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Sean McCawley, Fit for Life in Napa Valley: Recover from injuries by slowing down your exercises with eccentric exercise

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Sean McCawley, Fit for Life in Napa Valley: Recover from injuries by slowing down your exercises with eccentric exercise





Sean McCawley

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“I’m not sure I should come in for my training session today. I might have lifted something the wrong way when I was bending down to prune my roses. Now, I have some tightness and pain in my lower back and right side of my hip. What do you recommend?” read one of the emails from Revy in my inbox on a Monday morning a few weeks ago.

Revy is one of our personal training clients who frequents our fitness center twice a week. Her attendance is among the upper percentile in terms of showing up ready to go for her twice-weekly training sessions. Fueled by a light pre-workout meal, a bottle of water, and the assurance that she would show up 15 minutes early to complete her dynamic stretching routine that has been etched into her memory banks, one could say Revy is the ideal personal training client. The coaches fight over who trains Revy because she listens and comprehends the exercise tactics we cue her to perform with intense concentration, purpose, and an eagerness to receive positive feedback.

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As a woman just entering her 60s and embracing a life of retirement, Revy has embraced a fit and active lifestyle as the key to paving a path of adventure and fun to fuel the aspirations of traveling, hanging out with her friends and family, and recreational activities she’s always wanted to delve into. However, after training for over 18 months, Revy experienced something unusual she hadn’t felt after the positive outcomes she garnered from consistently adhering to her fitness routine. Following two hours of pruning rose bushes, raking up leaves, and filling up her brown compost bin, she woke up with back pain that severely disrupted her daily activities the next day.

After reading Revy’s email, I felt sympathetic toward her discomfort. She has worked diligently to ensure the condition of her body is nurtured and operating at full capacity thanks to her efforts to eat healthy and exercise regularly. However, I understand that certain events are out of our control, and outliers in the course of everyday life can present a shift in the normal rhythm we’re accustomed to.

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I trusted Revy’s intuition that exercise might make things worse. I told Revy I was confident we could adjust her training regimen to avoid exacerbating the injury. Furthermore, her program would be revised in an effort to alleviate her pain and rehab the site of her injury. This meant the coaching team knew to incorporate lower back injury prevention, stretching, and less compressive movements in her exercise prescription. As a productive intervention, we incorporate isometric and eccentric modes of exercise when participants report an onset of pain from an unlikely event in which they endured a musculoskeletal injury.

Isometric exercise can be defined as a mode of exercise in which the surrounding joints aren’t moving but are still under tension. A common example is the straight-arm plank. This position is commonly understood as positioning oneself in the starting position of a push-up and maintaining that position for a specific period of time. We usually instruct our personal training clients to hold a plank for 20 to 30 seconds to start.

Once planks can be maintained for a proficient amount of time, about 45 seconds to a minute, we progress to the next mode of exercise, eccentric movements. Commonly understood as a slow-lowered or “negative” portion of an exercise, eccentric muscle contractions can be identified as the lengthening of a muscle fiber.

A commonly perceived normal exercise routine consists of a one-to-one ratio of lifting a load and lowering it at the same speed. Performing this mode of a normal one-to-one ratio of time in the accent and descent of the push-up is commonly understood as the traditional way of exercising. This isn’t what we wanted to do for Revy.

We knew that Revy’s body was in a state of distress. Instructing her to perform three sets of 10 repetitions for her compound lower and upper body movements might exacerbate the injured area because the rate of muscular contraction and physical exertion could potentially overstress an already stressed area. Therefore, performing three sets of four repetitions of slow-lowered descent exercises would be beneficial and avoid the risk of pushing past Revy’s limitations. We put Revy in a successful situation by reducing her repetition count but lengthening the duration of the repetition. This way, she would still be performing exercise but in a modified style that decreased the mechanical movements of her joints yet still applied productive stress to her muscles. The likelihood of straining the area further decreased by reducing the amount of movement on the joints in her back and hip. Most importantly, Revy could still attend her beloved training sessions to stay consistent in her journey to be fit and strong for her everyday life activities.

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It’s worthwhile to refine one’s fitness habits when an injury occurs. The last thing we want to do is either “push through the pain” and make things worse or just quit exercising altogether. We can still keep moving when an injury presents itself. After an unexpected injury occurs, take a step back, reassess what we can do, and keep pressing forward by consistently adhering to a ritual of regular exercise.

Sean McCawley, the founder and owner of Napa Tenacious Fitness in Napa, welcomes questions and comments. Reach him at 707-287-2727, napatenacious@gmail.com, or visit the website napatenaciousfitness.com.

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Fitness

How to make exercise a consistent routine in 2025

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How to make exercise a consistent routine in 2025

By Gwendolyn Bounds

For The Washington Post

Eight years ago this month, like many Americans, I made a resolution to become fit and strong.

About 7 in 10 U.S. adults set goals at the start of a new year, and personal health or fitness goals are the most common, according to Gallup. But by mid-February, 80 percent of the people who set New Year’s resolutions will have abandoned them, Gallup reported.

I, too, had tried before, my pledge generally lasting a few months before old habits (sitting! screens!) returned.

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But that year was different. I had a specific goal in mind — to compete in one obstacle course race. Tying my New Year’s resolution to something concrete was a critical first step to exercise being almost a nonnegotiable in my day. Last year, I completed my 56th race.

Once a resolution is made, specific tactics make it more likely to stick. Here is what habit and fitness experts, and my own experience, suggest:

Have a longer-term obtainable goal

Going out too hard is a common misstep, said Peter Duggan, a strength, conditioning and rehabilitation specialist at Fuel Sport & Spine in New York. “People say ‘I’m going to go crazy’ and then come in to see us injured by the middle to end of January,” he said.

(Hanna Syvak / Adobe Stock)

Having a longer-term goal and plan is better, suggested Duggan, who works with professional athletes and amateur fitness enthusiasts. That can be as simple as a 5K race in April or a 90-day first-quarter (Q1) challenge where you measure your January progress against your February progress and your March progress against February and January.

This way, you have some form of momentum. But if January blows up because you get sick, then you still have February and March, Duggan advised. Start small if you’re a newcomer: Go from walking or jogging in January a couple of times a week to running 25 minutes two or three times a week in February and longer in March. Then set another goal for the next quarter.

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“You can’t just run up Mount Everest,” Duggan said. “You have to start at base camp. Use January or Q1 as base camp.”

Time block and preprogram your workout

Waking up and thinking, “I’m going to exercise at some point today,” is a vulnerable strategy. You must then spend extra time figuring out what you’ll do, when you’ll do it and where — time you probably don’t have in an already full day.

(Adobe Stock)
(Adobe Stock)

Instead, schedule and block out your exercise moments for the week, in advance, to reduce the likelihood of slipping back into old habits — such as coming home, jumping on the couch and scrolling on the phone.

“Physical activity takes time, and you need to be mindful of your other habits that need to change,” said Chad Stecher, a behavioral health economist and an assistant professor at Arizona State University. “Not only are you building a new habit, but how does that habit fit into the rest of the day?”

My solution: Since I live by my digital calendar for work, each week’s exercise gets scheduled in the same color-coded blocks as my meetings. I don’t skip meetings, so I don’t skip my workout. This removes the barrier of “at some point today.”

Leave yourself visual prompts

Cues, particularly visual ones, are some of the strongest motivators to create a new habit, said Stecher, whose research focuses on habit formation.

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For instance, placing your running shoes or workout clothes where they are the first items you see when you wake up reduces the likelihood exercise will slip your mind, Stecher said. It also serves as a commitment reminder that “you intended to do this,” he said.

In my living room, I keep a nice box that holds a yoga mat, balance board and foam roller. Seeing that box each time I walk to the kitchen means I’m more likely to use what’s in it when I have five to 10 minutes to spare.

Accessibility also matters, Duggan said.

“It has to be convenient,” he said. “We all have weeks when we are overwhelmed, but you can still carve out 20 minutes in your living room with some dumbbells or a HIIT [high-intensity interval training] class on an app.”

Build accountability slowly

Recent research suggests the amount of movement we get in a day, as measured by a wrist tracker, is a stronger predictor of mortality than age, smoking or even diabetes.

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How to Get Back in Shape After the Holiday Break

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How to Get Back in Shape After the Holiday Break
If you took a break from your fitness routine over the holidays, you are not alone. According to reports, nearly half of Americans, or 45%, hit the pause button on their workouts during the holidays. “Holiday travel, activities with friends and family, and trying to get a…
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Fitness

Is electrical muscle stimulation really a short-cut to getting buff?

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Is electrical muscle stimulation really a short-cut to getting buff?

In a 1993 film Dragon: The Bruce Lee Story there’s a scene where the main character sits at a typewriter wearing electrodes strapped across his chest and biceps.

The martial arts superstar is zapping his muscles so he bulks up without doing any exercise.

“Three minutes is like doing 200 push-ups,” he claims.

This technology, called electrical muscle stimulation or EMS, was explored by the Russians back in the 1960s to help athletes train, and it’s since been embraced by the likes of soccer star Cristiano Ronaldo and Olympic gold medallist Usain Bolt.

These days, EMS is promoted to people who want to get buff. You can even wear a whole-body EMS suit at the gym.

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EMS proponents say that the technology, which sends electric impulses through skin and into muscle below to make them contract, “bypasses” the brain, triggering muscles to work and grow in a “smarter and more efficient way”.

Some ads say you can get your weekly whole-body workout in just 20 minutes — without lifting a single weight.

It sounds too good to be true, so what is the scientific evidence for these claims?

What’s the theory behind EMS?

Our muscles are made up of different “motor units”, each consisting of a nerve and the muscle fibres it activates.

One type of motor unit is smaller, contracts slowly and takes a while to get tired, while the other is larger, contracts rapidly and fatigues quickly.

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The larger units use more energy but can generate more force. These are the ones that we use to build strength over time. 

EMS is often used as a supplement to training. (Getty Images: Milan Markovic )

When we voluntarily activate our muscles — by lifting weights, for example — our brain activates the smaller slower motor units first before activating the larger faster ones, says Swarup Mukherjee, a sports and exercise physiologist at Nanyang Technological University of Singapore.

“What EMS does is it reverses this natural recruitment order.”

And it is thought that by stimulating the larger motor units first, EMS can speed up the process of building muscle mass — and strength.

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From medicine to elite sport

Manufacturers of some EMS gadgets have landed in trouble for overstating their claims on late night infomercials.

While some gadget claims might not stack up, there is a scientific basis for using electricity to stimulate muscles. In fact, the idea has been around for centuries, and has developed into an important way to exercise muscles when someone has an illness or injury.

“For patients that are unable to physically exercise for whatever reason, electrical stimulation can replace exercise,” says Gordon Lynch, who studies the use of EMS with the Centre for Muscle Research at the University of Melbourne.

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“The evidence is really strong that we can get adaptations in muscle and recruit muscles in a way that that can be beneficial.”

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But, Professor Lynch says, it is less clear whether EMS works as a general fitness tool.

“There’s no real consensus about how to optimise this form of training for otherwise healthy people.”

Still, there are no shortage of online testimonials from people who swear EMS workouts are the way to go.

But what does the evidence say?

Some research, such as this small 2016 randomised controlled trial of middle-aged men, supports using EMS to build strength and lose fat.

And the technology’s “time-efficiency” and “joint-friendliness”  is seen by some researchers as attractive to those “unable or unmotivated” to do intense exercise.

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A 2023 review by Dr Mukherjee of 10 other studies also found EMS increased the size of the muscles they stimulated in healthy adults.

And since muscle is one of the most energy-hungry tissues in the body, building them should also help burn fat, Dr Mukherjee says.

Olympic medal winning Usain Bolt running fast.

Retired sprinter Usain Bolt is among the high-profile athletes who have used EMS. (Getty Images: Ashley Feder/Stringer)

But, he cautions, building bigger muscles does not necessarily translate to the sort of strength that will make gym exercises or everyday activities easier.

In fact, none of the studies in his review found EMS improved such “functional” strength.

“There isn’t enough body of data to convince us that it is an equivalent of voluntary resistance training,” Dr Mukherjee says.

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Other researchers who reviewed the evidence on whole-body EMS  concluded active people won’t get any advantage from the technology, although older sedentary populations may benefit.

One limitation of EMS is that it contracts static muscles, but to do specific activities our brain orchestrates a combination of muscles in a special way, Dr Mukherjee explains.

During bicep curls, for example, our biceps contract, while our triceps must lengthen and relax.

This is why there is a preference among proponents to combine EMS with traditional muscle exercises, Dr Mukherjee says.

Getting the right ‘dose’

Everyone’s muscles respond differently to EMS, Professor Lynch says, adding that this makes giving the right dose of stimulation a challenge.

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“If it’s not enough, then you’re not going to get any benefit at all. And if you over stimulate, then you can cause muscle damage.”

Sport scientist Nicola Maffiuletti of the Schulthess Clinic, an orthopaedic hospital in Switzerland, agrees.

Traditional muscle building involves progressively — and carefully — adding heavier weights to a training regimen over time as your muscles adapt and get stronger.

But Dr Maffiuletti says it’s harder to know how much current to use to get the right stimulation with EMS.

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“When you inject current you don’t know how to properly dose on an individual basis.”

Possible risks of EMS

Dr Maffiuletti is particularly concerned about the dose of current delivered by whole-body EMS suits.

These are a wetsuit-type outfit with electrodes that stimulate a number of muscles across the body at the same time.

He says it’s like “giving a pill” when we don’t know how much drug the pill contains, or what it’ll do to the person taking it.

“It’s not a cautious way to exercise.”

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While painful muscles are to be expected after a muscle workout of any kind, Dr Mukherjee warns people should not experience pain at the time of receiving EMS — discomfort yes, but not pain.

In 2016 Dr Maffiuletti co-authored a piece in the British Medical Journal calling for better regulation of whole-body EMS suits after seeing people’s muscles break down in a condition called rhabdomyolysis, which can lead to kidney damage.

While there are fewer reports of rhabdomyolysis from EMS these days, he remains concerned about how well people are screened before using whole-body suits at the gym.

Woman wearing gym gear and an electrical muscle stimulation suit doing a sitting exercise with round weight.

Experts advise caution when using EMS. (Getty Images: Nevena1987 )

Even experts who support the use of whole-body EMS in general fitness warn of potential harms and the need for better oversight.

The US Food and Drug Administration has warned some consumer products have reportedly shocked, burned, bruised and irritated the skin of users, and interfered with critically important medical devices such as pacemakers.

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If you are planning to fork out for EMS at the gym, Professor Lynch advises looking for a personalised approach with supervision by a professional like a physiotherapist who is trained in using the technology.

But he recommends making the most of more traditional forms of exercise and strength training first.

Finally, he adds, if weight loss is the goal you also really need to watch what you put in your mouth.

Delve into claims surrounding EMS in more detail on What’s that Rash? and subscribe to the podcast for more answers to more health questions.

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