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Too Much of a Good Thing?

Exhausted woman on exercise bike

Some patients come into my office under the assumption that they’ve got it all dialed in, training-wise. Here’s the usual banter, “I’ve been lifting weights for 35 years, and so I don’t need any help in that department.” Fair enough. As I’ve always prided myself on being an exceptional listener, and well aware of the fact that patients, in general, will tell me exactly what is wrong with them – no fancy diagnostic equipment needed - I just sit back and allow the person to "bury himself." My chairman used similar tactics during my seven-year residency. Slyly, he would guide you down that primrose path until you realized that you had made a fatal judgment error. Without fail this was done in front of about a hundred of our colleagues, true to form of TV medical dramas. To say that these lessons were etched into the memory centers of my brain is an understatement. And while you won’t be sitting in front of an audience of people during your clinic visit, let’s just say you’ll leave with some extra IQ points by virtue of our doctor-patient interaction.

And so it went. Just yesterday. “I’ve been training with weights all my life,” Steve said, and then the name-dropping began - all of the “Iron Game” pioneers with whom he trained as a young man. Yet not a minute later was I being told about his failed progress in the gym despite his perceived expertise and his inability to lose body fat. He was tired by 2PM every day and searching for the nearest couch as soon as he got home from work.

Lots of things could be going on, right? But Steve’s nutrition was clean – I could see it in his lab work - and he got 6 hours of sleep nightly, a number he became accustomed to over the years. Fine. His hormones were nearly optimal as well – one’s recovery from a bout of intense exercise and therefore your ability to make progress in the gym over time is a function of your hormonal status, agreed? So what else could have been at play here?

“It’s certainly not my training,” Steve said smugly. I sat back in my chair and listened to this 49-year-old describe the protocol that he felt was a “best fit” for him, because he had been doing it for 25 years, and it served him well back then. So why not now? Essentially a bodybuilding protocol, the regimen was comprised of 6-8 sets per body part, including wrist curls (one of my pet peeves) for forearm development. Quadriceps were trained, not with squats, but with leg extensions and leg presses, 8 sets of each! And how often was he training?  Six days per week, summarily hitting each body part with that volume and with high intensity, twice weekly.

Hmm…

Proudly he finished his laundry list of esoteric movements and advanced rep schemes including drop sets, accentuated negatives and 100-rep calf raises.

I leaned back in my chair and just looked at him. Askance. Silent. For thirty or more seconds, it was the two of us, staring at one another accompanied by only… chirping crickets. And then, as if one of those very critters whispered something epiphanous in his ear, Steve’s eyes veered upward and to the right, a sign that the left hemisphere of his brain had been activated – that’s where logic lies, broadly speaking.

His face said it all. Words were just superfluous at this point. More than 75% of interpersonal communication is nonverbal, right? I allowed the message to resonate within the confines of his skull for another minute – this is how lessons are indelibly written into one’s brain – the silence was deafening. Except in his head, the message was getting louder and clearer, being further refined as the seconds went by, like a gem in a rock tumbler.

“Oh,” Steve blurted out embarrassingly, having come to the realization that his self-proclaimed training “expertise” was far from it, so much so that he was doing the exact opposite of what he should have been doing. Shooting himself in the foot? Nope. “Blowing his legs off," in fact.

As per the first several pages of Get Serious, the human body is an adaptive organism. On a daily basis, it is bombarded with stresses, some good, some not so much, to which it responds in kind. Expose your body to the right signals, those that upregulate the right biochemical pathways, in the right dosages, and health will be yours. Expose it to the wrong signals, and disease will rear its ugly head. Now, what if I told you that too much of a perceived “right” signal is actually detrimental to the body? Is there such a thing as “too much of a good thing?” You’re damn right! Think of your friends who regularly participate in WOD-based exercise programs. Many get injured. Truth be told, nearly half of them have experienced a significant injury, sidelining them for weeks on end as they stock the waiting rooms of orthopedic surgeons everywhere!

And why? Well, for one thing, such protocols call for 4, 5 and sometimes 6 rigorous training sessions weekly. Does that make sense? Beating your body down during senseless routines, routinely, translates to… nothing. Failed gains firstly and injury second. Why? Well, when do you expect your body to recover? During the 23 hours between sessions? Wrong. Do you realize that the inflammatory response, the very process that mediates recovery, peaks at 48-72 hours? So how do you expect to recover in 23 hours?

I know, you’re training different body parts. Again, wrong. Because at the “heart” of the recovery process is your brain and your endocrine (hormone) system. Is 23 hours an ample recovery period for your central nervous system? What about your adrenal glands, the source of the stress hormone cortisol released as an integral part of your “fight or flight” response? The answers? No and no.

Chronically exposing your body to elevated cortisol levels, the product of intense daily training, will predispose you to not only injury but to hypertension, insulin resistance, fatigue and fat gain. Steve’s progress in the gym had not only stalled but also worsened, and to boot, he got fat! The proverbial “double whammy.” So what did he do? Trained more and trained harder. Yikes! In his mind, his failed gains were the product of training too little. So what should he have done to break this vicious cycle of overtraining? Firstly recognize it! How? We’ll talk more about this in the next piece...

[Reference: Cadegiani F, Kater C. Hormonal aspects of overtraining syndrome: a systematic review. BMC Sports Sci Med Rehabil. 2017;9:14.]