, which range in difficulty from patio pavers to mud and moss-slick rock gardens more appropriate for mountain biking than road biking. Axel is known for its rough field cobbles with soft, grassy, muddy shoulders; they are as difficult to ride at high speed as they are dangerous, especially for riders without experience or proper equipment.
With the team prepped and ready, it was up to me and our mechanic to get the bikes and remaining equipment shipshape. The courses of Axel are notoriously hard on wheels, so all the bikes were equipped with our special “Roubaix” wheels: aluminum Easton tubulars with heavy-duty puncture-resistant, wider tires. The wheels were an abnormally heavy setup for racing, but would give our riders the best possible chance at avoiding flat tires or crashes due to poor traction.
Unlike the Peace Race, the race organizers at Axel provide somewhat more edible food options, so I didn’t need to cook. From that standpoint it made the race logistics a bit easier on me, although I packed double of everything in the medical kit in hopes that it would be like carrying an umbrella when rain is in the forecast: preparedness would stave off necessity.
Prepping for Axel also gave me time to reflect on the weeks I had spent traveling to races in Europe, and I was truly sad that this would be my last race with the team. I knew they would get excellent care from other soigneurs as they continued their racing season, but the infectious excitement of racing had done its work and I was hooked. Had it been any other kind of hard work, I would have been looking forward to a respite, but I found soigneur work inspired an ethic and passion in me that I had never experienced to that extent.
The hour has grown late, my candle has begun to flicker, my laptop battery is waning and (most upsetting of all) my glass of wine is empty; we’ll pick this up next week with the pavé pandemonium of Three Days of Axel!
Does she remind you of anyone? Over the past few weeks, I’ve been feeling a lot like her! I’ve had a number of very stressful life events arise — some I could control, and some were completely out of my hands.
Probably the most stressful thing in my life right now is the thing that I’m also the most excited about — in a few days, I’m leaving to spend 2 months at the USA Cycling training center in Sittard, Holland and traveling throughout the continent with various elite road cycling teams. I have worked really hard to make this fantastic opportunity into a reality and I can’t wait to get over there. USA Cycling operates with the riders themselves as its number one priority, as they should be, so staff needs get bumped down the ladder rungs and are dealt with only after all of the riders’ needs are met. This structure gives USAC riders in Europe an outstanding experience, and expects staff members to be flexible and able to jump on a plane with little notice (or have departure dates delayed suddenly). After having my departure date delayed a few days with still no definite travel itinerary, I’m doing my very best to stay cool and prepare for all the things I can without stressing the rest.
Sports psychologists tell us that people who participate in physical activity, and especially people who compete in sports, have different mental toughness and coping skills that help us to deal with stressful situations. Developing those traits can help us to perform better under pressure, both in sports and in life.
Coaches in many sports that put tremendous wear and tear on the body but also require precision and fine motor skills have trended toward refocusing some of the training time that used to be spent repeating movements and routines on visualization exercise. Gymnastics is a notable example, and one of the first sports to adopt visualization and imagery as an important part of training. Athletes who devote time to mindful meditation and mental rehearsal of difficult movements often develop those skills better than athletes who do not practice visualization but instead rely on practice through rote repetition. Of both groups, the athletes who practice quieting their minds and mentally rehearsing the challenging task tend to outperform the athletes who rely solely on physical practice in competition. Many athletes also report a better sense of mental well-being and confidence when they regularly practice visualizing themselves succeed in challenging situations; the imagery of competence seems to transfer throughout all areas of life.
Look Out Through Quiet Eyes.
The term “Quiet Eye” comes from Joan Vickers, a kinesiology researcher at the University of Calgary who observed the habits of highly successful professional athletes completing precision tasks under mental pressure, especially putting in golf and shooting free throws in basketball. Vickers used sophisticated eyesight gaze-tracking software and concluded that the most accurate performers focused on a specific point on the target for several seconds prior to to any movement, and continued to concentrate on the same point while performing the task. In a broader sense, we can consider a “quiet eye” attitude to be one of intense focus on our goal while zoning out all the extraneous distractions in our environment. For a triathlete, this may be sighting a buoy to keep his swim tracking straight and efficiently in spite of other swimmers or rough water conditions. For a mountain biker, it might mean letting go of a little bit of control while staying still and focused to let the bike take a fast line through a technical descent. And when encountering a difficult life event, it might mean clearing your mind and allowing yourself to experience and acknowledge your emotions fully, one at at time without distractions.
Stop: Is it Environmental, or Internal?
One of our species’ defining characteristics is our capacity for pattern recognition. We can use it as an amazing tool for scientific discovery, and we can also misuse it drive ourselves crazy in the process. The ancient portion of our brains that governs memory, behavior, and emotion is the limbic system, which comprises several portions of the deep- and mid-brain. When a noxious stimulus enters our environment, the limbic system is responsible for identifying the threat and preparing our bodies for fight-or-flight response, firing up the sympathetic nervous system and releasing a wave of neurotransmitters and hormones to elevate our sensory arousal. If the stimulus is a saber-tooth tiger crouching to attack a paleolithic hunter, then the hunter’s limbic system correctly identifies the tiger as the threat and latches on to all the clues in the environment that could portend a tiger attack in the future. Early humans who did this well survived and passed on these genes for excellent pattern-recognition. Today, however, many of the things that make us anxious aren’t readily identifiable environmental factors, which confuses the limbic system into identifying false threats and anxieties. I can use myself as an example — I get very nervous about flying on airplanes, especially in turbulent conditions. My limbic system recognizes my anxiety but cannot attach it to any specific environmental stimulus, so instead it identifies my internal cues of anxiety as the threat and creates a sympathetic response to those, elevating my anxiety even further. Rapid respiration and heart rate, ringing in my ears, upset stomach, and other physical sensations that I experience when I am anxious are perceived by my limbic system as a threat, which can snowball into full-blown panic if I don’t recognize it and take active steps to break the cycle (mostly highly-rehearsed visualization exercises). Giving a name and a manifestation to our anxieties can be tremendously helpful in minimizing and tackling them, instead of coping with a nebulous cloud of doubt and malaise. Facing stress is challenging, but it makes it a whole lot easier to be able to identify the source of your stress — you may find that a raging torrent downriver is just a trickling spring if you track it all the way back to its source.
A Healthy Release.
Many athletes initially get involved in sports as a way to blow off steam and cope with stress. Sports and physical activity are a wonderful way to manage stress and help to find balance between work and life. Constantly appraise your motivation for participation in all activities — are you personally receiving satisfaction and purpose from them, or are you doing them to please someone else? When your fun, leisure activity becomes another onus instead of enjoyment, then it may be time to reevaluate if your stress-reliever has become a source of stress. It isn’t realistic to expect every day of training and competition to be a great day, but it is good to keep a rough tally of whether the great days outweigh the less great ones. You shouldn’t feel like your sports participation is an obligation, and if you do, it should signal that it’s time to talk to your coach or peers and restructure your participation in the sport. If you continue to compete out of a sense of duty instead of enjoyment, you could easily be headed directly down the road to burnout.
It’s important to recognize that much of an athlete’s training is to prepare her for enduring stress. This makes the assumption that stress will always be present in some capacity during competition (or, indeed, during life) and that success does not mean minimizing all stressful stimuli, but preparing the body and mind to use stress in a positive way for maximum performance. Think of a master martial artist — when an opponent throws a punch at his body, he doesn’t block the punch with his arm, risking breaking the bone and being thrown backwards as he absorbs its energy. Instead, he is likely to redirect the energy of the punch into a useful movement that throws his opponent off balance and puts him in a better position to anticipate the next move and ultimately prevail. Stress is the same way; if we avoid all stress, we also avoid all opportunities to develop strength, toughness, and strategies for recognizing opportunity in dismal situations. Sports psychologists talk about stress on a continuum from calm to distress. Calm and distress are situated on the far ends of a bell curve, with “eustress,” a term to describe stress used as a motivating factor, at the high point of the bell curve. This is meant to indicate that there exists a healthy degree of stress, and response to stress — it is up to us to condition ourselves to respond to it in a productive manner. We need to reframe stress not as a necessarily negative experience, but a powerful tool in our arsenal for top performance.
As for my own stress, I’m doing my best this week! I still don’t know what day I’m leaving for Europe, so I’m trying to be proactive about having everything I can control ready to go at a moment’s notice (and a big hat’s off to my employers for being so understanding about this!). I’m getting over a bad cold that was probably in part stress-induced; managing stress poorly can lead not only to mental fatigue, but to physical symptoms and even immune suppression. Going forward, this trip is a great exercise for me in preparing for what I can and rolling with the rest — watch this blog for more adventures in stress management soon to come!
It’s quickly approaching that time of year again — the 2 weeks or so where gyms are inundated, diet books fly off the shelves, and Americans once again resolve to better ourselves in the New Year. According to a Time Magazine article this week, the most common resolution will be weight loss and improved fitness. Year after year we fall into the same pattern; some of us succeed in lasting lifestyle changes, but the vast majority will quickly fall back into old habits. What can we do to break the cycle?
Last year at this time, I was still in graduate school and despite the fact that I was devoting myself to the scientific study of sports medicine, I was not practicing healthy lifestyle habits. I wasn’t making time for exercise and my eating was frankly atrocious. I had gained some weight and lost a tremendous amount of fitness, and I felt terrible. I had to change.
Today, I’ve lost 45 pounds and 6 inches off my waist from one year ago. I’m keeping up on very fast group bike rides and I’m running better than I ever have in my life. These changes haven’t happened overnight, but they have been consistent and lasting; I’d like to share some of my success with you in hopes that you can find it helpful in your lifestyle as well.
- Accountability. I’ve always done better when I had to be accountable to someone other than myself, whether it’s a dietitian looking at my food intake logs, a personal trainer giving me instructions on exactly what exercise to do, or a coach’s training plan. I knew that while I was taking an overload of graduate classes and working 2 jobs, the most important factor was going to be adherence to a healthy, calorie-negative diet. I used an app called My Fitness Pal to keep careful records of overall caloric intake as well as the breakdown in macronutrient percentages (carbs, fat, protein). The app certainly has its limitations, but it’s free, the mobile interface is user-friendly, and the food library is very complete. Having a bold number on a page really helped me to focus and think about selecting foods that would meet my nutrition goals, instead of eating without thought of effect.
- Food as Fuel; Exercise as a Privilege. This one was all about mindset for me. I had often fallen into the trap of punishing myself for eating badly with a really hard workout; completely unconsciously, I had begun to regard exercise as a one more onerous responsibility instead of a stress-busting, fun, healthy activity. I started planning my food intake around the workout I wanted to do that day, and I tried to make them as fun as possible. Going to the gym with my significant other was great incentive, with the added bonus that we tend to push one another to work harder. Mountain biking with my dog is one of my favorite things — I get a really fun ride with my best friend, and I got the dog good and tired so she wouldn’t bug me (as much) when I really needed to buckle down to work and study. I always felt better after a workout, and thinking of it in terms of an enjoyable activity instead of a means to offset other unhealthy choices removed a huge mental obstacle.
- Flatten the Playing Field. One of the classes I took last spring was a Health Policy class in the Department of Public Health. The professor explained public health initiatives through the metaphor of the myth of Sisyphus, the ancient Greek king who was condemned to roll a boulder up a steep hill only to watch it roll back down for eternity. With any health challenge we face, the steepness of the hill is determined by the factors that make success more difficult. As an example, consider quitting smoking. The factors that make it more difficult might include pressure from peers who are also smokers, life stress that is alleviated by smoking, fear of weight gain after quitting, physiological addiction to cigarettes, and even lack of insurance coverage for cessation treatments. Removing or reducing those factors makes the slope less steep — getting on a new insurance plan, joining a group to provide social support for quitting, taking up leisure activities that promote health and reduce stress. Furthermore, one can factor in advantages to quitting — reduced cost of insurance, improved health, eliminating potential harm to friends and family, and so on — that raise the bottom of the slope, leveling it out even more. Suddenly, pushing the boulder uphill isn’t daunting. The same was true for me with weight management — I needed to make good choices easier, and unhealthy choices less desirable. I committed to not buying any food that was inconsistent with my health goals to remove the temptation of having it in the house, and I cleaned out my cupboards and donated the offending food products I already had to a food bank. I started trading out sports massage services for personal training with a gym and scheduled my workouts during gaps between classes to make it as easy as possible to stick to my schedule. I even bought some particularly cool-looking running shoes; don’t underestimate the power of adding some fun to a workout! Making the right choices easier helped that boulder keep on rolling without much added effort on my part.
- Make SMART goals. SMART is an acronym used in athletic training and physical therapy rehabilitation; it stands for Specific, Measure, Assignable, Realistic, and Time-Oriented. I found these criteria really helpful in goal-setting for healthy lifestyle choices too. Vague goals (“I want to lose weight”) are hard to conceptualize and rarely succeed. Instead, I reviewed a lot of health literature and talked to experts to determine an appropriate and attainable specific weight goal for myself. I keep track of a lot of measurements to track my progress, including weight, hip, waist, and neck circumference, resting heart rate, and sleep patterns. My gym also has a station that takes more medically-oriented measurements, so I track blood pressure and body fat percentage using that equipment. Those measurements help me assess progress and adjust my practices to keep on track; I don’t think that keeping track of measurements to that degree of detail is right for everyone, but I’m a numbers-oriented person and it’s been really helpful for me. “Assignable” refers more to a rehab setting where a patient works with a variety of people, but I use that criteria to assign myself fitness tasks each week (for instance, this week’s job is a long bike ride on Tuesday). Realistic goals are crucial to success, so I shoot for a pound of weight loss per week. This makes it much easier to stay on track and such gradual progress is much more likely to be lasting progress. I make my goals time-oriented by setting fitness benchmarks, such as entering races or events and just having dates where I want to have achieved specific aims (usually these are regular doctor check-ups; I like showing off how to my doc how well I’m doing!).
- Be Realistic about Setbacks and Successes. I would be a big liar if I didn’t admit to falling off the wagon now and then. Sometimes it has been out of my control — I recently had to take a 10-day hiatus from exercise after a medical procedure — but most of the time I can point the finger to none other than yours truly. Too often, setbacks have snowball effects that result in a catastrophic tumble; we see this all the time with crash dieters whose resolve wavers and they end up gaining back even more weight than they lost. Willpower is not an inexhaustible commodity, so it’s important to identify potential pitfalls and offset their impact. For most people, getting it right 90% of the time is enough to see progress. For me, that means about 1 meal per week that’s less than stellar. I don’t go overboard, but I also try not to have such hard and fast food rules that a taste of forbidden cookie will send me spiraling in an out-of-control tailspin. Take it one day at at time; one bad meal isn’t going to demolish all your results, but neither is one good one sufficient for success — it’s all about consistency. Instead of totally cutting out an unhealthy habit, reduce it a little with an alternative; I can’t live without chocolate, so I started buying small quantities of extremely high quality dark chocolate and keeping it in the freezer, so it required a lot of work to break a little piece off, let it thaw, and savor it, instead of demolishing a whole candy bar. Little steps in the right direction are more powerful than trying to make giant leaps that may backfire into setbacks.
- Surround Yourself With Experts. Every big organization, school, or corporate entity has a board of directors to provide the best decision-making insight to the leadership. Establish your own personal board of directors to inform your lifestyle decision-making; I got this advice from a very wise high school principal, and it has proved to be an extraordinary tool for all kinds of big choices. In my journey to better health and fitness, I have sought out the company of experts with specific knowledge to fill in the gaps of the big picture. I had a bit of trial and error in assembling my board of directors — one mistake I made was wanting to get better at running, so I asked a well-meaning runner friend where I should start. “It’s easy!” she exclaimed. “Come out on a run with me and I’ll show you!” And thus ensued a horrible experience of being dragged around a totally inappropriate course at way too fast of a pace until I felt like I would never be able to take a full breath or keep food down again; it was really defeating and would have been very easy to give up right then and there. But instead I consulted a running coach who helped me to streamline my form for greater stride efficiency and ease. Similarly, I asked my friend Tommy Rodgers, a dietitian and local cycling legend, for some nutrition tips that helped me come away with a much better understanding of fueling my body. I also started getting regular massage therapy, which proved to be a huge boon — it helps me recover from hard activity much faster to optimize my training, and it’s a wonderful calorie-free reward for good lifestyle choices. Here’s a plug for my employer: at E3: Elite Human Performance, we have all of these services under one roof; it’s a superb resource no matter where you are in your fitness journey.
- Budget for Expenses. Healthy eating habits and exercise do incur some unique financial expenses, but look at it this way — have you priced type 2 diabetes recently? How about treatment for the dozens of cancers that have been directly linked to excessive body fat, or cardiopulmonary diseases? A little extra expense and careful spending now can add years to your life; it’s impossible to put a price on that. Fitness and healthy lifestyle don’t have to be all Whole Foods and exorbitant gym memberships; you can accomplish strength training at home with equipment you already have, join a free running club where all you need is a decent pair of shoes, and buying fresh produce instead of pre-packaged options can actually save a lot while optimizing nutrition. Investing in a training plan from a coach and other fitness-related services in the short term can help you build lasting habits, and you will reap benefits in physical health, self-confidence, and healthy habits for life. You don’t have to think of these commitments as long-term and continuous, but it’s great to try a variety of things and see what works best. I have been most successful with picking competitive events in which I want to participate and getting training plans built around the event schedule to keep myself on track. It incurs financial burdens, but the benefits of deeply enjoyable activities, friendships I have built through sports participation, and how great I feel when I’m eating and training well is more than worth the expense.
I want to wish you the best of luck on your New Year’s resolutions, whatever they may be. Remember too that any type of change is about the process, not the end point of the journey. Making that process deliberate, minimizing the obstacles in your way, and enjoying the voyage of reaching toward your goals will help you succeed. I’m well on my way to health for life, and I keep being surprised by unforeseen benefits I encounter. Keep your mind open to new possibilities along the journey; a year ago, I never could have guessed there was a runner inside me waiting to be let out!
What are you resolving to do this year? Tell me about it in the comments!