Plantar fasciitis confirmed

After a ridiculous 5 months of denial and fruitless hope, today I saw a sports podiatrist about my suspected plantar fasciitis situation. My hope was to get confirmation that I am in fact dealing with said situation, as well as a bossy treatment plan for how to go at it -- since, while my internet searches have yielded a bounty of suggested therapies, I haven't committed to any of them on a regular basis.

So yes, he thinks I have a "classic" case of plantar fasciitis. Before you go thinking I just wasted a barrel of money to confirm the obvious, he had a novel idea about why it might be happening. I'd been assuming that I just trained too hard last spring, when SuperAthlete J and I were working so diligently on our pace. All those intervals and tempo runs (and the heavy pounding that came along with them) must have done me in, right?

Well, maybe not. Smart Dr. Blahouse (who was a charmer in every way, I must say, and I really recommend him if you've ever got something going on with your sporty foot) took one look at me and said he suspected that one of my legs is longer than the other. The right leg, in fact, which is the one with the troublesome foot and, come to think of it, is also the side on which I've been having low back pain for about the past four years.

WTF, one leg longer than the other? How interesting. And Dr. Blahouse didn't soft-pedal his thinking one bit. He told me it was "very pronounced" and he could see that I was "clearly listing to the left." He basically made me feel like Quasimodo, lurching around his office.

That's OK by me, if it means a more obvious fix to my problem. To confirm his suspicion, Dr. B is sending me for a "limb length study" which is a fancy term for "an X-ray that will look at the bones in my legs and my hips." Assuming the suspicion bears out, next I'll get custom orthotics that will give me a bit of a lift on the left side -- and stop making my right side take the brunt of my high-impact activities (which, to explain the obvious, would be the probable cause of the plantar fasciitis and hip pain). He also suggested twice-weekly physical therapy sessions for 10 weeks, and one week of intense ibuprofen dosage to reduce the inflammation. Oh, and he also said I should continue using my Strassburg sock which, it must be confessed, most often remains undisturbed on my bedside table instead of encasing my leg with its healing magic.

So, there you have it. A bit of a bossy treatment plan and a potential reason for my foot troubles ... all in all, a successful visit to the sports podiatrist. More soon on whether Dr. B was correct. If not, I may want to take back all the nice things I said about him.

Intervals vs. steady state cardio: which is better?

Holy crap, did I go down the rabbit hole on this one.

SuperAthlete J, the one and only reader of my blog, wrote to me after my post-a-palooza yesterday and said she was particularly interested in what I'd written about a study saying cardio intervals offered more fat-burning potential than regular old steady state cardio.

I've seen and heard a lot about this idea for the past several months -- it does seem like the fitness industry has bought off on it hook, line and sinker. But, as I flipped through my magazines to refresh my memory and compose this post, I realized that no one is actually quoting the source material. I can't seem to find the original study. Instead, after a long Google session, all I found was a lot of questions, counter-claims and argument. Hmm.

Here is what I can say: generally speaking, it looks like cardio intervals can help burn more fat than steady-state cardio. And here is why (this is the tricky part):

• Apparently, intervals can generate a higher EPOC than steady-state cardio. What is EPOC, you ask? (See why I ran around in circles on Google?) It stands for Excess Post-Exercise Oxygen Consumption. Higher oxygen consumption means more calories burned AFTER THE WORKOUT IS OVER -- the mystical "after-burn" of exercise. Which means you not only benefit from the workout while it's happening, but for a while afterward as well. One article I read quoted an EPOC rate of 14% for intervals; 7% for steady-state. I don't know what those percentages correlate to, but even a science dumbass like me can see that intervals create twice the good thing that steady-state cardio does.

• There's also some research showing that HIIT (another acronym, another Google search!), which stands for High Intensity Interval Training, can help suppress appetite after a workout, thus leading to fewer calories consumed and more fat loss. Not sure if that's true for me and it doesn't really speak to the benefits of interval training as opposed to a side effect, but OK.

• Then there's research showing that because intervals mix things up during a workout, people find them less boring and stick with them ... which is another way of saying that doing anything at all is better than doing nothing. I definitely don't know if that's true in my case. I used to dread interval days and look forward to relatively mellow steady-state days where I could just hop on the stairclimber or elliptical trainer and read my book or watch TV. Intervals require a lot more attention and effort; sometimes I just want to zone out.

• It is also thought that intervals lead to decreased muscle catabolism (another Google search!), or degradation of the muscle as the workout progresses. I can't really comment any further on this one because I honestly don't fully get it. Don't we want the muscle to degrade so it can build itself back up? Maybe too much of that is a bad thing and intervals strike a better balance? I'm not sure.

The problem, in my mind, comes when people make claims saying that it's possible to get just as much gain from a 20-minute interval session as they do from a 60-minute steady state session. Unless your steady state is extremely moderate, that's not going to pencil out in terms of calories burned. Even when you add in the increased afterburn rate related to intervals, intervals probably lose.

Here's what I think: just like everything else related to diet and exercise, there's no magic bullet or quick fix. You've got to put in the time and effort. I just can't buy off on the idea that I can get just as much benefit (read: burn the same amount of calories and fat) in 20 minutes of hard work as I can in 60 minutes of moderate work. Maybe that's the skeptic in me. Maybe it really is possible.

But I don't believe it. So, despite the many asides in the fitness magazine articles touting the benefits of intervals -- and how they can reduce my overall workout time -- I'm not drinking the KoolAid. However, I am sipping it.

I really do believe in the power of intervals -- as an element of an overall exercise plan. And what I emphatically DON'T believe is that I can get away with substantially reducing my exercise time when I incorporate intervals into my workout. I could be wrong, but it just feels too risky.

So, what I've been doing is this: I make sure that I achieve a range of heart rates in all my cardio workouts. I want to cover everything from moderate to balls-out, and spend a pretty decent chunk of time at the latter end. To make that happen, I'm doing more classes -- spinning and Zumba in particular feel good because they alternate between moderate and high intensity work. And on my "machine days" at the gym, much as I'd like to, I don't set the elliptical to Level 10 and leave it there for an hour anymore. Instead, I work out at a moderate/high rate for 20 minutes. Then I do ten intervals: one minute at the highest intensity I can muster, one minute of recovery. That's another 20 minutes. Then I wrap up with a final 20 minutes, going back to the previous moderate/high rate. (Of course, all of this would be a lot easier if I was able to run, which offers the simplest opportunity to build intervals into a workout.)

In my mind, my approach gives me the best of both worlds -- the benefits of interval training and enough duration to really burn some fat and calories. God knows I couldn't manage 60 minutes of intervals, which would probably be the optimum (and superhuman, as far as I'm concerned) way to go.

I really don't know my way is the right way, but it's feeling good so far. I definitely know that I feel more wrung out after a session involving intervals than I used to after a steady-state workout. And my pants are fitting, even though I can't seem to stay away from the bag of fun-size Big Hunks I bought at the drugstore.

I'm going to close with a link to a page that represents the extreme end of the current rage for interval training -- this one says you can turn your body into a "fat-burning machine" in just 8 minutes every 3 days by following the "Tabata protocol." To me, this is the equivalent of those ads that say "Eat what you want and still lose weight!" Too good to be true. Maybe it works ... but I'd be too scared of busting out of my pants to find out.

http://www.tabataprotocol.com/

Another reason to stretch

I know stretching is good for you and all that, but I've never really been interested in it. Probably because, when I really started exercising with commitment and regularity, my time was extremely limited. I had a toddler at home and tons of stuff to do. I wanted to use the little bit of time I did have for working out to totally go for it. Stretching just fell by the wayside, and even though I've generally got more time to exercise nowadays, I've never made it a regular component of my workouts. Even when I was doing marathon training last year and ended the long runs feeling like my legs might break off at the hip, my stretching was really no more than cursory. Like I wrote above, I'm just not interested in it -- and I've never really felt that it does much for me.

Until now. Thanks to a study by the fine folks at Brigham Young University, I've got a concrete reason to stretch. Here's a synopsis: "Participants who weight trained three times per week and stretched two times per week for eight weeks INCREASED THEIR STRENGTH BY UP TO TWICE AS MUCH as those who only lifted." (Caps mine.)

A few more details: participants in the study did stretching exercises for 30 minutes on their non-weight training days. And none of the participants had done weight training before. I don't know if I could commit to 30 minutes of stretching on my non-weight days ... sometimes an hour of cardio is all I can squeeze in, and I wouldn't be willing to trade any of it away for stretching (there's that bad attitude rearing its head again). And I'm certainly not a newcomer to weight training, so my gains might not be as significant.

But I still find this interesting -- and if the idea of increased strength gains from my weight training is enough to get me to start stretching regularly, that's got to be a good thing, right?

One more interesting thing I read, along these same lines: early research shows that stretching has the same effect on muscles that weight training does. Both cause minute tears in the muscle fiber, which (through a complicated body process) eventually lead to new muscle growth.

So there you have it. I'm going to start stretching. Now if I could just find more time.

While I'm working that out, here's a shameless plug for my very favorite yoga superstar, Bryan Kest. His power yoga workouts are the very best and will totally leave you feeling stretched out to within an inch of your life. There's a link to his website on the right side of this page and from there, you can buy DVDs or download podcasts. I've got a couple of his DVDs and, now that I've proclaimed my desire to incorporate stretching into my workout routine, hopefully they'll be in more regular rotation than they've been in the past couple years.

ZUMBA®!

I actually don't know if there's a registration mark for Zumba but it sure seems like there could be. I first tried this workout in the late spring, just for fun with a friend of mine. If I remember correctly, I included it in a post that was all about my fitness hubris: during a week off between weight training sessions, I thought I'd "take it easy" and "just do classes at the gym."

Man, was I brought low. I've never been more sore in my life than I was after experimenting with a few new classes. And Zumba was the most illuminating of all. I'd seen people in the class at the gym and, based on what they looked like (mostly older, not particularly athletic looking), thought it would be a cakewalk for me. I even tried to make time for a 5-mile run beforehand so I could be sure to get a good workout. Thank goodness that didn't happen. Zumba knocked me flat and jumped on top of my crumpled body, cha-cha-cha'ing all the while. I literally thought I might pass out during the class. What's worse is that it was also quite hilarious because the class's reportedly simple dance moves were far beyond my extremely limited abilities.

What is Zumba, you may be wondering? Here's what the official website says (http://www.zumba.com/us/):

The Zumba® program fuses hypnotic Latin rhythms and easy-to-follow moves to create a one-of-a-kind fitness program that will blow you away. Our goal is simple: We want you to want to work out, to love working out, to get hooked. Zumba® Fanatics achieve long-term benefits while experiencing an absolute blast in one exciting hour of calorie-burning, body-energizing, awe-inspiring movements meant to engage and captivate for life!

The routines feature interval training sessions where fast and slow rhythms and resistance training are combined to tone and sculpt your body while burning fat. Add some Latin flavor and international zest into the mix and you've got a Zumba® class!

Aha! There is a registration symbol! And now my text is indented and I don't know how to fix it.

Anyway, Zumba. Although the class was hard and embarrassing, I also kind of liked it. Or maybe that's why I liked it. I talked my husband into trying one with me. And then a couple friends started taking it of their own accord. Before I knew it, I'd fallen into a Zumba rhythm: I take classes two or three times each week, usually right before my weight workout. It really does feel like a full-body workout. I like that I'm getting tons of cardio at levels that vary from moderate to super intense -- because what I'm reading lately says that cardio intervals will burn fat more quickly than steady-state cardio. (More on that in another post.) I also like that I can feel muscles working all over my body, especially my core. That's something I don't particularly notice when I'm doing other forms of cardio -- like the elliptical trainer or running.

I've now gotten comfortable enough with my Zumba moves that I did something that was either brave or really stupid this past weekend: I went to an outdoor Zumba class at the opening of a big new park here in Seattle. Not a lot of people participated, but there were definitely plenty of folks watching. Including, as it turns out, two of my friends, who came to see me and laugh along. I admit, it's funny. I'm never going to be graceful or fluid or a dancer in any way. I have terrible rhythm. But I also have a great time, and get a great workout. And if it helps me get comfortable in my own skin and accept one more of my many shortcomings, what's better than that?

Badass weight workout #3

Badass weight workout #3

1. Power move: dead lift

5 sets of 5 reps

As much recovery as you need between sets

Again, do some experimenting to see how much weight you can handle -- this should be at the very edge of what you can manage for 5 sets of 5 reps. Start by holding the bar at your hips with straight arms and an overhand grip. Hands should be about shoulder width apart, feet a bit wider than shoulder width. Rotate your hips back, bend your knees, slide the bar along your thighs and down over your knees (keep it close to the body) and drop into a squat that's as low as you can manage and still get back up. Keep your back flat, your chest out and, needless to say, your weight in your heels. Push back up through your heels with a flat back until you're back at standing. For reference, I'm doing 20 pounds on each side plus the bar, which weighs 45 pounds: 85 pounds altogether. Husband is doing 135 pounds altogether.

2. Mini circuit: one-leg side squats, one-leg overhead press, reverse grip pulldown

4 sets of 10 reps each

30 seconds of recovery between sets

• One-leg side squats

These are just like the single-leg squats from the first workout -- but instead of putting the other leg on a bench behind you, you put it on a bench on your side. Well that, and you only hold one weight (I use a 17.5, hub uses a 25). Try to keep all the weight on the standing leg. Your posture should be upright, straight up and down, as if you're standing on two legs, your standing foot directly below your hip. Drop down into a squat, bringing your hip back and keeping weight on your heel -- not toes. Your knee should be somewhere between your ankle and your toes, not over your toes. Keep your abs tight the whole time. In addition to working out your butt and quads, you'll feel a nice stretch on the inner thigh of the resting leg. Do all ten reps on one side first, then switch to the other.

• One-leg overhead press

A nice simple one. Grab a couple weights that are challenging but manageable (I use two 17.5s, hub uses two 25s). Stand one one leg. Holding the weights, raise your arms into "goalpost" position, with your elbows bent at 90º and at shoulder height. Slowly raise the weights overhead and touch them at the top of the motion, then bring them back to goalpost. Swap the standing leg on each set.

• Reverse grip pulldowns

Similar to the lat pulldowns from workout #1, but this time you do it with your fingers facing toward you, so you can check out your nails while you do the motion. Again, choose a weight that feels challenging but doesn't impact good form. Like the other one, this is a tricky move because it's easier to let your arms do all the work. Hands should be about shoulder width apart on the bar. Before you start pulling the bar down, rotate your shoulders down and bring your shoulder blades together. You should feel the movement primarily along your back and lats before you bend your elbows. Bring the bar to your collarbone, bringing your chest out to meet it.

3. Cardio meltdown: dumbbell chops and split jumping jacks

5 sets of 30 seconds each (10 sets altogether)

15 seconds of recovery between each set

• Dumbbell chops (aka "golf swings")

Grab a dumbbell in a decent weight -- something you're going to feel, but not too much (I use a 20, hub uses 25). With your legs straight and shoulder width apart, hold the weight in both hands at one hip and face forward. In one swift motion and with relatively straight arms, bring the weight up and across your body, raising it to shoulder height and straightening the top arm as much as possible. Don't lift or rotate your feet, but do rotate your hips and upper body as much as you can, so you're facing sideways as much as possible at the top of the movement. Bring the weight down WITH CONTROL so you're not swinging the motion too much; stop it at your hip. Repeat as many times on one side as you can in 30 seconds. The next set, do the other side. Yes, this means you'll do 3 sets on one side and two on the other, but that's OK.

• Split jumping jacks

I actually find these pretty easy -- but after slogging through the other two workouts, getting a little break feels nice and kind of deserved. They're just like regular jumping jacks, but instead of moving your feet side to side, you move them front and back. Do as many as you can in 30 seconds.

Badass weight workout #2

Badass weight workout #2

1. Power move: clean and press

5 sets of 5 reps

As much recovery as you need between sets

Again, do some experimenting to see how much weight you can handle -- this should be at the very edge of what you can manage for 5 sets of 5 reps. Start by holding the bar at your hips with straight arms and an overhand grip. Hands should be about shoulder width apart. Bend your knees and in one fluid motion, bring the bar to your collarbone. Watch your elbows and try to keep them pressing out and in toward your body; also try not to bend forward as you raise the bar. Bend your legs again and raise the bar overhead with straight arms. Maintaining control, reverse the movement: bring the bar back down to your collarbone, then back to start. For reference, I'm doing 7.5 pounds on each side plus the bar, which weighs 45 pounds: 60 pounds altogether. Husband is doing 90 pounds altogether.

2. Mini circuit: one-arm row, bosu ball pushups, single-leg Romanian dead lift

4 sets of 10 reps each

30 seconds of recovery between sets

• One-arm row

Again, choose a dumbbell that's heavy but allows you to do the movement efficiently and correctly (I do 32.5; my husband does 45). With the weight hanging from your hand, get in a tripod position over the bench: the other hand and one knee support your weight on the bench, the other leg balances you on the floor. If you bring that leg far enough out and to the side, you'll feel this in your obliques as well, a nice bonus. Make sure your back is flat and arm holding the weight is straight. Lifting FROM YOUR SHOULDER (this is important), pull the weight up alongside your ribcage until your elbow is bent at 90º. Return to start and repeat until the set is complete, then switch to the other arm.

• Bosu ball pushups

These don't need much explanation. Get in pushup position over the bosu, grip both sides of it, and go down as slow and low as you can. Do I need to say the bosu should be flipped over so the "ball" part is touching the floor and the flat part is facing you?

• Single-leg Romanian dead lifts

I have no idea why the interesting name comes from, but I do like these exercises. Again, grab a dumbbell at a weight that's significant enough to feel the difference while you squat (I use a 15, hub uses 22.5). Stand upright on one leg, with the other knee bent and holding the foot in the air behind you. Hold the weight in your opposite hand at your side with a straight arm. Bend your standing knee and drop into a deep squat, while simultaneously rotating to bring the weight across your body until it almost touches the floor next to your planted foot. Do I need to stay your weight should be in your heel? Keep your back FLAT; don't hunch over. Push through your heel to standing, repeat to complete the set, then switch legs. As with all squats, your knee should be somewhere between your ankle and your toes, not over your toes. Abs should be tight the entire time.

3. Cardio meltdown: dumbbell swings and jump squats

5 sets of 30 seconds each (10 sets altogether)

15 seconds of recovery between each set

• Dumbbell swings

Grab a dumbbell in a decent weight -- something you're going to feel, but not too much (I use a 25, hub uses 30). With your legs spread, hold the weight just below your crotch with both hands. Your legs should be very slightly bent and you should be using your back to bend forward -- a good test to know if you're in the right position is to see if you're feeling a stretch in your butt and hamstrings. If you're feeling it, you're good. Keep your arms straight and shoulders back -- shoulder blades should be pulling toward each other. In one swift motion, straighten your knees to snap upright and raise the weight to shoulder level. Bring it down WITH CONTROL so you're not swinging the motion too much, then repeat as many times as you can in 30 seconds.

• Jump squats

Oh, the torture. And these are so simple. Start in a low squat position, then jump up with your arms overhead (like, "Hooray! I'm doing squats!"). Return to the starting position and bust out as many as you can in 30 seconds. These are going to feel like hell long before you reach the halfway point but they're so worth it.

Whew!

Badass weight workout #1

I've got to say, I love these new workouts. They're relatively quick, they're broken down into three distinct sections which makes them feel less intimidating, and they make me feel really wrung out and virtuous by the end. I'm including the first one below, but a quick note re: the three sections first.

The first section in all three workouts is a power move -- it involves big muscle groups and about as much weight as you can handle, with as much recovery as you need between sets. The second section is a mini-circuit, using weights that are still a bit heavy but manageable enough to move through quickly; you get 30 seconds of recovery between each set. The third and final section is an all-get-out, go-for-it, swapping interval that's more about cardio than weights -- with just 15 seconds of recovery between sets. The end result? A weight workout with plenty of cardio that involves fast- and slow-twitch muscles to burn fat and increase metabolism while adding lean muscle (at least, hopefully that's what's happening). Regardless, these workouts are fun and I'm going to miss these when it's time to change up my routine.

Badass weight workout #1

1. Power move: free-weight squats

5 sets of 5 reps

As much recovery as you need between sets

Do some experimenting to see how much weight you can handle -- this should be at the very edge of what you can manage for 5 sets of 5 reps. Make sure your feet are spread far enough apart and keep your weight on your heels. Come down to a count of 4, getting as low as you can without sacrificing your ability to get back up, and come back up to a count of 2. For reference, I'm doing 105 pounds plus the bar, which weighs 45 pounds: 150 pounds altogether. My awesome husband Mike, who is doing these workouts with me, is doing 185 pounds altogether.

2. Mini circuit: bench press on the physio ball, single-leg squats, lat pulldowns

4 sets of 10 reps each

30 seconds of recovery between sets

• Bench press on the ball

Choose dumbbells that are heavy but allow you to do the movement efficiently and correctly (I do two 30-pounders; my husband does two 45s). With the weights in your hand, sit on the ball and slowly slide down until only your head and shoulder blades are touching it. Bring the weights overhead with straight arms, touching the edges together at an angle so there's a triangle of space between them. Lower arms to a 90º angle, tightening your shoulder blades as you go to keep the movement focused on your chest.

• Single-leg squats

Grab two dumbbells at a weight that's significant enough to feel the difference while you squat (I use 15s, hub uses 22.5s). Holding the weights at your sides, stand on one leg with the other foot resting on a bench behind you. Try to keep all the weight on the standing leg. Your posture should be upright, straight up and down, as if you're standing on two legs. Drop down into a squat, bringing your hip back and keeping weight on your heel -- not toes. Your knee should be somewhere between your ankle and your toes, not over your toes. Push your hips forward as you come back up, and keep your abs tight the whole time. Do all ten reps on one side first, then switch to the other.

• Lat pulldowns

Again, choose a weight that feels challenging but doesn't impact good form. This is a tricky move because it's easier to let your arms do all the work. Hands should be a bit more than shoulder width apart on the bar, fingers facing away from you in an overhand grip (or what I like to call "bicycle grip"). Before you start pulling the bar down, it's important to rotate your shoulders down and bring your shoulder blades together. You should feel the movement primarily along your back and lats before you bend your elbows. Bring the bar to your collarbone, bringing your chest out to meet it.

3. Cardio meltdown: alternating jump thrusts and angry medicine ball throws

5 sets of 30 seconds each (10 sets altogether)

15 seconds of recovery between each set

• Jump thrusts

Grab a soft medicine ball, not too heavy and not too light (we like the 10 pounder for this). Stand up, holding the ball at chest level. To begin, drop to a squat, set the ball on the floor in front of you, throw your legs back so you're in plank position (I have to do this one leg at a time but it's optimum if you can do them both simultaneously). Shoulders should be above your hands, which are still on the ball. Jump back into a squatting position with flat feet, then come straight up with a flat back and raise the ball overhead. Go back to starting position and repeat as many times as you can in 30 seconds. These are meant to be quick and totally blast your heart rate, so go for it!

• Angry medicine ball throw

Use the same ball, or one that's a bit lighter. Start in the same position as you did for the jump thrusts. Raise the ball overhead with bent elbows, then throw it down HARD so it bounces back up. Use your arms, core and legs to make the throw. As it bounces, catch it, bring it back overhead, and keep going, doing as many as you can in 30 seconds.

Whew!