December 20th, 2016

// How To Prevent Injuries When Training Hard – Q&A with @drnekessaremy

Happy Holidays!

The holidays here! And before we know it, we’ll be ringing in 2017! I know most of us are all already thinking of training hard to make up for all of the holiday treats. However training hard can be dangerous. Make sure before you jump into an intense training routine that you are cleared by a doctor to exercise, are wearing the proper workout gear and know how to train hard safely. You’re especially prone to injury when you’re training hard.

I recently had the opportunity to sit down and speak with chiropractor Nekessa S. Remy. Dr. Remy is based in downtown Toronto at the Integra Health Clinic. I got to ask her questions regarding how to prevent injuries when training hard. So, if you are about to embark on a fitness journey check out what we spoke about below:

Alicia: When training with an all-out effort, do you suggest a dynamic or static stretching routine?

Dr. Remy: For any workout routine, the most important factor for stretching is knowing when to perform each stretch; both types of stretching are important. Dynamic stretching consists of functional based exercises, which use specific movements to prepare the body for movement. This involves moving parts of your body and gradually increasing reach, speed of movement, or both, while increasing your core temperature. This type of stretching is best used before your workout as part of a warm up. We know that a proper warm up can not only affect the likelihood of injury, but also directly impacts your ability to perform to your maximum ability. As such, dynamic stretching plays a major role in maximizing your performance levels and should be a key part of any warm up

  • Like dynamic stretching, static stretching improves flexibility by moving joints through a specific range of motion. However, unlike dynamic stretching, it does not increase your core temperature. These stretches are often held for longer periods, ideally 20 to 30 seconds. Static stretching suppresses the central nervous system, relaxing the muscle spindles by lengthening them, and has been shown to actually reduce power and force production in several studies. This type of stretching is more effective during the cool down period of your workout.

A: What are some stretches that should be included in a routine?

Dr. R:  Flexibility is often overlooked as part of a heavy training routine. Consider the amount of time we spend siting behind a computer desk when not training, sitting watching tv or sitting behind in a car. These postures keep our joints in very restrictive positions. I recommend addressing the areas which are most restricted including the hips, shoulders and lower back. Some of my favourite stretches include:

Pigeon Stretch (Hips)

  • From Downward Facing Dog, step both feet together and bring your right knee forward between your hands so your outer right leg is resting on the mat.
  • If your hips are more open, inch your right foot away from you. Make sure your left hip is always pointing down toward the mat. If it begins open up toward the ceiling, draw your right foot back in toward your body.
  • Stay here with your hands resting on your right leg or walk your hands out in front of you, allowing your torso to rest over your right knee.
  • Hold here, breathing into any areas of tightness and tension for at least five breaths.

Then place your hands on the mat in front of you, tuck your left toes and step your right foot back.

Repeat using the left leg.

Cows Face (Shoulders)

  • Stand with your feet hip-width apart and pointed straight ahead.
  • Attempt to interlock your fingers behind your back. If you are not able to get your fingers to interlock, use a towel.

Hold for one minute, then switch sides and repeat.

Knee rolling (lower back)

  • Lie on your back as above with the knees bent.
  • Slowly lower both knees to the left whilst turning the head to the right.
  • Bring the knees up again and to the right whilst looking left.
  • Repeat this movement 10 times.

A: How often should someone train hard to achieve maximum results?

Dr. R: You can train anywhere from 3-7 days a week. The important thing is to incorporate cross training into your program. So whatever discipline you are training in, keep in mind that you are often working specific muscle groups repeatedly and ignoring others. Cross training on your “days off” can help to address muscle imbalances that can occur when focusing on only one activity. Cross training not only aids in reducing the occurrence of injury, but also allowing for maximum gains.

In general, you want to give your body 24-48 hours in between really hard training sessions. Within those 24-48 hours, you don’t have to be inactive, though; try an activity that will not hinder your training. Pilates, yoga and swimming are all great choices that will allow your body to remove while continuing to build supporting muscle strength which can ultimately also improve your performance.

 A: When should you back off from training hard?

Dr. R: The biggest sign that you should back off from training is pain and/or injury. Pain is a sign that there is an issue with your body. Keep in mind that most lifters do experience delayed onset muscles soreness or DOMS, as its often called. This soreness is the result of microscopic damage to muscle fibres involved in the exercise. This type of damage likely results from moderate stresses that were experienced during the exercise. This is a normal process which is required for growth in muscle size and strength. It will start approximately 24 hours after the workout but should be gone after 72 hours. If pain persists, there is most likely an injury. Training when injured not only will limit your body’s ability to recover from that specific injury but the compensation that occurs in other areas of the body can lead to other injuries occurring simultaneously.

A: Does hydration play a factor in your ability to train hard and stay injury free?

Dr. R: Water composes 75% of our muscle tissue. A study published in the “Journal of Strength and Conditioning Research” reported that a 1.5 percent decrease in water loss resulted in a decrease of muscle strength of the one rep max bench press. Given that such a small amount of water loss can compromise strength, staying hydrated is essential in muscle strength and gain. Researchers found that the amount of water within cells plays a critical part in whether or not muscle breakdown occurs. Preventing muscle breakdown is crucial since muscle breakdown stops muscle growth within muscle cells. Decreased body water leads to the shrinkage of cells and the breakdown of protein. Thus, by maintaining adequate fluid levels, we can cause cells to swell, thereby reducing the amount of protein breakdown and increasing the building of new muscle tissue which will ultimately improve strength gains and reduce muscle injury. Further more, dehydration causes our blood volume levels to drop which causes fatigue and dizziness. Training when fatigued will both hinder training and increase the risk of injury.

As a general rule of thumb, you should be taking in 1 Litre of water per 1,000 calories expended per day. So someone who burns 2,500cals would drink 2.5 Litre fluid daily.

A: How much water should you be drinking if you are training hard?

Dr. R:  The amount of water a person should consume daily is a controversial subject. The standard eight glasses of water a day prescriptions recommended all over the place won’t be enough for serious muscle seekers. This is fine for the average person who consumes around 2,000cals a day without much activity. However, if your workouts are frequent and intense, you will require more water.

As a general rule of thumb, you should be taking in 1 Litre of water per 1,000 calories expended per day. So someone who burns 2,500 cals should drink 2.5 litres of fluid daily.

A: What should my nutrition look like before and after a workout?

Dr. R: By eating a healthy, well-balanced meal one to two hours before exercise, and another health, well-balanced meal within one to two hours after exercise, most people can meet their workout nutrition needs without anything else.

Pre workout Meal:

If you’re looking to increased strength gains, your protein and calorie needs are likely higher. Keep in mind that calories from carbs should come from carbs that are low on the glycemic index. You could also add a protein + carbohydrate drink during your training. A typical meal could include:

1 to 1 ½ servings of dense protein (i.e. lean meats)

1-2 portions (thumb size) of healthy fats (i.e. nuts)

1-2 servings (fist size) of vegetables (broccoli, cauliflower)

1-2 handfuls of dense carbs (i.e. berries or brown rice)

If you don’t have over an hour to spare, a smaller meal like a shake or a smoothie is recommended as its easier to digest with limited time.

Here’s the make up of a good smoothie

1 scoop protein powder

1 fist of veggies (spinach works great in smoothies)

1-2 cupped handfuls of carbs (berries or a banana work great)

1 thumb of fats (like mixed nuts or flax seeds)

low-calorie beverage like water or unsweetened almond milk

 

Post workout Meal:

No matter what time of day you exercise, the key is to follow up with meals that combine protein, which helps your muscles recover, and carbohydrates, which replenish energy stores. For best results, eat within 30 to 60 minutes after exercise, when muscles are most receptive. During this window, an increase in enzyme activity makes the body more efficient at storing glucose for energy and building protein in fatigued muscles.

One of my favourites sport recovery smoothies combines banana, milk (almond), and yogurt makes for a fresh and satisfying sports recovery drink. Almond milk and yogurt work double duty, providing both protein and carbohydrates. Bananas are packed with potassium and magnesium―powerful electrolytes for healthy muscle function.

Another great example is this protein packed sandwich.

Use low-sodium cold cuts which provide some salt to help replace what’s lost in sweat during exercise. Add Tomatoes which boost of vitamin C. Try 100 percent whole wheat bread which will boost your fibre.

A: What are some beginner exercises to do if I want to train hard?

Dr. R: Before you start any new program it is important to ensure that your core can support heavy lifting. The core includes the traverse abdominis (TVA), erector spinae, obliques and muscles of the pelvic floor. These muscles work as stabilizers for the entire body. Core training is simply doing specific exercises to develop and strengthen these stabilizer muscles. Without proper stabilization you are setting yourself up for failure and/or injury.

Heavy squats, deadlifts, and barbell rowing give the core a challenging workout by themselves, but doing additional abdominal and oblique training helps to alleviate the injury factor. Handling the heavy weights that are necessary for mass building requires a very strong midsection.

Dead Bugs

This exercise not only improves core conditioning, it also builds stability in the hips and trunk.

  • Begin lying on your back with your hands extended above you toward the ceiling.
  • Bring your feet, knees, and hips up to 90 degrees.
  • Exhale hard to bring your ribcage down and flatten your back onto the floor, rotating your pelvis up and squeezing your glutes.

Dead bugs can also help prepare people for crawling exercises. They build the coordination necessary for any cross crawling activity because they essentially mimics the hand and leg movement, only performed on your back rather than your hands and feet.

Bird Dog

This is an excellent exercise for improving core stability because it hits multiple functions at once.

  • Start on all fours and tighten your abdominal muscles, keeping your spine and neck in a neutral position; you should be looking at the floor.
  • Slowly extend your left leg behind you while reaching your right arm forward, keeping your thumb towards the celling.

The Bird Dog works both anti-extension and anti-rotation, improves coordination, and puts the glutes and shoulders to work. You can think of this exercise as a plank-superman hybrid. And much like the dead bug, it’s a great exercise to help prepare for cross-crawl exercises. If you’re looking for an exercise that delivers a lot of bang for your buck, this one just might be it.

I hope you found Dr. Remy’s tips helpful for training hard in the gym. Make sure you stretch, eat properly, drink your water, plan your workouts in advance and make sure you are prepared physically train hard! Thanks again Dr. Remy!

For more info about Dr. Nekessa S. Remy and how to contact her please read below:

Dr. Nekessa S. Remy runs a chiropractic practice in downtown Toronto, at Integra Health Centre where she works amongst other leaders in the health care field. As a licensed chiropractor and Medical Acupuncturist, Dr. Nekessa Remy has developed an approach to injury management that is based on current research and measurable patient outcomes. Her passion for health and rehabilitation lead her to earning an Honours Degree in Kinesiology from the University of Western Ontario followed by a Doctorate of Chiropractic from the Canadian Memorial Chiropractic College where she graduated Magna Cum Laude. Dr. Remy is also a Registered Acupuncturist under the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario. She has held certification as a Can Fit Pro personal trainer and has worked in both the athletic training and sports rehabilitation fields. Most recently Dr. Remy has become a sports injury consultant for the Brampton Rebel Soccer Team, and in the summer of 2015 she brought her skills to the Pan Am Games Medical Team.

Twitter: @drnekessaremy

Instagram: @drnekessaremy

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