Six Reasons You Have Shoulder Pain When You Bench Press.

Why Do My Shoulders Hurt When Benching?

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The #1 reason that athletes avoid (or dislike) the bench press exercise, is shoulder pain.  Specifically, a deep achy pain experienced in the front of the shoulder.  There are several possible reasons for this pain, but the problem is the same: a nagging pain that occurs when you lower the bar to your chest, a pain that you need to push through, in order to raise the bar back to the start position.  This eBook will review the six most common causes of shoulder pain when bench pressing, as well as discuss the appropriate treatments for each cause.

Cause #1:  Too much/too soon (or simply too much volume).

Let’s start with the obvious.  If your body isn’t properly adapted to a load (which occurs over time), there exists the possibility of tearing a pectoral muscle or straining one of your shoulder muscles as you attempt to bench press an inappropriate weight.  This gradual increase of stress put onto the body during weightlifting is termed progressive overload.  Muscle growth aka hypertrophy as well as bone, ligament, tendon, and cartilage strength are stimulated via progressive overload.  Circulation and nerve connections between the brain and the involved muscles are also increased via this principle.  If an athlete doesn’t build up strength slowly, overtraining can result, which can present with many symptoms including feelings of depression, fatigue, sluggishness, irritability, and a sudden decreased motivation to exercise.  

Treatment #1.

Create progressive overload by increasing the weight that you lift slowly, do not jump up more than five pounds each benching day.  Yes, that means busting out those wimpy 2.5 pound plates!  You may feel silly putting those onto the ends of the barbell, but your patience will pay off as you make slow, steady gains.  Ramping up more quickly than that is recipe for injury (not to mention frustration once you quickly hit a plateau).  In terms of volume, three working sets is plenty to build strength.  One or two warm-up sets with lighter weights are allowed, even encouraged, but there’s no need to do more than three heavy sets.  Adding additional sets can cause acute shoulder pain during bench pressing, as well as unnecessary pain or soreness 24-48 hours later (DOMS  aka Delayed Onset Muscle Soreness)

Periodization is one technique that can help stave off overtraining, and incorporates such methods as varying the weights of an exercise over time, allowing for adequate recovery, and mixing up the strength training program so that the athlete is not doing the same exercise too often.  If the only chest exercise that you perform is the bench press, you may want to incorporate some of these principles of periodization, or work with a coach who is familiar with programming and can help you design a healthy weightlifting program.  

The phrase “Terrible twos” doesn’t just apply to stormy, cranky toddlers. Too much/too soon in bench pressing can feel like a full-blown tantrum in your shoulders. Four possibilities to prevent the terrible twos include:

1. Take a few extra rest days.

2.  De-load your bench pressing:

b.  Vary the number of sets and the repetitions per set for less overall volume

a.  After several weeks of slow steady gains, back-off 10-15% for two weeks

3.  Switch up the bench press with one of the following:

a.  Bodyweight or weighted pushups

b.  Decline bench press

c.  TRX chest presses or pushups

d.  Dynamic chest work (medicine ball passes, plyometric pushups) 

4.  Assure proper recovery (see next section).

Cause #2:  Improper recovery.

The strength and volume of a muscle are not created during bench pressing.  The strenuous contractions actually break-down the muscle fibers, whereas it is the recovery time that allows for the muscle cells to repair and grow.  Skeletal muscles need between 24 and 48 hours for proper recovery, which is why it is common advice to avoid performing exercises that work the same muscle group on back-to-back days.  

Treatment #2.

In addition to rest, nutrition plays a critical role in muscle recovery.  Eat adequate protein (especially in the one hour post-workout window) to allow the muscle fibers to repair themselves during their resting period.  Animal protein sources could include eggs, chicken, turkey, fish, beef, or pork.  Non-animal sources of protein usually come from dairy or grains (or questionably healthy protein powders).  While some athletes feel just fine after drinking a glass of milk or eating some cottage cheese or a bowl of quinoa, others discover that they feel bloated, lethargic, or heavy after consuming those foods.  There is fair evidence that grains and dairy may contribute to systemic inflammation in the body, so you may want to experiment with eliminating these foods and beverages if you suspect you are sensitive.  A functional medicine specialist can help you identify which foods you might be sensitive to, and can help you develop an individual nutrition protocol that will help you recovery more optimally.  

Drinking plenty of water is also important to helping your body stay hydrated during the recovery process.  If you were to view this on a molecular level, the biochemical pathway that drives protein synthesis, requires the building blocks found in water, do proceed efficiently.  It’s important to know that sometimes, plain water is just not enough to replenish fluids lost through exercise.  This may not apply to every weightlifting session, but since most people who strength train also engage in cardiovascular activities, it is good to know that you may need to replenish your sodium stores after a sweaty workout.  

Other crucial factors to muscle and joint recovery include getting enough sleep, managing your stress, and engaging in some variation of mind-body activity (yoga, meditation, tai chi etc.)

Cause #3:  Improper form.

Treatment #3.

There are three big mistakes that lifters make on the bench press:

A: Elbows flared out

If you allow your elbows to flare out to your sides, you place your shoulders in a more internally rotated position.  Since internal rotation under heavy load can cause shoulder impingement (experienced as pain in the front of your shoulder), you’ll want to be mindful about keeping your elbows tucked in closer to your body.  They won’t actually touch your ribs, but send them in that direction.  There’s actually a trick to getting this alignment correct: set your foundation first, and your shoulders will naturally be in an ideal position and you won’t have to think to hard about where your elbows are in space.  Let’s look at setting a proper foundation:

B: Unstable foundation

Plant your feet on the ground.  Don’t put them up on the bench, don’t lift them in the air.  Just plant them firmly on the ground!  Shorter than 5’6” or have short legs?  Place two 45 pound plates on the ground, and then plant your feet atop the plates.  You will want to use your legs to help drive the movement so you need to feel secure in your ground contact.  Next thing, arch your back as much as feels comfortable; there will be space between your low back and the bench, and your glutes and shoulder blades will remain in contact with the bench. 

Squeeze your shoulder blades together and pull your arms all the way back into their sockets.  Having trouble picturing this?  Lie on your back, and then reach your arms up so your fingertips reach for the ceiling.  Now, reach two inches higher!  You get this extra reach by protracting your shoulder blades.  This is sometimes the position that novice weightlifters will adopt when reaching up to unrack the bar, but it is the exact opposite of proper form for the lift!  From here, find proper position by keeping your arms straight, and imagining that you could drop the top of your arm bone directly into the cup of your shoulder.  Finally, squeeze your rhomboid muscles to pinch your shoulder blades together underneath you.  A final cue is to think about pulling the bar apart just before you lower it. That’s your bench pressing position: retracted shoulder blades and arched back.  This also prevents the top of your shoulder from rolling anteriorly (forward), which would shorten the pectoralis minor muscle, creating aberrant shoulder biomechanics.  

TIP #1: You will benefit from receiving a lift-off (hand-off) from a spotter so you can maintain this close-packed shoulder arrangement.  If you’re lifting the bar off the supports on your own, you may need to reset your shoulder position once you get the bar steadied at the top of your lift.

TIP #2: If this shoulder set-up isn’t feeling natural to you just yet, you can practice this on a foam roller.  Place it lengthwise along your spine.  Plant your feet on the ground, arch your back, and then pull your shoulder blades together and feel them “wrapping” tightly around the roller.  Keep your arms straight.  Release the squeeze and reach up towards the ceiling, protracting your shoulder blades, and then go back and forth several times to really understand the difference between scapula protraction and scapular retraction.

C: Touching your chest on every rep

For a lift to be considered valid in a powerlifting competition, the athlete must touch the bar to their chest, and then wait for the “green light” to lift the bar off their chest.  These details of judging were developed to attempt to standardize the bench press exercise and to assure that no lifter was “cheating” by bouncing the bar off their chest.  There are certain sacrifices that every athlete must decide whether they are willing to endure during the pursuit of personal or team records.  For most people’s anatomy and biomechanics, lowering the bar all the way to their chest, creates a dangerous position for the shoulder to press a load.  Getting the bar all the way down creates some internal rotation in the shoulder as well as forward translation of the top of the arm bone in the shoulder socket.  

To geek out on biomechanics for a moment: for a muscle to generate optimal force at a joint, the bones must be properly centrated, that is, their surfaces need to be in the most optimal contact.  When the humerus translates forward, it throws off the centration of the joint, preventing the muscles that attach to the arm and shoulder bones from generating proper force, and placing the shoulder in a position that invites injury.  The acute risks are tearing a pectoral muscle, tearing a deltoid muscle, or causing damage to the joint capsule of the shoulder.  

There is a second category of risks that is lesser known.  This is the cumulative effect of repetitive motions performed from a compromised shoulder position.  These risks would include shoulder impingement and rotator cuff strain.  There are tricks designed to lessen the distance between the top position of the bar and the lifter’s chest, such as positioning the spine in an extremely arched position, and taking an extra wide grip on the barbell.  Also, for individuals with very large or barreled chests, this issue presents less of a problem.  

Powerlifters who wish to set records in competitions accept these risks as part of the sport, but for the majority of gym-goers, there is no need to lower the bar all the way to the chest.  Take a video of your next lift or ask a friend to watch you, and then make sure you stop when you reach a 90 degree bend at your elbows. For most people this means stopping when the bar is about an inch from the chest. Individual anatomy differs, so you will have to discover what feels best to your shoulders. If you are bench pressing solo, you can set-up a bench in a power rack with the safety supports set at a height that allows the bar to travel almost down to your chest but not quite. That extra inch not only prevents you from going too low, but also serves as a safety net if you miss a rep.

*One caveat: some people do just fine bench pressing with the bar touching the chest. That is usually because they are:

  1. Purists/classic bodybuilders who will “push through” or ignore their pain in order to perform the exercise the way it is presented in popular media (always bar touching chest or it doesn’t count).
  2. Flexible enough in their thoracic spine to create a large enough arch in their back such that optimal centration of the glenohumeral joint occurs right around where the bar hits their chest. Reasoning by extremes, if you could arch your back enough to raise your chest up off the bench by one foot, you wouldn’t have much distance to cover as you lowered the bar to your chest, and your shoulders would be in a good position (although some would argue that this is a recipe for back pain).
  3. A large-chested individual. Simple geometry dictates that the bar would hit their chest earlier (higher) than it would for a smaller-chested individual.

Cause #4:  Muscle imbalance.

Even with proper form and adequate recovery, if you are pushing more than you are pulling, you are setting yourself up for shoulder pain and dysfunction due to muscle imbalance between the anterior chest and shoulder muscles and the posterior shoulder and back muscles.  This imbalance is often referred to as Upper Crossed Syndrome.  

Treatment #4.

Make sure you are doing some version of horizontal pull for every horizontal push and likewise: one vertical pull for every vertical push.  

Vertical push exercises Shoulder press Push press Incline bench Vertical pull exercises Pull ups Chin ups Lat pull downs
Horizontal push exercises Bench press Decline bench Pushups Horizontal pull exercises Bent over barbell rows One arm dumbbell rows Seated rows

It’s also crucial to add in at least one rotator cuff exercise each “push” day, to assure proper shoulder health.  

Tuck a rolled-up hand towel into your armpit before you begin these exercises, this will keep your shoulder in the correct position.  Pick one of these three options, and perform 3 sets of 15.  Use very light resistance for these!  Descriptions are for right shoulder rotator cuff strengthening.  Reverse directions for left side.

Option 1, Cable machine: 

Set the cable machine to it’s lightest setting.  Stand in between the two cable stands, so that you could easily grab one with each hand.  Use your right hand to reach across to grab the handle on your left.  Return your body to the starting position and slowly step to your right until you feel adequate tension on the cable when your right elbow is tucked into your side at a 90* bend and your hand is facing forward. 

Slowly externally rotate (pull your right hand out towards your right side) against the resistance of the cable.  Slowly return your hand to the starting position.  There shouldn’t be any “bicep-curl” action happening, rather your elbow should stay at 90* throughout the motion.

Now you can use that same cable for this internal rotation exercise, just position your body so you are facing the opposite way.  Your starting position will be your right hand swung out to the side (remember elbow is still bent), and then you will internally rotate (pull your right hand in towards the midline) until it ends up in front of your elbow.  Slowly release the tension to return to the starting position.

Option 2, Theraband tubing:

Anchor tubing securely to your left (at elbow level).  Grab the end with your right hand, and proceed as you would in the cable machine option.

Option 3, Dumbbell:

Hold a light dumbbell (2 to 5 pounds) in your right hand, and then lie prone on a table with your right arm hanging off to the side and your elbow bent to 90* and supported with a small pillow or towel.  Keeping your elbow stationary, raise and lower the weight in an arc from full external rotation to full internal rotation.  Repeat for 3 sets of 15 arcs.

If you are experiencing any shoulder pain during bench pressing, de-load your bench pressing for a few weeks and focus on pull exercises and rotator cuff rehab.  If the issue still doesn’t resolve, a sports chiropractor can help you determine the exact cause of your pain and set you in the right direction for treatment and rehab so you can get back to bench pressing pain free.

Cause #5: Joint fixation.

Treatment #5:

This isn’t the most common reason for shoulder pain when bench pressing, but when fixation (subluxation) is present in either the shoulder or the thoracic spine, restoring normal motion to the involved joint(s) brings huge relief to the painful shoulder(s).  If you’ve perfected your form, allow for proper recovery, are pressing an appropriate load, and are balancing your pushing with your pulling, this may be what’s holding you back.  A sports chiropractor can perform an exam to find out whether you have joint fixation, and would perform the appropriate adjustment(s) to restore the biomechanics of the area.

Cause #6:  Soft tissue adhesion and/or trigger points.

Any time a muscle becomes chronically overworked or overused, it tightens up, receives decreased supply of circulation, and if left untreated, develops scar tissue (adhesion) that limits range of motion, decreases muscle firing time, and causes pain.  Common muscles in the upper body that develop adhesion are the pectoralis major, pectoralis minor, anterior deltoid, and the infraspinatus and teres minor muscles of the rotator cuff.  

In addition to developing adhesion, muscles can also develop trigger points. Trigger points are taut, irritable bands (knots) that develop in a muscle when it is injured or overworked.  Commonly a cause of joint pain, they are known to cause headaches, neck and jaw pain, low back pain, tennis elbow, and carpal tunnel syndrome.  They are usually sensitive to pain when compressed, and may send referred pain to other specific parts of the body.

Trigger points are slightly different than a muscle spasm.  A muscle spasm is an entire muscle contracting vigorously, whereas a trigger point is a local twitch response concentrated in a small point within a muscle.

The good news is that you can generally use the same tools to address both adhesion and trigger points.  If you notice any tenderness or tightness in any of these muscles, your first line of action should be self-myofascial release followed by static stretching.  

Treatment #6.

Self Myofascial release (self massage) for trigger points:

Trigger point therapy can reduce the discomfort associated with trigger points.  This is done by applying pressure directly to the trigger point.  Find the trigger points by palpating your tissues for areas of “knots” and discomfort.  Hold pressure at each trigger point for 30 seconds or until the tenderness dissipates.  This technique also generally helps to breakup adhesions.

What tools should I use for treating my trigger points?

  • Fingers/elbow/knuckles
  • Foam roller
  • Handheld tool
  • Theracane
  • Tennis ball, hard rubber ball, racquetball

Is it time to call in a professional?

If you can’t locate the source of your pain, or repeated self-treatments aren’t lessening your pain, it’s time to call in an Active Release Techniques (ART) specialist.  ART certified sports chiropractors are trained to locate the problematic muscles and treat them appropriately to reduce the adhesion and allow you to bench press without pain.  

How is your bench pressing going?  Continuing to hit PRs?  Or experiencing nagging shoulder pain?  What steps are you going to take to resolve your pain?  If you have any questions please feel free to send an email to Dr. Sandy Baird at info@riverstonechiropractic.com.

Oakland Manual Therapy vs. Massage Therapy

Have you been prescribed manual therapy in Oakland for your injury? This article explains what’s the difference between manual therapy and massage therapy and which works best for injury?

manual therapy in oakland on a knee

The terms manual therapy and massage therapy get tossed around interchangably, but it can be important to really focus in on the differences so that you can best choose which is going to help you resolve an injury. From an insurance perspective (which is an influential perspective but not the only perspective), manual therapy (CPT code 97140) includes all of the following:

Connective tissue massage

Joint mobilization and manipulation

Mobilization of the nervous system

Manual lymphatic drainage

Manual traction

Passive range of motion.

According to the CPT code definition for code 97140, manual therapy providers use hands-on techniques during treatment. So as you can see, massage falls under the umbrella of manual therapy, but a manual therapist can offer a wider-spectrum of therapies.

If you are in need of manual therapy in Oakland, we offer the full spectrum of hands-on therapies listed above. In addition to that, we also offer several instrument or tools assisted therapies (IASTM) to help you breakdown the tightness in your muscles and fascia to restore normal tone and function. You can book your manual therapy session on demand HERE.

tool assisted manual therapy in oakland

You may find yourself wondering about the mechanisms of how manual therapy in Oakland works. There are no clear-cut answers, but there are several proposed mechanisms.

How manual therapy works:

Neurophysiological: Manual therapy produces an inhibitory effect on the nervous system. Releasing the built-up tightness in muscles and connective tissues changes the brain’s perception of pain by altering the pain pathways. It also relaxes the nervous system, so that your brain can make more intelligent movement choices from a calm state.

Biomechanical: Manual therapy creates short-term change in the pliability of our soft tissues, it improves range of motion, and it corrects positional faults. Muscle firing is increased because the muscle spindle’s mechanism gets reset with manual therapy, much like your buggy phone or laptop starts working properly again following a reboot.

Psychological: A manual therapy session may offer some of these benefits depending on how patients view and respond to care.

There is strong evidence in the literature to support the therapeutic use of manual therapy, including several articles showing a positive effect of manipulation/mobilization in acute low back pain. (Ann Intern Med 1992;117(7):590-598) and again in the Physical Therapy journal 1992 (Article on Efficacy of Manual Therapy). More recent articles show strong evidence that combining corrective or functional therapeutic rehab exercises with manual therapy give the best results in reducing pain and returning to activity. Kinesiotaping is also helpful to help re-activate the nervous system once it has been reset by manual therapy.

kinesiotape helps manual therapy

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How to Prevent Neck Pain While Sleeping

For a lot of people, myself included, once you age out of your twenties, sleep injuries are FOR REAL! Waking up with excruciating neck pain that ruins your day is no fun at all, and luckily there are some concrete steps that you can take in order to prevent the chance of that happening. In this video, I’m going to show you the two safest sleeping positions, including tips and tricks for making them the most comfortable in terms of preventing achy hips, shoulders, and necks. And then I show you a GOLDEN TIP for what to do with your head and neck ANYTIME YOU SWITCH SLEEPING POSITIONS so that you won’t wake up with that terrible neck pain anymore! Click on the image to watch the video.

Safe Twisting For Your Back

Is twisting good for your back? Does it miraculously detox your internal organs as some yoga teachers claim? Or is twisting terrible for your spine as some physicians assert? Well, truthfully, the answer lies somewhere in between. Spinal rotation is one of the primary movements that the lumbar spine (low back) should be able to move through. You should also be able to bend forward (flexion), extend your spine backward (extension), and laterally bend your spine (leaning to the side) which is actually a specific type of rotation. But this video zooms in on rotation (twisting). I show you how to safely twist into a forward twist, and how to safely twist backward. I also explain why twisting while leaning forward gets such a bad rap, and what you can do to minimize your injury risk. See the full transcript below for “Safe Twisting For Your Back”.

“Hello I’m Dr. Sandy Baird from Riverstone Chiropractic here in Oakland California and today I’m going to show you how to safely twist. Now we’re gonna be twisting to the back and twisting to the front and there’s different spinal biomechanics that are involved with each one so I’m gonna break it down and show you how to do that. There’s a lot of misinformation out there about twisting your back… some people would say it’s the worst thing you can ever do for your spine, other people would say that it “detoxes” your internal organs, so I think the answer is somewhere in between those two extremes. Spinal twisting or rotation is one of the main movements that your spine needs to be able to do to promote healthy biomechanics to properly lubricate the joints and to safely move you around. So there’s flexion, which is rounding forward, there’s extension, which is arching back, there’s rotation to either side, and there’s lateral bending which is kind of a variation on rotation butI’m going to show you how to safely twist your spine when you’re going in to an extension based twist and how to safely twist your spine when you’re going into a flexion or forward based twist so stay tuned for that.To do a safe twist in a forward facing or flexion direction, what you’re gonna want to do is flex forward first and then rotate so I’m going to show you what happens if you were to rotate first and then flex… so I’m just gonna hold on here just so you can kind of see degrees of rotation… so if you were to rotate first this is about as far as I can rotate and then if I want to flex forward I get to right about there before I feel some binding and pinching through my right-sided low back. Now if I come back to this position and I flex forward first and then I take my rotation I can go a little bit further and it feels much smoother, I don’t feel any catching or binding in my back so it’s different for going into extension and I’m going to show you that next. If you want to do a twist into extension meaning your low back is going to arch back in this direction, as you twist you want to think about doing your twist first and and then adding your extension, so if I’m going to the other side we’re twisting and then extending and this is actually like a nice mobility exercise you just kind of get into the flow of twist extend come back through center, twist extend and come back to your center. If we were to do the opposite if we were to go into extension and then try to twist it doesn’t feel that great and you can actually see like I’m trying to twist as far as I can and you know I can probably like move my shoulders to get a bit more twist but my torso is not able to twist more because I’ve already maxed out the extension of my spine, so for extension rotate extend and back to center, so that’s how you safely do a twist into extension. I think a lot of the bad press about rotation and flexion meaning coming to this position and then you know you’re you’re putting your kid in your car seat and then they wiggle or kick and you fight that and oh my gosh all of a sudden your back is killing youI think that that is what gives us the bad rap like we don’t want to be holding load and then going into this position that does create a lot of pressure on the intervertebral discs in the low back, but unless you have certain very rare spinal conditions there’s nothing wrong with a bodyweight twist where you’re flexing and coming to one side it’s one of the motions your spine is designed todo and in my opinion if you don’t use your motion you lose it.”

Neck, Back, Chest, and Shoulder Pain from Chest Binding

I’m excited to announce a FREE RESOURCE for our community that I’ve been working on for the past few months. Released today! This is a picture and video-rich guide to the stretches, strengthening exercises, and mobility techniques that you can do at home to reduce the neck, shoulder, chest, and back tightness and pain that stems from wearing a binder. Take a look below and download it for free for yourself or for a friend!

Nutrition Timing and Anxiety

For about two months as I was training for the trans bodybuilding competition, I tracked my macros very accurately, very consistently. In most cases I would plan them out so that I wouldn’t have any big surprises at the end of the day. I would input my big meals first. I’d already prepped my meals so I knew what was coming. I would put a protein shake in there, make sure my breakfast was logged accurately. And whatever else was left in there, then id do a quick scan of what I might want to eat. Maybe there’s a treat that I could fit into my macros, maybe I’m craving peanut butter, maybe I haven’t eaten fruit in awhile and our fig tree is producing, maybe we’d just bought something interesting at the grocery store.  Whatever that was, I would fit that in. And then I knew that I would end up with a certain amount of calories at the end of the day. And I couldn’t get to any point at the end of the day where I wanted to eat something but realized it wouldn’t fit into my plan. 

Now if you want to know the science behind nutrition timing, I would suggest you check out Jeff Nipard’s youtube channel, specifically the video he did on the post-workout anabolic window myth. This article is going to be more focused on the intuitive nature of meal timing, or listening to your body in terms of what it needs based on the activities you are asking it to perform.

So my “always plan-ahead” method was great and it worked really well. I met my goal of preparing for the bodybuilding show. But I did have a lot of anxiety or fear around the possibility of being hungry. I feel like I had to intake so many carbs and so many electrolytes (which usually have sugars built-in) to get through my intense workouts, and then I’ve got to eat enough protein right after workouts to recover properly. And I was constantly thinking “Oh my gosh, I’m just not going to have enough calories left by the end of the day”” Or “Oh no, I’m going to be hungry in between my last two meals of the day!”  And for that period of time it really was an anxiety-ridden thing, but I just went with it and stuck to the plan and told myself “its going to be what its going to be” because these are the calories that are on my plan that are going to get me towards my goals. 

Then during my trip to Atlanta for my bodybuilding show, I ate according to more-or-less the same rubric, but I didn’t track my macros very closely, actually I didn’t track them at all for four days. And then when I came back to town, I didn’t track but only held a loose idea of my macros in my mind. But I didn’t track. And I actually found that I wasn’t very hungry after 3 or 4pm. After I’d eaten my first and second of my three daily prepared meals (not including breakfast), I was pretty content for the rest of the afternoon. I didn’t need a lot of snacking. Sometime it would even be to the point that come 7pm, when it’s time for that last meal, I was a bit ambivalent about eating it. I mean, I did eat it, because it was in the plan! But I wasn’t that hungry at 7pm. If I had to skip a meal, I would feel fine skipping that one. 

It didn’t dawn on me until after the competition, when a lot of the stress was off, I didn’t feel the need to track everything so carefully, it really did dawn on me that I wasn’t using my body physically so much in the later parts of the day. I would burn some energy treating patients, sure, my job is moderately physical, but compared to my morning workouts, I wasn’t burning nearly as much energy, and I realized that maybe it’s ok that I front load my day with my proteins and my carbs and my calories. I mean, if that’s what I need to get through my workouts and to recover from them, then why the heck not?!

So what I’m trying this month is I’m still going to plan my day out so that I meet my required calories, I’m still trying to eat at a slight deficit to get leaner, but I’m not going to worry about whether Ive eaten 70% of my calories before 2pm or not, because it probably doesn’t matter in the long run. As I understand Nippard’s summary of the post-workout anabolic window nutrition timing, the research shows that there is some benefit in intaking protein within a thirty (or so) minute window, but not a huge benefit. And he stated that carb intake during that window was irrelevant to muscle building assuming a person had an adequate overall protein intake. Specifically, the anabolic window doesn’t open/shut as fast as a light switch flicking on/off, but there there is some benefit to intaking protein sooner rather than later. He didn’t list exact percentages of performance or recovery benefit associated with intaking protein ASAP versus a few hours later. But I honestly think I would get a 10% improvement if I could just shake the stress and the anxiety that comes with worrying about whether I had eaten a certain amount of calories by a certain hour.  To feel good, to feel relaxed, to feel energized, and well fed, well fueled, well nourished. Thats where its at for me right now!

If you are looking for help setting up your own nutrition plan, please feel free to contact me. I offer customized nutrition planning to help you eat towards your goals!

Why the 80/20 Rule Doesn’t Work for Nutrition

A common approach to eating is to eat 80% “clean” food and 20% treats/sweets/not-so-healthy foods. It makes sense initially that this would be a less strict way of eating that could increase your long-term compliance to your diet. But upon further exploration, it turns out that it might not be the best fit for you. Let me explain.

To quantify in calories (kcal) what 80% and 20% of your daily calorie intake might look like, let’s assume that you were eating 2000kcal/day. This is a reasonable estimate for someone who is around 150-175 lbs, who exercises moderately 3-5 times a week, and who is trying to eat at a maintenance level (neither lose nor gain weight). Using this nice round number as an assumption also makes the math really easy. If you want to calculate your personal energy requirements, this “How To Calculate Your Macros” video will show you how.

Setting aside any judgement of what defines a food as “dirty” or “junky” or “clean”, I am choosing to use the words “clean” and “junk food” solely for ease-of-reading. So if you were going to eat 80% clean foods, you would be eating 1600 kcal of clean food. And since 20% of 2000 is 400, so you would be eating 400 kcal or junk food on a 2000 calorie diet. Further, we can assume that the 400 kcal is most likely going to be coming from carbohydrates (carbs) (and perhaps partially from fats) since no one is going to choose boiled chicken breast as their junk food. Since there are 4kcal/g for carbohydrates, choosing junk food such as chips, cookies, cupcakes, and sugary crackers translates to about 100g carbohydrates. (The calculation is slightly different if you were to choose ice cream or fried-foods that were more fat-laden than carb-laden.)

Now for a lot of people, 100g carbs is likely more-than-half of their daily carb totals! You can watch the above linked video that explains how to calculate your daily nutrition needs in terms of quantities of proteins, carbs, and fats if you want a refresher. So if you are trying to eat towards your goals, and you eat half of your carbs in one sitting on a big junk food snack, you are going to be left with the unfortunate struggle of trying to pack in a lot of protein into your day with very little carbs to go with it.

On top of that, for many people, eating 100g carbs at once feels pretty terrible! Your blood sugar spikes up, your body signals insulin to rush in to mitigate that sugar rush, and then since such a big dose of insulin was rushed in, you end up with low blood sugar, which can cause headaches, dizziness, wooziness, and other uncomfortable sensations.

I think a better approach is to shoot for about 10% of your daily calories coming from junk food. 10% of 2000 kcal/day is 200 kcal, and that is plenty to fit in a small cupcake, muffin, cookie, sweetened yogurt, or a small serving of ice cream. If you know that you can fit one thing like this into your diet everyday, you are less likely to binge eat everything in sight when the stress of attempting perfection for too long backfires. Try it out and let me know what you think.

Trans Bodybuilding Competition: My Experience as a Non-Binary Competitor

Front double-biceps pose 10/6/18 Trans Bodybuilding Competition in Atlanta.

Bodybuilding. Sounds interesting. Building one’s body. Training hard in the gym and eating right. Seeing some results. Work a bit harder. Consider competing. Realize one’s options as a non-binary person are 1) Compete in stilettos and a glittery bikini or 2) Sign up for a mens competition. Neither option feels like a good fit. Get discouraged. Lose focus on weightlifting and nutrition. Feel yucky in own body. Start going to gym again and eating right. See some results. Consider competing. You can see how this becomes a frustrating and not-very-gender-affirming-cycle.

trans bodybuilding competition flyer

Enter Trangender (trans) bodybuilding competitions. When I saw the trailer for the film “Manmade” that was screening at this years Frameline Film Festival in the Bay Area, I was shocked! I had no idea that this type of space had opened up in the bodybuilding arena. But it was really just a passing thought in my mind that I would ever be a part of of something like that. I’d never felt like I was lean enough to be a “real” bodybuilder. But then months later, I saw a facebook post for the International Association of Trans Bodybuilders event that was coming up in Atlanta in October. I thought “yeah, maybe if I lived in Georgia I would go try that, but that would be crazy to fly in from the Oakland Bay Area just to go flex my muscles on a stage! But I couldn’t shake the idea from my mind over the next few days. I peeked into my calendar just to check whether I was free that weekend. I texted my mom to see if she happened to be available to watch our kids for a long weekend. I told her it wasn’t for certain, just considering making a trip to Georgia for what I thought at the time was a self-indulgent and frivolous reason. And sure enough my calendar was blank and my mom was free. I asked my spouse what they were doing that weekend. Hmm, they were free as well. And my brother and his family had just moved to Georgia a few months prior so I would have a place to stay and could also spend some quality time with them if I made the trip.

The cards seemed to be lining up. But I had one HUGE lingering doubt. And that is, “Would I be lean enough?” By the time I saw the event posted, I would have exactly eight weeks to prepare to step onstage. I didn’t want to embarrass myself by showing up too fluffy. I’d been making some great progress with my workouts and had been consistent with tracking my nutrition since I started working with a new personal trainer (Emmet Logan of YesBodies, they/them pronouns) in February of this year. I was generally feeling pretty great in my body, but I wanted to get leaner and continue to appear more masculine. I ran the idea by my personal trainer. A long rambling stream of words tumbled out of my mouth….”So there’s a trans powerlifting and bodybuilding competition coming up in eight weeks and I’m thinking of doing one or the other or maybe both and I know I’m not super-lean but I’m getting there and what do you think? Is it crazy or is there a chance I could be ready in time?”

My trainer gave some very thoughtful answers to my question and helped me clarify my goals in terms of focusing on the bodybuilding competition over the powerlifting competition. The main thing that I took away from our conversation was that I might as well try my best and go for it, and even if I didn’t meet all my aesthetic goals, that I would still come out of the competition knowing if it’s something I’d want to pursue further or just something that was fun and interesting for a one-time experience,

So Emmet designed an 8-week strength-training routine for me with the goals of putting on as much muscle as possible in as little time as possible and torching off as much body fat as possible while keeping me healthy and strong. It included some new (to me) tortuous techniques such as German Volume Training (10 sets of 10 reps of compound exercises at 70% of your max with only one-minute rest periods) and Muscle Flushing (Multiple drop sets that run so much blood through a muscle that you think you’re going to puke with the aim of pumping up the muscle with nutrients and stimulating growth). And then I think there was a variation of the German Volume Training thrown in there for one of the four-week cycles of muscle building. But my trainer is smart and sneaky so they didn’t call it that by name. They just wrote down the reps and sets of the exercises I needed to complete and I methodically worked through four intense weight-room workouts on my own each week and then Emmet pushed me on Fridays when I trained with them.

I experience a variety of emotions throughout this training cycle. Strong bursts of rage, anxiety, sadness, and excitement punctuated longer periods of focus and empowerment and fatigue. The first time we did German Volume Training, my quads were in shock from doing so much volume (total of all sets x reps) of front squats. They were twitching and fiery and, despite doing variations of back squats and front squats for years, I finally felt them working and growing. I swear I watched them grow a whole inch in circumference as I was driving home from the workout. But around my sixth set I’d really settled into my front squat form in a really comfortable way. I’d struggled with that particular lift before and just the repetition of having to pick the bar right back up every minute felt really amazing to lock in that form. And it was also really hard. And Emmet said something like “get into position, elbows up, and let’s go…picture yourself walking onstage!” And at that moment I just felt so much anger. I wanted to stop and rest and all the anxiety I had about whether I’d be “ready” for the competition had already melted away under the weight of the barbell and I don’t even know where the anger came from or where it was directed but I experienced anger in my quad muscles, anger in my back, anger in my blood. And I got through the set, and the emotion passed as soon as my quads were no longer under mechanical tension. I was exhausted after that workout of deadlifts and squats, but was surprised by what happened next.

Two days later, I was foam-rolling my quad muscles to try to release some of the tension and soreness that had built-up from the squats. It was painful. Really painful. Painful, but necessary. It’s the kind of pain I could push-through while keeping my leg muscles mostly relaxed and not having to hold my breath. I guess birthing a baby prepares you well for foam-rolling! So I was mentally prepared to get through this necessary evil, so that the post-workout soreness wouldn’t last more days than necessary. But just moments into rolling out my right quad, I felt that quick fiery flash of anger jabbing into my brain and electrifying my whole body. And as soon as I recognized that emotion as anger, it crashed into sadness. Waves of sorrow and sadness flooded my body with every breath. If I’d stopped foam-rolling and distracted myself by scrolling through Facebook on my phone, I think it would have rolled to a stop. But I kept going and kept breathing and kept feeling whatever this was that was coursing through me. And crying uncontrollably face down on a mat at the gym. As a healthcare provider who releases built-up tensions in people’s bodies all day long, I recognized this as trauma leaving the body. All the what-ifs and am-I-good-enoughs and do-I-look-a-certain ways that had entered my quads during the vigorous muscle building were now being processed and healed and remodeled and repaired through this self-muscle work. I tell my clients all the time that foam-rolling is good for their muscles, but I’ve never told anyone (yet) that it can be a spiritual experience if you keep breathing and lean into the discomfort.

oakland trans fitness foam rolling quads

I didn’t tell many people that I was preparing for a bodybuilding competition. I guess I was afraid that if people responded with a surprised “I didn’t know you were into that?!” then I would take that as “Wow, you don’t look like a bodybuilder” or “You don’t look very lean”. I knew I looked strong. But not necessarily lean. That was my insecurity. I wasn’t afraid of being in the spotlight on stage and forgetting my poses. I wasn’t stressed-out about wearing a sports-bra on my chest when everyone else would be bare-chested. (The sports-bra selection process was mentally-consuming because I wanted to get it perfect. Minimalist in the back to show my back muscles but not feminine or strappy, etc.) But really, my whole eight-week preparation was plagued by the worry that I wouldn’t get lean enough. I was professional-archery-competitor-accurate about weighing and measuring all my meals. I didn’t eat at a restaurant for eight weeks. I prepared an egg-white scramble with spinach every morning to eat with my gluten-free toast. In total, I shook-up sixty protein shakes in my blender bottle, one each morning to have it prepared for the day. I prepared 180 boring but not unpalatable protein-rich healthy meals in portable containers so I could eat my other meals spaced out at approximately 11am, 3pm, and then 7pm. I took my own food to a wedding. I took my own food on a camping trip. I mixed up electrolyte powders, creatine powders, BCAA concoctions stirred into pre-workout drinks, and post-workout and evening recovery supplements. Everything was very organized and dialed in. And it took a lot of my mental energy to track my macros (food intake) and check off all the boxes.

trans bodybuilding meals

I applied a self-tanner. Oh yes, that was a whole experience just by itself. It required five coats and lots of stained towels and sheets and several patient helping hands. I am naturally a very pale person and it was shocking to see the difference a tanner made in seeing my muscle definition. I realized that I was closer to my leanness goals then I had realized. And it made me mad to realize that probably every fitness model who has every been on the front cover of a magazine had great lighting and a tan and that they don’t naturally look like they do in those pictures if you were to see them in the offseason. And so much crap is marketed towards us with the messaging that you aren’t good enough.

sandy baird biceps pose trans fitness

So I arrived to the Seven Stages Theater on a warm afternoon in Georgia. I was thankful that we didn’t have to stand around outside for too long because the sun was hot and my tanner was temporary (the top-coat layers tend to drip off when you sweat). Six of us contestants gathered and shook hands and started talking about where we were from and how we heard about the competition. I instantly felt at home with these guys. We all have many similarities in our life-stories even though we are at different points in our transitions or in our fitness journeys. I met two people at this event who had lost over 100 pounds. Two other people had competed as women (butches) earlier in their bodybuilding careers and were now reuniting to compete as men in this trans bodybuilding event. It was a friendly competition. I got some tips on how to pump-up before the show. Other guys were sharing tips on when to carb-up and how to pose.

 

We had a lot of waiting around time while they set-up the weigh-in area. It felt like catching up with old friends even though I’d never met these fellows before. We all had a good bonding moment when Wes (the overall winner of the competition) walked in. He strutted in wearing a bright red stringer-style tank top. His traps and lats were popping out all over the place and he looked amazing and it was so clear that none of us stood a change against him! Someone joked about trying to run off a pound to get into a lower weight class so they wouldn’t have to compete against him. Another wondered what could they quickly eat before the weigh-in so that they could move up to heavy-weight class to avoid competing against him. We greeted him not with, “Hi man, how are you?” but “How much do you weigh?” It was all in good fun and I felt very supported by this community as I dealt with the nerves of getting out there to do my posing routine.

Behind the scenes view of side triceps pose. AP photo on Ottawa Citizen webpage

The organizer and the stage/theater-manager were both very conscientious with checking in about the use of pronouns. I was also offered a choice to go onstage with the other trans-men or have my own category (non-binary gender). I opted to go onstage with the other guys because I was too nervous to go up there all by myself. No one made any comments about what I was wearing. There was a lot of general banter about top-surgeries and transition-related topics. When the time came, we were all called up onto stage by the order of our numbers (there were a total of eight contestants). The judges called for some quarter turns, which from what I can tell are called relaxed poses but you don’t look or feel very relaxed in them because you are semi-flexing and trying to remember to smile). And then they introduced each of us and had us do our favorite pose. The crowd was super-supportive and high-energy and it felt very empowering and celebratory as we went through our poses. Then we walked off stage and then came back separated by weigh-class.

sandy baird trans bodybuilding relaxed pose

Side “relaxed” pose

I had spent a lot of time debating whether I was going to try to make the lightweight class. I was really close to the cutoff of 145 pounds. After weighing over 205 at the end of my pregnancy, and then 185 after delivery, I’d gotten down to 175 by February. Between February and July I’d come down to 155 or 160. And I knew that it would be tight having only eight weeks to get to 145, so I set it as my goal and decided to see how close I was a week out from the competition before deciding if I wanted to do all the water loading and cutting and carb manipulation and sweating and spitting that can be common in weight-class competitions.

Trans bodybuilding competition weights

Most recent few years of my fitness journey include weighing 185 top left, 160 on the foam roller, and 147 competition day.

I was weighing in at 148 or 149 the day before I hopped on the airplane to Atlanta, so I decided that I would probably be holding water from traveling anyway and I decided not to do all that stuff and just get out there and look the best that I can and show off my hard work and not worry about weight classes. Even though moving down into the lightweight division would have meant getting a third-place trophy, I think I made the right decision to not add that extra layer of stress to my experience. I ate a bunch of jelly beans the night before as I alternated between coats of tanner and practicing my poses (which is actually more work than you might think it is to hold all those muscle contractions). I didn’t weigh or measure my meals that weekend and only loosely followed the rubric of what my meal plan had looked like the months prior.

And I felt fantastic. I felt energized. I felt masculine. I felt powerful and strong. And I had a lot of fun. Everyone’s first question to me now is “would I do this again?” And it’s a really hard question to answer. Yes I definitely would do a trans bodybuilding competition again. I felt like there was such a nice mix of body types and body fat levels and throughout this whole prep I’ve focused in on the fact that this is allowing me to redefine what bodybuilding means to me. It doesn’t have to mean sparkly swimsuits and booty poses and high heels. And it doesn’t have to mean starvation diets and extreme dehydration techniques. In every way I have been celebrating this body that I have built and it was an amazing experience to participate with a group of athletes who are also redefining and rebuilding their own bodies.

sandy baird back pose trans fitness

But traveling to Atlanta isn’t something that I can likely do every year. It wasn’t cheap and it took a long time to get there. On the other hand, to my knowledge, there are currently not other opportunities to compete as a non-binary person. I can still do my thing in the gym and stay on top of my nutrition, but in terms of a community event, I really hope that the IATB can grow and expand their vision and bring trans bodybuilding to the Oakland and SF Bay Area! We have a growing community of LGBT focused gyms and trainers and I would think a trans bodybuilding community would be a natural extension of that. Maybe by 2020?

AP Photo/David Goldman

 

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Acupuncture and Post-Surgical Care

Acupuncture and Post-Surgical Care

A Guest Post by Katrina Hanson LAc, owner of Prism Integrative Acupuncture in Oakland

oakland acupuncture practitioner Katrina Hanson

 

What is Traditional Chinese Medicine (TCM)

TCM is an ancient healing system involving acupuncture, herbal medicine, moxibustion (moxa) warming therapy, cupping massage, nutrition, lifestyle, and other healing modalities. Together, they bring patients back into balance by addressing the root of a problem rather than just the symptoms. Some acupuncture points trigger a release of calming hormones, some rewrite pain pathways, some awaken the immune system, have anti-inflammatory effects, or increase circulation. Many pharmaceuticals are derived from medicinal herbs; herbs in their natural form are generally a milder form of related pharmaceutical medicines. Moxa helps warm and promote circulation, cupping releases muscle tension, nutrition and lifestyle changes help prevent symptoms from recurring. Acupuncture and TCM work in a series of treatments, generally starting with 1-2 treatments per week and spreading out to monthly treatments as your symptoms improve. Just like you have to take your medications every day for them to work, you have to get acupuncture regularly to see results.

 

Surgery in TCM

In Chinese medicine, surgery is considered to block the flow of the meridians (similar to nerve and blood vessel damage in Western medicine). Improperly healed scars and old scar tissue can have the same effect, potentially causing pain, sensation loss, decreased circulation, and even impaired internal organ function depending on the depth of the scar tissue. Acupuncture as soon as possible after surgery helps to promote healing, reduce pain, swelling, and bruising, and prevent scar tissue from forming. Once the bandages are removed, scars can be worked on directly to prevent adhesions and reduce the appearance of scars. Cupping massage is also used to treat surgical scarring and adhesions to underlying tissues, and moxa can be used for post-surgical pain as well as reducing scars.

 

Post-Surgical Constipation

Acupuncture is extremely useful for alleviating postoperative constipation. Studies have shown that patients receiving regular acupuncture post-surgery actually perform better (have more frequent, easier, less painful, and more complete bowel movements) than those taking laxatives or stool softeners alone. Acupuncture points on your arms, legs, and abdomen are most frequently chosen for this purpose, especially two points on either side of your navel. Acupuncture is also helpful for boosting your energy post-surgery, which is generally the most long-lasting surgical side effect.

 

Swelling, Pain, and Bruising

Acupuncture and moxa (herbal warming therapy) help reduce swelling and pain post-surgery. They can even be used around bandages during those initial weeks when swelling and pain are more prominent. Acupuncture is done very superficially over areas of swelling or around bandages and moxa is done either over swelling or on distal points (on your arms and legs) to promote circulation and lymph drainage. Acupuncture house calls are a great way to recover more quickly from surgery; an acupuncturist can come to your home the day after surgery and all you have to do is take a recovery nap!

 

Scars, Neuropathy, and Scar Tissue

Surgical scars that are at least two weeks old can be worked on with acupuncture. Such treatments not only reduce scar pain, but also help to break up scar tissue and adhesions, increase local circulation, and aid healing. This leads to less noticeable scars and a reduction in keloiding. Scars may not only be cosmetically undesirable, but may also have an impact on health. This is especially true for very large scars; scars with abnormal coloration, lumpiness, numbness, tingling, itchiness, heat or cold sensations, achiness or pain, tenderness to touch, and muscle restriction. Such scars and associated adhesions can indicate or lead to nerve and blood vessel damage, decreased range of motion and muscle strength, increased likelihood of future injury, or chronic pain (especially pins and needles, tingling, and burning pain). Scars are especially important to work on if they’re on the torso, where underlying adhesions can impair bowel function, chronic pelvic pain or infertility, depending on the site of the scar. TCM considers any visible scar a potential issue and we work on all of them with either acupuncture, moxa, cupping, topical serums, or a combination of these.

Katrina Hanson LAc

I am a California licensed and nationally certified acupuncturist. I received my training through the Acupuncture and Integrative Medicine College (AIMC)’s rigorous four-year Master of Science program, and interned at UCSF Benioff’s Mission Bay Children’s Hospital and the San Francisco Homeless Prenatal Program, as well as at AIMC’s teaching clinic.

I went into the program with the intention of focusing in LGBTQ medicine, and this continues to be a driving focus of my practice. I specialize in transgender medicine, hormone regulation for every body, pre-post-surgical care, scars, neuropathy, and hair loss. I love guiding patients through times of hormonal upheaval, allowing them to stay grounded despite the emotional turmoil that often accompanies times of illness. My favorite part of my job is watching people regain ownership of their healing process, reconnect with their bodies, and make positive changes in their lives.

In addition to maintaining a private practice, I teach at Bay Area acupuncture schools–instructing students on gender vocabulary and pronouns, western and eastern transgender medicine, and approaches for creating an LGBTQI-inclusive practice. In my spare time, you can find me hiking or camping with my partner and our dogs

All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.

How to Calculate Your Macros

In this video, I talk about why you’d want to calculate and track your macros, and then I show you step by step how to calculate your macros. Once you get your macros set, you will want to test them out for 4-6 weeks before making any adjustments, since everybody reacts differently to certain percentages of proteins, fats, and carbs.

 

 

 

 

 

 

 

You can zoom into the picture above to take a closer look, but everything is explained in details in this video:

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Riverstone Chiropractic is conveniently located on Grand Avenue in Oakland CA. We serve patients from Oakland, Berkeley, Albany, Richmond, Walnut Creek, El Cerrito, Emeryville, San Leandro, Alameda, and surrounding cities in the bay area. Riverstone sports chiropractor Dr. Sandy Baird uses their background in athletics and massage therapy to provide their patients with effective and personalized sports medicine treatments, which include Active Release Techniques, chiropractic treatment, deep tissue massage, and rehabilitation exercises. Riverstone Chiropractic - 3409 Grand Ave #5 Oakland California 94610 - (510) 465-2342