Injury Update 2

Alright, I put some weight on my arms a few minutes ago to see how they felt and the soreness is coming back pretty quick.  I'm frustrated that it's taking so long to heal. I'll keep you updated.

Injury Update

My elbows feel much better already. I'm going to take another couple of days just to be safe before getting back to weights, but I'm encouraged at the improvement from yesterday to today. I'll be in the gym this evening to do some SSRC, or sustained steady-rate cardio, for about an hour. I'd do some HIIT, but I prefer doing that on the erg (rowing machine) because of my foot injury, so I'm going to hold off on HIIT until my arms are healed up too.

Explanation For Absence

Hi All,

I've been dealing with a tendonitis flare-up in my elbows (tennis elbow) the past 10 days or so, which is why I've been mostly taking it easy. I need to let the joint heal some before I get back in the gym, although I'll continue with cardio work. No sense letting myself go completely while I'm out. I anticipate being back on weights in the next week or so. Just need to make sure I'm being smart about my body.

Best,

Marcus

Tennis Elbow: Can I Lift Weights?

What Is Tennis Elbow?

The Injury:

I've had minor issues with my right elbow off and on for the past several years. I always assumed it was a minor hyper-extension, because it usually only gave me trouble when I was playing basketball. If I warmed up well, I rarely felt pain. Shooting hoops is probably the origin of the injury, as I spent several hours each day playing basketball years ago. It was really all I did.

In recent months, I'd have small amounts of swelling and pain in my elbows, especially my right elbow, while doing triceps lifts. It came on feeling like tightness or tension in my lower triceps, where it reaches the elbow. After lifting, it would be sore for a day or two and I'd be good for the next week. It was never bad enough that I thought something was wrong, just irksome. 

About 10 days ago, however, I did a pretty beast triceps workout where I maxed out the pushdown machine for reps and then did 110lbs on skull-crushers. My elbow felt pretty tight afterwards and, as usual, I thought nothing of it.

A few days later, on Chest & Biceps day, I tried to do my first lift, decline bench press, and couldn't perform my working set safely. The tightness was still there and it was severe enough to feel like I should stop after my first rep. So I listened to my body and stopped, telling myself I'd take a couple days to heal up.

It's now been over a week and I still have soreness while at rest. I can't very well give up lifting, because I'd sacrifice all the progress I've made these past several months. Yet, I need to give my elbows time to heal and figure out how to prevent future problems.

Research Findings:

Since I'm a little nerdy about these types of things, I did a significant amount of research this past week to figure out what's going on with my elbows and how I should treat them moving forward. Currently, I don't have health insurance, so it's important that I treat my body well and problem-solve on my own as best I can.

I started with a symptom-check. I had soreness in my elbow, where the triceps meets the elbow. The hard spot on my elbow was sore when it rested on objects. The pain was exacerbated by elbow flexion and extension.  I couldn't feel any swelling where I felt tight, which was a little surprise. Continued activity made it feel worse and rest made it feel better.

My knee-jerk instinct told me that I had tendonitis in my elbow, which makes sense since it's an overuse injury that is exacerbated by the types of activity I've been engaging in. So I looked it up to confirm. Tendonitis in the elbow is called "Tennis Elbow," because it's common amongst tennis players. The giveaway was that I didn't have any swelling, which typically indicates tennis elbow, rather than something else like a tear or arthritis.

As I researched it, I find a couple of interesting things that convinced me my guess was accurate. For example, the triceps exercises that brought on the pain were all lifts that require wrist stabilization; in this case, triceps push-downs and skull-crushers. Both require a really strong grip and stabilization of the wrist to be performed properly, which is why they are the lifts that have been giving me the most trouble over these past several months. Other lifts like bench presses didn't typically cause any trouble, because I didn't have to flex my wrist. Typically, pain is more severe in lifts where my palm is flexed downward, a classic tennis elbow symptom.

Also, the lack of swelling and location of the pain is atypical for bursitis, so I ruled that out. Bursitis is one of the conditions that's most often mistaken for tennis elbow. 

Finally, tennis elbow is more common amongst people with rotator cuff issues, which I've had problems with for years now. It all made sense.

What Is Tennis Elbow?

Tennis Elbow is tendonitis in the elbow. In short, it's an inflammation of the elbow tendons caused by micro-tears on the tendon that connects the muscle to the bone. There is little consensus about the initial cause, since a majority of cases are overuse, but some cases are brought on suddenly through excessive exertion.

When To Visit The Doctor

It's advised that you seek medical attention if pain becomes severe enough to limit daily activities, persists with rest, or causes numbness or weakness in the hand. Since I have none of these issues and am confident in my self-diagnosis, I'll move forward by examining the treatment strategies. 

Treating Tennis Elbow

How Is Tennis Elbow Treated?

Tennis Elbow is typically treated with rest, ice, anti-inflammatory drugs, and progressive strengthening exercises (once the acute symptoms subside).

Elbow straps and topical anti-inflammatory medications can also help with the symptoms.

Can I Lift Weights With Tennis Elbow?

It seems to be ubiquitously agreed that you should rest until the acute pain subsides, but that does not mean sustained rest will improve your symptoms. On the contrary, excessive immobilization makes the condition worse for most people.

My research indicated that once you start to feel like you can lift again, to start with light weights and make sure your form is perfect. Progressively add weight without sacrificing your form. If you ever feel like you're aggravating the injury, stop what you're doing immediately.

These are all pretty commonsensical notions, so I don't think they require further explanation.

My Lifting Strategy

While I'm dealing with this, I'm going to back off my high-intensity training program and fall into a maintenance/general health phase. I need to stay healthy more than I need to get stronger or bigger. The one thing that will destroy my size and strength gains is an extended break because of injury.

I'm going to avoid lifts that require too much forearm or elbow extension. So my triceps work is going to be mixed up somewhat, in addition to my chest workouts. I figure I'll focus on flies and perhaps dumbbell presses if they aren't painful. Since decline bench gave me some trouble, I am going to avoid barbell presses for the time being.

I'm also going to drop biceps and triceps lifts from my workout for now. They'll get plenty of work during back, chest, and shoulder exercises. Typical arm workouts are highlighted as some of the most aggravating for tennis elbow, so I'll avoid them until I'm healthy.

In their stead, I'll add some forearm exercises (when the acute symptoms) are gone, to try and prevent further injuries. I'll also increase my focus on my scapular muscles and rotator cuffs.

I'm going to take a couple more days off to let my body heal, then I'll get back to it. Wish me luck!

Workout Log 9/18-9/19: Cardio Days

Cardio Days

9/18/12: Attempted Chest & Biceps

Cardio:

On Wednesday I went into the gym with the intent to do my Chest & Biceps day, moving me closer to "back on schedule." It turned out to be really silly. I did a 10min warmup on the treadmill before doing my rotator cuff lifts, then had to wait for the decline bench press.

The guy on the decline bench was the definition of a "pacer," or someone who paces him/herself during workouts so they can perform maximal reps with the minimum of effort. Unless you're going for absolute strength gains, pacing is a really poor habit...and one that pisses off everyone else in the gym. Most people are trying to tone, lose body fat, or build muscle. For each of these goals, shorter rest periods are better. Specifically, research has shown that about 1min rest between sets is optimal.

In any case, while waiting I just used a recumbent bike, thinking it would help my legs recover a bit from the day before when I hit them pretty hard. I think it worked somewhat, as my legs don't feel so bad today as I expected. In total, I did 20 minutes of cardio at a moderate pace. Nothing crazy, but my heart rate was over 140 for that duration, so it was something.

The Importance of Rest:

When the decline bench opened up, I set it up at the weights I used last time. My first warmup set was 155lbs for 10 reps. It was WAY harder than it should have been, which made me nervous. I figured it was possible I just needed the warmup, so I added weight for my next warmup set of 175. I only did 9 reps at 175. My elbows, biceps, and triceps all felt really tight at this point, so I decided I should take the rest days as recommended in the program after the end of the "work week."

Notes:

Not sure if my triceps and elbows are going to be an ongoing problem or not. They seem to get inflamed on Delts & Triceps days. All three of the triceps workouts on that day cause tension and swelling in the top part of my elbow, where it meets the triceps muscle. I need to figure this out right away. I can decrease weight on triceps exercises, but I don't want to sacrifice muscle development. Better than getting hurt or not being able to perform other exercises, though. I think that's what I'll do next week, drop weight and see if that helps at all. I'll also move my pushdowns to the back of the workout because I maxed that machine out. Should help out a good deal I think.

9/19/12:

Cardio: 

Decided to take my rest days, so I just did 20 minutes of cardio on the stair-stepper. I went pretty fast and kept my heart rate around 150bpm the whole time, so I called it good after that. My legs were still pretty sore. I'll be building up to longer sessions though as I get back into good "cardio shape."

 

 

Workout Log 9-17-12: Legs

Legs Day

My Workout: 

 

Workout Notes:

Today's workout was INCREDIBLY difficult, in spite of all the red marks ;) 

My weight was down a couple pounds, which was good to see as I got there, but I also felt a little "off" before my workout. Not entirely sure what it was, since I ate pretty normally and drank a ton of water that day. If it happens again, I'll try to figure out what the cause was. 

I started with a little rowing to warm up, then did some dynamic stretching for my lower-back and legs. Leg extensions were probably the only workout that went correctly for me today. I gauged my weight just right to get my working set into the right rep-range. 

Leg press presented a challenge, since the leg press machine at my gym only goes up to 1000lbs. As you can see, I did 15 reps at 1000lbs, so I was well outside the ideal rep range. I'm either going to have to start going to the other gym on leg days or increase the difficulty in another way, possibly by going below parallel or slowing my reps down. But I definitely need to be able to make this lift more difficult. I may also move it to the back of the quadriceps section, which should decrease my strength some on the lift. Next week I'll probably just try to go lower and slower. Then make additional changes when necessary.

Hack squats were challenging as well, but in a different way. I feel like my knees are going to pop when I hit the right depth. It's awkward using a hack squat machine because I don't feel like I can get my feet out in front of me far enough to prevent my knees from poking out over my toes, which is probably why my knees feel like they want to explode as I approach parallel. I'm either going to decrease weight next week and try to go deeper, or find a replacement exercise that I can practice good form with. I do like the concept of using a machine for squats when lifting heavy because you don't need to worry about supporting muscles as much. Perhaps the other gym's hack squat station has a longer platform? I'll check it out. 

Leg curls made it readily apparent that my hamstrings are getting significantly stronger week-over-week. Not only did I increase weight by 20lbs, but I did an extra rep. I'll have to jump up another 20lbs or so next week and hopefully I'll land in the right rep-range. 

I had the same problem on stiff-legged deadlifts as with leg curls, they were a bit too easy. I'll increase weight next week by about 10lbs. 

Calf presses were much easier this week in spite of the massive weight increase. I figured that would happen since my calves have been under-worked recently. They have always been an "overdeveloped" muscle relative to the rest of my body, so I haven't spent much time on them this past year. My rest-pause set was pretty high-rep, so I can still increase weight next week. I was pretty close on the seated calf raise though, so maybe only a 20lb increase there next week.

Workout Log 9-16-12: Delts/Tris

Deltoids & Triceps Day

My Workout: 

Workout Notes: 

This workout was really good. I increased weight or reps on every lift except for seated triceps press and side lateral raise. That means I'm still seeing good strength gains from this workout, which should indicate muscle growth as well given that my weight loss has been very gradual.

A couple of things that this workout has brought to attention is the fact that on certain lifts I can't perpetually increase weight. The only one where that will be a significant challenge in this particular workout is the triceps pushdown, which I maxed out for 10 reps. I may only be able to do 10 reps to exhaustion next week, but a week or two after and I'll be adding reps instead of weight. So I need to figure something out here. Maybe find a comparable exercise or find a way to add difficulty. I'll let you know what I decide to do. Let me know if you have any ideas.

Also, I have come a bit off schedule because of things in life. I'll gradually get back on schedule by nixing a rest day here or there, but it'll be at least a week before workout days correspond to the right day of week. I'm not going to cut out a workout to get back on schedule. So today is leg day and tomorrow I'll do chest/biceps.

I also haven't been keeping track of my diet lately, which is silly. No program is complete without accurate diet recording. I've not been eating too much calorie-wise, but some of my food choices haven't been "clean," so I'm going to get back into recording diet. This is both scientifically significant and helpful for accountability. 

I also have been doing research about what my next program will be after this one. I am pretty excited to try it out, but all I'm going to say about it now is that I'm glad I started with this program!

Workout Log 9-13-12: Back

Back Day

My Workout

Workout Notes: 

Today I did yoga and weight lifting. The lifting session was Dorian Yates' Blood & Guts Back workout. I started with yoga and it was my first time getting back to yoga after a couple years.

Yoga

Yoga was tough, as expected. I've already mentioned how inflexible I am, which is a big part of why I want to get into it. Muscularly, there were a few parts that were difficult, like the plank poses and some of the warrior poses, but I didn't feel exhausted by any means. I probably would have been better off with the plank poses if I hadn't done chest the day before...I was pretty sore beforehand and got really shaky at points, but nothing that was going to make me sore.

There were also times when my muscle kept me from getting into a pose. For example, one required stacking your knees on top of one another. I never got a stretch from that because my calves wouldn't let me get them close to each other. Although generally I was able to get really good stretches.

One unexpected thing I noticed was pretty severe soreness in my feet from all the balancing and standing barefoot. My right foot, in particular, had trouble. I'm not sure if this is something I should be concerned about or welcome. With all the scar tissue in my feet, it could just be me working some of that out. On the other hand, it could simply be the injury. Can't be sure until I do it for awhile. If it gradually starts to get better or worse, I'll have my answer. In the meantime, I'll keep taking anti-inflammatories, icing, stretching, and massaging it.

Lifting

Lifting wasn't too bad today. I improved on all my working sets that count. It's hard to know on the wide-grip row and pull-downs because I had to use machines either because the equipment wasn't in the gym (pull-downs) or their were douchebags sitting on the machines for 10+ minutes (rows). So I improvised and still went to exhaustion, which is the real point here. I'll keep the weight the same next week and see if I really earned these improvements or if it was just the result of using machines.

For the lat pullovers, I wanted to hit it a little harder, so that's why I did the rest-pause set after I finished the straight-set to exhaustion. If you're not familiar with rest-pause sets, you've been missing out. They are an advanced technique if you're already in pretty good shape, so I don't recommend them for beginners. Get a good 3-6 months of lifting under your belt before you start these.

Rest-Pause Sets Definition

In a rest-pause set, you lift to failure, then rack the weight, as usual. But instead of taking 1 minute to rest, take 15 seconds of rest before performing another set with the same weight to exhaustion again. You can usually get another 1-3 reps out of it, thereby increasing your overall muscle damage to maximize growth and strength. Try it sometime, just make sure you have a spotter or are using a machine that enables you to perform the exercise safely.

Workout Log 9-12-12: Chest & Biceps

Chest & Biceps Day

My Workout

Workout Notes

You can see what the ideal workout is for this day here. It is Dorian Yates' Blood & Guts trainer, just like before. There are two exercises I messed up here a bit by not lifting heavy enough. The first was Incline Dumbbell Press. I was able to get nine reps and was supposed to hit exhaustion between 6-8 reps. Next time I'll have to raise weight again!

I also went too light on Dumbbell Flies, which was also supposed to be between 6-8 reps. I'll increase weight next time on those as well.

It's been striking how much stronger I feel from one week to the next since starting this program. This was only my 3rd Chest and Biceps day and the weight I'm lifting has gone up a lot. Granted, on Decline Bench Press, I was overdoing it for my warmup sets last week, but my working set weight has gone up consistently.

The two workouts I'm most impressed with, though, are Incline Dumbbell Press and Dumbbell Flies. I've gone up very quickly on the Incline Press. Last week I was doing 10lbs less and performed 2 fewer reps as well. It could be, in part, that I made my warmup sets truer warmups, but the improvement is still encouraging.

On Flies, however, I have no such excuse. I didn't change anything but my working set and still exceeded my own expectations pretty wildly with a 10lb increase and the same number of reps.

Excited to see what I can do next week!

Working Out While Sick

Is It Okay To Exercise While Sick? 

This is a very common question. In the past month, I've had three different friends ask me if it's okay to work out while they're sick; and if so, what they should do. Unfortunately, it's not a simple answer, so I always respond with a question of my own before answering...

What are your symptoms?

Your symptoms are the most important factor in whether or not you should work out.  There are certain symptoms you should avoid working out with and some that don't present significant risks. The rule of thumb is that it's okay to work out if your symptoms are all "above the neck"... provided you follow a few rules.

Rule 1: Never Exercise With A Fever

Working out with a fever can be dangerous for a couple of reasons. First, it dramatically increases your risk of dehydration, which can cause injuries or even heat stroke. Aside from the effects of dehydration, you also increase your risk for heart failure. It's not a question of how tough you are here, just don't work out with a fever.

Rule 2: Don't Work Out When Your Symptoms Are Below The Neck

Congestion, hacking cough, upset stomach, and body aches are all reasons to stay out of the gym. Exercising with "major symptoms" can prolong your illness or make it much worse.

Rule 3: Listen To Your Body

Obviously listen to your body and don't ever work out if your symptoms are severe, even if they're above the neck, because working out temporarily suppresses your immune system by forcing your body to use resources to rebuild muscle and connective tissue when it should be used to fight off your sickness. However, if your symptoms are light and isolated above the neck, it is generally okay to work out.

Practicing What I Preach

Last Friday I came down with a fever and severe sore throat. By midday Saturday, I also had nasal congestion, body aches, and chills. During that time, it would have been unwise for me to work out because of the fever and body aches, so I got extra rest and took care of my body.

On Sunday, my fever and whole-body symptoms subsided, but I started developing a cough, which kept me out of the gym again. As it turns out, my decision to avoid going to the gym on Sunday was a good one, because Monday my fever, body aches and chills all returned worse than before. I didn't even go to work that day (very rare for me) because I was so ill. I slept and stayed hydrated.

Tuesday morning I felt well enough to go back to work, but still had a fever and severely swollen throat for the first half of the day. Around midday, I began feeling better but didn't want to risk the improvement by going to the gym.

On Wednesday morning I felt much better than on Tuesday and most of my symptoms had subsided by the time I got off work, so I went to the gym. YAY!

Workouts From First Week Of October

Chest and Biceps Day: Tuesday Oct. 4th

The Workout

 

Back Day: Wednesday Oct. 5th

The Workout

 

Deltoids and Triceps Day: Thursday Oct. 6th

The Workout

 

Leg Day: Friday Oct. 7th

Enter The Sickness

I was supposed to do legs today, but got really sick. I didn't go to the doctor, so I'm not sure what exactly I had, but my symptoms indicated that I shouldn't work out until I was healthy, which was Wednesday the 12th. It was brutal taking so much time off, but it's better than dragging out an illness or risking my health.

Not sure when it's okay to workout sick? Check out my next post and I'll break it down for you. 

Workout Log 8-30-12: Leg Day!

My Leg Workout

Leg workouts have always been my favorites because they're what I'm best at. I've always had large, disproportionately-strong legs. So this workout was really fun for me because it was a heavy leg lifting day and I moved a lot of weight around.

As before, this workout comes from the Dorian Yates Blood & Guts 6-week trainer. You can find the leg workout here.

My workout is below. To save time moving forward, I've started using FreeWorkoutLog.com to keep track of my lifts. It's pretty cool because you can track things like weight, body measurements, and improvements on individual exercises. From time to time, I'll post updates charting my improvement. Most likely after each program is completed.

Workout Details

Workout Notes: 

I was a little surprised by my performance today. Since this was my first leg workout in the program, I underestimated on several of my lifts and wound up needing to perform extra reps to hit exhaustion on my working sets (last set of each exercise). Next time, I need to increase weight on every single lift to perform the workout properly. It did feel good though lifting as much as I did. I should probably be Hack Squatting about 450 and Leg Pressing well over 1000 to get into the 10-12 reps range at exhaustion. Hopefully I'll do a bit better next time of figuring out my weights.

The ideal workout plan is below for quick comparison, but you can also check out the program at the link above.

 

Sorry For The Absence

My computer died a couple weeks ago, making it difficult to keep up. I was able to get a new laptop last Friday, then got really sick, which threw off my productivity and ability to workout. Today I'll post my workouts for the past couple weeks and explain why it's not wise to workout when you're sick.