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For February 27, 2017

  • Mountain Biking - 12 Tips for Handling the Hills
    Mountain Biking - 12 Tips for Handling the Hills

    Mountain biking injuries are increasing along with the soaring popularity of the sport. Nearly 50,000 mountain bikers were injured in 1995, a big increase from the previous year. However, there's no reason to be intimidated by mountain biking. Dr. Edward R. Laskowski, co-director of the Sports Medicine Center at Mayo Clinic, Rochester, Minn., says using common sense and learning a few new skills are all that's needed to enjoy off-road pedaling without injuries.

    "They say you never forget how to ride a bike and it's true � the neuromuscular program of bicycling is retained from childhood," Laskowski says. "In mountain biking, we just have to hardwire a different set of skills into that program for use in off-road situations."

    Here are some things to do that will enhance both your safety and fun:

    1. Helmets � It's not just a theory that helmets save lives and prevent serious head injuries � it's a scientifically proven fact.

    2. Common sense � Now that your head is protected by a helmet, use the brain underneath the helmet to avoid dangerous circumstances. Practice off-road riding skills on easy terrain before you rattle up and down the challenging stuff. Always ride in control, and walk your bike through terrain that looks too risky. Yield to and be respectful of other trail users. Be careful not to spook animals, especially horses, which can kick you or throw their rider.

    3. Equipment � Make sure the bike frame is the right size for you. A bike shop can help if you have questions. Always check the brakes and other components for damage before you begin riding. Take along repair equipment and learn how to make basic repairs in the field such as fixing a flat tire.

    4. Cadence � Use your gears to keep a cadence between 80 to 100 rpm. "Certainly this will be variable depending on the steep climbs and descents that you encounter, but generally a cadence of 80 to 100 rpm is less stressful to the knee because it doesn't involve a lot of grinding torque," according to Dr. Laskowski. "When you pedal in the 40-, 50- or even 60-rpm range, it produces a fair amount of sheer force on the knee." A cycle computer with a cadence meter is a helpful device to track your pace and training progress.

    5. Shifting � Lower gears make it easier to pedal; higher gears make it harder. Learn how the gear combinations between the chain ring (at the pedals) and the freewheel (at the rear wheel) make it easier or harder for you to pedal. Part of the fun of mountain biking is anticipating changes in terrain and shifting accordingly. "It's a good trick to shift to a lower gear ratio as you descend to the bottom of a hill so you don't have to start the uphill in too high a gear, which can stress your knees," Dr. Laskowski says. "The same concept works as you approach a descent. You don't have to shift immediately toward your highest gear. You can notch it up gradually as your cadence permits."

    6. Descents � On a steep descent, get out of the seat and put your weight over the back wheel to improve your balance.

    7. Climbs � It's OK to get out of the seat and rock the bike back and forth a little as you pedal up a hill. However, too much rocking � or pedaling in too high a gear � is inefficient and hard on the knees.

    8. Cornering � Don't begin braking while turning. Brake gradually to a safe speed before you go into the corner.

    9. Braking � The front brake usually has about twice as much stopping power as the rear brake. Applying the front brake suddenly during a steep descent can send you over the handlebars. Instead, use both brakes simultaneously and gradually.

    10. Skidding � Applying the back brake hard can put you into a skid. This robs you of control of your bike and may cause damage to the trail.

    11. Obstacles � Pick a path and focus on it. Learn the skill of "lofting" (pulling up on your handlebars) and shifting your weight back to get your front wheel over obstacles like rocks, logs and bumps.

    12. Wilderness safety � Hiker's rules apply. It's easy to get lost when you're having fun on a bike. Tell others where you're going to ride. Take a map, compass or Global Positioning System (GPS), first aid kid, plenty of water and appropriate clothing.

    Copyright 1995-1999, Mayo Foundation for Medical Education and Research.

  • Can a Caffeine, Ephedrine Combination
    Can a Caffeine, Ephedrine Combination
    A recent Canadian study finds an ephedrine-caffeine combination can enhance short-term, high-intensity endurance performance.

    By Bruce Krip, M.Sc.

    THURSDAY, January 27 (EndurePlus.com) -- It's well established that caffeine has ergogenic properties, which soon after ingestion can prolong time to exhaustion during exercise. The studies that have found these results have been done primarily on very fit subjects with high maximal aerobic power and with performance tests that have lasted at least 30 minutes. The extent of improvement appears to be dose related until a dose of 5 to 6 mg/kg, above which no further enhancement occurs. That works out to 350-420 mg of caffeine for a 70 kg or 154 lb person. The ergogenic effects have been attributed to many different physiological factors leading to the stimulation of the central nervous system and/or stimulation of the energy metabolism in peripheral tissues. This includes: adenosine receptor blockage, improved neuromuscular transmission, increased muscle contractility, and increased catecholamine (adrenalin) levels.

    Ephedrine is a sympathomimetic drug that is both an alpha and beta-adrenergic agonist which can stimulate adrenergic receptors in the central nervous system and peripheral tissues. In simpler terms, ephedrine, in essence, mimics adrenalin by displacing noradrenaline in the nerve-ending binding sites and attaching to �excitatory� receptors of the nervous system. Although presumed by the IOC to induce performance enhancement, the investigators of this study (and as reported previously in EndurePlus) could not find any published research reporting observations that ephedrine improves physical performance.

    So here we have two drugs, one well established as an ergogenic aid (caffeine), and the other with no ergogenicity to it (ephedrine). In fact, there has been some suggestion that ephedrine on its own may even be ergolytic (detrimental to performance). The goal of the researchers in this study was to prolong the ability to sustain exercise that leads to exhaustion in 10-20 minutes of effort, a duration of time that is not likely to deplete energy stores. Thus, in contrast to research that has hypothesized that caffeine can prolong exercise time by reducing the rate of carbohydrate oxidation during exercise, the researchers in this study were interested in prolonging exercise at an intensity at which increased arousal is probably more important than substrate availability. Considering the central nervous system effects of both caffeine and ephedrine, this investigation was designed to evaluate the effects of these two substances, individually and in combination, on exercise that leads to exhaustion in about 15 minutes. The combination of caffeine and ephedrine is based on the speculation that caffeine induces a "permissive" action on ephedrine, lowering the threshold concentration needed for a physiological effect(s) and potentiating the physiological effect(s) of a given ephedrine concentration.

    After a pilot study by the same investigators determined that caffeine and ephedrine levels peaked at 1.5 hours after ingestion, untrained subjects consumed either 5 mg of caffeine per kg of bodyweight, 1 mg of ephedrine per kg, 5 mg of caffeine and 1 mg of ephedrine, or a placebo 90 minutes before exercise. The main finding of this experiment was that the combined caffeine and ephedrine treatment increased time to exhaustion during high-intensity exercise by approximately 38% compared to placebo. The researchers said that since neither the caffeine nor ephedrine treatments alone showed a statistically significant change in time to exhaustion, the hypothesis that ingesting a combination of caffeine and ephedrine would enhance performance more than ingesting either substance alone should stand. Rating of perceived exertion was significantly lower in the caffeine plus ephedrine group as well, signifying that the drug combination may have played an effect on either the central nervous system, the peripheral nervous system or both.

    One unexpected result of the experiment was the relatively high incidence of nausea, which reduced the number of subjects available for the study. Four of the 12 subjects stopped exercising during the caffeine-ephedrine trial because of nausea. The researchers reported that the nausea was stimulated by the exercise and was not reported by the subjects prior to commencing exercise. It was presumed that the interaction of the high-intensity exercise with the caffeine and ephedrine was the cause of the nausea since these subjects were able to complete all the other trials uneventfully. Perhaps the masking of perceived exertion allowed subjects to push their bodies to limits not normally reached, causing greater levels of lactic acid production? There has been some suggestion that severe acidosis can cause nausea, as I'm sure many of us have experienced once or twice before!

    The researchers of this study believe the ergogenic effect(s) of combined caffeine and ephedrine come from the perceptual masking of fatigue, allowing untrained subjects to continue exercising for longer periods. Unfortunately, because the study was conducted on untrained subjects, it is still not clear whether this supplement combination may be of any benefit to a well-trained endurance athlete, especially if there is a risk of nausea. And, of course, there is the morality and legality of such drug use, which I'm not even going to begin to get into.

    Bell, Jacobs, Zamecnik, Effects of caffeine, ephedrine and their combination on time to exhaustion during high-intensity exercise. Eur. J. Appl. Physiol. 77:427-433, 1998.
  • Fish Oil May Help Unclog Diseased Heart Arteries
    Fish Oil May Help Unclog Diseased Heart Arteries

    In a fat-fearing world, fish oil is emerging as one fat even a cardiologist can love. Adding to evidence that the omega-3 fatty acid promotes heart health, German researchers have found that a daily dose of fish oil may help slow or even reverse the hardening and narrowing of arteries in patients with heart disease.

    In the current issue of the Annals of Internal Medicine, researchers from the University of Munich report that a fish- oil capsule a day may ``modestly'' improve blood flow to the heart and bolster traditional therapy in patients with atherosclerosis, or hardening of the arteries.

    In a study of 223 men and women, those who took a dose of fish oil per day for two years had fewer atherosclerosis complications such as heart attack and stroke. Two fish-oil patients had complications, compared with seven patients on a placebo pill that contained other fatty acids similar to those of the ``average European diet.'' Most patients were also on cholesterol- lowering drugs, and many had previously had surgery to unclog their arteries.

    One of the ``good,'' polyunsaturated fats, fish oil has widely been thought to have important heart benefits. Found in fish such as salmon, it is a key component of the low-saturated-fat Mediterranean diet that has been linked to the lower incidence of heart disease in that area of the world.

    Just how fish oil bestows its benefits has been unclear, but researchers have suspected that it somehow helps clear clogged heart arteries. The German team, led by Dr. Clemens von Schacky, used X-rays to peer into the patients' heart arteries at the beginning and end of the study. They found that after two years, the arteries of the fish-oil patients, on average, offered more room for blood flow.

    The improvements were not dramatic, however; the fish-oil capsules failed to reverse the disease course in most patients. In the fish-oil group, 14 patients did show a mild reversal of artery clogging, compared with seven in the placebo group. Two fish- oil patients showed moderate reversal, while no placebo patients did. For 35 in the fish-oil group, atherosclerosis progressed slightly, and for four, artery narrowing progressed moderately _ results that were almost identical to those of the placebo group, in which 36 worsened slightly and five showed moderate disease progression.

    Still, von Schacky's team concluded that the benefits found in this study are significant enough to warrant including fish oil as part of traditional heart-disease treatment. Taking a daily capsule or dining on fish twice weekly would fulfill the prescription, according to the researchers.

    Dr. Robert Vogel, a cardiologist at the University of Maryland in Baltimore, agreed that the omega-3 fatty acid, in the form of food or pill, is a wise addition to heart-disease therapy. But he pointed out that fish oil has been shown to have greater effects on factors other than atherosclerosis in treating heart-disease patients. Other research, said Vogel, has revealed that fish oil may help correct heart-rhythm disturbances and that it has a blood-thinning effect. It also appears to spur chemical changes in blood vessels that help them dilate.

    ``As a supplement, fish oil has fairly dramatic benefits,'' Vogel said. ``This is an area of research that has been consistent.''

    Annals of Internal Medicine (1999;130:554-62)

  • Fen-Phen Loses Major Case in Court
    Fen-Phen Loses Major Case in Court

    (MSNBC News, Aug. 6 1999) � A Texas woman who suffered heart-valve damage won a $23 million jury award Friday in the first verdict involving the diet-drug combination fen-phen.

    MEDICAL RESEARCHERS have warned for a long time that the diet drug fen-phen could cause heart problems but it was not until Friday that a jury put a price tag on the injuries a person has suffered from taking the drug. In Texas, a jury awarded more than $23 million to Deborah Lovett, 36, who claimed her heart valves were injured after she took the diet drug combination called fen-phen. The drug�s maker, American Home Products, said it would appeal, but the verdict is a damaging blow and there may be many more to come.

    �We have made a statement that they can�t do this to people like me and you,� said Lovett, following the announcement of the verdict. The verdict is a big legal defeat for American Home Products, whose drug division made one of the pills in the fen-phen pair. Texas jurors agreed with Deborah Lovett�s lawyers, who claimed the company failed to warn doctors that fen-phen could cause heart damage. �If the doctors would have had any idea, I wouldn�t have been on the medicine in the first place,� said Lovett.

    The company, vowing to appeal, said Lovett had heart trouble long before she ever started on fen-phen. �She had a pre-existing heart valve problem that had been going on for almost seven years before she first took any diet drug medication,� said Bob Schick, a company lawyer. But Lovett claimed taking fen-phen made her heart trouble much worse.


    The fen-phen drugs, taken by millions of dieting Americans, were pulled off the market two years ago after medical researchers discovered that the combination could weaken heart valves. Since then, nearly 3,000 fen-phen users have sued the American Home Products, whose drug division made the pills.

    Several of those cases have been settled. But legal experts say the company�s big loss Friday, against a woman who already had heart trouble, means future settlement will cost much more. �They will pay more money to settle the meritorious cases that have been filed. It increases the size of the plaintiff�s likely demands,� said Ellen Pryor, a professor at SMU Law School.

    The company still hopes it can settle most of the remaining cases � possibly by working out a deal with fen-phen users that could even include paying for regular medical checkups for those who took the diet drug and haven�t yet developed any heart trouble. But recent federal court decisions have made it harder to work out big nationwide settlements. And Friday�s verdict makes the company even more vulnerable to lawsuits.


    Fenfluramine, the �fen� part of fen-phen, had been sold since the 1970s but became widely used in the 1990s when doctors prescribed it in combination with phentermine. When taken alone, phentermine was never associated with health problems. It remains on the market. Lawyers for Madison, N.J.-based American Home Products argued that Lovett was seeking compensation for a health condition she had before taking the drug and said her obesity was a bigger threat than the drug.

    �Obesity is a serious health risk,� attorney Joe Piorkowski said in closing arguments. �This is not a dangerous product. The fact that it is not on the market (now) doesn�t mean it was a dangerous product at the time. The benefits outweighed the risk.� But Lovett�s lawyers told jurors that American Home Products was motivated by profit and hid evidence that its diet drugs caused valvular heart disease.

    Attorney Kip Petroff said the company knew of dozens of reports of heart damage in patients taking the drugs, but did not warn the FDA or doctors. �They did wrong and they hurt her,� he said.

    The Associated Press contributed to this report.

  • Soy crazy: How much is enough?
    Soy crazy: How much is enough?

    By Karen Collins, R.D. SPECIAL TO MSNBC

    A RECENT STUDY in the Archives of Internal Medicine found that high levels of LDL (�bad�) cholesterol dropped 6 to 10 percent when soy was added to people�s diets. This confirmed the results of many other studies. As a result, the Food and Drug Administration is allowing a claim on food labels which says that soy protein � as part of a diet low in saturated fat and cholesterol � helps reduce the risk of heart disease.

    Soy foods differ, however, in their content of isoflavones, natural phytochemicals that seem to be vital for soy protein�s cholesterol-lowering effects. Some soy drinks and meat replacements are made from soy protein concentrate that has been washed with alcohol, removing most of the isoflavones. Also, studies in which soy lowered blood cholesterol included 25 grams of soy protein daily. Since foods can meet the FDA�s approved claim if they contain only 6.25 grams, you might need to eat anywhere from one to four servings a day of these foods to achieve similar results.


    Soy may help lower cancer risk as well. Some studies show that when people consume soy daily, their colon cells divide and reproduce in a manner much less likely to lead to cancer.

    One study found that women who ate soy at least twice a week had more than 40 percent lower risk of breast cancer than women who ate soy less than once a month. Results vary considerably between studies, however. These disparities in results possibly reflect the different effects soy many have on cancer that occurs before or after menopause, effects of how early in life one starts eating soy, or the effectiveness of different types of soy foods.

    Scientists believe that soy�s protection against breast cancer involves substances within soy called �phytoestrogens.� These substances have a chemical structure similar to our body estrogen. Because of this similarity, they may be able to block estrogen�s cancer-promoting effects on breast cells. Scientists are concerned, however, that these plant estrogens could also promote breast cancer growth in those who have or have had breast cancer. Research is in progress to solve this dilemma.


    For now, it is certainly reasonable for most of us to include soy foods as part of a healthy diet. People in Asia, who routinely eat one or two servings of soy foods daily, suffer far less from heart disease and many cancers than do Americans. If nothing else, soy foods provide an alternative protein source as we decrease meat consumption and increase our use of plant foods.

    Since we know very little about the effects of very high levels of soy or isoflavones, most health experts discourage people from assuming more is better and jumping prematurely to supplements. Instead, they say, it is wiser for people to learn how to include soy foods in their diets. This warning applies particularly to people with a current or past breast cancer diagnosis. Some researchers suggest that for them, eating a moderate portion of a soy food once or twice a week would probably be safe, but that daily use (and certainly soy supplements) should be avoided until research on this question is concluded.

    Meanwhile, the American Institute for Cancer Research says that research is quite clear on the benefits of eating a mostly plant-based diet � centering our eating around vegetables, fruits, whole grains and beans of all kinds. So if you�re looking for a good bet, it is to use soy as just one part of a balanced, plant-based diet.

    Karen Collins is a registered dietitian with the American Institute for Cancer Research in Washington, D.C.

  • Dan Wirth - Part 2: Simple Guidelines for Effective Weight Training
    Dan Wirth - Part 2: Simple Guidelines for Effective Weight Training

    This is Part 2 of a 2 Part article. Part 1 ran on August 1st.

    What is weight training? - Machine or free weight implements that are pushed, pulled or lifted for the isolation of specific muscle groups. Machine exercises generally have a pre-set range of motion and require less balance and control so learning is faster. Free weights (dumbbell, barbells) are usually more advanced forms of training where virtually any movement can be done for overall development.

    Fundamental Guidelines

    • Frequency - 2 to 6 times per week
    • Duration - 20 to 130 minutes
    • 1RM - One repetition with maximum weight
    • Intensity - Relationship of weight used to your maximum strength level
    • Volume - Number of sets and repetitions performed

    Intensity and Volume Guidelines

    Phase Sets Reps Intensity of 1-Rep-Max (1RM)
    Endurance 2-4 15+ 50% or less
    Hypertrophy 3-5 8-12 60% to 70%
    Base Strength 3-5 6-8 70% to 80%
    Strength and Power 3-6 4-6 80% to 90%
    Max Power and Strength 3-6 1-3 90% to 100%

    Each Phase of training has a corresponding intensity and volume range. Training for endurance is much different than training for maximum power! You should spend the most time in the phase of training that most closely matches your goals. However, you will always want to spend some time in the other phases of training so that your progress doesn�t stagnate from a lack of variation. This is what periodization is all about! All Fitrex.com programs will follow a specific periodization �map� depending upon the emphasis of the program that you choose!

    Dan Wirth M.A., C.S.C.S.
    Fitness Director (Fitrex.com)
    Director of Strength and Conditioning
    The University of Arizona

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