Why You Need A Coach

For most of you reading this who used to compete in sports, think back to your younger days. Can you imagine stepping on the field without the direction of a coach? Without someone calling the plays? Without someone providing structure and discipline? Without someone making you do the things you hated or without setting standards and providing goals that were high, yet attainable? Can you imagine competing without that “coach” who probably knew more about you than you knew about yourself?

In life, I feel that we all need coaches and that we all have the potential to be great coaches in some aspect. However, my definition of coach is not limited to sports. A coach can be a teacher, business owner, mentor, or anyone who guides someone else or an organization to reach their potential.

The following is a list that I feel all great teams, organizations, and individuals have:

• Discipline: Ever see a successful business where the employees come in whenever they feel like it? Ever see a successful team with no guidelines or disciplinary procedures for those who skipped practice? I see success as reaching your potential. Champions raise the bar even further. We have all seen that team with all the talent in the world but that never seems to win. If you’re a good coach, you have discipline because without it, you have nothing.

• Work ethic: It’s true that to reach the top of your given field you have to have some “natural talent.” If you are 5’6” with no athletic ability at all, maybe the NBA isn’t for you. However, for the most part, it’s overrated. If you take a look at champions from any sport or life endeavor, they worked harder than most, if not all, of those beneath them. You want to be like Tiger? Then maybe you should have started hitting golf balls when you were two years old. You want to be like Mike? Wake up every morning at four and start practicing your jump shots. If you’re a good coach, you will make sure your athletes work hard and smart.

• Goal setting/focus: Being able to set goals is important. They have to be high but achievable. You have to have short- and long-term goals or else you won’t be able to stay focused for the long haul. Goals need to be broken down into years, months, days, and even hours. If you’re coaching a team that says they want to be champions but can’t focus on what is important right now such as practice, forget about the long-term goal.

• Mental toughness: The goal that you set above (if it’s worth anything) will be tough to reach. You will have setbacks. The strong will fight through it. The losers will give up.

• Motivation: A good coach is able to find out why their athletes are doing what they’re doing and how to get even more out of them. This extrinsic motivation needs to be internalized as intrinsic motivation inside that person. Most major changes in a person’s life come after some failure or the realization that they are not even close to their potential. Motivation needs to be individualized, and it comes in many forms, though anger is the most common. Anger is a strong energy, and if channeled the right way, can make your average person downright dangerous in a good way. Remember those people who told you “you can’t.”? The company that didn’t hire you? The person who wouldn’t give you a reference? The times you failed and had to look yourself in the mirror for what you truly were?

• Consistency: All of the above need to be done over the long haul. If you want to be Tiger but you’re just picking up the clubs at 25 years old, you might need to find another profession. It takes years of the above to be successful (see my definition) at anything.

You can not do it alone because knowledge is necessary to reach your goal. Take a look in the mirror now. See yourself for who you really are and what you want to be. Print out this article and read it again in the near future. If you see the same person, analyze what you have been doing since you first read this. If you see a different person, stay on that same path that leads to success.

Go Long, Live Short?

I don't find this surprising:

Healthy men over 50 who had finished at least five marathons in the last five years were more likely to have major calcium deposits in their arteries than healthy men who did not run as much, according to a study presented yesterday at an American Heart Association meeting in Chicago.

Calcium buildup is a sign that arteries are hardening, even when patients lack other symptoms. ...

About 36 percent of the 108 male marathon runners in the study had coronary artery calcium scores above 100, possibly a sign of increased cardiovascular risk. Similar scores were seen in 22 percent of 216 men who did not run and had risk factors for heart disease similar to those of the marathon group.

Dr. Möhlenkamp said he got the idea for the study after hearing about some healthy older male runners who had heart attacks when running marathons. As a man who runs about 12 miles a week, he said, he was surprised by the possibility that long-distance running might pose heart risks.

To my scientifically untrained eyes, that doesn't look like a huge difference in the study group and the control group. If 22 percent of the non-runners have these elevated calcium levels, vs. 36 percent of the marathoners, what's the actual increased risk from running marathons? The crude math says it's 61 percent higher, but I have no idea the extent to which calcium levels are associated with mortality.

My instincts and experience tell me that there's a point of diminishing returns with any type of exercise. The only studies I've seen on the subject (from the Harvard Alumni Health Study) showed an L-shaped association between exercise and longevity: The guys who did no exercise had the highest mortality rates, while the ones who did the most were about at the same risk level as the ones who did moderate amounts. So we know that some exercise is good, and vigorous exercise is better than moderate or light exercise.

But then there are the individual cases, which I wrote about here. If seemingly healthy middle-aged men drop dead from running or cycling long distances, it seems entirely possible that there's something inherently dangerous about it that we're all missing.

They'd Rather See You Die than Admit They're Wrong

I'm an excitable guy, but I don't think I'm going too far off the deep end when I say this story by Adam Campbell in Men's Health has some of the best reporting I've ever seen in a mainstream health and fitness magazine.

Here's how it opens:


It's a wonder no one has tried to have Mary Vernon's medical license revoked.


Since 1999, the 52-year-old family doctor has been treating diabetic patients in Lawrence, Kansas, with an approach that was abandoned by most physicians in the 1930s. Worse, this Depression-era remedy is the opposite of the current guidelines established by the American Diabetes Association, a nonprofit organization that spent nearly $51 million on research in 2005, and so should know a thing or two about how to handle diabetes.


There's no question that Dr. Vernon is trouble -- but for whom? Not her patients, that's for certain. They just won't stay sick. People walk into her office afflicted with type-2 diabetes and, by every objective medical measurement, walk out cured. There's $51 million that says that isn't supposed to happen, not in a clinic in Kansas, and definitely not as a result of cleaning out the refrigerator.


"My first line of treatment is to have patients remove carbohydrates from their diets," explains Dr. Vernon, a petite, energetic mother of two who also serves as the president of the American Society of Bariatric Physicians. "This is often all it takes to reverse their symptoms, so that they no longer require medication."


That's it?


That's it -- a simple strategy, but one that's controversial. If Dr. Vernon and a growing cadre of researchers are correct about carbohydrates, we may be looking at an epic case of ignorance on the part of the medical community. That, however, pales next to the implications for the American Diabetes Association, namely that the very organization dedicated to conquering diabetes is rejecting what could be the closest thing we have to a cure.


I'll let you read the rest on your own, and just add this:

Not only do we know the cure for diabetes, we know how to prevent it, just as we know how to prevent obesity. Cut the carbs, kill the disease.

The lengths to which we go to ignore the obvious are astounding now, and promise to get even more absurd as society pays an ever-greater price for our corpulence and the diseases associated with it. For example, in the UK, the national health service may soon pay for gastric-bypass surgery for the most obese adults and teens.

The argument in favor of public financing of these surgeries is that they'll save lives, and perhaps even save money in the long run. It might be cheaper to spend thousands now to staple stomachs rather than spend multiples of that when the obese patients have advanced diabetes and heart disease, requiring expensive drugs and perhaps even amputations.

The argument against?


Dr. Geoff Rayner, a public health expert at City University, said: "We are medicalising something that is actually to do with how we live as a society. People become overweight because of their environment -- because we take a car rather than walk, because we spend hours in front of the TV, and because we are saturated by a junk-food industry. If you take a purely medical approach to this, you start to normalise what is a deeply abnormal state."


Oh, and did we mention the carbs?

Dead Man Running

Dead Man Running

It's been more than three years since Lou Shuler wrote "Death by Exercise," a look at the surprisingly high body count associated with serious endurance training. And yet, running marathons is more popular than ever. (Nice to know I've had such a profound influence on the exercise culture.)

As you might expect, the body count is rising:

This has been an unusual season for the cardiac health of marathoners. After years in which almost no deaths were attributed to heart attacks at this country’s major marathons, at least six runners have died in 2006.

Two police officers, one 53, the other 60, died of heart attacks at the Los Angeles Marathon in March. The hearts of three runners in their early 40s gave out during marathons in Chicago in October, San Francisco in July and the Twin Cities in October. And at the same marathon where Mr. Turner was felled, another man, 56, crumpled near the 17th mile, never to recover.

This year’s toll has sobered race directors and medical directors of marathons. But, as Rick Nealis, the director of the Marine Corps Marathon, said, “Statistically, maybe, it was inevitable.”

The risk is still small -- an estimated 1 in 50,000 marathoners will die with a race number pinned to his chest -- but researchers are finding more signs of cardiac damage from racing, on top of a higher risk of skin cancer and at least one scary thing I can't even pronounce.

There's nothing in the new research that suggests major health problems are inevitable with marathoning. The best conclusion is that it's dangerous and ill-advised for some. But that brings me to something I find mystifying:

If someone is new to strength training, no one suggests that he immediately start bulking up for powerlifting or bodybuilding competition. It's understood that very few people have the kind of genetics that make such ambitions realistic.

And yet, I'd guess that most people who start running have, somewhere in their minds, the idea that they'll someday run a marathon. And it seems to me that the running industry cheers them on.

I don't read running magazines, so I can't say this for sure, but I'd be surprised to find many precautions against long-distance running in their pages. Books about training for marathons tend to outsell my books about progressive strength training for beginners and intermediates.

Some of the titles are kind of disturbing, too. Take, for example, The Non-Runner's Marathon Trainer. If I wrote a book called The Non-Lifter's Guide to Competitive Powerlifting, I wouldn't sell a single copy. But somehow a book about extreme endurance training for novices is considered perfectly reasonable.

Am I the only one who finds that strange?

Death by Exercise

Hundreds of guys -- including some of the world's fittest men -- have taken their final breaths while wearing running shoes. Here's how to outsmart the reaper

By: Lou Schuler

Guy goes out for a run. It's just a 4-miler--nothing, really, to a seasoned marathoner who usually runs 10 miles a day, 7 days a week. Nobody knows why he stops 40 or 50 yards short of his front door--maybe he's checking his pulse, maybe he's tying a shoe--but everybody knows what happens next to Jim Fixx, the 52-year-old patron saint of running: He dies.

You've heard that story. But you may not know about Edmund Burke, Ph.D., who was to serious endurance cycling what Fixx was to running. He died on a training ride last fall, at age 53.

And you almost certainly haven't heard of Frederick Montz, David Nagey, or Jeffrey Williams, three brilliant physicians at Johns Hopkins University who died while running. The oldest of the three was 51.

You'd think that exercise icons should live to be 100. And yet, every year, a few of them go permanently offline at half that age.

Two questions arise. The first is obvious: Why do the hearts of such highly conditioned men fail during exercise designed to make their hearts stronger? The second is so radical it borders on treason against the health and fitness cause: Is there something wrong with the entire notion of endurance exercise as a healthy, life-extending activity?

I've been skeptical about the benefits of aerobic exercise for years. But the answers surprised even me. Pull up a chair--you'll want to be sitting down when you read this.

The Road to Nowhere

The idea that a well-trained endurance athlete could just drop dead was unfathomable a generation ago. Thomas Bassler, M.D., went so far as to say that anyone who could finish a marathon in less than 4 hours could not have serious heart problems. He conducted a study on 14 marathoners who had died of cardiovascular disease, and concluded that all were malnourished. Unfortunately, he reported this conclusion in the July 27, 1984, edition of the Journal of the American Medical Association. Fixx had died 7 days earlier.

Nobody today believes that endurance training confers immunity to anything, whether it's sudden death from heart disease or the heartbreak of psoriasis. Every time you lace up your running shoes, there's a chance your final kick will involve a bucket, and every expert knows this.

"I think the risk is inescapable, and it's bigger than we're letting on," says Paul Thompson, M.D., director of preventive cardiology at Hartford Hospital in Connecticut and a researcher who studies sudden death and exercise. One of Dr. Thompson's studies showed that 10 percent of the heart attacks treated at his hospital were exercise related. "Those heart attacks tend to be in people who aren't fit," he says. "But that doesn't mean that's the only group that gets it, unfortunately. There are these very fit guys who go out for a run and drop dead."

Dr. Thompson's studies and others show that the chances of sudden death are about one in every 15,000 to 18,000 exercisers per year. That comes to one death for every 1.5 million exercise bouts. Curiously, the most serious endurance athletes seem to be at the greatest risk. Here's how it breaks down, according to an often-cited 1982 study published in the New England Journal of Medicine:

• One death per 17,000 men who exercise vigorously 1 to 19 minutes a week
  
• One death per 23,000 men who exercise vigorously 20 to 139 minutes a week
  
• One death per 13,000 men who exercise vigorously 140 or more minutes a week

I had to look at the chart twice to see its startling conclusion: The highest death rate is among the men who exercise long and hard, and is much higher than that of the men who exercise short and hard. Worse, the guys who do hardly any vigorous exercise had a lower death rate than the guys who do the most.

About a zillion studies -- I lost count in the millions -- have shown that aerobic exercise leads to a healthier heart and a longer life.

So I have to wonder why more of such a healthy activity is worse, rather than better.

Sweatin' to the Oldies

In 1970, a study of San Francisco longshoremen made a strong argument that physical activity helps prevent heart disease. The longshoremen who got promoted to mostly sedentary management positions developed heart disease 25 percent more often than those who worked on their feet.

An important note about this study, and similar ones that preceded it: The subjects weren't doing formal, steady-pace endurance exercise. They were walking and stopping, lifting things up and putting them down.

Numerous formal exercise studies followed, many of them attempting to quantify how much physical activity is needed to prevent heart disease, and at what intensity levels. The Harvard Alumni Health Study found that heart-disease risk starts going down when you expend more than 500 calories a week and continues to decrease until you get to 2,000 calories a week. Then things level off--more exercise doesn't offer more protection.

The bottom number isn't much exercise; a 200-pound man walking 2 hours a week at 3 mph will burn 600 calories. And the top number isn't particularly intimidating, either. Our 200-pounder would have to run about 16 miles at a 12-minute-mile pace to burn 2,000 calories a week. (Lighter guys will burn fewer calories per minute or mile; bigger men will burn more.)

Intensity is a separate issue, with some studies showing that moderate-intensity exercise (walking, bowling, playing golf) helps your heart, and others showing little benefit until you start cranking (running, lifting serious iron, playing basketball or soccer).

Still other studies measure heart-disease risk by activity level, and these show something really interesting: Once you get past the 75th percentile of physical activity--guys who exercise more than three-quarters of the population--protection against heart disease levels off. In fact, among the most active, it actually declines slightly, according to a review in Medicine & Science in Sports & Exercise. In other words, the superactive are more likely to die than the merely active.

Snow Problem

One reason it's so hard to understand the whole death-by-exercise phenomenon is that so few people die during formal exercise--there are only about 100 cases per year. So it helps to look at those who suffer heart attacks during heavy physical exertion in general, rather than fitness activities in particular. One important study, published in the New England Journal of Medicine in 1993, looked at 1,228 nonfatal heart attacks, 54 of which occurred during or soon after serious exertion. (The cutoff point was 6 metabolic units, or METs. This means the exertion was greater than or equal to six times the energy required by a body at rest. Heavy strength training is considered a 6-MET activity, as are wood chopping and snow shoveling; running 12-minute miles racks up 8 METs.)

The researchers divided the cases into three categories and found that about 18 percent of the exercise-induced heart attacks occurred during lifting and pushing, 30 percent during jogging or sports (racquet sports in particular), and 52 percent during yard work, such as splitting wood.

And that brings us to a major cause of death by exertion: snow shoveling.

A researcher at William Beaumont Hospital in Royal Oak, Michigan, tallied 36 snow-related deaths in the Detroit area following two heavy storms. (Curiously, several of the victims were using snowblowers.)

It's easy to see why frozen precipitation scores such a high body count. "Heart rates go up like a maximal treadmill test," says Barry Franklin, Ph.D., director of cardiac rehabilitation and exercise laboratories at the Beaumont hospital. "Combine that with cold weather, which constricts arteries, and you have a prescription for disaster."

An interesting point: The men who shovel off to meet their makers following a snowstorm, or who have to call an EMT after putting ax to wood, aren't doing aerobic activities. There's no endurance component. Snow shoveling and wood chopping are anaerobic activities--strenuous efforts that can't be continued longer than a few minutes without stopping to rest.

In other words, these activities resemble strength training and are very different from running or cycling. So you'd probably guess that weight lifting also has a pumped-up body count.

Nope. In fact, it has virtually no body count. A few guys a year die from dropping barbells on their tracheas, and some strokes turn up in the literature, but you'd be hard-pressed to find any cases of heart attacks associated with weight lifting. Post-cardiac-arrest patients are regularly trained back to health with weights, and I couldn't find any references to any of them dying, either.

Strength training protects your heart in two ways: First, says Franklin, you get a predictable increase in diastolic blood pressure, which governs the return of blood to your coronary arteries. (If your blood pressure is 120 over 80, 80 is the diastolic number.) That's different from aerobic exercise, in which systolic blood pressure (the first number) rises but diastolic pressure stays the same or possibly even decreases. Both numbers go up by quite a bit when you lift, which means blood is being pushed back to your heart with equivalent force.

Second, most of us tend to hold our breath briefly while lifting. This increases blood pressure dramatically and used to scare the daylights out of doctors, who feared aneurysms could result. But new research from the University of Alberta in Edmonton shows that brief breath-holding actually exerts a sort of counterpressure on arterial walls that neutralizes the rise in blood pressure. Aneurysm avoided.

In other words, your body seems designed to protect itself during brief, heavy exertion and lifters shouldn't ever have to worry about death by exercise.

Final Exam

However, don't bank on it. The fact that hardly anyone dies during strength training doesn't prove it can't happen. Barry Franklin points out that the men at greatest risk of sudden death during exercise are middle-aged; most lifters are young. More of us older guys are lifting today, but when the studies I've cited in this story were put together, in the '80s and early '90s, you didn't find many gray-hairs in the weight room. If a middle-aged guy was exercising, he was most likely running, riding a bike, or swatting at a fuzzy yellow ball.

But now we do have a substantial population of middle-aged men in health clubs, and we know a few of them will do their final cooldowns at the county morgue. Franklin recently looked at exercise-related deaths at a major chain of health clubs. Using swipe-card data, he tallied 183 million gym visits in the study period, during which time 71 members died while working out. It's not known what the deceased were doing at the fatal moment, so we can't draw many definitive conclusions.

But Franklin did find two interesting trends in the data: The average age of club members was 32. The average age of the 71 who died was 53. The 71 also averaged just two trips to the club per month. It's possible they were exercising outside the gym, but Franklin doubts it. If they had been, most of them would probably still be alive.

And that's the most reasonable conclusion one can draw about death by exercise: The best way to avoid it is to exercise. "The person who's at greatest risk of an exercise death is the person with known or hidden coronary artery disease who is habitually sedentary--a couch potato, all year round," says Franklin.

You don't need to turn into a marathoner. (Look what happened to Pheidippides.) But you should work out frequently; many studies have shown that the overall amount of time you spend up and moving matters.

Some endurance exercise is fine, if you like it. Strength training is probably more than fine--it specifically prepares your body for the shock of sudden, strenuous exertion, such as shoveling snow, which is most likely to kill you if your body isn't ready for it.

We can't attach any sort of dose-response number to weight lifting as a preventive to sudden death, but we do know it's pretty hard to kill yourself while doing it. For example, if you assumed that every death recorded at the health clubs occurred during strength training, you'd still end up with just one fatality for every 2.5 million exercise sessions, which is lower than the one in 1.5 million that shows up in older studies of mostly aerobic exercisers.

But any time you exercise strenuously, on the road or in the squat rack, you're taking on a small risk of a big problem. "It's like investing in the stock market," says Dr. Thompson. "You're putting your money down, looking for a long-term gain. But you could put your money in WorldCom and lose it all. There's a risk to everything."