tsac report issue 32 - National Strength and Conditioning Association

Transcription

TSAC REPORT
ISSUE 32
NSCA MISSION
As the worldwide authority
on strength and conditioning,
we support and disseminate
research-based knowledge
and its practical application,
to improve athletic performance
and fitness.
TSAC EDITORIAL
REVIEW PANEL
Mick Stierli, CSCS
Katie Sell, PHD, CSCS
Ty Colvin, MS, LAT, ATC, CSCS
Travis Ireland, MS, ATC, CSCS
Patrick Conway, MS, CSCS,*D
Henry “Hal” Williamson, TSAC-F
Jon Barba, CSCS
Stew Smith, CSCS
Ian Crosby, CSCS
Tony Soika, MS, CSCS
Jon Carlock, MS, CSCS,*D
STAFF
Editor
T. Jeff Chandler, EDD, CSCS,*D,
NSCA-CPT,*D, FNSCA
Editor Elect
Rob Orr, PHD
Publications Director
Keith Cinea, MA, CSCS,*D,
NSCA-CPT,*D
Managing Editor
Matthew Sandstead, NSCA-CPT
Publications Coordinator
Cody Urban
CONTACT
NSCA TSAC
1885 Bob Johnson Drive
Colorado Springs, CO 80906
phone: 800-815-6826
email: tsacreport@nsca.com
© 2013 National Strength and
Conditioning Association.
Reproduction without permission is
prohibited.
TSAC REPORT
ISSUE 32
TABLE OF CONTENTS
04
09
11
14
16
18
22
A RESEARCH UPDATE ON EXTREME CONDITIONING
PROGRAMS: WHERE ARE WE NOW WITH CROSSFIT?
GUY LEAHY, MED, CSCS,*D
THE PERFORMANCE TRIAD
TRISHA STAVINOHA, MS, RD, CSSD, CSCS
DOES FITNESS EQUATE TO REDUCED INJURY RATES IN
RESPONDERS?
BRYAN FASS, ATC, LAT, EMT-P, CSCS
HIGH-INTENSITY INTERVAL TRAINING METHODS FOR
TRAINING TACTICAL ATHLETES
KAMERON ABSHIRE, MS, CSCS
OVERTRAINING SYNDROME IN THE TACTICAL ATHLETE
KEITH CHITTENDEN, MS, CSCS, TSAC-F
EXTREME EXERCISE FOR MENTAL TOUGHNESS AND
SELECTION: EFFECTIVE TRAINING OR ERRANT BULLYING?
PART I
TYLER CHRISTIANSEN, CSCS,*D, USAW, RSCC AND MIKE ASKEN, PHD
SAUNA SUITS AND WEIGHT LOSS
PATRICK CONWAY, MS, EMT, FF-1, CSCS,*D
NSCA’S TSAC REPORT | ISSUE 32
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A RESEARCH UPDATE ON EXTREME
CONDITIONING PROGRAMS: WHERE ARE WE NOW
WITH CROSSFIT?
The views expressed in this article are those of the author, and do
not necessarily reflect the official position or policy of the Air Force,
the Department of Defense, or the U.S. Government.
Extreme conditioning programs (ECPs), such as CrossFit/P90X/
Insanity, continue to be popular training programs (5,8,14). Such
ECPs are very popular with tactical populations, and the interest
in ECPs has now even filtered into employee fitness programs for
large corporations. Despite the popularity of ECPs, these programs
remain controversial (3,15). Concerns have been expressed
regarding the safety and efficacy of ECPs, and isolated case
reports of ECP-related injuries continue to fuel the controversy
(7,10). It has been very difficult to sort out fact from fiction
regarding ECPs because until very recently there was an almost
total lack of published research that critically examined these
programs. Within the past two years, however, some examples of
ECP research have been published in peer-reviewed journals, or
presented at national conferences through organizations such as
the National Strength and Conditioning Association (NSCA) and
the American College of Sports Medicine (ACSM). Though many of
these reports are preliminary, we are at last beginning to acquire
some evidence-based findings that will assist in evaluating the
safety and efficacy of ECPs.
INITIAL STUDY
The first full paper on ECPs was not published until November of
2013 (17). This study utilized 43 subjects (23 men and 20 women)
with wide variations in fitness and body composition. The 10-week
study used several different training protocols characteristic of
ECPs (e.g., Olympic lifts, kettlebells, push-ups/pull-ups, ring work,
and bodyweight exercises). All training sessions were supervised
by a Fellow of the American College of Sports Medicine (FACSM)
and an ACSM Registered Clinical Exercise Physiologist (RCEP).
Of the 11 subjects who dropped out of the training program,
nine (16%) of them cited overuse/injury as the reason for not
completing the study. Maximal aerobic capacity (VO2max) was
measured as part of a maximal graded exercise treadmill test
(Bruce Protocol), while body fat percentage was estimated using
air displacement plethysmography. Compared to pre-test values,
the remaining study subjects significantly improved VO2max (both
absolute and relative) and body composition after the 10 weeks
(17).
Though interesting, the study contains design flaws that limit the
value of interpretation. There was neither a control group nor an
alternative intervention group, and the subjects’ diets were not
controlled. The subjects followed a “Paleolithic diet,” which could
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have contributed to a part of the body composition changes. It
would have been interesting to compare this study group to one
which trained using high-intensity interval training (HIIT) to see if
there were differences in VO2max/body composition. In addition,
the 16% dropout rate due to injury could have been compared to
injury rates using HIIT protocols, to see if differences existed.
FURTHER STUDIES
Within the last two years, several papers investigating various
aspects of ECPs have been presented at national conferences.
Three of these measured acute metabolic responses to ECP
protocols. One such study looked at lactate/cortisol responses
to an ECP (19). This study consisted of 18 subjects (nine men
and nine women) with previous resistance training experience.
The training program consisted of 10 sets of three exercises
(barbell back squat, barbell bench press, and barbell deadlift).
The protocol used a descending pyramid scheme (10 repetitions
of each exercise, followed by nine, then eight and so on until
there is only one repetition on the final set). The lactate/cortisol
values recorded after the training period were extremely high,
nearly twice that seen in traditional resistance training programs.
The authors concluded that “long-term sequential use of highintensity/short rest programs may promote overtraining,” (19). The
study also suggests that such programs may be inappropriate for
individuals who are not highly trained athletes accustomed to such
training programs.
A related study from the same laboratory utilized 12 men and 13
women with at least six months of resistance training experience
(9). The protocol was similar to the previous study; 10 sets of
back squat, bench press, and deadlift using a descending pyramid
design. Plasma lactate was measured immediately before and after
the workout. In addition, a two-dimensional analysis of changes in
mechanics during the barbell back squat was performed. As with
the previous study, post-training lactate levels were very high.
In addition, the biomechanical analysis documented significant
changes in knee and hip angles occurred in both men and women
during the test protocol. The authors concluded “these changes
serve as a potential avenue to explain the increased injuries seen
in extreme conditioning protocols,” (9). A potential cause for
said injury risk could be that exercises are being performed with
changes in technique as the individual tires. Fatigue has been
associated with reductions in proprioception, which supports this
potential cause. The authors suggest that perhaps one way to
reduce the risk of such injuries may be to use resistance machines,
rather than free weights, when performing such ECP training (9).
A RESEARCH UPDATE ON
EXTREME
PROGRAMS:
VERY
LONG CONDITIONING
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UP
LOTS
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ROOM
WHERE ARE WE NOW WITH CROSSFIT?
A third study from a different lab investigated lactate responses to
two ECP protocols (2). In this case, the popular CrossFit Workouts
of the Day (WOD) called “Fran” and “Donkey Kong” were
examined. The “Fran” WOD is a timed benchmark of performing
95 lb barbell thrusters and pull-ups consecutively for three sets
of varying repetitions (21, 15, and 9 repetitions per round) (2).
The “Donkey Kong” WOD uses the same pattern of three sets of
21, 15, and 9 repetitions but for burpees, kettlebell swings, and
box jumps, all while mixing stair-climbing between the exercises
(2). The study’s subjects consisted of 16 men/women between
the ages of 20 and 47. Prior to the study, all subjects completed
a maximal graded exercise treadmill test, where data on maximal
oxygen consumption (VO2max), maximal heart rate (HR), and
ratings of perceived exertion (RPE) were collected. Besides plasma
lactate, HR and RPE were recorded during the WODs in order
to predict exercise intensity and caloric expenditure. The results
indicated that both WODs were very metabolically taxing, with
high lactate levels post-exercise. In addition, WOD HRs averaged
90% of maximal HR, and 80% of VO2max. Estimated caloric
expenditure was also very high. The high HRs seen in this study
are greater than recorded for a previous study from the same lab
testing another ECP known as P90X (13).
As has been noted elsewhere, the HRs measured during
discontinuous exercise appear to be higher than those recorded
during steady-state exercise, even when matched for VO2 (13).
Therefore, VO2/energy consumption values calculated from HRs
collected from ECPs like those in this study could overestimate
actual VO2/energy cost. The high lactate values, however, do
indicate that exercise intensity was high. The authors also noted
the potential injury risk of such programs by saying, “the thing
we’ve seen with a lot of these workouts is that you go flat-out as
fast as you can, but then your form falls apart. You really need to
be technically correct with a lot of these exercises or else you’re
going to get hurt,” (2).
PERFORMANCE EFFECTS
Several studies have compared various training adaptations seen
in ECP-trained subjects to those from more traditional training
methods, such as resistance/cardiovascular training. One study
compared the aerobic/anaerobic power of ECP-trained individuals
versus subjects who utilized traditional resistance training (RT).
Eight ECP subjects and six RT subjects participated in the study.
The tests for aerobic/anaerobic power were the Bruce Protocol
and the Wingate Anaerobic Test. Results of the study indicated no
significant differences in VO2max or Wingate peak power between
the ECP group and the RT group (19). Another study from the
same lab examined whether ECP-trained subjects differed from
RT-trained subjects in performance of one-repetition bench press
(BP) and one-repetition back squat (BS), plus the medicine ball
shot put, vertical jump, and the Margaria-Kalamen power test.
There were no significant differences in performance between ECP
and RT subjects on any of these tests (1).
Another study compared performance of ECP-trained subjects,
this time using tests related to muscular endurance, agility, and
flexibility (16). Nine ECP-trained and seven RT-trained individuals
were the study subjects. Tests utilized in the study were the
push-up, pull-up, T-test, and sit and reach test (all were performed
according to NSCA guidelines). When compared, there were no
differences in performance between ECP and RT subjects on
the push-up, T-test, or sit and reach test. The ECP subjects did
perform significantly more pull-ups than the RT group. The latter
result is somewhat confounded because the mean body mass
of the ECP group was less than the RT group, as increased body
mass does have a negative impact on such tests (21).
An additional study compared performances on the MargariaKalamen power test, the anaerobic step test, and the Cooper
1.5-mile run test between CrossFit-trained subjects and subjects
who followed traditional exercise programs recommended by
the ACSM (4). The results indicated that male CrossFit trainees
performed significantly better than those using ACSM protocols
on the Margaria-Kalamen power test. By contrast, there were
no differences in performance on the step test or the Cooper
1.5-mile run test. Unfortunately, direct measures of aerobic
fitness (VO2max) were not recorded. This study also attempted
to determine relationships between performance on the above
tests and performance on three common training components
of CrossFit: a 1RM deadlift, a one-minute row for distance, and a
timed test known as “Murph.” The results revealed no significant
correlation between any of these CrossFit components and
performance of the above tests (4).
One study investigated the relationship between VO2max and
body fat percentage on performance of a CrossFit workout named
“Cindy.” This WOD consists of performing as many rounds as
possible in a 20-min span of 5 pull-ups, 10 push-ups, and 15 squats
(11). Seven men and three women who had trained using CrossFit
for at least three months participated in the study (11). Maximal
oxygen consumption (VO2max) was measured using a treadmill
test, and body fat percentage was assessed using dual-energy
x-ray absorptiometry (DEXA). The results found a significant
relationship between body fat percentage and the number of
rounds of “Cindy” completed. By contrast, there was no significant
correlation between VO2max and the number of “Cindy” rounds
completed.
Another study from the same lab also examined the metabolic/
cardiovascular responses to “Cindy.” Nine volunteers (seven
men and two women) who had trained with CrossFit for at least
three months were the study subjects. All subjects performed a
baseline treadmill test to determine maximal oxygen consumption
(VO2max). A portable metabolic cart and heart rate (HR) monitor
were worn during the performance. Average VO2 recorded
during “Cindy” was 33.3 +/- 5.5 ml/kg/min, with an average HR
of 170.8 +/- 13.5 beats per minute (BPM). The “Cindy” workout
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produced an average caloric expenditure of 260.6 +/- 59.3 kcals.
The exercise intensity of “Cindy” would place this protocol within
the lower range of “vigorous intensity” exercise (64 to 90% of
VO2max) based on ACSM guidelines (12).
One study compared the physiological responses of untrained
individuals in a CrossFit training program to a traditional combined
cardiovascular/RT training program. The study lasted four weeks
in duration. The subjects were tested for body fat percentage,
systolic/diastolic blood pressure, and resting HR. At the end of
the study, no significant differences in any of these physiologic
measures were found. The short duration of the study, however,
does limit interpretation of the results (17).
MILITARY STUDY
One of the greatest concerns regarding ECPs is the potential
for injury. Isolated case reports of rhabdomyolysis and retinal
detachment resulting from ECP exercises have been reported,
though no large-scale study looking at ECP injury rates has
been published previously (7,10). A recent study presented the
first data regarding injury rates of ECPs in a military cohort (6).
This study utilized a survey delivered to 1,393 soldiers in a light
infantry brigade. The survey collected data related to personal
characteristics, tobacco use, unit/personal physical readiness
training, Army physical fitness test (APFT) results, and injuries.
The survey revealed that 1,032 soldiers participated in an ECP
or related programs such as the Advanced Tactical Athlete
Conditioning (ATAC) program, or the Ranger Athlete Warrior
(RAW) program. The remaining 340 soldiers did not participate
in any of these programs. The survey results indicated that risk
factors for injury included gender (female), body mass index
(BMI) greater than 25, smoking, running mileage greater than
16 miles per week, and slow run times (greater than 15:51 on the
APFT). Factors protective of injury include resistance training,
agility drills, and participating in unit physical training at least five
days per week. When comparing the injury rates of soldiers who
participated and those who did not participate in ATAC/ECPs,
overall rates of injury were similar, though the ATAC/ECP group
did exhibit a significantly greater increase in overuse injuries
after the programs were initiated (6). The soldiers who did not
participate in ATAC/ECPs for the duration of the study did not
display increases in overuse injuries.
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FINDINGS AND CONCLUSION
What can be said at this point regarding the efficacy of ECP
training programs such as CrossFit, P90X, and Insanity? Clearly,
much additional research needs to be conducted before firm
conclusions can be drawn. The research published to date
does appear to provide some preliminary indications regarding
physiological adaptations seen from ECPs. There does not seem
to be convincing evidence at this point that ECPs significantly
improve aerobic power or VO2max. The only study which found
this result lacked a control group, and all studies which have
utilized a control group have found no differences in aerobic
performance/VO2max when compared to ECP subjects. One
study which found no relationship between VO2max and ECP
performance is consistent with this interpretation. The adaptations
seen from ECPs appear to be broadly similar to those obtained
from traditional RT, as no consistent differences in strength,
power, and muscular endurance have been seen when ECP-trained
subjects are compared to RT subjects. This observation is not all
that surprising, since RT constitutes a significant component of
most ECP training protocols.
Extreme conditioning programs appear to differ in one significant
aspect from traditional RT, which is that ECPs seem to be more
metabolically taxing than traditional RT. Three studies have
documented very high levels of plasma lactate and cortisol,
in some cases twice the average values seen from traditional
RT. One study, which found negative changes in back squat
biomechanics associated with high post-training lactate levels,
was consistent with the hypothesis that ECPs can produce
significant neuromuscular fatigue, which may lead to an increased
risk of overuse injuries. The results from the U.S. Army Combat
Brigade, which found an increased incidence of overuse injuries
associated with ATAC/ECP programs, is also consistent with this
interpretation (6).
A related concern, and perhaps the most important, is that ECP
certification programs do not require a Bachelor’s degree in
Exercise Science, Physical Education, or a related field to qualify to
take the ECP certification exams (13). In addition, ECP certification
programs do not require the prior acquisition of evidence-based
certification programs such as those from the NSCA or ACSM.
The fact that no ECP certification program is accredited by the
National Commission for Certifying Agencies (NCCA) may also
be cause for concern. One ECP study where training sessions
were supervised by highly trained personnel exhibited a 16%
dropout rate due to injury. It is possible that injury rates might be
significantly higher from ECP sessions which are supervised by
individuals who lack this advanced training/education.
A RESEARCH UPDATE ONVERY
EXTREME
LONGCONDITIONING
ARTICLE TITLE PROGRAMS:
GOES HERE
AND
TAKES
UP
LOTS
AND
LOTS
OF ROOM
WHERE ARE WE NOW WITH CROSSFIT?
In summary, ECPs continue to be very popular programs with
tactical athletes. From the limited evidence to date, it does not
appear ECPs offer training benefits which cannot be acquired
through more traditional training programs, such as resistance/
cardiovascular/HIIT training. These more traditional training modes
may also offer the potential for lower injury risk, yet result in the
same training adaptations. A related factor is that individuals
who possess ECP certifications are not required to possess
the advanced training available from universities or esteemed
organizations such as the NSCA or ACSM. Though
much more research is necessary to reach a unanimous conclusion,
ECPs do not seem to offer training benefits above and beyond
those already found from an evidence-based, all around program
consisting of traditional RT, aerobic, HIIT, agility, and balance
training.
REFERENCES
1. Arnett, SW, Sobrero, GL, Schafer, MA, et al. CrossFit vs.
resistance-trained individuals: Evaluation of strength and power.
Medicine and Science in Sports and Exercise 45(5): 130, 2013.
2. Babiash, P, Porcari, JP, Steffen, J, Doberstein, S, and Foster,
C. CrossFit: New research puts popular workout to the test. Ace
Prosource: 2013.
3. Bergeron, F, Nindl, B, Deuster, P. et al. Consortium for
Health and Military Performance and American College of Sports
Medicine consensus paper on extreme conditioning programs in
military personnel. Current Sports Medicine Reports 10(6): 383389, 2011.
4. Church, B, Jeffery, C, Jones, M, et al. The influence of
CrossFit on fitness in men and women. Journal of Strength and
Conditioning Research 27(10): 49-50, 2013.
5. Cooperman, S. Getting fit, even if it kills you. http://www.
nytimes.com/2005/12/22/fashion/thursdaystyles/22Fitness.
html?pagewanted=all.
6. Grier, T, Canham-Chervak, M, McNulty, V, et al. Extreme
conditioning programs and injury risk in a U.S. Army Brigade
Combat Team. US Army Medical Department Journal 4-13 and 3647, 2013.
7. Hadeed, M, Kuehl, KS, Elliot, DL, et al. Exertional
rhabdomyolysis after CrossFit exercise. Medicine and Science in
Sports and Exercise 43(5): 224-225, 2011.
8. Helm, B. Do not cross CrossFit. 2013. Retrieved from Inc.com/
magazine/201307/burt-helm/crossfit-empire.html.
9. Hooper, D, Szivak, T, Comstock, B, et al. Effects of fatigue from
resistance training on barbell back squat biomechanics. Journal of
Strength and Conditioning Research 27(10): 2-3, 2013.
10. Joondeph, SA, and Joondeph, BC. Retinal detachment due to
Crossfit training injury. Case Reports in Ophthalmological Medicine
Article ID 189837, 2 pages, 2013.
11. Klisczezewiez, B, Snarr, R, Blessing, D, et al. Metabolic and
cardiovascular demand of a named CrossFit workout “Cindy.”
Medicine and Science in Sports and Exercise 45(5): 129, 2013.
12. Kliszczewicz, B, Snarr, R, and Esco, M. The relationship
between aerobic power, fat free mass, and Crossfit performance.
Journal of Strength and Conditioning Research 27(10): 24, 2013.
13. Leahy, G. Evidence-based physical training: Do CrossFit or
P90X make the cut? TSAC Report 22: 1-7, 2012.
14. Lipinski, J. We’re one big team, so run those stairs. http://
www.nytimes.com/2013/03/31/business/crossfit-offers-anexercise-in-corporate-teamwork-too.html.
15. Robertson, E. CrossFit’s dirty little secret. 2013. Retrieved
from http://www.huffingtonpost.com/eric-robertson/crossfitrhabdomyolysis_b_3977598.html.
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16. Schafer, MA, Arnett, SW, Sobrero, GL, et al. Evaluation of
muscular endurance, agility, and flexibility in healthy trained
Crossfit and weight trained individuals. Medicine and Science in
Sports and Exercise 45(5): 130, 2013.
17. Smalley, JS, Van Dyke, PY, Petrella JK, et al. The effects
of Crossfit on fitness compared to traditional separated
cardiorespiratory and resistance training. Southeast Chapter
of the American College of Sports Medicine Abstracts 72: 2013.
18. Smith, MM, Sommer, AJ, Starkoff, BE, et al. CrossFit-based
high-intensity power training improves maximal aerobic fitness
and body composition. Journal of Strength and Conditioning
Research 27(11): 3159-3172, 2013.
19. Sobrero, GL, Schafer, MA, Arnett, SW, et al. Comparison of
aerobic and anaerobic power in CrossFit and resistance trained
individuals. Medicine and Science in Sports and Exercise 45(5): 130,
2013.
20. Szivak, TK, Hooper, DR, Apicella, JM, et al. Acute physiological
responses to a high-intensity, short rest resistance exercise
protocol in men and women. NSCA National Conference &
Exhibition Abstracts, 2012.
ABOUT THE AUTHOR
Guy Leahy is currently serving as an exercise physiologist in
Tucson, AZ. Leahy is a member of the ACSM (American College of
Sports Medicine) and NSCA (National Strength and Conditioning
Association), and is a Certified Strength and Conditioning
Specialist® (CSCS®). Leahy is the author/co-author of over 40
professional articles, including original research, which has
appeared in publications such as the Journal of Strength and
Conditioning Research, TSAC Report, Medicine and Science in
Sports and Exercise, Nature, Science, and Scientific American.
Leahy is also a columnist for the TSAC Report. He has presented
at several conferences, most recently at the 2013 NSCA and ACSM
Annual Conferences. He was also a guest speaker at the 2012/2013
TSAC Conferences. Leahy holds a Master of Education degree from
Western Washington University and a Bachelor of Science degree
from the University of Oregon. Leahy can be reached at xrciseguy@
gmail.com.
21. Vanderburgh, PM. Occupational relevance and body mass bias
in military physical fitness tests. Medicine and Science in Sports
and Exercise 40(8): 1538-1545, 2008.
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VERY LONG
ARTICLE
TITLE
GOES HERE
TRISHA
STAVINOHA,
MS,
RD, CSSD,
CSCS
AND TAKES UP LOTS AND LOTS OF ROOM
THE PERFORMANCE TRIAD
The “performance triad” is one of the U.S. Army Surgeon
General, Lieutenant General’s top initiatives to improve soldier’s
performance, health, and wellness. The three components
(physical activity, good nutrition, and adequate sleep) have always
been pillars of good health. The emphasis of the performance
triad is on soldiers taking personal responsibility to make the right
choices for their health, and to understand that an imbalance
of any one component will negatively impact readiness and
performance.
Exercise, nutrition, and sleep are not health behaviors that are only
beneficial to the military. Every athlete, coach, professional, and
parent may perform better at his or her job if they were physically
fit, properly nourished, and well rested. The problem is these
simple, familiar behaviors are often misunderstood, ignored, or
forgotten.
Training for performance of tactical athletes goes beyond just
an exercise routine and recommendations are not the same for
everyone. Performance training should not be short-lived or a fad,
it should support individual fitness goals as well as minimize the
risk of injury. Unfortunately, this is not always the case for many
soldiers who take on extreme conditioning programs for which
they are not properly trained (4).
The other idea behind performance training is to encourage
soldiers to pay closer attention to what they are doing (or not
doing) during non-Army time. Soldiers will partake in physical
training (PT) every day, but this may not include weekends,
holidays, training holidays, vacation, or time off for moving. This
could add up to almost three months of non-training days per
year. Although it is not recommended to run every day, soldiers
should be encouraged to seek out training activities during their
off time.
Performance nutrition does not necessarily imply going on a diet
or taking supplements since supplements cannot make up for an
unhealthy diet, they can only complement a healthy diet. Rather,
performance nutrition is designed as a fuel to support training
and to speed up recovery times. Skipping meals, particularly the
meals around a workout, will not support recovery. It is important
to never start a workout on an empty tank; this includes hydrating
and fueling before, during, and after training. However, it is
possible to do this in excess, which will promote weight gain or an
upset stomach.
A pre-workout fuel choice may just be an eight-ounce sports
drink, or water and a banana. If training lasts over 60 min,
particularly if in hot weather, a sports drink for extra carbohydrates
and electrolytes during the workout may be necessary (2). After
the workout, most athletes (even a 200-lb operator) only need 20
– 25 g of high-quality protein and 30 – 90 g of carbohydrates with
20 g of essential amino acids within the 30 – 45 min following
training (1). Many post-workout protein supplements contain 60
g of protein and very little carbohydrates. A larger athlete with
greater protein needs will still only utilize 20 – 25 g of protein
at once; the rest will turn into glucose or carbohydrates. Most
commercial meal replacement drinks have 10 – 15 g of protein and
30 – 40 g of carbohydrates and are shelf stable, perfect to pack in
a gym bag. To better utilize protein intake, a tactical athlete should
have one or two immediately after a workout and then a meal that
contains more carbohydrates and protein 1 – 2 hours later. As an
example, 16 oz of chocolate milk has about 15 g of protein and
60 g of carbohydrates.
The third component of the performance triad, and often most
overlooked, is sleep. In the past (and probably still today), sleep in
the military was viewed as a crutch; those who got less sleep were
somehow stronger than those who got a full eight hours. When
asking a crowd of leaders, “who got eight hours of sleep last
night,” it is almost looked down upon if a commander raises his/
her hand. If we want surgeons to be well rested when they operate
and accountants to be well rested when they do taxes, we should
also want our war fighters to be well rested too. Growth hormones
are produced during sleep, so insufficient sleep can negatively
impact muscle recovery. People who routinely get less than seven
hours of sleep have more trouble with weight gain (3). This could
be because they are eating more to stay awake or burning fewer
calories during the day due to fatigue. For example, if someone is
tired, they are more likely to take the elevator than the stairs.
Ultimately, training according to specific fitness goals, eating a
performance diet, and getting sufficient sleep is the choice of
the individual. The goals of the performance triad initiative is to
encourage soldiers to be more proactive with their health, educate
them on the importance of these components, teach them to set
reasonable and personal goals, and convince them to make the
right choices for their own performance and health. The program
educates soldiers on the benefits of proper exercise so they meet
their fitness goals, the meaning of performance nutrition so they
are matching their fueling needs for their mission or training plan,
and the importance of adequate sleep so they are better rested for
the workout the next day.
The initiative is being pushed at military installations worldwide
but will be piloted and studied at Joint Base Lewis-McChord, WA;
Fort Bliss, TX; and Fort Bragg, NC. The program will eventually
include retirees, family members, and Department of the Army
(DA) civilians, but for now it would be in the best interest of
tactical athletes to get a good night’s sleep and learn more about
how to live a healthy lifestyle.
9
TRISHA STAVINOHA, MS, RD, CSSD, CSCS
For more information, references, and tip sheets, please visit the
U.S. Army Medicine website at http://armymedicine.mil/Pages/
performance-triad.aspx.
REFERENCES
1. Figueiredo, VC, and Cameron-Smith, D. Is carbohydrate
needed to further stimulate muscle protein synthesis/hypertrophy
following resistance exercise? Journal of the International Society
of Sports Nutrition 10(1): 10-42, 2013.
2. Joint Position Statement: Nutrition and Athletic Performance.
American College of Sports Medicine, American Dietetic
Association, and Dietitians of Canada. Medicine and Science in
Sports and Exercise 32(12): 2130-2145, 2000.
3. Kobayashi, D, Takahashi, O, Deshpande, GA, Shimbo, T, and
Fukui, T. Association between weight gain, obesity, and sleep
duration: A large-scale 3-year cohort study. Sleep Breath 16(3):
829-833, 2012.
ABOUT THE AUTHOR
Trisha Stavinoha’s Army and dietetic career began in 1998 after
earning her Bachelor of Science degree in Nutrition from Texas
State University and was accepted into the U.S. Army’s dietetic
internship program. Stavinoha earned her Master of Science degree
in Sport Nutrition from Long Island University while concurrently
competing on their track and field and cross country teams. She has
been a credentialed sport dietitian and strength and conditioning
coach since 2008. Her credibility in sport nutrition comes from
being a soldier, scholar, and athlete. Stavinoha’s experience with
athletes includes a wide range of Olympic hopefuls in the Army’s
esteemed World Class Athlete Program, high school and collegiate
cross country runners, triathlete and endurance athletes, tactical
soldiers, Wounded Warriors, and overweight service members
trying to pass body fat and physical fitness standards.
4. United States Army Public Health Command. What Army
leaders should know about extreme conditioning programs. Public
Health Notice No: 0312-01. Retrieved from http://phc.amedd.army.
mil/PHC%20Resource%20Library/PHN_No_0312-01_Extreme_
Conditioning_Programs_and_the_Army_2012.pdf.
10
DOES FITNESS EQUATE TO REDUCED INJURY
RATES IN RESPONDERS?
In all the classes that I teach there are two specific questions that
I ask in the very beginning. By an unscientific show of hands,
“how many of you have pain right now?” Then I ask the followup question that really gets the point across, “how many of you
have sustained a soft-tissue injury on the job?” If your department
mirrors the national data, then we are looking at an injury rate of
16% in the fire service to over 60% in emergency medical service
(EMS) personnel from patient handling/transport alone (3). These
injuries occur when the load exceeds the ability of the tissue to
dissipate the forces placed upon it. One study that is particularly
concerning stated that when anonymously surveyed, 54% of
responders have sustained but not reported a soft-tissue trauma
on the job (4). With such a high unreported injury rate plus the
reported injuries, are the exercises a tactical facilitator chooses in
the pursuit of reduced injury rates actually increasing the rate of
injury? Could the popularity of high-intensity Olympic-style lifting
programs magnify the rate and severity of injury?
OCCUPATIONAL STRAIN AND COMMON EXERCISES
Most departments run 911 medical calls, but in some departments
up to 80% of all runs are medical. So, it only makes sense to focus
not on just fireground biomechanics, but also the biomechanics
of patient and patient handling equipment. Tactical facilitators
must realize that there are specific patterns that responders
are exposed to when handling patients, and as a rule, these
biomechanical patterns have high-torque and high-tissue load on
the spine and extremity joints. McGill has shown that there is no
single exercise that challenges all the abdominal muscles while
sparing the back (2). For example, if someone only performed situps and leg raises without additional back strengthening exercises
it would exceed the safe lower back compressive loads that the
National Institute for Occupational Safety and Health (NIOSH)
has set (5). This constant compressive tissue loading with flexionbased exercises may lead to damaged tissue and lumbar discs
compounding an injury mechanism that is ever-present in the
work environment.
Another issue consistently seen is that many responders lack
the basic job-specific range of motion in the calf/ankle and hips.
Because of this restricted motion spine loading during normal job
tasks versus spine sparing when taking a load is commonly seen.
One possible way to reduce responder injury is to stop lifting
from below the knees. When looking at many fitness programs, a
tactical athlete may even have to lift from shin-height. Yet, most
lifting in the field is performed from floor height; even when
done properly these deep lifts exceed NIOSH recommended peak
torques (5). The vast majority of calls will require a lift from the
floor onto a transportation tool and it is much less likely to see a
lift from shin height. As tactical facilitators observe crews lifting
spine boards, patients, or weighted mannequins, take note of a
few common biomechanical nuances that have been consistently
observed.
1. When performing spine board lifts with only two responders,
it is common to see heels up in the air on the initiation of
the lift. Also commonly seen is poor hip rotation, which
often causes an excessive trunk angle when initiating the
lift. Another improper mechanical pattern is a profoundly
kyphotic lifting posture, especially at depth (see Figure 1).
All these patterns that are consistently documented place
excessive stresses on the knees, lumbar spine, and hips. Part
of this issue is in training that “all hands working” meaning
that there are four sets of hands on the lift not just two. A
safer strategy would be to use a lifting device to distribute
the load and increase mechanical advantage. A MegaMover™
flexible stretcher is one example of how responders can lift
with reduced spinal torques and a higher lift height to meet
NIOSH recommendations (5).
2. Stretcher loading has been a challenge since they were
invented. Chassis height, responder height, terrain, patient
weight, and stretcher weight all factor into the difficulty of
lifting this device into and removing it from an ambulance.
The most common improper pattern observed is a ballistic
shrug/curl with spine extension as the cot is lifted up so the
wheels can enter the patient compartment. A more troubling
problem has emerged now that most departments are
moving to powered stretchers and the sheer weight of these
stretchers is causing a profound spinal extension under load
with the load held away from the body in many cases (see
Figure 2). If the crews follow manufacturer recommendations
on these powered stretchers then two responders will load
and unload at all times but many departments still treat this
tool like its predecessor, which usually weighed about 45
lb less (95 lb) and that is not factoring in the weight of the
patient on the stretcher. Today’s powered stretchers can
weigh over 135 lb when empty.
When assisting patients from a seated position, many responders
will have the patient put their hands around their neck while the
responder lifts the patient. The poor biomechanics alone are
staggering and this is another prime example of when a tool or
device should be used to help boost leverage and distribute the
load to multiple responders.
11
Moving a patient from a bed to a stretcher usually involves one
responder leaning over the stretcher to reach for the sheet to pull,
which places them in a flexed posture that puts enormous load on
the lumbar spine, not to mention shear forces on the rotator cuff.
Meanwhile, the second responder is often kneeling on the bed to
“assist” in the transfer. This responder will most likely be kneeling
on an unstable surface with trunk flexion and an unobtainable
neutral spine, which all adds up to a recipe for a soft tissue
overexertion injury. Utilizing an assistive device as seen in Figure 3
can help responders achieve a neutral spine posture when moving
a patient to or from a bed, and will help avoid putting responders
in compromising lifting positions.
Almost every call a responder goes on will place them in situations
of high tissue loads. Many responders have “engineered”
exercises that mimic the job, which often display a lot of poor
technique on exercises like deadlifts and basic kettlebell swings.
Unfortunately, this also transfers to more dangerous exercises like
good mornings, heavy Roman chair hyperextensions, weighted
crunches, and tire flips being performed well past the point of
good form. This misdirected approach ultimately sets these
responders up for injury.
As tactical facilitators, we must understand that many
departments only have access to aging fitness equipment with
many pieces donated by well-intentioned citizens. Due to this lack
of equipment or knowledge of how to use what they have, many
responders make their own equipment. Tire flips, sledgehammer
drills, homemade sandbags, Olympic-style lifts, and burpees
done to failure or with poor technique every week do not make
for a well-designed strength program; however, this is all many
responders “know” as their definition of fitness. Tactical facilitators
need to be aware that sometimes the most important step in
correcting or starting an effective program is getting the tactical
athlete to adhere to the right mindset when it comes to fitness
and focus on proper form and execution. David Frost explained
it best in his session at the 2012 TSAC Conference, “emphasizing
fitness alone may increase one’s risk of injury. We should never
have to sacrifice fitness to emphasize movement, but it’s far too
easy to sacrifice movement when emphasizing fitness,” (1).
12
REFERENCES
1. Frost, D. NSCA TSAC Conference. Protecting our public
protectors. Norfolk, VA, 2012.
2. McGill, S. Low Back Disorders. Champaign, IL: Human Kinetics;
218-222, 2007.
3. Poplin, G, Harris, R, Pollack, K, Peate, W, and Burgess, J.
Beyond the fireground: Injuries in the fire service. Injury Prevention
18(4): 228-233, 2012.
4. Studnek, JR, Crawford, JM, Wilkins, JR 3rd, and Pennell, ML.
Back problems among emergency medical services professionals:
The LEADS health and wellness follow-up study. American Journal
of Industrial Medicine 53(1): 12-22, 2010.
5. The National Institute for Occupational Safety and Health.
Centers for Disease Control and Prevention. Accessed December
31, 2013 at http://www.cdc.gov/niosh/.
ABOUT THE AUTHOR
Bryan Fass is an expert on public safety, injury prevention, fitness
and wellness, speaking, consultations, as well as being an author of
the “Fit Responder” and column writer for officer.com, firerescue1.
com, and ems1.com. Fass works nationally with departments,
corporations, and state and local governments to design and
run targeted injury prevention and wellness programs for public
entities and private organizations. He is frequently contacted
for expert opinion and content contribution for all aspects of
public safety. President and founder of Fit Responder, Fass also
functioned as a paramedic for over eight years.
VERY LONG ARTICLE TITLE GOES HERE
DOES FITNESS EQUATE TO REDUCED INJURY RATES IN RESPONDERS?
Figure 1. Measuring the Lifting Posture
Figure 2. Example of Loading a Stretcher with Spinal Extension,
Shoulder Extension, and the Load Away from the Body
Figure 3. Assistive Device Helps Responders Achieve a Neutral Spine when Moving a Patient
13
KAMERON ABSHIRE, MS, CSCS
HIGH-INTENSITY INTERVAL TRAINING METHODS
FOR TRAINING TACTICAL ATHLETES
Creating workouts appropriate for tactical teams can present a
unique challenge. Many police and fire departments deal with
limited budgets, substandard facilities, restricted time, and
insufficient personnel. When combined with the very nature of
tactical job requirements, these challenges present a daunting task
for tactical facilitators. Creating a program that is time effective,
fiscally responsible, physically engaging, and still enjoyable is the
day-to-day challenge that police and fire departments struggle
with worldwide. Using a high-intensity interval training protocol
can minimize needed space, allotted time, and required equipment
without sacrificing fitness goals and standards.
Traditional high-intensity training combines simplicity and ease of
setup with a high level of physical demand. To put it very simply,
this method focuses on high-intensity intervals with very little
rest, much like circuit training. The difference is that the majority
of high-intensity training circuits employ submaximal intensity
neuromuscular exercises as opposed to extremely high metabolic
loading. Likewise, few circuits have predetermined rest periods
between stations with the rest typically acquired due to the
logistics of changing stations.
Organizing these high-intensity interval workouts for effectiveness
and efficiency can be done in several ways. Each organizational
plan offers aspects that may suit a tactical team better depending
on available facilities, equipment, and time. The first option is
the traditional high-intensity interval workout, and is the most
time efficient method. Unfortunately, unless using bodyweight
exercises, this is limited by the amount of equipment in the
facility and the amount of space available to move safely. In the
traditional high-intensity workout, an exercise is chosen by the
facilitator and demonstrated to the tactical athletes. The safest
and most effective exercises are those that recruit large muscle
groups and allow fast powerful movements to be performed safely.
A good example of an appropriate exercise is a front squat,
provided that proper form is followed and the exercise is closely
monitored by the tactical facilitator. Each tactical athlete is
given a prescribed amount of weight and the timer is set. For
eight rounds, the tactical athlete attempts to perform as many
repetitions as possible in the allotted amount of time. The
facilitator or training partner will score each round, and at the end
of the eight rounds, the round with the fewest repetitions is the
score assigned. Tactical facilitators should be aware of a loophole
with this scoring system in that some tactical athletes might
decide to perform at submaximal intensity for all rounds to ensure
their poorest round scores are higher. While this workout will only
take approximately 4 min from start to finish, workout space and
14
equipment availability can limit how many tactical athletes can
train at once. Table 1 provides a basic example of a traditional
high-intensity interval workout. Another popular and equally effective option is to use a “modified
Tabata method.” This modified method uses a timer to keep
tactical athletes on task, competitive, and focused, all while
reducing the amount of time and space required to train. When
this method is used, more than one exercise is employed and
stations are utilized. This method allows tactical facilitators to
get an entire team in and out of the gym in a time-efficient
manner. When utilizing this method, it is recommended that the
workouts get divided into separate categories. For the purposes
of this example, the categories used are strength endurance,
power endurance, and endurance. Workouts are then setup
and demonstrated before the team is split into groups to begin
their specified workout. Table 2 provides an example of a power
endurance day, strength endurance day, and endurance day.
This modified Tabata method allows multiple tactical athletes
to workout in less than 30 min. This method is a great way to
minimize gym time and maximize the physical and mental benefits
of exercise. Another benefit to this workout method is that
progress can be easily tracked. If a tactical facilitator can come
up with 15 – 30 different Tabata workouts and record the scores,
a training journal will identify strengths and weaknesses for each
tactical athlete. By categorizing the workouts into different “days,”
the facilitator can determine which tactical athletes are efficient
in which areas, and which ones may need more individualized
exercise instruction. Tracking workouts in these categories also
helps departments with more than one team balance the teams on
a physical level properly.
In conclusion, the traditional high-intensity interval and modified
Tabata methods of training are tough, physically demanding
workouts that require a certain level of baseline fitness. When
using these methods, tactical facilitators must ensure that all
workouts include proper warm-up and cool-down protocols, and
that all exercises are performed with the tactical athlete’s safety
in mind. That being said, this method can harbor a competitive
atmosphere that gears itself toward the mentality of police and
fire departments. These tactical athletes will be able to stay in
peak physical condition while decreasing workout times, which,
in turn means they will have more time performing the duties of
their job.
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ARTICLE
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HIGH-INTENSITY
INTERVAL
TRAINING
METHODS
AND TAKES
UP
LOTS
AND
LOTS
OF
ROOM
FOR TRAINING TACTICAL ATHLETES
TABLE 1. SAMPLE OF TRADITIONAL HIGH-INTENSITY INTERVAL WORKOUT
ABOUT THE AUTHOR
Front Squat (8 rounds)
Kameron Abshire is a police officer for
the Raleigh Police Department in Raleigh,
North Carolina. He received a Master of
Science degree in Exercise Sport Science
from East Carolina University. He is a
Certified Strength and Conditioning
Specialist® (CSCS®) through the National
Strength and Conditioning Association
(NSCA), as well as an active member of the
TSAC Program. His research interests are
in high-intensity interval training methods
and fitness training for first responders.
Abshire works with tactical teams in North
Carolina to help them create strength and
conditioning programs geared toward
tactical movements.
10 s preparation time
20 s of as many repetitions as possible
10 s rest
This is approximately a 4-min workout
TABLE 2. SAMPLE OF MODIFIED TABATA METHOD
Power Endurance Day (5 rounds)
10 s rest
1. Power clean
2. Box jumps
3. Clap push-ups
4. Pull-ups (variations can be used)
5. Battle rope wave
Strength Endurance Day (8 rounds)
10 s rest
1. Dumbbell ﬂat bench press
2. Bent-over rows
3. Front squat
4. Deadlift
Endurance Day (6 rounds)
1 min of as many repetitions as possible
10 s rest
1. Stationary bike
2. Treadmill 5% incline
3. Bodyweight squats
4. Jump rope
15
KEITH CHITTENDEN, MS, CSCS, TSAC-F
OVERTRAINING SYNDROME IN THE
TACTICAL ATHLETE
The tactical athlete always needs to be prepared for when duty
calls. Regardless of the specific population, tactical athletes are
expected to complete high levels of training in order to complete
the challenges that the job requires. However, excessive training
can be harmful to the tactical athlete as they prepare for a
mission. Rest and recovery is as vitally important to the tactical
athlete as is training in preparation for deployment.
Excessive aerobic and anaerobic exercise can be commonly
characterized as a condition known as overtraining syndrome
(4). Overtraining syndrome can be the result of large volumes of
exercise bouts (excess of 4 – 6 days a week of aerobic activity and
in excess of several hours a day), or a drastic increase in volume
where the tactical athlete cannot make appropriate adjustments.
A tactical athlete can experience fatigue, mental exhaustion,
decreased testosterone levels, decreased performance, mood
changes, immunity suppression conditions, and increased tissue
trauma resulting in increasing prevalence to injuries as a result of
overtraining syndrome (3). In any type of training, there will be tissue trauma that is sustained
after the workout. When the individual uses adequate rest and
recovery periods between workouts, the tissue trauma will be
repaired and the muscle fibers will adapt to the stress to increase
performance in the activity. If high volume or frequency do not
allow enough recovery time, the tissues will not get enough repair
time and the minor tissue trauma may evolve into a more serious
chronic tissue injury with chronic inflammation (3).
An overuse tissue injury may not be as apparent as an acute
injury from a trauma such as a groin strain or an ankle injury. As
an example, the injury may be undetectable because the trauma
is low intensity and can be ignored because of high tolerance to
pain or the tactical athlete mistaking the sensation as delayed
onset muscle soreness due to consistent training intensity (> 90%
VO2max) (3).
Acute overtraining can cause a condition called exertional
rhabdomyolysis where the muscle suffers from continuous
trauma, which causes the extracellular material such as
myoglobin, potassium, and creatine kinease to be spilled into the
bloodstream. This can cause urine to resemble a dark cola color,
filtration problems to the kidneys, and renal failure (2). Exertional
rhabdomyolysis can be fatal if not treated immediately.
Overtraining syndrome can affect other systems in the body
other than the musculoskeletal system. The hematological system
is affected by overtraining syndrome. Iron deficiency can occur
by hemolysis of the red blood cells carrying iron to maintain
16
hemoglobin to the cells. When iron becomes too low, oxygen
carrying ability of the red blood cells decreases in the form of
hemoglobin deficiency—as a result, the tactical athlete may
become anemic (5). Overtraining syndrome can cause a chronic
systemic inflammatory process (5). Research has shown that
when an athlete overtrains, there is a hyperviscosity in the blood
because of the formation of cytokines causing increases
in the volume of the blood (5). Cytokines are cells in the body
that are released in the presence of inflammation of a tissue
during an injury. When the immune system senses an injury,
cytokines are released to help mediate immune cells to heal
damaged cells. When too many cytokines are released at once or
they are chronically released, they can increase the risk of disease
in the blood (5).
While suffering from overtraining syndrome, the body constantly
releases immune system mediated cells to repair damaged cells.
This chronic release of immune cells contributes to the chronic
fatigue a person feels after intense training and insufficient
recovery time. A common complaint a tactical facilitator may hear
is the feeling of “heavy legs,” which refers to a symptom that is
felt in chronic fatigue syndrome that is often linked to overtraining
syndrome (5). This is a sign of venous insufficiency in which
blood flow is interrupted by value dysfunction in the veins. As a
result, the tactical athlete may have pooling of blood in the lower
extremities due to an increased viscosity (thickness) of blood that
is trapped in the lower extremity (5).
Overtraining can also cause mood swings and changes in
demeanor. For example, an individual that is usually an upbeat,
enthusiastic person may become withdrawn, depressed, antisocial,
have a loss of appetite, and even display aggressive behavior
toward other people (3). Overtraining can cause a decrease in
hormone production resulting from a decline of secretions from
the hypothalamus gland, which can affect mood and depression
(3). Another result from overtraining syndrome is a compromised
immune system known as immune system suppression. If the
tactical athlete is chronically fatigued and exhausted, the function
of the immune system to fend off viruses and bacteria (humeral
immunity) can be compromised and lead the tactical athlete to be
more susceptible to illnesses and colds (3).
Another cause of overtraining syndrome can come from peers
of the tactical athlete. Competition among tactical athletes can
negatively influence them to participate in multiple sports or
activities simultaneously while training for upcoming missions.
This takes away time off and adequate rest after operations (1). If
the tactical athlete competes and trains at higher intensities, the
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OVERTRAINING VERY
SYNDROME
IN THE TACTICAL
ATHLETE
risk the tactical athlete will succumb to overtraining syndrome
increases. Considering the age of the tactical athlete, the
symptoms may not be obvious as intensity and duration of the
training will increase to satisfy the demands of coaches and the
ability to compete (1). The symptoms that commonly appear
are mood change, decreased performance in the sport, mental
exhaustion, feelings of burning out, and higher frequency of
injuries (1).
One efficient way to decrease overtraining is to use periodization
in training. Periodization allows the tactical athlete to schedule
different intensities over a period of a year. It will also allow for an
off-season or a recovery cycle to be factored in so that the tactical
athlete will have adequate rest time (1).
REFERENCES
1. Claps, F. Exertional rhabdomyolysis. Strength and
Conditioning Journal 27(3): 73-75, 2005.
4. Smith, LL. Tissue trauma: The underlying cause of overtraining
syndrome? Journal of Strength and Conditioning Research 18(1):
185-193, 2004.
5. Varlet-Marie, E, Maso, F, Lac, G, and Brun, J. Hemorheological
disturbances in the overtraining syndrome. Clinical Hemorheology
and Microcirculation 30: 211-218, 2004.
ABOUT THE AUTHOR
Keith Chittenden is currently a Certified Strength and Conditioning
Specialist® (CSCS®) and a Tactical Strength and Conditioning
Facilitator (TSAC-F). He holds a Master’s degree in Exercise Science
from the California University of Pennsylvania, and is currently a
doctor of physical therapy student at the University of Hartford.
Chittenden has over 12 years of experience with performance
enhancement and post-rehabilitation for athletes of multiple
sports, police officers, and military personnel.
2. Kutz, M, and Seacrest, M. Contributing factors to overtraining
in the adolescent multi-season/sport athlete. Strength and
Conditioning Journal 31(3): 37-41, 2009.
3. Rheba, E, and Symonds, LM. Correlations between injury,
training intensity, and physical and mental exhaustion among
college athletes. Journal of Strength and Conditioning Research 24
(3): 587-596, 2010.
NATIONAL’14
37TH ANNUAL NSCA NATIONAL CONFERENCE AND EXHIBITION
JULY329
NSCA’S TSAC REPORT | ISSUE
– 12, 2014 | LAS VEGAS | NSCA.COM/NATCON14 17
EXTREME EXERCISE FOR MENTAL TOUGHNESS
AND SELECTION: EFFECTIVE TRAINING OR
ERRANT BULLYING? PART I
The opinions expressed in this article are those of the authors and
do not necessarily represent the policies or procedures of any
affiliated organizations.
A major focus in many tactical performance circles is to develop
programs to assure that tactical athletes make it to the “next
level” in their careers. However, a practice widely seen in some
of these programs is to make the training so intense or punishing
that it will leave these elite tactical athletes pushed to the point
of exhaustion, wondering if they will survive the next two minutes
without vomiting and pondering the thought that they may have
developed exertional rhabdomyolysis.
The individuals who create these workouts often justify them by
simply adding two words “mental toughness.” However, coaching
that rationalization as mental toughness training begs two
questions: Is this wise and effective physical training? And, does
it really train mental toughness? The answer is no on both counts.
Individuals who think “puke training” is mental toughness training
are like those who misunderstand the warrior as an aggressive
killing machine rather than a skilled and dedicated servant of
his/her country, community, and family. As a retired Navy SEAL,
Richard Machowicz, wrote in his book, “Being a warrior is not
about the act of fighting. It’s about being so prepared to face a
challenge and believing so strongly in the cause you are fighting
for that you refuse to quit,” (5).
A man way before his time and a true pioneer to the strength and
conditioning community, Dr. Mel Siff, once stated that “any fool
can create a program that is so demanding that it would virtually
kill the toughest marine or hardiest of elite athletes, but not any
fool can create a tough program that produces progress without
unnecessary pain,” (6). There should be full agreement with this
philosophy, however, there are often counterarguments from
those who foster the belief of mental toughness rationalization
first mentioned. Common, but misguided, are comments such as,
“If I don’t push to the edge, how am I supposed to get mentally
tough,” “I’m training for selection into…,” “I have to prepare for the
unknown,” and, of course, “you need to train for the worst case
scenario.”
In reality, these are not counterarguments but rather supplements
and validations of Dr. Siff’s quote. Training mental toughness is
essential, but proper implementation is the critical qualifier. Direct
or explicit mental toughness skills training will prepare for the
“tough” days and extreme challenges.
18
A human performance system can be defined as a coordinated
body of methods forming a complex or singular whole (speed/
power, strength, endurance, energy system development,
prehabilitation/rehabilitation, and mental skills). A method is a
procedure, a technique, or a way of doing something (i.e., circuit
training). It requires the integration of physical and mental training
approaches, not the assumption that one will automatically create
the other.
It is widely accepted that mental toughness is needed for tactical
settings (during selection or in battle), sports (making big plays
or game winning plays), stressful situations, high-stress leadership
roles, and/or the “curve balls” of everyday life. Some believe
mental toughness is something an individual is born with while
others believe it is something that evolves naturally over the
course of a life because of hard work. Some people think it is a
natural side effect of grueling physical training and others find
it hard to pinpoint what is actually meant when using the term
“mental toughness.” Is it the ability to grind through lifting heavy
things, crushing an extremely hard circuit, or going toe-to-toe with
life or death situations?
While there is no doubt that there is a physical and genetic basis
to mental toughness, a premature narrow insistence on these
components significantly overlooks the full nature of mental
toughness and the fact that it can be trained. Mental toughness
has been defined by Michael Asken in the book “MindSighting:
Mental Toughness Skills for Police Officers in High Stress
Situations” in a manner that breaks it down and shows why it is a
set of skills that can be trained:
Mental toughness is possessing, understanding, and being able
to utilize a set of psychological skills that allow the effective,
and even maximal execution, or adaptation, and persistence of
decision-making and physical skills learned in training and by
experience. Mental toughness expresses itself every day, as well
as in high stress, critical situations (2).
According to Asken, properly implemented mental toughness
training will incorporate at least five key skills (1):
1. Arousal control: Goal of controlling arousal and energy to
maximize the “O-ZONE” (optimal zone of natural excellence)
preventing or managing reaction of high stress (upregulation
is increasing arousal and downregulation is inducing a more
relaxed state)
EXTREME EXERCISE FOR MENTAL TOUGHNESS AND SELECTION:
EFFECTIVE TRAINING OR ERRANT BULLYING? PART I
a. Examples of upregulation: Cue words, cue images,
attentional focus, music, etc.
b. Examples of downregulation: Tactical breathing, tactical
muscle relaxation, biofeedback, relaxation imagery, yoga and
meditation, etc.
c. Benefits: Controls physiology and psychology of stress,
maximizes focus, increases response readiness, reduces
mission anxiety, reduces “brain-lock,” enhances stress
resistance, and conserves energy
2. Concentration skills: The ability to concentrate and focus for
responding effectively in high-stress situations
a. Examples: Internal (form and skill) and external
(performance effect) focus, locus of focus (location of focus),
ambient, selective attention, etc.
b. Benefits: Enhances performance, decreases overreactions,
decreases reaction time, and maximizes situational awareness
3. Performance imagery: Mental rehearsal and anticipation of
involvement in any situation
a. Examples: Use of multi-sensory images, use of effective
perspective, and PETTLEP (physical, environment, task,
timing, learning, emotion, and perspective)
b. Benefits: Improves decision making, aids analyzing and
correcting errors, enhances confidence, reduces surprises, and
produces emotional control
4. Self-talk: Internal talking to self, the “inner voice,” as a
performance-related tool
a. Examples: Monitoring of internal dialogue, use of STEP UP
(self-talk for enhanced performance under pressure), short
cues, negative thought stopping, affirmations, etc.
b. Benefits: Encouraging self, encouraging others, avoiding
negative thinking, promoting proper focus, priming needed
responses, focusing attention on actions and skills, and
facilitating positive reinforcement
5. Goal setting: Developing and putting objectives, check points,
and an end point in place
a. Examples: Setting long-term and short-term goals and
setting time or distance goals
b. Benefits: Builds confidence, demonstrates progress,
maintains motivation, guides decision making, and creates
responsibility and accountability
The mental training skills allude to the abuse that occurs with the
coaches who confuse “selection into” or “screening out of” with
the actual physical and mental training of selection. Assuming
health and ethical considerations are met, there is a rationale to
putting applicants through grueling challenges or tests to push
their limits in order to assess what those limits are, what their
current status is, and to rank applicants in their pre-training—but
that is not training.
It is also appropriate, beneficial, and essential to make final testing
(and appropriate interim points) prior to selection as extremely
challenging or tortuous as necessary to simulate missions that will
occur. However, that supposes that selectees have already been
prepared, both mentally (by teaching mental skills, not assuming
they developed them because training was physically tough)
and physically. It is the job of tactical facilitators to implement
human performance systems that train mental toughness skills
and develop energy systems so that the tactical athletes have an
integrated platform to perform their technical tactical skills.
Mental toughness should be considered a combination of attitudes
and skills. Perhaps it is ultimately skill, as skill allows success via
execution, which in turn reinforces confidence and skills, such
as, self-talk or imagery of success (4). This reinforcement can
influence attitudes as well (4). The tactical athlete should develop
a performance platform through a well-rounded strength and
conditioning system with proper methods. They should not use the
method of puke training or “crushing” the athlete with poor form
as it may increase the chance of injury and deplete the central
nervous system on a daily basis.
When preparing a tactical athlete for selection into general or
specialized positions and assignments, tactical facilitators need
to be methodical and know when to increase intensity (load and/
or volume). Tactical facilitators should avoid applying random
exercises and sessions with the hope that they will somehow work,
overloading the central nervous system.
In addition, tactical facilitators should avoid starting at 100% effort
in order to evaluate how long it takes for a tactical athlete to
“break down.” For example, when first teaching a squat, tactical
facilitators should not load the bar with 100 kg and hope the
tactical athlete can perform the movement. They should first teach
the movement of the lift and then increase the load as can be
handled by the tactical athlete. The goal is not to beat the tactical
athlete into the ground until the day of selection and hope that
they have gained the mental toughness skills, physical platform,
and ability to recover sufficiently to sustain the selection process.
We should all be aware of the age-old saying that Hippocrates
was famous for, “above all, do no harm.” If we wish to abide by
Hippocrates’ wisdom, we need to develop a platform for strength,
power, energy systems, prevention, and management of injuries
with rehabilitation/prehabilitation, and mental toughness skills to
19
optimize the tactical athlete’s chance of success. The mind and
the body are very much integrated and we need to train that way.
Incorporating the five mental toughness skills of arousal control,
concentration, goal setting, performance imagery, and self-talk
is essential to this success. Developing the five mental toughness
skills proposed by Asken within a human performance system may
assist the tactical athlete with the selection and post-selection
process (1).
Retired Army Ranger Lieutenant Colonel Dave Grossman is correct
in emphasizing that in high stress and critical situations “we don’t
rise to the occasion; we sink to our level of training,” (3). Tactical
facilitators have an obligation and need to ensure that the training
they provide is not just mindless or rationalized bullying, but it is a
comprehensive, integrated, and scientifically sound methodology.
Part two of this series will discuss the actual implementation of
Asken’s five mental toughness skills, and where they can be placed
within a human performance system.
REFERENCES
1. Asken, M, Grossman, D, and Christensen, L. Warrior Mindset.
Millstadt, IL: Human Factor Research Group; 94-214, 2010.
2. Asken, M. MindSighting: Mental Toughness Skills for Police
Officers in High Stress Situations. Camp Hill, PA: MindSighting,
2005.
3. Grossman, D. On Combat. Retrieved October 11, 2013 from
http://www.killology.com/on_combat_ch2.htm.
4. Gruber, K., Kilcullen, R, and Iso-Ahola, S. Effects of
psychosocial resources on elite soldiers’ completion of a
demanding military selection program. Military Psychology 21: 427444, 2009.
ABOUT THE AUTHORS
Tyler Christiansen is a veteran soldier currently working as a Human
Performance Specialist with the U.S. Army 7th Special Forces
Group. Christiansen has worked with various tactical athletes as
a Human Performance Specialist for Athletes’ Performance in the
Special Operations Forces community, as the Tactical Strength
and Conditioning (TSAC) Coordinator at the National Strength and
Conditioning Association (NSCA), as an Exercise Physiologist at
the Army Physical Fitness Research Institute, and as a contractor
in Baghdad, Iraq. Additionally, he has worked with sport athletes
at Iowa State University, Illinois State University, and the Colorado
Rockies Major League Baseball (MLB) organization.
Mike Asken is a psychologist for the Pennsylvania State Police
(PSP). In that capacity he works with the PSP’s Special Emergency
Response Team (SERT) and Tactical and Negotiation Teams.
In addition to providing psychological evaluations for cadet
candidates and troopers, Asken teaches at the Pennsylvania
State Police Academy and works with performance issues. He has
presented training strategies to various organizations including
the National Tactical Officers Association (NTOA), the New
England Crisis Negotiator’s Association (NECNA), the Memphis
Police Department, and the Federal Bureau of Investigation
(FBI), to name a few. Asken has written several articles that have
appeared in esteemed journals and has authored the books
“MindSighting: Mental Toughness Skills for Police Officers in High
Stress Situations,” and “Emotional Intel: Mental Toughness Skills for
Optimal Response in High Stress Crisis Negotiations.” He was also a
co-author for the books “Going Deep: Psychoemotional Stress and
Survival in Undercover Policing,” and “Warrior MindSet.”
5. Machowicz, R. Unleash the Warrior Within. New York, NY:
Marlowe; 15, 2002.
6. Siff, M, and Verkhoshansky, Y. Supertraining. (6th ed.) Denver,
CO: Supertraining International; 1999.
20
2014 EVENTS
TSAC CONFERENCE
APRIL 15 – 17 | SAN DIEGO, CA
MOVEMENT PERFORMANCE CLINIC
MAY 2 – 3 | COLORADO SPRINGS, CO
TRAINING FOR HOCKEY CLINIC
JUNE 6 – 7 | COLORADO SPRINGS, CO
NSCA NATIONAL CONFERENCE
JULY 9 – 12 | LAS VEGAS, NV
21
A common problem faced by the military is that many soldiers
are required to meet specific bodyweight requirements as part of
their physical and fitness standards. Unlike civilian counterparts,
the inability to make bodyweight standards for soldiers can lead
to disciplinary action such as reductions in rank or even discharge
from the service. Due to these adverse actions, many different
tactics are used by soldiers to help maintain or lower bodyweight.
While some soldiers will increase their exercise and watch their
diet, others may try fad diets or equipment touted to help people
lose weight quickly.
One such approach to facilitate rapid weight loss is the wearing
of outfits designed to make the soldier sweat excessively. Many
soldiers do not see the act of losing large amounts of water weight
quickly or raising internal body temperature to high levels as
risky. A possible reason for this misconception may be due to the
approach taken by the companies selling these devices who claim
their products are “therapeutic,” “healthy,” and “help you safely
lose weight fast.” Before donning a sauna suit and putting the
body through the risks that come with these approaches, it would
be useful to take a look at how the body cools itself and what
happens when substantial amounts of water and minerals are lost.
Four external mechanisms that can affect body temperature are
radiation, conduction, convection, and evaporation. Radiation is
the transfer of heat between objects through electromagnetic
waves with the hotter object passing heat to the cooler object.
An example of radiation would be the heat transferred from a
hot road to an individual. Temperature can also be influenced by
conduction, which is when an outside substance transfers heat
during physical contact of the objects. Water provides a good
example as cold water draws heat away from the body while hot
water transfers heat to the body. Convection is defined as the
transfer of heat from one place to another by the motion of a
heated substance and can be explained by wind blowing across
an object to cool or heat it up depending on the temperature of
the wind. Evaporation occurs when water, which is cooler than the
object it is in contact with, draws heat away from the object. When
the water gains enough heat it is converted from a liquid to a gas.
The human body uses different ways to regulate internal
temperature for heat buildup. Circulation and respiration provide
two examples. As the internal temperature of the body increases,
circulating blood is shunted outward to superficial blood vessels.
Considering this, during exercise the primary means of heat
loss is through evaporation, whereby internal water is excreted
through millions of sweat glands located in the skin. By sweating
water to the surface of the skin, evaporation can occur which
will bring temperature down through evaporation. Respiration
provides another means of heat transfer through evaporation by
22
dispelling heated air when breathing out. When all of these ways
are combined, the human body can be efficient at reducing rising
internal heat (11).
By controlling heat through circulation, and respiration, humans
are able to sustain high levels of physical activity for long
durations. Other mammals can only perform short bursts of heavy
physical activity before resting because they primarily reduce heat
through respiration alone. Humans discovered long ago that if they
kept chasing animals that were much faster at a steady pace, the
long distance would not allow the animals to rest enough to cool
off though panting alone. Eventually the animal would develop
heat exhaustion and be unable to continue running. Once heat
exhaustion occurred, the human was then able to catch the faster
animal. This begs the question: why wear a suit that is designed to
stop one of our greatest assets during physical performance?
Research has shown that uniforms worn by football players (e.g.,
football pads, a helmet, jersey uniform, and a tee-shirt) can greatly
influence core temperatures as they block the surface area used
to dissipate internal heat (2,12). Because deaths from overheating
have occurred to football players, many modifications have been
made to make their uniforms as porous as possible in order to help
reduce this hazard (2,12). While these studies used football players
as examples, the same dangers of overheating could be applied to
tactical athletes wearing outfits, such as body armor or protective
vests, which are specifically designed not to let any air in or out
(3,4).
It is estimated that most people lose 1 – 2 L of water in sweat in
one hour of heavy exercise (about 2% of bodyweight), but the
body can only absorb 1 L an hour of water consumed (8,11). So,
to wear gear which forces the body to sweat even more water
than normal is a recipe for disaster as an individual cannot
ingest sufficient water to replace what is lost in such a scenario.
Furthermore, as water is excreted sodium, chloride, potassium,
and magnesium, are also lost. These minerals are needed to
ensure the muscles work properly. As the body overheats and
loses water, it also loses sodium and potassium which can result
in hypernatremia whereby muscles begin to fail. It is worth
reiterating the fact that the human heart is a muscle. With water
weight losses of 4 – 5% of bodyweight, significant impairment of
physical and psychological functions can lead to heart palpitations
or worse (1,9,15).
For each 1 L of fluid lost the heart will increase its beats by
approximately 8 beats per min, but in the process it will lose 1 L of
cardiac output (oxygen getting to tissue) (11). In other words, as
water is lost, the heart tries to work harder by beating faster while
it loses its ability to transport oxygenated blood to the tissue.
As mentioned above, 1 – 2 L is a normal loss of fluid for an hour
of hard exercise, so 2 L of lost cardiac output would be typically
experienced by most athletes exercising hard for an hour (5,7,13).
Wearing gear designed to make the body sweat more can severely
increase this loss of water, minerals, and the ability to use oxygen.
equipment used by this patron has to be cleaned prior to letting
other patrons use it. Even in the locker room, wearing waterproof
attire will cause sweat to pool up and it will fall as they take it off,
again presenting a health hazard.
When a tactical athlete loses a lot of water, it does not make the
tactical athlete lose body fat also. The tactical athlete will only lose
water weight for a short period of time before it is replenished by
eating and drinking after the exercise. For example, fighters who
lose 15 – 30 lb for a weigh-in the day before a fight can regain
most of this weight to get to their true fighting weight on the
day of the fight. Some may argue that replenishing the water and
minerals lost will require more calories to be expended to replace
them, but that is like saying an injury requires more calories
because the body has to repair itself; tactical athletes should not
hurt themselves simply to lose a few pounds of weight.
As a final point, for those who think that wearing a sauna suit will
release toxins and viruses from their body, this simply is not the
case. An infection can use the body’s sweat as a vehicle to move
from one area to another, but sweating it all out will not get rid
of the infection entirely. While not proving to be very effective at
removing toxins, using a sauna suit while sick will just increase the
likelihood of spreading the illness to others.
The last point to consider is if a person wearing clothes designed
to make them sweat should be allowed to use equipment that will
also be used by others. If it is normal to sweat around 1 – 2 L an
hour with heavy exercise when not wearing air tight clothes, then
a person in a sauna suit will sweat even more. The question then
becomes, where is all the sweat going? Sweat will be dripping
onto equipment and onto the floor, which will become a safety
and health hazard. People can slip and fall on a wet spot and
sweat can cause cross contamination infections such as MethicillinResistant Staphylococcus Aureus (MRSA) which can survive on
surfaces and transmit to others by sweat (6,10,14). This means
The wearing of attire designed to overheat the body or to increase
sweat is not recommended as a training method. Tactical athletes
using sauna suits in the hopes of losing weight or sweating out
an illness are putting themselves in danger. For those in the
military who are desperate for a shortcut to maintain or make their
bodyweight standards, sauna suits and air-restrictive clothing are
not considered a safe option. Tactical facilitators should foster
a forward reaching program to assist those soldiers concerned
with meeting bodyweight requirements prior to forecasted
assessments.
23
REFERENCES
1. Anastasiou, CA, Kavouras, SA, Arnaoutis, G, Gioxari, A, Kollia,
M, Botoula, E, and Sidossis, L. Sodium replacement and plasma
sodium drop during exercise in the heat when fluid intake matches
fluid loss. J Athl Train 44(2): 117-123, 2009.
2. Armstrong, LE, Johnson, EC, Casa, DJ, Ganio, MS, McDermott,
BP, Yamamoto, LM, Lopez, RM, and Emmanuel, H. The American
football uniform: Uncompensable heat stress and hyperthermic
exhaustion. J Athl Train 45(2): 117-127, 2010.
3. Cadarette, BS, Blanchard, L, Staab, JE, Kolka, MA, and Sawka,
MN. Heat stress when wearing body armor. U.S. Army Research
Institute of Environmental Medicine. Natick, MA; 2001.
4. Cheuvront, SN, Goodman, DA, Kenefick, RW, Montain, SJ,
and Sawka, MN. Impact of a protective vest and spacer garment
on exercise-heat strain. European Journal of Applied Physiology
102(5): 577-583, 2008.
5. Cheuvront, SN, Kenefick, RW, Montain, SJ, and Sawka, MN.
Mechanisms of aerobic performance impairment with heat stress
and dehydration. J Appl Physiol 109(6): 1989-1995, 2010.
6. Fritz, SA, Long, M, Gaebelein, CJ, Martin, MS, Hogan, PG, and
Yetter, J. Practices and procedures to prevent the transmission of
skin and soft tissue infections in high school athletes. J Sch Nurs
28(5): 389-396, 2012.
7. González-Alonso, J, Mora-Rodríguez, R, Below, PR, and Coyle,
EF. Dehydration markedly impairs cardiovascular function in
hyperthermic endurance athletes during exercise. J Appl Physiol
82(4): 1229-1236, 1997.
13. Stöhr, EJ, González-Alonso, J, Pearson, J, Low, DA, Ali, L,
Barker, H, and Shave, R. Dehydration reduces left ventricular filling
at rest and during exercise independent of twist mechanics. J Appl
Physiol 111(3): 891-897, 2011.
14. Waninger, KN, Rooney, TP, Miller, JE, Berberian, J, Fujimoto,
A, and Buttaro, BA. Community-associated methicillin-resistant
Staphylococcus aureus survival on artificial turf substrates. Med Sci
Sports Exerc 43(5): 779-784, 2011.
15. Wilson, G, Hawken, MB, Poole, I, Sparks, A, Bennett, S, Drust,
B, Morton, J, and Close, GL. Rapid weight-loss impairs simulated
riding performance and strength in jockeys: Implications for
making weight. Published ahead of print. J Sports Sci, Sep 9, 2013.
ABOUT THE AUTHOR
Patrick Conway works as an Exercise Physiologist with the U.S.
Air Force. One of his duties is to create fitness programs for
injured military members seen by Air Force medical providers.
Conway teaches and certifies approximately 400 military
members as physical training leaders per year. He also conducts
running clinics with motion analysis (Dartfish) and Functional
Movement Screenings (FMS) for military and civilians on the base.
He is certified with FMS and TRX systems, as well as a certified
Emergency Medical Technician (EMT) and a Level 1 Firefighter
(FF-1). Prior to the Air Force and college, Conway worked at the
Tonopah Test Range as a member of the Special Weapons and
Tactics (SWAT) special response team.
8. Goulet, ED, Rousseau, SF, Lamboley, CR, Plante, GE, and
Dionne, IJ. Pre-exercise hyperhydration delays dehydration and
improves endurance capacity during 2 h of cycling in a temperate
climate. J Physiol Anthropol 27(5): 263-271, 2008.
9. Laursen, PB, Watson, G, Abbiss, CR, Wall, BA, and Nosaka, K.
Hyperthermic fatigue precedes a rapid reduction in serum sodium
in an ironman triathlete: A case report. Int J Sports Physiol Perform
4(4): 533-537, 2009.
10. Leamer, NK, Clemmons, NS, Jordan, NN, and Pacha, LA.
Update: Community-acquired methicillin-resistant Staphylococcus
aureus skin and soft tissue infection surveillance among active
duty military personnel at Fort Benning, GA, 2008-2010. Mil Med
178(8): 914-920, 2013.
11. McArdle, WD, Katch, FI, and Katch, VL. Exercise Physiology:
Energy, Nutrition, and Human Performance (5th ed.) Philadelphia,
PA: Lippincott Williams and Wilkins; 74-77, 97-98, 623-647, 2001.
12. McCullough, EA, and Kenney, WL. Thermal insulation and
evaporative resistance of football uniforms. Med Sci Sports Exerc
35(5): 832-837, 2003.
24
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tsac report issue 32 - National Strength and Conditioning Association

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