Exerpt from Shaping Up

introduction
THE TALE OF TWO DOCTORS

In the last few de cades, there has been explosive growth in exercise science.  We have witnessed it as doctors and in our own athletic endeavors, huffing around speed-skating rinks and bounding up Alpe d’Huez and—more important—helping others do it. We offer this book as a means of spreading those discoveries.

People continually come to us with the same questions about exercise, repeated tales of wasted months and years without the fitness or the health they sincerely seek. It’s not for lack of trying. Millions slave away at one- size- fits- all fitness programs, not even tailoring them to their individual exercise needs. Many don’t even know they have individual needs. And people in general, no matter their starting level, are overwhelmed by misconceptions about exercise heaped upon them, few of which are based on medical reality. Sadly, we see people spend time, energy, and money committing the same training errors.

Before coming to us, that is.  Our experience is that people are genuinely eager to exercise, and that they can be disciplined and effective—if they know where to start and exactly what to do; they need a fitness philosophy that works, that they can embrace for life. So what works? Herein lies the problem. People who
know exercise science and people who exercise never talk to one another.  Most doctors read only medical journals, and not much about training science, while sports scientists who develop and analyze training research often don’t work with individual athletes. And if people see a sports doctor at all, it’s for an injury, not for training advice. So relatively little of the great techniques developed by exercise scientists ever reaches people who exercise. Instead, fitness- seekers get training advice from a nurse they know from the gym, from a trainer certified online (which we would caution against—many athletic training certification sites require only a fee, no course work or testing), or from a brief list of tips, and none with respect to their current condition. Or people exercise the way they always did, based on what their coach told them to do in high school.  It became clear to us that some of the training programs currently available, though wildly popular, are wanting in terms of very basic facts.  We know that everyone who wants fitness deserves a lot better, and they get a lot better when they have good information.

We study exercise science and we work with people who exercise. We have coaxed many athletes into the new, science- based era of fitness.  Medically, we know how training works, and we know what information fitness- seekers need to make it work in the real world. We keep up on continuing research—there remains much to be learned, but we also know far more than we did ten, even five years ago. In our athletes and in our patients, we’ve seen the metamorphosis that occurs when the lightbulb goes on regarding how exercise actually works.

First, research shows us that an effective exercise program needs to pinpoint each individual’s starting point. Ours does. In addition, studies show that the best programs also need to be tailored to a broad range of starting abilities. Ours also does that. We are veterans of the fitness battlefield; we know the best strategies for victory with new recruits as well as the celebrated and the battle weary. We know the training needs and goals of beginners as intimately as those of elite athletes, and we respectfully address the entire spectrum and acknowledge individual differences. Second, the right information needs to be geared for the general public.  Our program is unique in that it is designed for everyday people. Unlike many fitness programs, it doesn’t rely on knowledge gleaned from helping beautiful people stay beautiful; it’s not based on what worked for people who are already in good shape, who are well disposed to stay in good shape, and who have ready access to swimming pools and gyms and are not stuck in an office all day. Too often, everyday people “mysteriously” fail when they try those programs. We know that the luxuries of time and access are significant factors in getting fit. Just about everyone could easily be fit if they had a staff, were paid to be fit, and didn’t have a
job and a family. Faster, Better, Stronger is, instead, based on what we have seen works for everyone who wants to get in shape, people who work and have a family or other obligations, who don’t necessarily have a gym membership or four hours a day to work out or plan meals. We understand, because we too have day jobs. We work as physicians, with Olympians and everyday athletes, with people you see at the grocery store, and with people you see on professional teams. In fact, we developed the UC Davis Sports Performance Program because we wanted to give every fitness- seeker a place to go for sports orthopedic, nutrition,
physiological, biomechanical, and psychological guidance under one roof, to establish a place where sports medicine could be tendered in a more comprehensive, holistic way. Our facility has blossomed into one of the premier training centers in the United States. Since then, we have expanded our vision to Utah’s Orthopedic Specialty Surgery Hospital (TOSH), whose goals reflect ours: to be the best sports medicine and injury prevention facility in the world, and one of the few in the country to open its doors to athletes from seasoned pro to newcomer. This hospital and sports research center, where Eric works as both a surgeon and the medical director, offers surgery, rehab, human performance testing and coaching programs, nutrition consultation, bone density testing, motion analysis,
pool therapy, and more—a veritable candy store for anyone who’s ever wondered about exercise and his or her body. Much of what we supply in this book mirrors advice we prescribe to clients at TOSH, based on the training philosophy we have developed over de cades.

We have helped people of all athletic abilities achieve their best, based on their goals. Some of them ended up winning national and inter national titles. Others happily finished their first century bike ride or 5k walk.

It all started in 1985 when Massimo Testa, M.D. (or Max as friends call him), became team physician for the 7- Eleven professional cycling team. We didn’t know it then, but this American team would usher U.S. cyclists into the international spotlight for the first time. Team 7- Eleven with team manager Jim Ochowicz (now USA Cycling president) and team director Mike Neel (the first American to ride for a Europe- based team) was also a “Who’s Who” of people who would go on to become cycling legends: Andy Hampsten (the first and only American to win the Giro d’ Italia—the Italian version of the Tour de France), Bob Roll (currently a Tour de France commentator), Davis Phinney (a Tour de France stage winner and author of one of the classic books on cycling), Chris Carmichael (who went on to train Lance Armstrong), Ron Kiefel (the first American to win a stage in the Giro), Tom Schuler (one of the most successful cycling and sports managers of all time), Jonathan Boyer (the first American to race in the Tour de France, and a two- time winner of the Race Across America), Jeff Bradley (a national champion multiple times
and currently a successful bike shop owner in Iowa), and Jeff “Peppy” Pierce (the first American to win the final stage of the Tour de France in Paris). And then there was Eric Heiden.  Eric was twenty- five years old. Five years earlier, at the Winter Olympic Games in Lake Placid, New York, he had won all five men’s speedskating
races. After he had retired from speed skating and started medical school, he turned to another passion of his—cycling—and joined Team 7- Eleven.

Together, we observed that the team’s cyclists did not enjoy the benefits of scientific exercise training. (Even today, in the United States, sports medicine is not a preventative medical specialty focused on exercise science and performance as it is in Europe.) Eric had been exposed to a scientific approach to exercise training as a skater. Max had studied training science as part of his specialty as a medical student in Italy, applying structured, individualized training to all kinds of athletes from amateurs to professionals.  In contrast, 7- Eleven cyclists’ daily program focused mainly on volume, without the full benefit of the structure or organization we knew advanced performance. Their approach was to simply ride, and ride hard, but without a plan, a target, or a goal, and without distinguishing between the various types of fatigue. The team’s cyclists displayed great enthusiasm and discipline, but to us they seemed miles from reaching their potential, and many were essentially pedaling up the wrong road.

We convinced some of our teammates to try a more structured training approach. With that, this program was born.

For American pro cycling, it was a pivotal moment. Ours was a unique combination of athletic experience and cutting-edge sports medicine knowledge. With it, Team 7- Eleven went on to astonish the Europe an cycling world with stage wins in the Giro d’Italia and Tour de France. It gradually shifted the axis of American professional cycling, and this is reflected in America’s showings in the international arena today. A young and talented Lance Armstrong joined the team and won the world championship in 1993, and the rest is history.

This information is simple, but may represent a turning point for you as well. Even if you feel you have read everything on fitness that has come down the track, Faster, Better, Stronger will help you look at your training in a different way. This program does not make for quick sound bites, however; it can’t be summed up in an advertising blurb, and it’s not based on what worked for one supermodel or high- profile athlete. We don’t simplify proven training techniques to make you feel like you have really “gotten something,” only to frustrate you when you try to actually use it. Nor does our information require a calculator and a degree in exercise
physiology to understand. Instead, it’s plain- speak on what people need to know to get fit, based on what has worked scientifically, in hundreds of cases. And we present it in a way that’s easy to understand and simple to do—we’re good at that. We explain things to people who seek better fitness every day. We believe that taking the time to do so makes a positive difference in the outcome. We also think we have quite a bit of experience at making real exercise science doable for everyone.

We have one confession to make: The information in this book is really no secret. Olympians and elite athletes in Europe practice these methods; the coaches who train them know about these techniques and so do the scientists who have proven what works. Every one of them knows one piece of the puzzle or another. Almost all of the components of our approach have already been written up in medical journals squirreled away in the recesses of your public library. We did not create these techniques. The problem is that those elite athletes and their trainers are reluctant to reveal what they know, owing to the fact that their livelihood depends
upon maintaining an edge over the competition. The scientists who publish in the medical journals don’t directly train real people. And real people rarely want to spend their time at the library poring over stuffy medical journals. We are not bound by any of these constraints. We follow training science and have applied it. We, in essence, close the loop.

The knowledge in this book encapsulates forty years of our accumulated reading of scientific and medical journals combined with as many years of our practical experience at world championships, the grand European bike tours, and the Olympic Games, center stage and behind the scenes. We have assembled all of the pieces of the training puzzle, fitted them together to form the big picture, and then tested it in the real world. Now we want you to benefit, to use it to enrich your health with every stride, dance step, or pedal stroke.

With this information, there is no reason for you to spend another breath or another dime on outmoded training techniques. The time has come to bring your  exercise methods into the new millennium. For us, the true mea sure of our success is how many people we reach with this information.

In Part One of this book, we detail the solid science behind your body’s responses to exercise. Humans are thinking animals; we do better at anything when we understand how and why it works. So we give you scientific “secrets” in several areas of fitness: the prescriptive aspects of exercise; the kinds of movement your body needs; how to get started; how you improve as you move; fueling your body with the right food and water; what rest really accomplishes; how to buy and use gear properly and avoid injuries; and motivation. These “secrets” can help you throughout your life and can be applied to any exercise program, be it ours or another you try. We shepherd you around medically known fitness pitfalls; we also debug and clarify some all- too- often-misunderstood medical and biological truths about
exercise. We offer you ways to find your hidden talents and strengths (yes, we all have them) and to compensate with intelligence and mental focus for the gaps in natural ability (which we also all have). In Part Two of this book, we help you design your own unique, individualized exercise program based on the marriage of scientific outcomes and what we’ve seen works on the street and in the gym. We know that everyone’s biology is a little different, and each person has a unique constellation of strengths and weaknesses. For this reason, Part Two begins with several easy self- assessments (or optional lab tests) in four areas:  cardiovascular endurance, strength, flexibility, and coordination. Once you have assessed your current fitness level, we guide you through assembling blocks of activities into a twelve- week program. Beginners and those at risk start with sessions of very light exercise, fitter readers with more rigorous exercise. No matter your condition now, you will precisely customize the intensity of your exercise sessions and their duration to increase your level of fitness as you progress through the twelve weeks. Each week of exercise is broken into very doable daily blocks of twenty to sixty minutes each. Each block concentrates on one or more of the basic components of fitness. We also give you the means to adjust the program to fit you exactly, based not on intuition, the hottest new training technique, or what your best friend does, but on exercise science. We then give you instructions on how to recalibrate your exercise for another twelve weeks, and onward in your new life of fitness. We also offer activities, exercises, and workout routines for you to use to accelerate your progress. These concepts are similar to those we originally designed for our clients, many of whom are professional athletes.  In this manner, Faster, Better, Stronger focuses your time and attention on precisely what works and what’s necessary for you. This program isn’t designed just for jocks, and it doesn’t take much time. An investment of four to eight hours per week (for most people) could add immeasurable quality to your life; with it you could become more active, vital, and energetic, and more likely to live free from disease, pain, and medication. This is a customized, science- based program designed to guide you into a lifelong fitness habit, a life during which you can feel more alive, eat better,
sleep more soundly, age more gracefully, work more efficiently, be mentally sharper, play harder, and feel happier.

So you want to get more fit? Feel healthier, be stronger, look younger, live longer? You can. We will show you how. We will give you step- by- step instructions on how to make the most of your body through exercise— physically, mentally, biomechanically, and nutritionally. We have seen good, substantial outcomes—harder abs, lower cholesterol, and leaner bodies—and you will, too.

Your success will depend in part upon teaming up with a physician.  You wouldn’t take your car on a cross- country journey without having it first given a thumbs- up by a mechanic. In our experience, many of us have our cars checked more often than we do our own bodies. So talk to your doctor. Take your body in for a checkup and have your major systems tested before you begin this journey. Even a small change in activity can have broad and highly individual consequences. Doctors are not Merlin, and modern diagnostic equipment is not a crystal ball, but physicians do have special expertise and technology that enable them to detect problems
that are silent or invisible to the naked eye. And they can often help you fix them or avoid breakdowns with simple adjustments to your exercise plan. Call your doctor and explore with her how a fitness plan might  affect you.

Sharing how exercise affects people, in fact, inspired us to write this book. By doing that we hope to benefit what is perhaps the organ most important to your overall fitness: your brain.
—Eric Heiden, M.D.
—Max Testa, M.D.