Out Swinging CF

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Can You Squeeze In a 20 Minute Workout Today?

by on August 20, 2012
in exercise, workout tips, workouts

Of course you can!  Who can’t find 20 minutes to spare?  This is what I do if my day is booked, there is not a chance I can get to the gym, and I need to break a sweat to maintain my sanity.  It is short, but it is not easy.

Basically, you pick one exercise for each of the SIX basic movements that human bodies are designed to do: a squat, a hip hinge, a push, a pull, a twist or anti-rotation move for the abs, and a single leg move.  Pick your favorites, or get crazy and try something you never do.  You will do three supersets of paired exercises.  In a superset, you move from one exercise directly to the next with no rest.  THEN, you rest, and repeat the superset for a specific number of times.  Huh?  Never mind. Here are the pairs

Squat move + Twist or Abdominal stability (examples below…or come up with your own!)

body squat x 15 followed immediately by front plank x 60 seconds

kettlebell goblet squat x 8 followed immediately by Russian twist x 16

dumbbell squat x 12 followed immediately by side plank, 30 sec/side

Pick one of these combinations, and do three supersets, resting only 60 seconds between each.  The grand total of time for this superset pair should be around 6 minutes or less.  Then, move to the next superset pair.

Push + Pull (examples below or come up with your own!)

Push Up x 10 followed immediately by horizontal rows x 8 (I use my dining room table for these)

Dumbbell military press x 8 followed immediately by pull ups x as many as you can do (this number will go down with each superset!)

Dumbbell chest press x 8 followed immediately by bent over dumbbell rows x 8 (use heavy dumbbells)

Again, pick ONE of these and do three supersets resting only 60 sec between each.  Six more minutes.  Last superset coming up.

Hip hinge + Single leg exercise  (examples below or come up with your own!)

Dumbbell or Kettlebell Deadlift x 8 followed immediately by alternating forward lunge x 8 (with dumbbells) or 12 if bodyweight only

Single leg bodyweight deadlift x 6 each side followed immediately by alternating backward lunges x 6 each side  (with dumbbells) or 12 each if bodyweight only

Kettlebell swings (my favorite) x 20 followed immediately by walking lunges x 8 each side

Same thing here:  no rest between paired exercises, but 60 seconds of rest between the supersets…three times.  Grand total…about 18 minutes. Use the 2 minutes for a brief warm up before you start…body squats, push ups, plank, or just run around the house for 2 minutes and have the dog chase you.

Of course, you can mix and match exercises or come up with your own.  The key is to move quickly between each exercise, and only rest between each superset.  Sixty seconds passes by very quickly.  I use my iphone to time the rest periods, just to keep me honest.

Try it and let me know what you think.

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How To Gain Muscle

One of the drawbacks to not digesting nutrients very well is that people with CF are often small.  Male or female, we tend to run on the petite side if we are pancreatic insufficient.  With earlier diagnosis and better enzyme replacement therapy, this is slowly improving, of course.  But for those of us who are already full grown, it can be a constant struggle to keep weight on. Not only do we want to maintain weight, it is often encouraged to have a few extra (I said, “a few”) pounds on board to stay strong and resilient to lung infections.

I don’t know about you, but when I need to gain weight—which is pretty much always—I would rather put on lean muscle tissue than fat.  This is not just an aesthetic issue, either.  The amount of lean body mass (LBM) you have (this includes everything but fat and water) correlates with disease severity.  The less LBM a CF patient has, the more severe their disease tends to be.  Additionally, LBM decreases with age, so as we get older it becomes more and more important to try to increase muscle mass.

So, what does it take to gain muscle?  Three things, well…maybe four.  If you are pancreatic sufficient, it takes doing three things, regularly.  If not, it takes four (the fourth being, obviously, sufficient supplementation with pancreatic enzymes).  This post is all about thing number one:  Resistance Training.

First, you have to lift weights.  Muscle tissue does not grow unless you impose a stress to it that it cannot handle.  When you do that, the muscle adapts by healing and coming back bigger and stronger.  In my opinion you should lift weights at least three times per week if you are serious about gaining muscle mass, and it is everyone’s opinion that you must lift heavy weights (for you).  So ladies, forget about the purple Barbie weights.  Soup cans will not work for long.  Sure, you may have to start there, but within a couple of weeks, you will be strong enough that you will have to put some energy into finding heavier resistance.  I realize most people are not training program junkies like me, and that you might not have a clue what to do with those heavy weights.  One great resource is The New Rules of Lifting for Life, by Lou Schuler and Alwyn Cosgrove.  You can probably find about a million training programs online, but the reason that I like this one is that it is scalable…you get to decide what level you begin at in each of the basic movements, and progress from that point.  So, brand new lifters or old pros have something to gain from this book.  I am also working on my own CF-specific training program, which will hopefully be available in a couple of months.  Don’t wait for me though…get started now.

So, in summary, if you want or need to gain weight, do it in style—by adding muscle.  There are three keys to doing this.  First, find a weight lifting program that works for you, and commit to it for at least three months.  If you do this, in addition to the two remaining steps outlined in the following posts, you will increase your lean body mass, and with it, your chances for a longer and healthier life.  When you see the progress that you have made in the three months, I’m betting that you will be hooked for life.

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How to Structure Your Weight Lifting Routine

by on September 20, 2011
in exercise, general, motivation, workout tips

Nobody wants to walk into a gym to lift weights knowing nothing about weight training.  First of all, it is obvious, and who wants to look as clueless as they feel?  But you are not clueless if you have read my “perfect workout” series. You know to immediately roll and loosen up your joints, to then move into some corrective work, then to do movement preparation drills.  Now you are ready to lift…

Let’s start with my basic “Rules of Lifting”

First, begin by working the biggest muscles first, then moving to smaller ones.  If you are going to include your legs into your lifting that day, start with squats or deadlifts.  If you are giving your legs a day off, start with back exercises.

Second, focus on complex moves.  Complexity is in…isolation is out.  A “complex” lift is one that uses several muscle groups, and as a consequence, movement occurs at multiple joints.  A squat is a perfect example of a complex lift. In the squat, you not only use the gluteals and hamstrings to extend the hips, but you also use the quadriceps, hip flexor group, and the stabilizing muscles of the entire core.  Compare this to the knee extensor machine, a classic isolation movement occurring at a single joint. In this move, you sit on a chair, hook your ankles under a pad, and extend your lower legs.  This is an isolation move occurring across the knee..not only that, but it is an isolation move that you almost never do in real life.  Below is a sampling of both types of lifts.  An isolation move or two won’t hurt, but focusing on the complex moves is better overall approach.  Additionally, if you are going to do both types of lifts, do the complex moves first. The biceps curl can wait till the end (for all of you mirror gazers…).

Complex lifts (multiple joints move): Squat, Deadlift, Lunges, Bench press, standing military (overhead) press, Horizontal rowing, pull ups

Isolation lifts (single joint movement): biceps curls, adductor/abductor machines, triceps extension, leg extension, seated hamstring curl

Third, learn perfect technique.  If you do this first and foremost, and you focus continually on technique (even when you fatigue) you will not get injured.  On the other hand, if you are sloppy, it is very possible that you will hurt yourself as you lift heavier loads.  This cannot be over-emphasized.  We are not talking rocket science, though.  I learned by reading books and watching others.  These days, not only can you read, but YouTube makes it easy to learn the basics. Just make sure you are watching a trained professional, not an actor/actress from a reality TV show (you know who I’m talking about).

Begin lifting light.  For the first few weeks, you get stronger NOT by lifting heavy, but simply by training your nervous system how to do the moves.  Once you have good form and the movement patterns are grooved into your brain, it’s time to get serious.  Begin light for a warm up set or two, and then work hard! You will not “bulk up.”  The last repetition of your work sets should be difficult.  If the final repetition is easy, or even moderately easy…go heavier!

Take a day or two off between lifting for the same muscle group.  You have made teeny little tears in the muscle fibers by asking them to lift heavy weights.  But don’t panic…this is good.  If you feed your muscles and rest them appropriately—they heal and come back even stronger.  This is the whole point of weight lifting.  It is called Specific Adaptation to Imposed Demand (SAID principle for you exercise physiology nerds).  Your body adapts to what you ask it to do.  If you want it to get stronger, you must ask it to lift heavier objects than it is used to lifting.  It then adapts, and, poof, you are stronger.

Now that the basics are covered, how about the more specific questions of what moves, how many exercises to do, how many reps and sets to do, with what frequency should I lift, and how hard should it feel.  How will I know if I am doing too much?  Too little?

A beginner should try to work every muscle group at least twice a week.  Once a week…not good enough unless you are just trying to maintain the muscle mass you already have (and even then, twice/week is better).  Three times a week is even better, but only by a little bit, so if you are really working hard to fit it in, at least get in two workouts per week.  What are the muscle groups to target?

Legs: Both front (quadriceps) and back (hamstrings) of the thighs.  Think lunges, squats, stability ball hamstring curls, step-ups, and more lunges

Hips: Extensors (that would be the butt, Bob), and flexors (these are usually very tight and mostly need to be stretched).  Think squats, more squats, deadlifts,  kettlebell swings, lunges again

Back: Huge muscle groups!  Latissimus dorsi is the big one (lat pull downs, pull ups, rowing movements), anything where you pull something toward the center of your body either horizontally or vertically

Chest: Pectorals and anterior shoulder:  Think push ups, bench press (flat, inclined), dumbbell flies

Shoulders: Three heads to your deltoid muscles, so they like to be worked at different angles.  Exercises here include vertical pressing moves like the military press, with bar or dumbbells,  lateral raises (bend over an inclined bench for a different angle), dumbbell forward raise, and my favorite, kettlebell clean and press.

Abdominals:  Plank holds (front and side), bicycle, stability ball curls, regular curls, dumbbell or kettlebell renegade row (killer), Russian twist

Arms: both front (biceps): rows, pull ups, biceps curls, and back (triceps): triceps press or kickback, pushups, horizontal and vertical pressing moves

Is your head spinning?  Like I said, it is NOT COMPLICATED!  Pick one move from each group (some exercises overlap groups because they are complex, and therefore work across multiple joints).  Study the precise form from books, YouTube, friends who know, or a trainer before you try each exercise. Start light.  Warm up first.  Then gradually add weight until the last repetition is fairly difficult.  In the beginning, strive for two sets of 10-15 repetitions of each exercise.  In exercises where you hold for time, aim to increase your time by 5 seconds each time you do the move.

KEEP TRACK OF YOUR PROGRESS.  I know it looks silly.  But if you don’t know what you did the last time, how can you progress?  You have to challenge yourself by doing a tiny bit more or holding for a few seconds longer than the last time.  I carry a workout log around with me.  I look to see what I did on that exercise the last time I did it.  Then I will either increase the weight, or the number of reps, or decrease the rest between sets.  Only a tiny bit.  It’s all about baby steps and consistency.

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Step Five of the Perfect Workout: Strength Training

I almost forgot I had a few steps to go in describing my perfect workout.

Here is why (David Letterman style) I think strength training needs to be a key component in your workout–especially if you have CF:

10) You can seriously increase your appetite, especially if you are doing a heavy lifting program.  Lifting heavy and the consequent eating like a horse is how I gained six pounds in six weeks.  Doesn’t sound like much, I know, but it’s about 6% of my body-weight (you do the math).  The only time I’ve ever been able to gain that much weight was the first year of college.  Man did I love that all-you-can-eat cafeteria.

9) It’s great to beat your son at arm-wrestling.  OK, so he’s only 12.

8) Maintaining bone density is pretty important, unless you want to crumble into a heap of skin and bones in your old age.  Yes, I did say ‘old age.’  It will happen.

7) In CFTR-able people (code name for those without CF), lifting weights increases insulin sensitivity.  There is no reason to think this won’t be true in CF as well.  If you CFRD or are on the verge, or, if you don’t want to develop CFRD, a little weight training can absolutely not hurt!

6) You get to buy new clothes when you ‘outgrow’ your old shirts, pants, etc.  Ladies, don’t worry–I’m kidding.

5) Who wants to be soft?  Weight training will firm up those abs and legs and arms in very little time.  Try it.  You will be amazed.  In addition, who wants to be skinny and wimpy?  This will not be the case if you adhere to a regular lifting schedule.

4) Being stronger will make the regular chores of life easier.  Easier means requiring less energy.  Requiring less energy means requiring less oxygen.  Less oxygen required means even if you have sucky lungs–that’s a technical term–you will still be able to carry on, soldier.

3) Coughing is easier and more effective if you have strong abdominal muscles.  This is just true.  Given that we cough, and the effectiveness of our coughs is directly proportional to our health…strong abs are very important.

2) Let’s face it, body image can be impaired in CF.  It’s not hard to imagine why this is true, but this is a very important issue, especially in kids. One very good way to improve body image is to develop muscle.  Development of muscle is not impaired in CF (as long as you eat and digest food).  We can ALL do it.  And when you do develop muscle that is visible to the naked eye…you feel better about the way you look.  Even if you cough.  Even if your fingernails look funny.

1)  I left this for last because it is my favorite reason to lift.  You are in control when you lift.  Not CF.  CF doesn’t affect your strength.  CF doesn’t stop you from developing strong muscles.  There is absolutely no difference between you and normal Joe GymRat, when it comes to getting strong.  Booyah.

These are good reasons to add resistance training to your workout.  The next post will discuss how to design your program.


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