I am uncertain of how many times I have told patients that posture may be influencing their back, neck or shoulder pain, but I am pretty sure it is a cause of many people's problems. Unfortunately, there are few ways to assess or measure one's posture. The question of "how would you describe your posture at work?" is often met with a simple "terrible!" or "bad!".

For those that know me, I have been a fan of wearables in helping track various metrics from heart rate, forces during running, ground contact time and spine range of motion etc. I believe that putting a measure on something is the only true way to know whether you can fix it. I believe the same is true for posture.

The Upright Go is one of those wearables that will track posture and I have been trialing one over the last week. I have used other devices such as the Vimove 1 and 2, along with the LumoBack and LumoLift. All of these devices can help with both measuring and improving posture, but I find both the Upright Go and the LimoLift to be the most convenient. Sure, they are not as accurate as the device I use here at the clinic (Vimove) but for the simple task of measuring and retraining, I find this device more than enough, especially for the price.

​The device works by placing it between the shoulder blades and calibrating the position (ie your ideal posture). You then get a reminder (small vibration) when your upper back tilts forward for a certain amount of time and a certain degree (all user configurable). This serves as a way to remind you throughout the day to sit up.

The fact that it is so simple is both a plus and a minus. Some complain that the data is not that useful, inaccurate or has risks for human error in the calibration process. The reality is that when I compared the data side by side from the Vimove sensors (the device I use in clinic that is much more accurate and measures multiple points along the spine), the general trend was almost identical. The Upright Go is far more simple and accessible to most people and the price point is very good for the potential benefit.

The Upright Go is a device that I think will improve your posture and I would certainly recommend this for people who are looking for a simple way to measure and fix this common problem.

​Ian

Please note that I am in no way paid for this review and I have purchased this device on my own.

​This was a great article to read that gave me hope in my endeavors to get faster despite my age. The main take home message is how to adjust your training as you get older and the importance of strength training. I have linked the article below.

How to Run a Marathon Faster as You Get Older
https://www.nytimes.com/2018/11/02/sports/how-to-run-a-faster-marathon.html

I love the fact that at 41 and 43, these two runners are going so fast still. 

#ageisjustanumber

Follow what I am reading here

I am excited to launch a new service that can revolutionize the bike fitting world and the way it is deliveried. Using motion capture software and your smartphone, the bike assessment process can now be done at home. You will need a few key shots and ideally a tripod, but the actual capture of accurate video is relatively simple.

After taking the key footage (about 3 seconds worth for each sample), you send in the file and I can analyse the position and send a report back with some recommendations. Here is an example of what can be done (and I filmed myself using this exact technique).

Any questions, ask in the comments below.

Running assessment results from the Chocolate Box Training Session - 12 April 2018

Session:
400m running sample taken at/or around a self selected estimated race pace for the UTA event in May. Comprised of 2 x 200m with a 10 second break with increasing pace.
Surface: Grass
Intensity: Low
Limitations: Very small sample of running which may give false readings (eg running on a camber or uneven part of the grass track. Not "real" race conditions and no hills.
Future tests: Longer samples done on the trails to simulate real conditions. Use fully loaded race pack and check the influence the extra weight has on the legs. Normal ranges are each kilogram added is equivalent to 3-5kg under foot (Ground Reaction Force).

Main findings:
All runners generally had low cadence and high contact times (All in the 270-310ms range). This was likely due to the speeds run but they are on the very upper end of the scale of normal. Our aim is to generally try and keep contact times below 250ms (pending speed). The best runners tend to have contact times below 200ms. By improving cadence and contact times, runners can apply less total load to the legs and generally become more efficient with less braking forces applied. 

Initial Peak Accelerations (IPA) varied only a little in this run and all came roughly in normal ranges. High IPA values are associated with sudden forces and our goal is to keep these down on long slow runs. There was one runner who had a significant variation in this and I would encourage another few samples in order to see if this is a problem or just evident on this run (ie running on uneven surfaces).

Ground reaction forces were all generally high in terms of absolute numbers. When looking at these forces, there is no strict rule as to what is regarded as "too high" or "optimal" as speed again has an influence. However, in terms of conversion, 1750 N (newtons) of force per stride is the equivalent of just under 180kg (178.6kg). Just by reducing this number by 10%, one can appreciate how much better the legs will feel over 22, 50 or 100kms. One runner (and I might hold some bias here as I have seen her before and we have worked on this), had an amazingly low average of 1108N (about 2 x body weight). Most other runners came in at 2.36 x - 2.45x body weight. 

Here are some of the graphs without the names attached. If you have any questions on how to improved this or how to interpret the scores, please don't hesitate to contact me for a chat. There are many more details to go through and consider and I look forward to discussing this at the next session.

​
​

One of the challenges in Sports Physiotherapy is on how you can get accurate data, and furthermore, how you can get accurate data when the athlete is not in front of you. I have been using objective measures for strength, range of motion, ground forces, speed etc, for almost my entire career as a sports physiotherapist and when I started Sports Physio Online, I was determined to continue using objective measures for assessments and outcome measures.

There are now a number of excellent wearables that allow me to continue to monitor athletes accurately and determine whether there are improving and performing well. As part of my approach to sports physiotherapy, I recommend a number of wearables for clients and each one has a specific value.

Garmin GPS enabled watches

Although most triathletes now are familiar with the Garmin or Suunto ranges of watches and cycling computers, it is important to note some of the specific differences and how they can be used in the load monitoring context. For example, a few years ago Garmin introduced the advanced running dynamics for the 620 Forerunner. Before this watch, stats such as contact times and balance was rare, if not impossible to find. I previously relied on expensive running lab equipments (a force plate treadmill) to give me this data.

Why was this so important? Well the studies examining running economy showed that this value was the most reliable at predicting how efficient a runner was. Contact time also changes over time when factors such as fatigue set in (contact times usually increase with fatigue) and is an immensely valuably statistic when training the injured runner.

What I have learnt when utilising the force plate and the Garmin advanced statistics is that I can now match up a specific outcome in the lab, with something that each runner can use everyday. For example, if a specific runner has excellent balance and contact times with a set cadence, I can then match up those stats with the Garmin and get the athlete to practice this every time they run. Further, I can re-test them at a later stage to see if those values are valid.

So what else can be tested?
Another exciting development in the wearable technologies field is the ability to test ground reaction forces during running. Using a device called a ViMove, I can place sensors on the shin bones (tibia) of a runner and see how much force is placed on that limb each foot strike. Suddenly the limitations of using a force plated treadmill are removed and I have tested runners outdoors with in their normal training environments (even on 20 km runs). I can see how fatigue affects runners, how different gradients, shoes, running styles and surfaces all influence them

I am now consulting at North Curl Curl Physio starting this month. I will be focusing on running assessments, analysis and re-training using the innovative technologies such as a force plate treadmill, ViMove2, Runscribe and video analysis. The "Run Lab" as I like to call it, is one of the best devices I have used to get objective data for running and it allows instant feedback when re-training. 

I have written an article about this service here but please feel free to contact me for questions or details.

To follow up on the last article on fuel efficiency testing, I decided to undergo a Lactate Threshold test to further define my zones in training (and to test out another gadget!). This was done using the BSX system, which measures muscle oxygen during exercise and estimates your threshold from this value. Admittedly, this test wasn't as pleasant as the fuel efficiency test, as it took me to failure after around 40 minutes on the treadmill. However it did confirm a few things and I found it very useful.

What is involved?
The BSX insight lactate threshold testing unit is a non invasive test which is different from the typical lactate testing involving taking small repeat samples of blood. I really like the reviews from DC Rainmaker so I will link his review here rather than rewrite something that has been done before. In summary however, it is a device that is relatively easy to use and repeatable. It is a shame that the device has been discontinued but I am still interested in utilising it and then testing it against the more traditional blood test version.

The basics involve measuring the oxygen level in the muscle of your calf while exercising. Based on the principle that the muscles utilise oxygen during exercising in order to produce energy, the BSX Insight measures this oxygen content and displays a percentage of oxygenation in that muscle (Sm02). As you exercise at higher intensities, there is a build up of lactate concentration from this process and also a corresponding decrease in the content of oxygen in the muscle. Typically, what happens in a progressive run test, is that Sm02 goes down steadily as intensity increases but then suddenly it drops exponentially, which is the sudden gradient change that you see in typical lactate threshold tests. The device will report the level that it predicts your threshold is, based on this sudden change. The corresponding heart rate (or intensity) is the threshold that you can sustain, otherwise know as the lactate threshold.

Why is it important?
Lactate threshold has traditionally been a metric that athletes have used to determine the maximum level of intensity they can sustain for long periods without "blowing up" or fatiguing rapidly i.e.. If you can sustain this maximum, you will perform better. Knowing this number is important in training and races so you can keep to your zones. Typically athletes can go above this threshold for a certain period of time before rapidly fatiguing. This time that athletes can sustain above threshold is a different metric that is sometimes referred to as functional reserve capacity (FRC) but I will not go into that today.

Lactate threshold is different between individuals and is also different between the same individual at different levels in fitness. An "untrained" individual may have a lower threshold than that same individual after some months of training. Most formulas to work out threshold are based on age, max heart rate and resting heart rate, and do not take this change of fitness into account. Hence they are often advocated as a "ballpark" figure or estimate.

What about my FTP?
Functional Threshold Power is another way to get similar results if you use a power meter on the bike. I personally find it much more useful than my lactate threshold heart rate or speed, particularly when running, as there are many other factors that influence heart rate and speed, namely simple things such as length of training, heat, ingestion of caffeine and gradient of the run, ride. In saying this however, I do like having another metric to use as a guide. Knowing that you can hold a certain speed at a certain heart rate or matching power and heart rate, helps determine if there are is any disparity and can warn you that something isn't right. Further, threshold ability can change based on factors such as muscle fatigue as well. You may be feeling fine with respects to heart rate on a run, but the legs just cannot go any faster despite your efforts. This is typically seen at the end of a long session such as a run or in the late stages of a race. Threshold heart rate alone will not help guide your efforts here.

Take home message
Although there are some limitations, in my opinion, the use of the lactate threshold test is a useful metric to obtain in order to "dial in" your efforts. When complemented with your FTP and knowing your maximal aerobic function (MAF), you can better tailor you efforts or zones to get the most from training, or more commonly to just slow down.
​

I have heard the term "I am fat adapted", a number of times over the years and although embarking on this experiment of lower carbs, moderate protein, higher fat (LCMPHF) diet for only a short time, I was beginning to wonder if this concept could be proven. How would I know when I am "fat adapted"? Can I improve on my ability to burn fat as fuel?

So I decided to do what I normally do, and find a gadget that could give me this type of data and quantify it. I approached one of my colleagues from Morph Performance to conduct the test (known as a fuel efficiency test) and I was certainly surprised at the results. The test itself is relatively easy and it clearly answered my questions. The test consists of a progressive treadmill effort that increases in speed every 2 minutes. You are monitored using a heart rate strap and also a respirometer (a device that measures respiratory quotient by analysing the air you breath). The total test time is about 20 minutes plus the set up time. 

The Results

Although I have nothing to compare it to, I was surprised as to how I continued to burn fat throughout the test. Only embarking on the lower carb, higher fat diet about 5 weeks ago, I didn't think that there would be a result other than the "high intensity exercise equals almost all carbs as fuel" picture. I was pretty shocked to see that I could utilise 20% of my energy from fat at just above threshold levels, which equates to around 198 calories per hour (about 2 gels per hour of carbs equivalent). It also demonstrated that my intuition of my "fat burning zone" or aerobic zone was estimated correctly (around the 140 bpm and below). What it also emphasised was that carbohydrates are still an important energy source. Here are some of the stats...

At around the "easy" level that I have been training at (about 138 bpm), I burn an estimated 28 grams of fat per hour. Since fat delivers around 9 calories per gram, this equates to around 252 calories per hour. Compared with carbohydrate, 1 gram delivers around 4 calories for a total of 428 calories per hour. As a percentage, it was around 37% of fat, 63% carbs. As you can see, when I went faster, this stayed between 35%-37% until the "cross over" as seen on the graph below, where carbohydrates significantly take over and fat utilisation starts to drop. One thing I would likely do differently next time is to start faster and push to a much higher intensity to see whether fat drops off more (mine seemed to rebound a bit back up near the end).

So how do I use this information in training?
Firstly, I have to say that I was pleased to see that my intuition during training was pretty close to the zones reported. I knew that I could train for long periods in a fasted state if I stayed  under 140 bpm and the results backed up my estimate. During these sessions, I have grown confident that I would need minimal fuel and I would not "bonk" (run out of energy). Typically these "long" sessions were between 2-5 hours, but it did take a while to get used to and I had to be strict on not going above this (i.e. I walked up hills). I have only just started some higher intensity efforts while fasted and have been using carbs during these sessions as a top up (based on feel).

The second piece of information that I feel can be easily overlooked, is that carbohydrates still supply a significant portion of energy so I will certainly not be completely eliminating these from my diet. Actually what I will likely be doing is calculating roughly how much training I do and use this test as a guide to see how much needs replacement. Eg a hard session for 1 hour may use up to 200 grams of carbohydrate.

Will I continue to try and become more "Fat Adapted"? Will I stay LCMPHF? In short, I feel that boxing up my eating habits into one particular group is not truly reflective of what I do, nor is it a good guide to eating and training effectively. By saying "only eat 50 gram of carbs per day" or "you must have 2.5g or protein per kg of body weight" is overly simplified and doesn't take into account the many variables and individual needs, not to mention the stage of training you are in or the session goals. Also, recognising that high intensity does require high carbohydrate supplies is an important aspect to understand. What I like about this test is that it gives me more detailed guidance about the use of energy and the energy sources at specific intensities for me at this moment in time... I plan to repeat this test and see if it is something that can actually be trained. I will likely use this guide and continue as I have been doing, "going by feel, measuring outcomes and making adjustments".

Special thanks to Courtney from Morph Performance for conducting the test.

Admittedly I am a Strava fan and the old adage of "If it's not on Strava, it didn't happen" sometimes crosses my mind. So after an interval session this morning on Zwift, I was somewhat stressed that the auto upload did not work. No worries,  I did the session and that is all that matters. How well did I do the session though? Did I hit my planned targets or did I go too hard on the "moderate" intervals? How will I compare this session to next session???
Step 2 - Search for "how do I manually upload a Zwift file?"  Thanks to Google I soon discovered that this can happen and there is an easy fix. Zwift saves the files on your PC and you can upload it. Simple. Except it didn't upload and instead gave me an error... 5 times!
Step 3 - By this stage I was determined to get it fixed as the file was there so I tried loading Zwift again and closing it down. Voila! The file "fixed" itself and the manual upload worked fine.

So in the end I was happy that my file uploaded and I actually did the session as planned (which intuitively I already knew), but having that information did give me peace of mind. So if you are like me and love the stats, percentage efforts, watts etc, I hope this can give you a simple way to fix the problem of Zwift not syncing up.

Getting any business started is often balancing out what has to be done with what I would like to be done. One of my missions in setting up Sports Physio Online is to provide endurance athletes with the knowledge of many and provide an opinion to help filter the information into layman's terms. Over the years I have read a number of articles in the area and have used Flipboard to save the list that I have found interesting and useful.

So as a stepping stone to spreading this information, I have added these magazines of hand picked topics to my website, and will begin adding commentary to many more (hopefully sooner than later). So feel free to subscribe and have a look. Post questions if you like.

The link is here
​