Episode #134: How “Active Release Technique” Can Help Your Body Feel Better.

In this podcast, Active Release Technique, nitroglycerin for injuries, low volume weight training. Does it matter if you burn fat or carbohydrate during a workout? Raynaud syndrome, Epsom salts, weight training, soreness, asthma remedies, is sugar free, gum healthy and lap band surgery.

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Welcome back to the Ben Greenfield Fitness Podcast. This is Ben and I'm recording today's episode in Spandex. That's right, I'm wearing my bicycling uniform because I'm going on a bike ride today and sometimes the best way to get my butt out the door to exercise is to actually dress like I'm going to do it. Little tip for you there. So in today's podcast I have an interview with Dr. Kevin Christie about something called Active Release Technique, which many of you may know as art. It's an interesting interview about a technique that's really useful for improving or helping with injuries and also for assisting with performance. We've also got, of course, our listener Q and A and a few special announcements. So let's jump right in to this week's content. Special Announcements if you were over@BenGreenfieldFitness.com this week, you may have seen the post about breakfast. Specifically, my question to you about what confuses you about breakfast because it does seem to be one of the more confusing meals of the day. For example, for weight loss, do you eat breakfast? Do you not eat it for carbohydrates, fats and proteins? Do you include all three? Do you only do carbs? Do you just have some fruit? The idea about breakfast and the influence that it can have on the rest of the day is something that's pretty important. And so I put up that post. I'd love to hear your comments about what confuses you about breakfast. And in an upcoming post, I'm going to be answering all your questions, so be sure to head over to BenGreenfieldFitness.com and pipe in on the conversation there. Speaking of the conversation, tons of Q and A and conversations about fitness, fat loss and nutrition happening over at the Ben Greenfield Fitness Facebook page. Just go to facebook.com bgfitness to check that out. And get in on some things that you really don't see over@BenGreenfieldFitness.com and then finally, for those of you out there who are interested in advertising on the blog over@BenGreenfieldFitness.com, just shoot me an email or go to the Show Notes for this episode and episode number 134 and there is an advertising information sheet there. So let's go ahead and get on to this week's content. Get the inside edge from Ben Greenfield Fitness delivered straight to your phone. Just text the word Fitness to 411247 and you'll instantly get exclusive VIP discounts and insider tips that no one else will ever see except you. Do it now. Text the word Fitness to 411247 and you'll be in Ben's VIP Text Club for free.

Listener Q and A.

If you have a question for the podcast, you can call toll free to 877-209-9439 or if you' Skype to username Pacific Fit. You can also use the free Ben Greenfield Fitness iPhone app and ask a question by pushing the Ask Ben button that's there on the iPhone app. And by the way, Android people, the Android app does come out next week. It's just finishing up its beta testing. It'll be available to you for free next week. And then finally you can of course use the Ask Ben form, which is on the Show Notes for any of these podcasts over@BenGreenfieldFitness.com and the first question comes from Becky, who says, have you ever heard of using a nitroglycerin patch for healing injuries? What would be the potential side effects? Do you think it would be effective for my friend who has a nagging Achilles injury? Well, nitroglycerin patches are pretty interesting. The idea behind them is that they're supposed to regulate the nitric oxide levels delivered to an area and potentially improve healing by increasing some of the nutrient and the oxygen delivery, nitric oxide being something that can improve the diameter of the blood vessel that's actually feeding an area. However, all of the studies that have been done on the active ingredient of these nitroglycerin patches, which is specifically something called glyceryl trinitrate, have not found that there is any additional benefit of using a nitroglycerin patch over any of the standard treatments for things like tendinosis or things like, say, Achilles tendinitis. Not only was it found to be ineffective over standard treatments, but there's not any evidence that these nitroglycerin patches actually do affect the enzymes responsible for increasing nitric oxide production. So ultimately, unless the sports medicine clinic that your friend is going to has some new cutting edge research that I haven't seen, there's not a lot of evidence that these patches are going to help out too much. So they may want to think twice about what they're doing now. They do now have a patch that actually delivers a non steroidal anti inflammatory drugs specifically into an injured tissue area. So whereas I've never been a huge fan of encouraging people to take something like say ibuprofen or Advil in the past just because of the damage that can do to the gastrointestinal tract, they do have a patch now that is a prescription based patch that you apply to an area that delivers the same drugs locally, thus bypassing the stomach and you end up with less of the stuff in your bloodstream. So that's something that I would consider over and above a nitroglycerin patch. The next question is from Mike Schrankel who says, what do you think of low volume, high intensity weight training? I've seen a website that goes to great lengths explaining that performing extra sets beyond a light warmup and one heavy set yields only 0 to 5% more muscle growth. I like the short time commitment, but I'd like to do a wider variety of exercise with fewer sets if I can get decent results. When we're talking about muscle growth, the most important component to consider is the actual time under tension that the muscle is exposed to. So for example, during a workout, you generally want to get about 150 to 200 seconds of time under tension for the muscle group that you want to grow. And when you're doing just one set, it has to be a very, very long set to complete failure, or it needs to be multiple sets of shorter reps in order to amass that amount of time under tension for the muscle. Now, doing multiple sets for a muscle mentally a lot of times is easier than just doing one set to total fatigue for a muscle. So for example, doing five sets of 10 of say a biceps curl for the bicep is a lot of times much easier and more feasible for the average person than doing, say one set of 50 bicep curls. And that's the idea between splitting things into multiple sets. So the idea behind this low volume weight training is that you really don't need to do much in terms of an additional set. But most of the research on this was done over a decade ago. And since then, research has shown that you do need multiple sets or that high amount of time under tension for a muscle to really optimize muscle growth and hypertrophy compared to a single set. When I say hypertrophy, that's just basically muscle growth, specifically the muscle cells and muscle fibers in the area that you want to work. Now, when would doing one set be appropriate? For example, if you wanted to just increase your power or you just wanted to increase your strength and you didn't want to actually put on muscle, that's where doing a single kind of high intensity set, like one set of eight reps of a super heavy bench press would come in handy. But if you're just looking for muscle growth, multiple sets are going to be effective. And most of the research that that's on the website link that you sent over to me is pretty outdated when it comes to this stuff. And you're going to find that most bodybuilders, pretty much any individual who's wanting to get a muscle to grow larger is doing a lot more than just one single set, with the caveat that if they are doing a single set, it's usually high, high reps, we're talking like, you know, 40, 50, 60 reps. So next question is from Lorna, who says, why does it matter whether I burn fat or, or carbohydrate during my workout? I thought that if I am at a caloric deficit at the end of the day, fat will be used for energy, giving me a body fat loss. Whether I burn carbohydrate or fat. A deficit will mean fat stores are reducing when it all balances out, will it not? Well, you're right, Lorna, in that at the end of the day, really the total amount of calories that you've burned is most important. However, you also need to consider your limited time in getting the most efficiency out of your workout. So if you take two people and you put them side by side and you tell one person to say, walk on the treadmill for an hour at a low fat burning intensity, say like 50% intensity, they are going to burn a high percentage of fat during that workout. They're not going to burn many calories, but they're going to burn a high percentage of fat. Furthermore, their heart rate isn't going to get very high and they're not going to be breathing that hard, so there won't be a real big metabolic or hormonal response to that long, easy walk on the treadmill. Now, if you take another person you tell them to do eight two minute sprints on the treadmill, each separated by, say, two minutes of easy recovery walking. That person is going to get a very high heart rate during that workout. They're going to be breathing very hard, they're going to increase the number of hormones and the metabolic response to that workout. So they're burning a lot more calories even after the workout is done. And even though they're going to primarily be burning carbohydrate during the workout, because the workout is performed at a high intensity and your body uses carbohydrate when you work out at a high intensity, the overall number of calories that they burn will be similar or greater than that easy one hour walk on the treadmill. So what it comes down to is they're going to get more bang for their buck and they're going to lose weight more quickly in a shorter period of time than the person who's doing the easy fat burning cardio. The other thing to consider is that a lot of times, even if you are working out in, say, like a fat burning zone, you're still not burning as much fat as the person who's working out hard. And the reason for that is this. If you're working out hard and you're burning like, say 800 calories an hour, you're going to be burning a lot of carbohydrate. Because you're working out hard. You might be burning say, 70% carbohydrate. So you're only burning 30% fat, but that's 30% of 800 calories. Now, if you go out and do something easy, say, like you're working out at 300 calories an hour, you might be burning 50 or 60% fat, but 50 or 60% fat of 300 calories is still a lot less fat than 30% fat of 800 calories. So you need to think about the total calorie burn in addition to the overall fat percentage. And what it comes down to is that in most cases, you're going to lose weight more quickly if you're working out at an exercise intensity that makes you breathe hard and makes your muscles burn. And kind of my three pillars of fat loss that I talked about in last week's top 10 fat loss secrets that I released over at BenGreenfieldFitness.com is that your number one priority for fat loss should be weight training. Your number two priority for fat loss should be cardiovascular interval training. And your number three last priority for fat loss should be easy, slow, Cardio. So hopefully that helps out with your question. Another question from Laurel, who says. Well, she has a two part question. The first is, she says, are there homeopathic or home remedies for Raynaud's phenomena? For those of you who don't know what Raynaud's phenomena is, is it's basically a disorder that causes a discoloration of the fingers and the toes. They usually get kind of reddish and a little bit purple, and many times they have areas of very low blood delivery. So you basically get very, very sensitive to cold temperature. And, for example, when you go out for a run, you know, your friends might be able to run with no gloves on or some thin gloves on, and you got to wear thick mittens because your hands or your feet get cold so easily, just because there's not enough blood going to the area to actually heat the area. So when you have this issue, obviously, one thing you can do is just try to keep blood flowing as much as possible. So when you're in the cold, you can basically try to wiggle and move your toes and fingers as much as possible. And if that doesn't work, you can do, like, windmill motions with your arms and your legs just to try and get more blood into the area. You can massage your hands and your feet. That'll help with blood flow quite a bit as well. Sometimes Raynaud's comes on in basically what would be termed an attack to where you'll be fine and then all of a sudden you'll get really cold. That's where doing things like the arm swinging and massaging an area can help to improve blood flow. As far as natural remedies or supplements that you could take, Three of the top herbal supplements when it comes to blood flow and assisting with temperature regulation in the extremities are ginkgo biloba, and ginger is another. And then rosemary is also kind of a traditional circulatory tonic to support healthy circulation. So you can supplement with any of those. And the other thing that's. That's shown promise for Raynaud's is biofeedback. And basically, biofeedback is actually training the body to have less of what's called a sympathetic nervous system response. Response that can kind of shut off the blood flow to the area. And so it shuts down your response to stress. It reduces the closure of those blood vessels and lets you get more blood flow and thus more heat to your extremities. So biofeedback is a deal where you're going to go into a Biofeedback practitioner. Typically, you're hooked up to a computer and some equipment that's monitoring your physiological or your biological response to stress. And then through a series of sessions, you learn how to consciously reduce your stress response. And something like that can be useful for a variety of conditions, but it's something to try out for the Raynaud's. And then the second part of your question is, what do you think of Epsom salts as a source of magnesium? Well, in an Epsom salt, typically the type of magnesium you're going to find in Epsom salt that you would add to, say, like, bath would be a magnesium sulfate. And it's definitely a great source for soothing muscles, for assisting with relaxation. Compared to, like, oral supplementation with, you know, a few hundred milligrams of a magnesium citrate, which is typically the type of magnesium that I recommend people supplement orally with. You're not going to get as much absorption from, like, an Epsom salt bath, but you will get quite a bit of magnesium exposure. And a lot of the benefits of magnesium. Don't get your bath too warm. That can actually decrease the absorption. If you're in a real, real hot bath, I believe it's over 103 would be what you'd want to avoid, but you can definitely use Nep some salt if you want to get even higher percentage of magnesium in your salts bath. Use just magnesium flakes, and you can get magnesium flakes. There's one company called Ancient Minerals that makes a real, real good magnesium flake that you could try. I'll put a link to it in the show notes, but that's actually what I use. I don't soak in Epsom salts. I soak in magnesium flakes. And I noticed that I typically feel a lot better after using that versus an Epsom salt when it comes to soreness or relaxation. But ultimately, it is a good supplemental way to get your magnesium in. Although I wouldn't completely neglect taking oral magnesium as well. And our next question is a call in question from Jeff.

Hey, what's up, Ben? This is Jeff from Tampa. A question for your awesome show. All right, I'm sold. I know I need to do resistance training. I'm an endurance athlete, basically, runner, cyclist, and every time I get started with weight training, I go in, I do some dumbbells. I just kind of do a little bit of a circuit training. I always get stiff and achy and sore after the first and second time, I just give up, and I go, I just hate this. So can you Give me some tips on how to get started with resistance training. So I'll stick with it. Thanks, Ben. Appreciate you, man.

Bye. So, yeah, that's one of the top reasons people drop out of a weight training program early is the soreness. Because there's lots of of muscle tiredness that occurs, muscle tiredness, muscle tearing that occurs when you're weight training. Weight training and running are two of the top activities that cause a lot of that muscle soreness. And those are the two of the top activities that people tend to hate or avoid doing. What I would recommend is that you start with just two days a week of weight training if you're going full body and go closer to four days if you're splitting it up and doing like upper body one day, lower body another day, and then another upper body, lower body session. Now what I would really recommend that you do is go listen to the first five episodes of my Get Fit Guy podcast. And in those first five episodes I really lay out pretty much everything that you would need to get started with weight training. Now I'm going to put a link to that podcast and these are real short episodes. You could get through the first five episodes in 30 minutes. But I'll put a link to those. And for those of you listening in the week this podcast comes out, be sure to check BenGreenfieldFitness.com on Friday because I'm going to list the top 10 episodes that have ever appeared over at that Get Fit Guy podcast so that you can listen to some of the more popular and more helpful podcasts that are available over there. So definitely listen to that podcast, don't overdo it. And of course include your recovery protocols when you start weight training. It doesn't seem like it would make this much of a difference, but something as simple as getting your protein in after you've finished and throwing in some branched chain amino acids or some proteolytic enzymes, something like a recover ease supplement after you've finished weight training can make a huge difference in your soreness. So listen to those Get Fit Guy episodes. Those are going to go into a lot of detail about how to get started with weight training. Next question from Ralph, who says, I have a hard time running and have been told I have athlete induced asthma. I've been told this because I have a hard time breathing during exercise and it sounds like wheezing. Is there anything I can do to help with this? Well, this is something that's, it's not super common, but it does happen in people who exercise who don't have any asthma at all. And then they get an asthma attack or they have a lot of hard, a lot of trouble breathing as soon as they begin exercise. And the idea behind this is that it's believed that people who get exercise induced asthma are more sensitive to changes in the temperature or the humidity of the air. So when you're sitting around doing nothing at all, a lot of times you're breathing through your nose. And your nose actually serves to warm and humidify and cleanse all that air that you're inhaling. And once you start exercising, you start breathing through your mouth. And then the air that hits your lungs isn't warmed, it's cold, it's not as humidified, it's drier. And the contrast between the warm air that's in your lungs and that cold air that you're inhaling can trigger an attack. So what happens is your airways start to swell and typically you'll produce a lot of mucus as well. And all this swelling and the mucus blocks the airways, and it makes it more difficult for you to exhale or to push air out of your lungs. So it can feel like you're having a very hard time breathing. My wife has had to deal with this before, and to a certain extent, learning how to control your breathing seems to help her a little bit. Specifically, she does yoga, which teaches a deep diaphragmatic breathing. And it also helps you to relax as you focus on your breathing. So that can be one thing that's very useful to try. But the other thing you may want to look into is one of those power breather devices which can also improve the strength of your inspiratory and expiratory muscles. With the idea being that if you do start to go into a bronchospasm, you would at least have a little bit more to fight against it with, so to speak. Now, you may actually need to go and get a bronchodilator. And this would be one of those steroidal based inhalers that you use when you feel a spasm starting to come on. And that will open up the airways and kind of reverse that spasm. If that's something that you don't want to do or you don't want to use a steroidal inhaler, you can try natural remedies. I mean, they're out there. Oregano is one, for example, that was mentioned on this show before when I conducted an interview on somebody about oregano and the many uses of that. You could listen to that interview@bengreenfieldfitness.com oregano. Other things that people will use are like some of the curry extracts or curcumin extracts, like a turmeric mixed in water or tea, like an herbal tea, local raw honey traditionally used for, like, allergies, pollen allergies, things like that. That's something that some people have used before for exercise induced asthma. There are just a ton of natural remedies out there. You know, one of the things that I have is written by Carolyn Dean. It's called the Future Health Now Encyclopedia. And it's basically this awesome database of searchable herbs and supplements and natural remedies that can be used for conditions like this. So I could fill up an entire hour of podcasting just with what's in there on asthma. For example, I'll put a link to her encyclopedia in the show notes, but I actually have a copy on my computer and I just, I'll open it up and press search and find. And I can read up on a lot of this stuff really easily with that encyclopedia that she wrote. So very, very useful to have on hand. I'll put a link to that in the show notes to this episode, episode number 134. Now, a lot of times there's something called vocal cord dysfunction that exercise induced asthma, or folks who have exercise induced asthma or have been diagnosed with exercise induced asthma were actually misdiagnosed and they actually have the vocal cord dysfunction. That's something that can be fixed through therapy, through kind of like a breathing and vocal therapy. You may want to look into vocal cord dysfunction and somebody in your area who may be able to help you out with that. You'll also want to make sure that you avoid stark contrasts in temperature and humidity when you're exercising. Don't go straight from your house or your office out into the cold air to exercise, gradually warm up, or just avoid the cold air altogether and stay indoors when those stark temperature contrasts exist. Or if you have to exercise in the cold, wear a scarf or some type of covering over your mouth so that it warms and humidifies the air just a little bit in the same way that your nasal passages might. But those are some things to look into. I'm not a doctor, but I would definitely check to make sure that you don't have vocal cord dysfunction. Look into some natural remedies, get your inspiratory and expiratory muscles stronger consideration, consider a bronchodilator and also watch those stark changes in temperature. Now, the next question comes from Kat, who says do you know of any potentially harmful effects of chewing sugar free gum? Well, I think a lot of us don't really know exactly what's in our gum, but if we analyze it, most gum today has five things in it. It's got this gum base, which is the part that's kind of left in your mouth while you're chewing as some type of sugar, either just regular sugar or else a sugar substitute like an aspartame, sugar alcohol, asorbitol, xylitol, etc. Usually has some type of wax based softener in there. Typically in addition to the sugar, some type of flavoring in there, which is usually, and it's an artificial chemical flavor. And occasionally you'll get like a real peppermint extract and a good gum. And then a lot of times the gum has artificial colors added to it, so it just looks a lot nicer, you know, like a red or a white. So in terms of the actual ingredients, if you pull gum off the shelves, like if you take like a peppermint XL gum and pull it off the shelf, the ingredients are maltitol, gum base, sorbitol, glycerin, gum arabic, natural and artificial flavors, mannitol, aspartame, artificial color, acesulfamy, potassium and wax, carnauba wax. So the first ingredient there is maltitol, that's a sugar alcohol. In most cases, there's not enough of it in the gum to cause diarrhea or gas or bloating. But if you're chewing lots of gum during the day and any of the ingredients in the gum end with ol, indicating that there are sugar alcoh, it may cause a lot of gas and bloating. So that's something to think about. I'm not really against sugar alcohols that much, other than the fact that they can cause that gas and bloating because they're just not digested all that well. The gum base typically is made up of some type of elastomer. They'll use usually like a calcium carbonate as a filler. Some of them will use like a talc as a filler. And the percentages of those are going to change based off of the type of gum that you're chewing. Like a bubble gum versus a regular gum. An elastomer is typically like a natural latex or a synthetic rubber, which is basically what the very first gum was, just rubber off the rubber tree. The resin that's in there provides a body or a strength to the gum, and usually that's derived from a Terpene or. Or a rosin, which is from like a tree. Typically, there's like a wax, like a paraffin wax or a microcrystalline wax in there. A lot of times they'll put fats in there to plasticize the rubbery stuff that you chew on. And that typically comes from a hydrogenated vegetable oil. They put an emulsifier in there, and that just basically helps keep the gum moist. Usually that's a lecithin, or the other one that they'll use is a glycerol monostearate. They'll put a filler in there, again to kind of give the gum a little bit more texture. And typically that's a calcium carbonate. And sometimes to prevent the gum from oxidizing, they'll use an antioxidant in there. Typically, BHT is one of the more common ones. And BHT stands for butylated hydroxytolein. And it's basically an organic compound. You'll find it in cosmetics, pharmaceuticals. It's used in petroleum products like jet fuel as well. They even embalm dead people in it. So lots of things going on there in that XL gum. The other things that I talked about, the glycerin, that's just a syrupy liquid that's chemically produced. You combine water and fat. And, you know, something vegetarians or vegans might want to think about is that usually it's coming from an animal source. The fat that's used in that, and it's just used to basically plasticize the gum. Gum arabic is typically going to come from the acacia tree. It's a hardened SAP taken from a couple different species of the acacia tree. All those natural and artificial flavors, they can come from anything. I read the US Code of regulations on natural flavors a few weeks ago. I'll give it to you again here. It's the essential oil essence or extractive protein, hydrosylate, distillate, or any product of roasting, heating, or enzymolysis, which contains the constituents derived from a spice, fruit, fruit juice, vegetable, vegetable juice, edible yeast, herb bark, bud, root, leaf, or any other edible portion of a plant, meat, seafood, poultry, egg, dairy product or fermentation product thereof, whose primary function in food is flavoring rather than nutritional. So pretty much anything on the face of the planet could be used as a natural or artificial flavor. The colors that they'll use in there just vary. They'll use the reds, the yellows, the blues, the typical stuff that you would see in sodas and drinks, Same stuff they use in Gum. The aspartame that you'll find in most gum, that's an amino acid. It's not a naturally occurring amino acid, but it's broken down in your body into aspartic acid, phenylalanine, and methanol. And then those are broken down further into formaldehyde, formic acid, and a couple other compounds. And some people get headaches and intestinal cramping from aspartame. There's. There's kind of arguments that go back and forth about whether it's a neurotoxin, but I'm pretty careful with that, as well as the acesulfamy potassium for a lot of the same reasons. The wax that's used in gum is taken from the leaves of a palm tree, and it's mostly just a bunch of fatty alcohols and fatty acids. Same stuff they use in, like, car wax or shoe polish or cosmetics. So really, though, all of this stuff is just in trace amounts in gum. So it sounds really bad when you hear about it all at once, but, you know, it's not something you have to worry about if you're like popping a couple pieces of gum in the afternoon to keep your appetite satiated. However, I personally, because I chew a lot of gum, I go for a natural gum. I use spry, and it's really just like a natural peppermint oil extract with a little bit of xylitol, which is like a sugar alcohol added. You know, it's likely that chewing a couple pieces of, you know, like the XL peppermint that I just got done talking about is not going to hurt you that much. But if you're a chronic gum chewer, using it a lot to control your appetite, chewing gum all day long, you may benefit from going for a more natural gum source. But I think a lot of people just pop gum thinking that it's. It's so small that it couldn't do any damage. Probably true. Unless you're chewing a ton of gum. You know, like getting up there in the range of like four to eight pieces per day, that's when you'd want to start thinking about maybe chewing on some stuff that might not be bad for you. So, last question. This question is from Ryan, who says, I recently read an article about lap band surgery and complications that are occurring with lap band surgery. I'd like your thoughts on this. And Ryan sent me a link about people who are dying after getting lap band surgery. So lap band surgery has nothing to do with music or bands. It's basically this adjustable band that's put around the upper part of your stomach, so it makes your stomach into the shape of basically like an hourglass. So it really slows how quickly food moves into the stomach. You feel fuller after eating less. And it's a little less invasive than, like, getting your stomach stapled or removing part of your stomach. And it's also designed so it can be inflated or deflated with minimal surgery to allow more or less food in, as the case may be. And so with that narrowed opening to the stomach, it can actually make it really hard to digest some foods. And if you don't think thoroughly chew your food, you end up getting a lot of discomfort. And if people are used to just mowing down their food and then they get lap band surgery, they're really not going to be in a happy place. I don't know how these people died, but it's likely that the complications due to surgery were not from them not chewing enough food, which just would have caused some gastric distress, but more likely related to, I'm guessing, some type of infection or error that occurred with the surgery. So lap band surgery, when performed in the right way, is not super dangerous, you know, as long as there's no hospital or physician errors involved. But I'm not a huge fan of surgeries to control weight. However, you simply cannot control your appetite. Lap band surgery is one of the less invasive surgeries that you could get. I'm not totally against it, but I would definitely research the hospital or the physician who's going to be doing the surgery on you, because it's very likely that most of these people died from infections, not from anything related to the actual lap band or the physiological effects of the lap band itself. So always something to think about when it comes to surgery. I mean, there's tons of different surgeries you could get when it comes to controlling appetite. You can remove part of your stomach, you can get it stapled, you can bypass the stomach. But lap band is probably one of the safer, less invasive ones. So those are all the questions for this week and next, we are going to move into the interview on Active Release Technique with Kevin Christie after this special message.

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Hey folks, Ben Greenfield here and I get a lot of questions from you guys about different types of treatments and rehab protocols or ways to deal with injuries or biomechanical issues that may or may not be mainstream. Today I have a chiropractic physician and certified strength and conditioning specialist on the call and his name is Dr. Kevin Christie. And Kevin is certified in something called Active Release Technique as well as Active Release Technique biomechanics. And while he has lots of experience in many other areas of rehab and chiropractic issues to today we're going to focus on art. For those of you who don't know what art is, Kevin's going to be explaining that and he's going to be going into detail about how it's actually used in athletes and the general population to really help increase range of motion, deal with injuries and do everything else that he'll talk about today. So Kevin, thank you for coming on the call.

My pleasure.

And of course, naturally the first question is can you describe art to us?

Yeah, definitely Art or Active Release technique is a motion based soft tissue treatment. So one of the biggest difference that people always are confused by is the difference between this and say other forms of deep tissue work or massage. And really the active component is very important. So a lot of times the patient and as well as the practitioner is moving quite a bit as we do it. And generally speaking we're trying to shorten a muscle or ligament, get a contact on there and then release that. And by doing that you're going to lengthen the muscle and such to release it and break up your scar tissues, maybe your trigger point adhesions, things of that nature. And really try to, like you said, increase range of motion, get blood flow back to the area because that's a big part of the healing, reduce some of the pain symptoms and really trying to increase the function of the muscle. So that's in the short paragraph that's Active Release Technique. A lot of people will describe it as a good hurt. And so it's not like you're laying there and getting work done. It's comfortable, we have a purpose in mind. And so when you're getting the treatment done, definitely can feel it, but it's not too much, it's not overbearing. But most people describe it as a good hurt.

When I first had art performed on me, it was at an Ironman triathlon. And a lot of times you'll see. See you guys, you art practitioners at Ironman triathlon events, and I've seen you at a few half Ironman events as well. And for me, the first time that I got art was when I was dealing with some low back and some sacroiliac issues. And I wanted to go see you guys prior to the race kind of, you know, for me it was a last ditch effort. I saw you guys over there and it ended up actually freeing up my back quite a bit and decreasing a lot of the tightness that I would usually experience during something like an Ironman eventually. But I really didn't know what to expect when I wentwent in andand sat there. And for people listening in who may want to be in a better boat than me and know what they're getting into if they decide they're gonna go see an art specialist. Can you walk us through what a typical treatment might be like? Can you make up a fake issue and walk us through how you'd actually work on something like that, like what a typical session would look like?

Yeah, definitely. From my standpoint, I tie into art biomechanics as well, which you mentioned. There's a decent amount of providers out there that also have that, and they don't necessarily have to have the biomechanics to do videotaping and such. But a lot of times an evaluation we'll take, let's say a chronic hamstring strain. We can do a lot of different things with that. We've got that upper hamstring tendinitis, some people will call it. It's kind of a misnomer. But they come in, had this for a while, bothers them when they run, maybe when they sit and such. One of the great things with the active release technique, besides the actual manual therapy aspect of it, is the diagnostic aspect of it, really trying to figure out why it's happening. Obviously our goal is to get rid of the pain, but we also need to really figure out why you're having that. Usually that pain is just the alarm system that's going off and there's some altered biomechanics. I mean, it could be other things like running form, but I'm not a running technique guy. But there's other things that can cause it, but we really need to figure out the root biomechanical cause of it. So not only do we come up with a diagnosis, okay, you've got A hamstring insertional tendonitis. Now we figure out with the tissue palpation art really trains us to, to understand the texture of the muscle and tendons and ligaments and see, okay, there's an adhesion in here, or this is a little dysfunctional here. And really pick apart the different aspects of the hamstring into the glutes, the adductors as well. So you need to really know all the muscle groups that are functioning during running, in this case, running, dealing with mostly triathletes. And we also can obviously take into consideration swimming and cycling with it as well. But from there we also need to take into consideration some functional testing that we do. We need to see how the glutes are functioning. So we're going to do some things like a hip extension test to see how it's firing. Are the glutes firing on time? A lot of times what we see when we have someone lying on their stomach and we palpate the hamstring group, the glutes and the low back and we have them perform a hip extension motion, which is obviously very important in running and in walking, we'll see that the hamstring and the low back dominate the picture. Instead of the glutes firing on time, they will either not fire much at all or they'll fire late. And I say that because I've had professional athletes where you test them and they get the most muscular glutes that you can possibly have. And you think, okay, they're going to have strong glutes, yes, but the firing of it is off, so it's just a little bit late. And they're hamstring dominant. And it's the same way with anybody else. Any other type of athlete, they can have that as well. And so when they perform that hip extension during running, they're actually overusing that hamstring, not getting enough of the main player, which is the glute. And so we need to figure that, we need to figure that out. And then a lot of times we see opposite hip flexor tightness, a lot of times it'll be both hip flexors are tight because they're typically sitting too much or other reasons. But if you have a hamstring strain on say your left and then on the. You always want to check the right sided hip flexor because imagine if that is tight and then you try to have a little bit of a stride length. If the hip flexor is tight, it's not going to allow the opposite leg to really swing forward a whole lot because of that opposite hip flexor causing the tightness there. And so we check things like that. Obviously, another big one is proper core stability, because let's now say Sally has improper core stability. The hamstring is supposed to be more the prime mover during hip extension and running and also single leg stance and such. Well, if you're not getting proper core stability, that hamstring will actually substitute act as a stabilizer of the hip. And if it's acting as a stabilizer, it's going to have a tough time also functioning as a prime mover. It'll do it, but over time it'll end up causing kind of a conundrum there with the hamstring and saying, okay, I'm overworking too much to try to stabilize your pelvis when on this left leg I'm in one leg stance. And now when you're asking me to do hip extension when the left leg's not in one leg stance, it's hard to do both things consistently without causing some type of overused strain. So you really need to put together the puzzle of why that hamstring is doing that.

So this is why. For example, I remember this. And in the times that I've been to art since then, people have me move and walk and jog and just stand there and watch me quite a bit before they even touch my body.

100%, yeah. And that's part of their way of seeing visually is there any compensations going on. And that's, that's a big part of what we do in our practices. If you're in a situation, like you said in Ironman, you can't really bust out the video camera and videotape it and put it on a computer in slow motion. But in a clinical setting, that's what we do try to figure out, is there anything that we can see in the running and walking that's going to show some sort of physical limitation that might put overuse strain on that hamstring? That's just one example of how a hamstring issue can happen. And now this. You know, you can give me any type of injury and there's usually a series of events or dysfunctions that can lead to that. And with the art, if they really keep up with the certifications and really hone in on the biomechanics, that's really what separates it, is really trying to paint a, an entire picture of the injury instead of just. A lot of times people go to the doctor and they get the diagnosis. They get four to six Weeks of rest and they get a little bit electrical spin and such, and that's all they really get. Maybe some medication and everything like that. And it helps with their pain levels, possibly. But they never were given a reason why they have it and a solution to prevent it from happening again six months to a year down the road.

Right, right. So basically you're taking. The way that I understand it is you're taking various muscles and attachments and manually pinning them or holding them down and moving the muscle through a range of motion. Is that a really elementary description or what am I missing there?

Well, I can give you the exact one because art is patented. So to be patented, they have to be different in a way. And what we do and what we're trained to do is we apply tension to the structure, not necessarily pressure. And there's. It's typically a thumb contact, but depending on the area of the body that we're working on, we could use our fingers too. But typically we get a thumb contact and we apply tension and we don't have a lot of slide on the skin. So like we're massage. There might be a lot of slide or some other forms. Cross friction massage is obviously a slide. There's no slide. So it's a tension with no slide. We get right onto the adhesion in a longitudinal fashion of muscle fibers. And then from there we get it in the shortened position, get our contact with our tension in the slide, and then we get a full lengthening of the muscles. Typically we try to have the patient do it actively so they're actually doing the movement. Sometimes depending on pain levels, tolerance, or the structure, we might passively do it for them. So we might grab their leg and go into, let's say, hamstring stretch as we got a contact on there, whereas a lot of times it's actively done. Pretty much that's the descriptive terms of art as far as what we're doing.

Yeah. After a session, I've felt sometimes like I just finished lifting weights because I'm moving various muscles through range of motion, you know, sometimes 10 times. And I've noticed that the art practitioner a lot of times tends to be sweating and grunting quite a bit too. So it. So it is a very active form of treatment, both from a. From the practitioner standpoint and the person receiving the art, it seems.

Yeah, definitely. I mean, that's why you can. There's not a lot. Not a lot of chiropractors doing it, a lot of physical therapists doing it, because it can be pretty taxing on us, but you know, it's worthwhile in the end.

Right. Does someone typically see an art practitioner once or is it something that you'll go back to for repeated sessions?

Well, obviously everything's different depending on the injury, the chronicity of it, if someone's had it for a year, you know, or if it's just been, you know, a week, there's always going to be different treatment plans. I usually tell my patients that let's look anywhere between two and eight visits depending on certain things and how you respond. I mean, everybody's different. I've never been a big fan of setting up an exact treatment plan for patients because everybody's going to respond differently. So I tell them, I was like, look, we're looking for a linear progression of reduced pain, increased function, and as long as we're getting that, we're doing well. Now, if we hit our head against a wall after a few visits, we may have to look at different angles. But if I haven't gotten progress and significant Progress in the 6 to 8 visit mark, then we might be need to look at something else. Because not everything is a cure all. And if there's anybody that tells you that they're going to get 100% results, they're lying to you. But we love to see visits, we love to see total resolution in one visit. It does happen, there's no doubt about that. But I'm always cautious to give that that as a serious treatment plan is just one visit because there's so many different factors, you know, and in my practice there's a little bit more to it than just art. So, you know, a lot of times I wait to do some of the functional videotaping until some of the pain levels are down because sometimes you're in a lot of pain that can fog your testing and your video because they are in pain. So you can't get a chance true picture of what's going on with them. And then we also give a lot of corrective stretches and exercises that we need to do. But with the active release technique, we're definitely looking at reduced visits and that's ultimately our goal.

Gotcha, Gotcha. Now, are there certain things that art shouldn't be used for in terms of soft tissue injuries or issues?

Yeah, I mean, well, as far as soft tissue, obviously I get a lot of people come in and they've run a race or they've been running for a while and they're not. And the first thing, if they got some foot and ankle stuff or shin Stuff is we got to rule out stress fractures. Obviously stress fractures, we're not treating that. That's more of a rest situation and needs to be addressed. Such and art, that would be definitely contraindicated. But most soft tissue lesions or adhesions or injuries and things, art can be a very big component to it. Now, it's not the end all be all to every injury that is soft tissue related. If there is usually multiple strains are grade one, two, three, if they've got a serious pull, an Achilles rupture, a calf rupture and things like that, there's going to have to be a period of time where there's rest and ice and some of those basic principles before we're going to get on there manually. If there's significant bruising, we got to go light or go around the areas and things. And so, you know, I had a guy come in a couple days ago with about a grade two ankle sprain. Real nasty, real swollen, real bruised and things like that. Couldn't really put it through a lot of ranges of motion. So that can always be a limited thing is the range of motion issue. So if they've got just. They can't move it at all, obviously it's going to be hard to do active release technique because they can't move their structure. So those are some of the contraindications to it. Amongst if there's any. If you're dealing with some special populations, I can go into a whole host of things like diabetes and all these different things that you might see in the clinical setting. But typically a person with a really bad diabetic foot, they're not going to be our active runners and such. I won't go into all those different things.

Gotcha, gotcha. Okay. So when you're doing art or when someone's going to see an art practitioner, what type of thing should they be looking for in terms of certifications or red flags if. If they're wanting to get art done?

Actually, it was funny I had that question. I was at a seminar where Dr. Leahy was talking. He was the developer art. And we were at a big golf injury expo thing and it was funny someone asked that question. He goes, well, you got to look out for the farts. And he goes, those are the fake active release technique providers. So he calls them the farts. And I say that because we do have to keep up a certification every year. So I have to go every year to a different one to keep up my certification. And there are people that were art providers and you can only call yourself an art provider if you do keep up with your certification. And so they haven't kept up with it for a few years. So they might not have gone to the seminar in five years but still say they do art, but technically they can't promote it, they can't put it on their website. They can't do things like that. So that's something to look out for. Also, as far as certification, there's a bunch of different levels of it, but if you've got a lower leg injury, and as long as you look at the art provider list on activerelease.com and as long as that provider has the certification for that, because it's broken down into upper extremity, lower extremity, spine, and then there's biomechanics, nerve entrapments, master's course. There's a few other things out there that they have. But as long as they're certified in your injury area, you know, if you've got shin splints and they've got lower extremity, then fine. If you got shin splints and they only got upper extremity and spine, then it's probably not the person that you want to seek out at that point if you're looking for the art. So just make sure that they have the certification. Call qualifications for your issue. And then there's other things on top of it that you might want to look for if you want to get videotaped. The biomechanics certification just means that I went through a certification to learn how to understand the biomechanics of the body videotaping. We're the ones that go to the Ironman events. We have the treatment tents and things like that. If you are an Ironman, there's actually an Ironman provider listing, which. Which I'm on. And that means that we've gone through the whole process and gone through the Ironman events. So those are the different things to look for, but at a minimum, just make sure that they're certified in the body part region that your injury is in, and you should be in good hands. And there's no guarantees, obviously, but that'll be the best way to go.

Gotcha. Gotcha. Well, one last question for you. We get a lot of people. Probably the most common injury that people especially right into this show with is problems with the IT band, specifically, like tightness, IT band friction syndrome, pain on the outside of the knee, pain kind of up in the outside of the hip from the IT band. If someone were Gonna go see an art practitioner for IT band. Friction syndrome. What would they need to expect in terms of what would be done with them at the session?

Okay, yeah. IT band obviously is every runner's nightmare. As a practitioner, we don't like to see our patients get it because it is a little bit of an uphill climb. But going to an art provider with this, typically the art structures that they will work on is obviously the IT band. We really try to strip that and lengthen it because it's typically a tightening of that just subtly that can cause it to rub. There's a little bony prominence on the outside part of the knee. And the IT band which makes it unique is that it comes from the hip. The TFL muscle comes all the way down. The tendon's a lot longer than the actual muscle that it comes from, which is rare. And then it crosses the knee joint and when it gets a little bit tight and then you flex that knee from 0 to 30 degrees, that's when it can rub and cause some frictioning over that bony prominence. And you get the over time the inflammation there. Then it feels like someone's kind of stabbing you with a knife on the outside of your leg. That's what it is. Inflammation response due to that friction. Well, typical structures that need to be addressed and this isn't across the board, but typically is obviously the IT band. So they probably work from the attachment point across from below the knee joint all the way up into the hip. They're not getting up into the hip. They're going to be missing the boat a lot of times because you definitely got to get up into that tfl. Typically the TFL muscle is becoming tight because of the glute medius and the glutes aren't functioning right to stabilize that hip. During one leg stance, which is running, you're going to go from one leg to one leg. And so we really got to make sure that we get rid of any adhesions or trigger points in those areas to correct the function of that muscle. The vastus lateralis, which is part of the quadriceps, which is on the outside part of the knee. And it kind of blends into where the IT band is. That tends to become, that tends to be. That tends to become tight. Then the VMO muscle. The VMO is also part of the quadriceps, which is more on the inside part of the knee. That muscle actually tends to become weak. But if there's adhesions in there, it's going to be hard for that to Activate properly. So you're going to get a little bit of a patellar tracking issue there with the tightnesses on the outside and the weakness on the inside. So you got to make sure that's addressed. Then. I always recommend getting on to the hamstring part, especially the lateral aspects of it, to see how that's going there and making sure everything's all right with that. But those are, at a minimum, the basic structures that should be worked on. From an art standpoint, as long as there's dysfunction in there, you could always go to the rectus femoris as well, which is another part of the quad that. That'll tend to become tight on people. Another structure that people forget about sometimes is the hip flexors. Regarding this, you need to make sure that's going well. The Ql, which runs on the side part of your low back, that's one that you want to be addressed. And then those are more your direct muscles. And then indirectly, you need to test things like you got to check the foot and ankle function. A lot of times, if there's issues with that, that's going to cause some probable issues with the IT band, because you might get a medial inward migration of the knee, which is going to put a stretch on the IT band. If they've got really flat feet, then that's going to cause some internal rotation of the tibia, the lower leg bone that will also put a stretch on the IT band. So those are all things that really need to be addressed as well. Leg length issues. And obviously, from a. An art standpoint, there's not a lot we're going to do with leg length issues, but you need to address it with other avenues of care as well. So expect some soreness. When you do get the IT band treated, you're going to find some of these hot spots along the IT band that is causing dysfunction. And, you know, the art provider is going to get on there and really try to break those up. So sometimes treatment for the IT band goes past that good hurt into more. A little more of a hurt, and just understand that. And it's just. It's just a process. But typically, you know, do a little bit of palliative care for the inflammation area, your ice, maybe your modalities and such, to try to decrease that. And then art providers gonna try to correct the structures that are causing it.

Cool. Cool. Well, Kevin, that was very informative. And for listeners who are listening in, who are down in the Florida area, that's where you're at, right?

Yeah, yeah. Definitely. We're in South Florida, Boca Raton in the Fort Lauderdale plantation area.

Cool. Cool. All right, folks, so if you have questions or comments, remember, you can go to the show notes for this episode and leave them there. And Kevin, thanks for coming on.

My pleasure. Thank you very much.

All right, folks, until next time, this is Ben Greenfield and Kevin Christie signing out from Ben Greenfield Fitness. Well, folks, that's going to wrap it up for this week. Be sure to visit the show notes to this podcast, podcast number 134, where you can check out everything that I talked about, including the oil of oregano, the magnesium bath flakes, the future health now encyclopedia, links to my breakfast post and more on that and everything else that I've discussed discuss. So be sure to go over to BenGreenfieldFitness.com check that out. And also if you haven't yet, head over to itunes and leave the show a ranking. It really helps out with our itunes popularity. So until next time, this is Ben Greenfield signing out from BenGreenfieldFitness.com.

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