Worked Up, Working Out

It’s been a frightening week to work out, or so it seems. Exercising too hard can make your muscles break and kill you, and likewise, thinking you aren’t exercising as hard as you should be can apparently kill you too. So, dead either way? At least if you go off running with the latest headlines, that’s what one could think.

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It’s an important finding that going too hard in spin classes can lead to rhabdomyolisis, which if you haven’t heard of it, is the breakdown of muscle tissue that leads to muscle fiber contents being released into blood [here]. Doctors highlighted cases of spin class-induced rhabdomyolysis in a recent article, pointing out that in 42 of 46 cases of spin-induced rhabdo, it occurred after their first class [here]. Now let me be clear; it’s no joke. Urine turning brown, decreased kidney function, potential death. Not stuff to fuck around with. At the same time, it’s important to think about how often it actually occurs.

Though the doctors said it’s “on the increase”, there wasn’t a specific number of cases. That makes sense in large part because it’s complex to count rare events in the population that only get measured when people go to the hospital. One study of military recruits counted 22.2 cases per 100,000 soldier-years [here]. For reference, there are about 200 heart attacks per 100,000 person-years in the U.S. [here]. Another study from 1997 estimated 26,000 cases of rhabdomyolysis are reported in the United States every year [here]. The main point to consider here is that rhabdomyolysis is a rare event, but counting exactly how many cases is “more” in a challenge. It’s also worth mentioning that rhabdomyolysis is more common in statin users [here], since 28 percent of Americans over 40 take them as of 2012 [here]. With hip pain following high intensity workouts also increasingly common, the high-intensity workouts du jour are no joke.

Then we have the finding that people who believe they are less active than their peers are more likely to die earlier than those who think they are as active or more active, regardless of their body composition, actual exercise habits, and health [here]. What is important about this finding is that while it was one study, it was one study conducted with three different samples, each of which had several thousand people. The authors measured perceived activity with self-report and actual physical activity with either self-reported measures of types of activity, or objective measures with instruments called accelerometers, and verified mortality using vital statistics (aka death certificates). There was a gap of up to 21 years between collecting the exercise data and the death data (records through 2011), which doesn’t allow causal inference, but at least prevents reverse causality (although arguably, would dead people really report they are more active than their peers??).

What I find interesting about this study is the set of questions it leads to. Is it a placebo effect? Is it mind over matter? Why would thinking you are less active than your peers be associated with earlier mortality (is it about the exercising at all)? That leads to a few questions I would have for future research. If the authors had a variety of social comparisons (how much money do you make, how active are you, how good is your sex life, how happy are you, etc.), would they find the same thing? Does thinking you are active really make health better? Some studies have found optimists have better health, perhaps because of lesser stress [here]. And more importantly, if this were a causal relationship, would changing people’s perceptions actually prolong (and perhaps along the way, improve) their lives?

These are fascinating findings in the context that 80 percent of Americans don’t meet exercise recommendations from the CDC [here]. For the record, for adults, it’s 2 hours and 30 minutes a week of moderate-intensity, or 1 hour and 15 minutes a week of vigorous-intensity aerobic activity, and resistance training two days per week [here]. So questions this raise for me are: what role can and should exercise play in health, who are the people we compare ourselves to, and why are we exercising so hard? These highlight the importance of moderation, and in paying attention to your own body, and for coaches/instructors/teachers, the importance of letting athletes slow down when needed. It’s also important to remember the severe outcomes are rare, and total fear isn’t the way to go either. Now if you’ll excuse me, it’s time for me to get after it.

Nerd Pose - Teaching Yoga While in Grad School

I completed my 200 hour teacher training while I was in grad school. Friends told me that it was a bad idea, that I would burn out, and that it would keep me from finishing my degree. I disagreed and decided to see how it went. I was done with coursework, beginning my dissertation, and while work kept me busy, I needed something besides research in my life. To my surprise, life became simpler with a dedicated, regular time devoted explicitly to self-care. It’s a popular idea that we should just do one thing and wait for the next thing to come “at the right time.” But how many things do we talk ourselves out of by waiting for “the right moment”? What is the right moment?

 

Teacher training was through my university and met once a week over 3 semesters. As it turned out, regularly thinking about something besides my dissertation and work made it easier, not harder, to complete the task at hand when needed. I’m not saying it was easy or there weren’t immensely stressed days where I didn’t know how I was going to do everything I was committed to doing. Hardly. Those days would have happened under any circumstances. I didn’t seek out opportunities to teach, but I did pursue them when they came my way. When I was given the advice that I should start out teaching more than one class so I don’t have to re-invent the wheel, I took it.

 

For the last year and a half, as I finished my dissertation, I’ve been teaching several group classes a week. I’ve done many hours of continuing education with various instructors. I had (or made) the time to do it, and I found it changed my life, and the classes I teach now are simply better for that effort. I was surprised how grounding it is (for me) to teach. I was surprised how much better I became at public speaking. I was surprised at how much better I got at saying “no.” I was surprised how amazingly fun it is to teach yoga. And most of all, I was surprised that I had the time to do a damn good job writing my dissertation. 

 

As I approached beginning a full-time job, I gave up the idea I could teach 5 permanent group classes every week, sub when I can, maintain my own practice, and move my body in other ways. Perhaps I could show up; but would I truly be present with students? Would I have anything of quality to offer? And if not, why do it? I’ve dropped to teaching one class per week, and I will see how it goes. I’ve read before that teaching yoga part-time is like being a superhero; you change out of your corporate gear, put on your spandex costume and save the day. I don’t know that I suspect I’ll end up in Marvel, but there was some truth to that. 

 

For anyone considering it, here is what I will say. During a time when professional life demanded that I strive for objectivity while personal life gave me nothing but subjectivity, yoga was my safe place. Learning to relate to people as other humans, and rather than go on about “my research” to shut the fuck up and get out of my students’ way was mindblowing. It was hard to bring the kind of presence and attention that being a yoga teacher demands when brain-fried (which is where I learned to say “no”). Being a beginner at something while becoming an expert in something else is humbling, frustrating, and at times disappointing. Wondering what colleagues would think gave me pause initially, but I found that people I worked with only cared about the quality of my work, and I just became “the yoga guy.” Last, as someone who is a bit “Type A”, I’ve learned to be content knowing that not everything is for me. 

 

There has been a sense of contentment to not depend on teaching for my livelihood in the changing yoga economy. There are no words for the amount of admiration and respect I have for people who brave it as full-time teachers and studio owners. I have learned I am not cut out for that life. But as I look back, I wouldn’t have it any other way. I have no idea where this will lead me, but I can’t imagine not teaching yoga, nor could I imagine not being a researcher. Perhaps these two dimensions of my life will collide, perhaps not. What I know is that I would have regretted not doing it, and if it is something you are thinking about, if there is a way you can make it work, you will make it work.

Back Soon! A Note From the Author

It was a really ambitious task to start a science blog as I finished my PhD. I initially thought this would be a great way to write out my thinking as I ran into problems with analysis, thought through challenging questions, and share what I’ve learned. The good news is that I’ve finished my PhD and will be starting work in a couple weeks. 

And while my thoughts that this blog would be a helpful place to share those things is definitely true, after I finished the few posts I’d planned to get it going, I simply ran out of time, and after I defended in May, I’ve been recharging my mind. I have lots of fun posts planned, so stay tuned. Also, I decided that while I could keep naming this blog after myself, I’d prefer to have a different name. So welcome to the Socially Skeptical Blog. 


Some of the topics include: 

- My frank advice on choosing grad school programs and finishing a dissertation

- My take on some recent papers about obesity 

- What some of the words commonly used about trauma and adversity mean and how we can use them more intelligently

- A population health perspective on yoga injury 

- Article summaries


Stay tuned!

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Why I Yoga

In no unclear terms, I love yoga. I love the practice of yoga, and when I say yoga, I mean a way of living your life in connection with now that sometimes is and sometimes isn’t connected to physical postures. I also love the physical practice of yoga, though that only scratches the surface. I love yoga for what it brings to my life, and I share it for all I believe it can bring to others. I love yoga, in spite of the fact that marketing might lead you to believe that yoga is not for me. I teach yoga, in spite of the fact that it’s rare to meet a student who looks like me. In case you’re wondering, when I say this, I mean that I am not a thin white woman in her early 20’s. 

 

I’m a big, burly, gay black man. I probably have the strength to force my foot behind my head, but in no way would I have a functional hip after doing it. When I walk into yoga spaces, I’m often the only person of color, the biggest person, and even with the best of intentions, many teachers stereotype what I can and can’t do, and no, it doesn’t feel good. As a teacher, I’m seeing the best and worst of it; both being humbled by how people from such different walks of life can have so much in common with me, and saddened when people dismiss me because they assume I have nothing to offer based on looking at me. 

 

After trying to yoga every damn day, to meditate for hours, to find meaning in being upside down, I’ve found power in consistency and simplicity. I don’t believe or argue that yoga is the ultimate workout, or something everyone should do. It’s something that everyone who wants to do, should be able to do. And while I’ve had experiences that have pushed me away both as student and teacher, I couldn’t imagine my life without yoga practice anymore than I could without hygiene. In a way I’ve found nowhere else, yoga has given me a space where I can completely be myself. How can that possibly be when I stand out like a sore thumb, or often, like a bull in a china shop? Because yoga reminds me of all that I am, at a deeper level than how I look, in a culture and time when I see so few reminders of it. Yoga allows me to go inward, on nobody’s terms other than my own.

 

When I say that, I don’t mean that we’re all sparkly fairy dust and love. I’m an atheist. I’m struggling a lot with the idea that all of us humans want the same things, because I see so little evidence of that. I mean that yoga reminds me of what’s under the labels we hold socially. When I practice, when my mind gets quiet, and I can listen instead of labeling, I forget that I am a gay, biracial man in a world that defines me by those. It isn’t that I arrive in a world where I can pretend those things don’t matter, because they do. Rather, I come to a place where I am reminded of my humanity, and the humanity of others who cross my path. 

 

You can call it magic, you can call it mystery. I call it amazing, because that’s what it is to me. And because my life is consistently better with it than without it, I yoga. I yoga because I’ve learned to pause, even for half a second before saying things I'd regret. I yoga because I’m reminded I wasn’t born just to pay bills and die, or to deny my own worth to please others. I yoga because in times like these, I want to show up for others as someone with a calm mind who takes care of himself. But most of all, I yoga because I want to.

 

 

Hard Work Doesn’t Have To Hurt

Like many people, I have had a strange lifelong relationship with work, discipline and discomfort. I began playing music in sixth grade and for years it was my main focus. Through middle and high school and into college, I practiced for hours every day. The consistency of practice made me feel safe. However, I was so serious that my perfectionism made me strive, never being good enough for my own self-judgment. And with that, I took the fun and joy out of playing music. I changed majors.

I then took self-discipline very seriously academically. I spent many Friday evenings studying and judged people for having fun. I believed that not having fun was a sign that I was smarter, that I was working hard enough. I then spent my masters program going between the extremes of being a social butterfly to spending my time constantly studying. Finding the middle was so foreign to me I probably laughed at people who mentioned it. I took that with me into my PhD program until I woke up on the side of the highway after a motorcycle accident.

My injuries were minor, but I wasn’t able to be physically active.  I hadn’t for a while, because I thought being active required extensive workouts. My teens and twenties were spent between extremes of striving for rigorous training and nutrition and inactivity and a poor diet. I hated team sports and biking was a calming way to move. When I’d tried exercising in gyms for 20-30 minutes just to make it a habit, personal trainers or others would make fun of me. For a while after the accident, junk food and beer became the way. But with the awareness that I had a chance to live that many people in motorcycle accidents don’t, I wanted to live better. I decided it was time for discipline.

I made academic success my focus, changed my diet and became active. I lost something like 70 pounds in the process. Yoga and meditation went from occasional things to essential things. I juggled work, life, my dissertation, and endurance sports like triathlons. I completed yoga teacher training. With every goal I accomplished, a temporary sense of reward came, but then dissipated. Discipline for the sake of getting a reward wasn’t fulfilling. All this self-work was rooted in the idea that I wasn’t enough, and living for external goals couldn’t last. Believing that “if I could just do X, then I would finally be happy” simply wasn’t true. Enduring pain to prove I can endure didn’t lead me to being awake. Running a half marathon didn’t make me love my body. The feeling that I had to be burning the candle at both ends to be “productive enough” or exhausted for a workout to be “sufficient” was unhealthy, unsustainable and no longer helpful. I felt lost.

When I finished teacher training last May, I’d already been teaching for a few months. I learned that the “this one way is the only way, go until it hurts and practice yoga every day” model didn’t work for me and wasn’t something I wanted to share. I continued to learn more about the human body, how to teach a class that goes beyond curating an experience, and how to hold space for the slow and subtle. I examined my relationship to practice and realized that vigorous yoga wasn’t the only thing I wanted, and wasn’t even what brought me to yoga in the first place. I needed more ease and less effort.


I started lifting weights again, this time ignoring the idea of “no pain, no gain.” I wanted to be strong in my whole body, in ways a yoga practice doesn’t build. I focused on finding strength to feel good. I found a trainer who listened to me. And when I had the opportunity to let go of a secure corporate job and take a fellowship to finish my PhD, I took it and let the moving pieces of my life settle down. 

A few months ago, I learned I had high blood pressure. While changing my habits with exercise, I didn’t change my diet and my body was letting me know I needed to. The math is simple, right? Simpler isn’t always easier. But knowing what lay ahead by falling into unhealthy habits, I sought a balance that would last. When an acquaintance said these words, it was like a catalyst: “hard work doesn’t have to hurt.”

For the first time in my life, my efforts are grounded in self-care. I eat well, work hard and get stronger because I want a better life. My fitness goals are to be healthy and able to move in older age. I work hard when I exercise, but I don’t strive anymore. I don’t care if I ever reach an ideal. I do it because I’m worth it, and self-discipline is an act of self-care. So far, I’m down 18 lbs, but I’m as worth it today as I ever was or will be, and while losing weight and changing my diet are necessary for my health, they aren’t measures of my worth. I eat a balanced diet while rejecting a diet culture that shames me for liking donuts. I stay active while rejecting a fitness culture that says burpees are the measure of my worth. And I am sharing this because I know I’m not the only one who struggles with this. Instead focusing on getting to the top of the mountain, I’m paying attention to my next step.