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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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Mere minutes of daily vigorous exercise can cut your risk of 8 diseases | CNN

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Mere minutes of daily vigorous exercise can cut your risk of 8 diseases | CNN

Move more. Sit less. For many years, that’s been accepted guidance for people wanting to get healthier.

Now that message is getting refined, with a growing body of research suggesting that certain types of movements may be more beneficial than others when it comes to health benefits.

The intensity of your exercise may matter as well. A new study published in the European Heart Journal found that a small amount of vigorous activity may be linked to lower risk of eight different chronic diseases.

The findings raise questions about why intensity matters and how people can incorporate more intense exercise routines into everyday life. To better understand the study’s implications, I spoke with CNN wellness expert Dr. Leana Wen, an emergency physician and clinical associate professor at George Washington University. She previously served as Baltimore’s health commissioner.

Before beginning any new exercise program, consult your doctor. Stop immediately if you experience pain.

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CNN: What did this study examine about exercise and its relationship to chronic disease?

Dr. Leana Wen: This investigation looked at how the intensity of physical activity is related to the risk of developing a range of chronic diseases. Researchers analyzed data from two very large groups in the UK Biobank, which is a long-term health study in the United Kingdom that tracks medical and lifestyle information from hundreds of thousands of participants. One group included about 96,000 people who wore wrist activity trackers that objectively measured their movement, and the other included more than 375,000 people who self-reported their activity.

The researchers followed participants over an average of about nine years and examined the development of eight conditions: major cardiovascular events, atrial fibrillation, type 2 diabetes, immune-related inflammatory diseases, fatty liver disease, chronic respiratory disease, chronic kidney disease and dementia, as well as overall mortality.

The key finding was that the proportion of activity done at vigorous intensity mattered. People who had more than about 4% of their total activity classified as vigorous had substantially lower risks of developing these conditions compared with people who had no vigorous activity at all. The numbers were stunning, with the participants having the following results:


  • 63% lower risk of dementia,

  • 60% lower risk of type 2 diabetes,

  • 48% lower risk of fatty liver disease,

  • 44% lower risk of chronic respiratory disease,

  • 41% lower risk of chronic kidney disease,

  • 39% lower risk of immune-mediated inflammatory diseases,

  • 31% lower risk of major cardiovascular events,

  • 29% lower risk of atrial fibrillation, and

  • 46% lower risk of death from any cause.

These results are amazing. Imagine if someone invented a medication that could reduce the risks of all these diseases at once — it would be very popular! Crucially, even people who exercised a lot still benefited if the proportion of time they spent doing vigorous physical activity was increased. Conversely, people who were relatively inactive also benefited from adding just a little bit of higher-intensity exercise to their daily routines.

CNN: What counts as “vigorous” physical activity?

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Wen: Vigorous activity is generally defined as exercise that substantially raises your heart rate and breathing. A simple way to gauge it is the “talk test.” If you can speak comfortably in full sentences while exercising, you are likely in the low to moderate range. If you are so out of breath that you can only say a few words at a time, that is vigorous.

Running, cycling, lap swimming or climbing stairs quickly could count. But this also depends on people’s baseline fitness. For some individuals, taking longer strides with walking can be vigorous exercise. Others who are already fairly fit would need to do more. It’s also important to remember that vigorous activity doesn’t have to be in the context of a structured exercise plan. Short bursts of effort in daily life, such as rushing to catch a bus or carrying heavy groceries upstairs, can also qualify if they raise your heart rate and make you breathless.

CNN: Why might higher intensity exercise provide additional health benefits?

Wen: Higher intensity activity places greater demands on the body in a shorter period. This type of movement can improve cardiovascular fitness, increase insulin sensitivity and support metabolic health more efficiently than lower-intensity activity alone. Some studies have also linked vigorous activity with cognitive benefits.

Greater intensity may have distinct benefits across different organ systems. The researchers found that some conditions, such as immune-mediated inflammatory diseases, appeared to be more strongly linked to the intensity of activity than to the total amount. On the other hand, type 2 diabetes and kidney disease were influenced by both how much activity people did and how intense it was. Why this is the case is not yet known, but intensity appears to have a significant impact across diseases affecting multiple organs.

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CNN: How much vigorous activity do people need?

Wen: The threshold for people seeing a benefit appears to be relatively low. The researchers found that once people reached more than about 4% of their total activity as vigorous, their risk of developing chronic diseases dropped substantially.

To put that into practical terms, we are not talking about professional athletes dedicating their lives to hours of high-intensity training. Everyday people may see benefits from just doing a few minutes of vigorous effort daily.

CNN: How can people realistically incorporate vigorous activity into their daily routines?

Wen: One helpful way to think practically is that vigorous activity does not have to happen all at once. It can be accumulated in short bursts throughout the day.

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People can take the stairs instead of the elevator and do so at a faster pace than usual. When they are heading to work, they can add some speed walking. They can park farther away when grocery shopping and walk briskly while carrying groceries.

Structured exercise also can incorporate intervals where people alternate between moderate and more intense effort. If you’re swimming laps, you can warm up at a more leisurely pace, then do a few laps at a faster pace, then again at a leisurely pace and repeat. This suggestion applies to any other aerobic exercise: Aim for multiple intervals of at least 30 seconds to a minute each where your body is working hard enough that you feel noticeably out of breath.

CNN: What about someone who is older or has mobility issues?

Wen: Not everyone can or should engage in high-intensity activity in the same way. Vigorous activity is relative to that person’s baseline. For someone who is not used to exercise, even a short period of slightly faster walking or standing up repeatedly from a chair could be considered high intensity. And not everyone may be able to walk. In that case, some exercises from the chair can have aerobic benefits.

Individuals who have specific medical conditions should consult with their primary care clinicians before embarking on a new exercise routine. People with mobility issues also may benefit from working with a physical therapist who can help to tailor exercises appropriate to their specific situation.

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CNN: What is the key takeaway for people trying to improve their health?

Wen: To me, the main takeaway from this study is that it’s not only how much total exercise you get but also how hard you push yourself that matters. And you don’t have to have a lot of high-intensity exercise: Adding just a little has substantial health benefits across a wide range of chronic health conditions.

At the same time, exercise needs be practical. People should look for opportunities to safely increase intensity in ways that fit their daily lives. The most effective approach to physical activity is a balanced one: Exercise regularly, incorporate more challenging activities when you can and build habits that are sustainable over time.

Get inspired by a weekly roundup on living well, made simple. Sign up for CNN’s Life, But Better newsletter for information and tools designed to improve your well-being.

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‘Not what the fitness industry is trying to sell you’: this is the one simple move everyone really needs to be doing, according to an exercise scientist

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‘Not what the fitness industry is trying to sell you’: this is the one simple move everyone really needs to be doing, according to an exercise scientist

Ask any exercise scientist what they would prescribe to someone serious about staying strong into their 50s and beyond, and the answer is rarely what you’d hope for — and certainly not what the fitness industry is currently trying to sell you.

It isn’t long sessions on one of the best under-desk treadmills or a stationary bike like the Peloton, nor the kind of machine-based exercises that isolate muscles without ever teaching them to work together.

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Ellie Kildunne built her powerful body by keeping things simple – focusing on these fundamentals

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Ellie Kildunne built her powerful body by keeping things simple – focusing on these fundamentals

Despite being named World Rugby’s Women’s 15s Player of the Year, England rugby star Ellie Kildunne admitted on an episode of Just As Well that the ‘gym was never easy’. In order for her to feel her best, she sticks to a no-nonsense approach to training and nutrition that focuses on the fundamentals: consistent exercise and eating enough.

‘If I haven’t put the work in, if I’ve skipped reps, if I haven’t eaten the right amount for the game, I would feel anxious,’ she says in her cover interview for Women’s Health UK. ‘But I’ve never put myself in that position because I want to be the best.’

What does being the best mean to her? ‘I want to become world player of the year twice. That’s my focus. Anything else that happens is by the by.’

On her episode of Just As Well last year, she said strength training now makes her ‘feel powerful’, while she ‘hates running’ – but a lot of her training involves speed, agility and endurance practice for her time on the pitch. That mix of conditioning and strength means she has built a strong, fast and resilient body.

Speaking of her physical transformation, she admits her personal body image hasn’t always been positive: ‘Body image is such a mental challenge,’ she tells Women’s Health UK. ‘My body is what made me World Player of the Year… I’ve got to remind myself of that.’ Visibility helps too: ‘We’re in that transition phase… social media is starting to lean more towards athletic women… I see people that look like me now.’ Now, Ellie says when she sees a muscular person, she thinks, ‘Respect. Because I know exactly what goes into that.’

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Headshot of Bridie Wilkins

As Women’s Health UK’s fitness director and a qualified Pilates and yoga instructor, Bridie Wilkins has been passionately reporting on exercise, health and nutrition since the start of her decade-long career in journalism.

After earning a first-class degree in journalism and NCTJ accreditation, she secured her first role at Look Magazine, where she launched the magazine’s health and fitness column, Look Fit, before going on to become Health and Fitness writer at HELLO!

Since, she has written for Stylist, Glamour, Cosmopolitan, Marie Claire, Elle, The Metro, Runner’s World and Red. Today, she oversees all fitness content across Women’s Health online and in print, spearheading leading cross-platform franchises, such as ‘Fit At Any Age’, which showcases the women proving that age is no barrier to exercise.

She has also represented the brand on BBC Radio London, plus various podcasts and Substacks – all with the aim to encourage more women to exercise and show them how. Outside of work, find her trying the latest Pilates studio, testing her VO2 max for fun (TY, Oura), or posting workouts on Instagram.   

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