I've been trying to keep my calorie intake up to at least 2000 cals per day, and, for the last week, up to 2300 cals per day. But, I'm perpetually stuffed! I am having to force myself to eat and I'm not enjoying it. My appetite and body work fantastically well at desiring and consuming only what's sufficient for my needs. I'm one of those lucky people who can eat what they like, doesn't have the urge to over eat and never really has to worry about calories. Except now....when I'm trying to 'bulk up', I'm watching every single one!
The aim is to eat around 70-100g protein per day, 250-290g carbs (of which 90g-100g sugars) and 70g fat (of which 20g saturated). Based on my age, gender, build, weight, activity level, etc, I should gain about 0.5lb in weight a week if I eat at least 2000 cals per day. I used this calculator if anyone's interested. I wish it was possible to tell the calories to go and build muscle (rather than the likely alternative of depositing the excess fuel in fat!). Ah well.
Mostly taken it easy today. Wore the ankle weights for a couple of hours and did a little bit of gardening. My lower back and left hip ache and my left shoulder is painful/achy.
Tuesday 19 May 2009
Saturday 16 May 2009
Stiffness and Bicep Tendonitis
Yup, felt very stiff yesterday after the hydrotherapy, especially in my hips and legs. It was good stiffness though - that sort-after 'delayed onset muscle soreness' (DOMS) (link). I made sure I stretched out the stiff muscles and generally rested. Today, the stiffness is subsiding.
Unfortunately, my impinged left shoulder is consistently problematic. After a bit of research, one of the symptoms is definitely bicep tendonitis, specifically affecting the short head which passes along the front of the humeral head and attaches to the coracoid process on the scapula.
For more information on bicep tendonitis see: link
I guess all I can do is rest and ice it, which is thoroughly annoying since I need to strengthen various surrounding muscles in order for the impingement of the shoulder to resolve! Maybe part of the reason for the inflammation is the stretching of the tendon as the scapula is retracted during the strengthening exercises....who knows...
Unfortunately, my impinged left shoulder is consistently problematic. After a bit of research, one of the symptoms is definitely bicep tendonitis, specifically affecting the short head which passes along the front of the humeral head and attaches to the coracoid process on the scapula.
For more information on bicep tendonitis see: link
I guess all I can do is rest and ice it, which is thoroughly annoying since I need to strengthen various surrounding muscles in order for the impingement of the shoulder to resolve! Maybe part of the reason for the inflammation is the stretching of the tendon as the scapula is retracted during the strengthening exercises....who knows...
Thursday 14 May 2009
Hydrotherapy
4th session today in the hospital hydrotherapy pool. I found it surprisingly tiring. My muscles just didn't seem to be up to the job - they felt very tired and fatigued quickly. I've aggravated the right abdominal muscle strain....again! Since the session, it's been difficult to use various big muscles without causing them to go into cramps/spasm. My hamstrings are tired...everything's tired! I'm a little concerned that my muscles really aren't refuelling properly or able to metabolise exertion properly. I think I need to monitor this to make sure it isn't getting progressively worse rather than showing the expected improvement in stamina.
Below, is a picture from the internet to give an idea of how the hydro works - we use 'woggles' (foam, roller floats) to help provide buoyancy and target particular muscle groups:
The water is very warm (34 degs?) which means that the muscles are supple and receive a good blood supply, further reducing pain and stiffness and injury.
Post Script 12 April 2013: For a detail description of the hydrotherapy routine I did, please see
Below, is a picture from the internet to give an idea of how the hydro works - we use 'woggles' (foam, roller floats) to help provide buoyancy and target particular muscle groups:
The water is very warm (34 degs?) which means that the muscles are supple and receive a good blood supply, further reducing pain and stiffness and injury.
Post Script 12 April 2013: For a detail description of the hydrotherapy routine I did, please see
Wednesday 13 May 2009
Ankle weights
In reaction to another day nursing strains to my MCLs, painful knots/trigger points deep in my left hip, a very tired, achy lower back and a sore, strained shoulder girdle, I bought some ankle weights!
I guess I just had to do something 'constructive'. I got the smallest weight possible 1lb (just under half a kilo). The plan is to wear them around the house and perhaps on walks that I want to be more strenuous. So far, they feel just right.
Here's to more leg muscles!
I guess I just had to do something 'constructive'. I got the smallest weight possible 1lb (just under half a kilo). The plan is to wear them around the house and perhaps on walks that I want to be more strenuous. So far, they feel just right.
Here's to more leg muscles!
Impact of severe deconditioning on muscle biology
Although I've put a link up to this information elsewhere, I reckon that it's important to put this info in full view.
Taken from: WAGENMAKERSC, ANTON J. M. (1999), 'Chronic fatigue syndrome: the physiology of people on the low end of the spectrum of physical activity?' Clinical Science 97, (pp.611–613) (link)
Severe deconditioning affects the blood flow to the muscles:
"...deconditioning plays an important, and so far under-appreciated, role in the abnormal physiology that is seen in CFS patients. Saltin et al. [9] have shown that 20 days of bed rest by healthy subjects reduced cardiac output and oxygen delivery to working muscles by 15–20%. Muscle blood flow during and following exercise is also reduced in elderly subjects [10]. This has, in part, been explained by a reduced vasodilatory capacity and in part by the decreased capillarization, which again is a consequence of the reduction in physical activity and deconditioning that are seen during ageing [10]. The development of abnormal autonomic or peripheral control of muscle blood flow is not limited to CFS patients [7,11] but also occurs in healthy subjects in the adaptation period to acute and long-term deconditioning."
Severe deconditioning adversely affects the biology of muscle and its ability to metabolise exertion:
".... some, but not all, patients with CFS show a severe loss of mitochondria. Six of the patients with the lowest mitochondrial activities performed a graded incremental exercise test on a cycle ergometer and had a dramatically reduced exercise capacity (maximal work rate 60–120 W; 20–50% of the normal controls). They nevertheless achieved heart rates and blood lactate concentrations normally found with maximal exercise [12,13]. These data indicate that these patients showed a metabolic adaptation to severe deconditioning, and that the adaptation to deconditioning may be as large as, but the reverse of that reported in trained subjects [14,15]. This implies that these patients experience the stress of maximal exercise during normal daily activities (20–80 W) and this again provides a reason to avoid exercise, so that they spiral down in a vicious circle of inactivity and exercise intolerance [12].
"One of the consequences of low mitochondrial density is a reduced oxidative capacity. This again leads to a reduced rate of resynthesis of creatine phosphate following high-intensity exercise [16]."
So, reduced blood flow to muscles, loss of mitochondira and the reduction in resynthesis of creatine phosphate (which is probably a consequence of the first 2 factors) all serve to cause deconditioned muscle to be fast fatiguing (i.e. significantly reduced endurance capacity) and slow recovering (i.e. requiring significantly longer to refuel and repair).
For further contextual information about creatine phosphate and its role in the biology of muscle fuelling and refuelling see: Link
Taken from: WAGENMAKERSC, ANTON J. M. (1999), 'Chronic fatigue syndrome: the physiology of people on the low end of the spectrum of physical activity?' Clinical Science 97, (pp.611–613) (link)
Severe deconditioning affects the blood flow to the muscles:
"...deconditioning plays an important, and so far under-appreciated, role in the abnormal physiology that is seen in CFS patients. Saltin et al. [9] have shown that 20 days of bed rest by healthy subjects reduced cardiac output and oxygen delivery to working muscles by 15–20%. Muscle blood flow during and following exercise is also reduced in elderly subjects [10]. This has, in part, been explained by a reduced vasodilatory capacity and in part by the decreased capillarization, which again is a consequence of the reduction in physical activity and deconditioning that are seen during ageing [10]. The development of abnormal autonomic or peripheral control of muscle blood flow is not limited to CFS patients [7,11] but also occurs in healthy subjects in the adaptation period to acute and long-term deconditioning."
Severe deconditioning adversely affects the biology of muscle and its ability to metabolise exertion:
".... some, but not all, patients with CFS show a severe loss of mitochondria. Six of the patients with the lowest mitochondrial activities performed a graded incremental exercise test on a cycle ergometer and had a dramatically reduced exercise capacity (maximal work rate 60–120 W; 20–50% of the normal controls). They nevertheless achieved heart rates and blood lactate concentrations normally found with maximal exercise [12,13]. These data indicate that these patients showed a metabolic adaptation to severe deconditioning, and that the adaptation to deconditioning may be as large as, but the reverse of that reported in trained subjects [14,15]. This implies that these patients experience the stress of maximal exercise during normal daily activities (20–80 W) and this again provides a reason to avoid exercise, so that they spiral down in a vicious circle of inactivity and exercise intolerance [12].
"One of the consequences of low mitochondrial density is a reduced oxidative capacity. This again leads to a reduced rate of resynthesis of creatine phosphate following high-intensity exercise [16]."
So, reduced blood flow to muscles, loss of mitochondira and the reduction in resynthesis of creatine phosphate (which is probably a consequence of the first 2 factors) all serve to cause deconditioned muscle to be fast fatiguing (i.e. significantly reduced endurance capacity) and slow recovering (i.e. requiring significantly longer to refuel and repair).
For further contextual information about creatine phosphate and its role in the biology of muscle fuelling and refuelling see: Link
Tuesday 12 May 2009
Overdone it
It's a recurring problem. I think I can 'just manage one more' and I strain something. Yesterday, I upped my bike time to 8.5 mins (rather than the planned 8 minutes) and then later did 32 wall squats (as apposed to the planned 30), 14 single leg calf raises, 9 reps with the leg theraband and a few stretches (lunges, piriformis and psoas stretches).
This morning, I've woken up with stinging strains at the crest of my pelvis on the RHS of my back. I guess it's strains of the thoracolumbar fascia(?). Plus, mild MCL strains on my both knee. I knew I'd done those during the squats.
My left shoulder was extremely painful yesterday evening. Pain radiating down my arm. I did some 'tennis ball' massage on the trigger points (link) on my scapula but ouch! it hurt. Will rest everything for the next 2 days before hydrotherapy on Thursday.
This morning, I've woken up with stinging strains at the crest of my pelvis on the RHS of my back. I guess it's strains of the thoracolumbar fascia(?). Plus, mild MCL strains on my both knee. I knew I'd done those during the squats.
My left shoulder was extremely painful yesterday evening. Pain radiating down my arm. I did some 'tennis ball' massage on the trigger points (link) on my scapula but ouch! it hurt. Will rest everything for the next 2 days before hydrotherapy on Thursday.
Sunday 10 May 2009
CFS sufferers beware
I've thought long and hard about why this muscle wasting has happened to me. And, the best I can come up with is that it's come about through an unlucky combination of factors, these being:
1. The debilitating effects of the mental health problems (including poor quality sleep for years)
2. The debilitating effects of medication taken for the mental health problems
3. The iron deficiency which probably went undiagnosed for some time due to the masking of the first 2 factors
4. My physical make up. I'm what body builders would call an ectomorphic body type - I find it hard to put on weight or muscle. I've always been a 'skinny bean' no matter what I ate
5. A poor diet during the most difficult years of the mental health problems. I probably ate enough calories but they were perhaps 'empty calories' meaning they contained little vitamin or mineral nutrition.
And so, for years I was significantly under active and 'ill'.
What worries me is that the likelihood of disabling muscle atrophy is not publicised to those who are most at risk. I was never warned about the possibility. I had no idea that, for example, if a muscle isn't used for 12 hours it begins to waste. It takes just 12 hours! Nor that once a muscle starts to waste, other muscles 'come to the rescue' and start to take over the work of this wasting muscle, thus adding to the original problem. It is not difficult to see how large pockets of important muscle then begin to waste away leaving just a few doing most of the work. I have been left with literally just sinews of muscle holding my joints together, leaving them unstable, easily fatigued and strained. If only I had been warned and given appropriate advice as to how to prevent muscle atrophy I would not be looking at 2 years of concentrated, painful work to rebuild my body.
There's an interesting article explaining how sufferers of Chronic Fatigue Syndrome are at high risk of muscle atrophy and all that this entails (link). I very much hope that GPs are helping CFS sufferers to manage both their illness and the unseen effect that the enforced body rest has on their muscles.
1. The debilitating effects of the mental health problems (including poor quality sleep for years)
2. The debilitating effects of medication taken for the mental health problems
3. The iron deficiency which probably went undiagnosed for some time due to the masking of the first 2 factors
4. My physical make up. I'm what body builders would call an ectomorphic body type - I find it hard to put on weight or muscle. I've always been a 'skinny bean' no matter what I ate
5. A poor diet during the most difficult years of the mental health problems. I probably ate enough calories but they were perhaps 'empty calories' meaning they contained little vitamin or mineral nutrition.
And so, for years I was significantly under active and 'ill'.
What worries me is that the likelihood of disabling muscle atrophy is not publicised to those who are most at risk. I was never warned about the possibility. I had no idea that, for example, if a muscle isn't used for 12 hours it begins to waste. It takes just 12 hours! Nor that once a muscle starts to waste, other muscles 'come to the rescue' and start to take over the work of this wasting muscle, thus adding to the original problem. It is not difficult to see how large pockets of important muscle then begin to waste away leaving just a few doing most of the work. I have been left with literally just sinews of muscle holding my joints together, leaving them unstable, easily fatigued and strained. If only I had been warned and given appropriate advice as to how to prevent muscle atrophy I would not be looking at 2 years of concentrated, painful work to rebuild my body.
There's an interesting article explaining how sufferers of Chronic Fatigue Syndrome are at high risk of muscle atrophy and all that this entails (link). I very much hope that GPs are helping CFS sufferers to manage both their illness and the unseen effect that the enforced body rest has on their muscles.
Patience
It's been a frustrating sort of day. Managed a 30 minute walk but my left glutes were complaining right from the start. They kept going into tight knots and causing sharp, intense pain deep in the hip joint during every foot strike. I came home and stretched out my hips (the usual piriformis and psoas stretches) and hamstrings. My lower back has been complaining today as well, connected to the tired hips, I guess. And, the right side of my trunk is still slightly strained and tired.
My shoulder girdle still aches. I've only done 1 set of physio exercises today. The muscles need some respite.
Today, I have energy and 'get up and go' but no muscles with which to expend it. After years of incapacity it is hard to be patient with my body....but patient I must be. I have dreams where I can run or swim like an athlete. One day, I'll have the muscles and stamina to put my heart and soul into lengths of front crawl or a sprint across open countryside, and I'll feel the life and blood coursing through me and I'll feel truly alive and real. I can't wait....
My shoulder girdle still aches. I've only done 1 set of physio exercises today. The muscles need some respite.
Today, I have energy and 'get up and go' but no muscles with which to expend it. After years of incapacity it is hard to be patient with my body....but patient I must be. I have dreams where I can run or swim like an athlete. One day, I'll have the muscles and stamina to put my heart and soul into lengths of front crawl or a sprint across open countryside, and I'll feel the life and blood coursing through me and I'll feel truly alive and real. I can't wait....
Saturday 9 May 2009
7 Minutes
I'm finally up to 7 minutes on the exercise bike, every other day (or there abouts). Initially, I could barely manage 3 minutes without my hip flexors and glutes aching like crazy. Today was the 3rd time this week I've done 7 minutes and I made sure I stretched out my hips (piriformis and psoas stretches) afterwards before applying heat. This seems to be the key - stretching and heat. The anticipated aching hips haven't been too bad at all this afternoon.
Also managed 3 x 10 reps wall squats (link) and 2 x 7 reps single-leg calf raises (link).
Just getting back to using the theraband to strengthen glutes and hips. Managed 8 reps in all directions on both legs [i.e. hip abduction (link), hip adduction, hip extension (link) and hip flexion]
Today, my shoulder girdle is aching, tired and strained. Not sure my muscles can manage the physio exercise demands, unfortunately. According to one website, I need to "Pay attention to pain. This is a difficult one. Pain can mean that the painful area is damaged and you should not move it until it has healed more, but it can also be much less important. If your joint is stiff, you will need to stretch it and cause some pain if it is to loosen up.Good pain is not too severe and settles down quickly. Bad pain is severe and takes a long time to settle down after. If you cause pain on exercise, and you may have to to succeed, make sure it is good pain." http://www.thephysiotherapysite.co.uk/physiotherapy/exercise/exercise-advice
My shoulders have 'bad pain' tonight....
Also managed 3 x 10 reps wall squats (link) and 2 x 7 reps single-leg calf raises (link).
Just getting back to using the theraband to strengthen glutes and hips. Managed 8 reps in all directions on both legs [i.e. hip abduction (link), hip adduction, hip extension (link) and hip flexion]
Today, my shoulder girdle is aching, tired and strained. Not sure my muscles can manage the physio exercise demands, unfortunately. According to one website, I need to "Pay attention to pain. This is a difficult one. Pain can mean that the painful area is damaged and you should not move it until it has healed more, but it can also be much less important. If your joint is stiff, you will need to stretch it and cause some pain if it is to loosen up.Good pain is not too severe and settles down quickly. Bad pain is severe and takes a long time to settle down after. If you cause pain on exercise, and you may have to to succeed, make sure it is good pain." http://www.thephysiotherapysite.co.uk/physiotherapy/exercise/exercise-advice
My shoulders have 'bad pain' tonight....
Discovering I have "severe deconditioning"
It's been 7 months since I started physiotherapy for, initially, left hip pain and strained medial collateral ligaments (MCL). It's been 4.5 months since I started physio for an impinged left shoulder.
Within a few months of starting physio in Oct 2008 it became clear that I was suffering from "severe deconditioning" (pervasive muscle atrophy or wasting) due to years of significant underactivity. From 2000 onwards I had been dealing with the delibitating effects of Complex PTSD (Link), depression and a severe dissociative disoder (Link), and later, an iron deficiency. During those years, my body simply didn't work properly. I was easily exhausted by any stimulus be it emotional, cognitive or physical. Being dosed up on various anti-depressants, tranquillisers and sedatives only added to my incapacity.
With this in mind, it is perhaps not surprising that the muscles in my body began to waste away, however, the inevitable weakness came as a real shock to me. I had always thought that once my brain started to work properly and was able to regulate my body correctly, then my muscles and strength would be 'there' waiting for me to use.
Not so.
According to my physiotherapist it's going to take 1-2 years of hard graft to rebuild the muscle mass I've lost throughout my body and recondition the nerves/tissues to function correctly. Until an abdominal strain 10 weeks ago, I was doing 2 hours of physiotherapy exercises every day. It was exhausting!
Within a few months of starting physio in Oct 2008 it became clear that I was suffering from "severe deconditioning" (pervasive muscle atrophy or wasting) due to years of significant underactivity. From 2000 onwards I had been dealing with the delibitating effects of Complex PTSD (Link), depression and a severe dissociative disoder (Link), and later, an iron deficiency. During those years, my body simply didn't work properly. I was easily exhausted by any stimulus be it emotional, cognitive or physical. Being dosed up on various anti-depressants, tranquillisers and sedatives only added to my incapacity.
With this in mind, it is perhaps not surprising that the muscles in my body began to waste away, however, the inevitable weakness came as a real shock to me. I had always thought that once my brain started to work properly and was able to regulate my body correctly, then my muscles and strength would be 'there' waiting for me to use.
Not so.
According to my physiotherapist it's going to take 1-2 years of hard graft to rebuild the muscle mass I've lost throughout my body and recondition the nerves/tissues to function correctly. Until an abdominal strain 10 weeks ago, I was doing 2 hours of physiotherapy exercises every day. It was exhausting!
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