Fitness Vital Signs

As an anesthesiologist I depend on a variety of vital signs to determine the health of the patient I'm caring for.  I never just pick one parameter to measure as an indication of the well being of the patient undergoing surgery.  For example, if I were to rely on only the patient's blood pressure to indicate well being, it is possible I could miss other significant problem areas even though the blood pressure looked great the whole time.

Determining your fitness level is similar. Yet, for many people, they rely on only a few parameters when measuring their fitness level. Some only rely on one parameter; weight. This is a very good parameter to focus on if you are very overweight or very underweight.  However, if you are within a reasonably normal range for weight, it is not very useful at all.  Patting yourself on the back for losing weight, or gaining weight to reach some arbitrary weight goal, is self defeating and at worst, harmful.  

If you are really interested in measuring your fitness level you have to measure several different parameters and then have a way of calculating or interpreting your measurements.  For example, in healthcare, we might measure a patient's blood count.  The lab will dutifully provide you a number.  However, this is meaningless until you have a comparison number from a large population to determine what is "normal" and what is abnormal and furthermore, how abnormal the numbers are.

The Speed Strength Combine is designed to provide each participant feedback on their overall fitness level with a raw number.  However, the scoring system also is designed to provide context for the raw score.  Each event (six of which are scored) is individually scored with a raw number and then given context by supplying a classification.  The labels are listed below from lowest point to highest:

• "Give me a Break"---less than -50 pts.
• "Out of Shape"---- from -50 pts. to -1
• "Untrained"----from 0 pt to 25 pts.
• "novice Athlete"----  from 26 pts. to 59 pts.
• "Athletic" ----from 60 pts. to 99 pts. 
• "Accomplished Athlete" ---- from 100 pts to 150 pts.
• "Advanced Athlete"---from 151 pts. 199 pts.
• "Super Athlete" ---from 200 pts to 250 pts.
• "Elite Athlete"----from 251 pts. 299 pts.
• "Bad Ass"---from 300 pts to 374 pts.
• "Demigod"---- 375 pts and above

   In this way you have feedback as to how you compare against the rest of fitness world.  This gives a full picture of your athleticism and fitness.  So, for example,  if one person is really strong in the bench press, this one event could skew his overall raw score in the combine.  However, the overall classification would weigh equally all of the events.

By measuring 6 events covering both running, agility, and strength, you can get an idea of your overall fitness and how you compare to the rest of the world.    So go ahead and try the six events (there are 8 events but only 6 are used for scoring purposes).  Go to the scoring sheet and enter the data and it will provide you a raw score along with an overall classification label as listed above.  Then come back in 4 to 5 months after some training and try again.  See where you sit. For most average everyday people in this world who consider themselves active but not a collegiate athlete, who have a 9 to 5 job and kids that keeps them busy during the day, striving to achieve greater than 150 points in the combine is a worthy goal and reachable.  Some will have to work harder than others to obtain this level.  However, the scale is designed to look at the general healthy population. It is designed to fit a standard bell curve, however, for the general american population after some training.  This means, that pick any adult male from a generally healthy group of people at random and allow them to train for 12 weeks, the expectation would be that they would most likely find themselves in the middle category (i.e.Acommplished athlete).  With some extra thought and effort they could achieve the category above.  Those who are collegiate level athletes and above naturally, are more likely going to find themselves competing at the Super Athlete and Elite Athlete level with normal training and with aggressive training can attain the "Bad Ass" category.  The scoring system expects very few (top 0.1% of the general american population) to achieve the "Demigod" category, so don't be crushed if that's not you.


So try it out.... go to this link to enter your scores.  see video to understand how it works.

Post-Work out Recovery and injury

In a competition geared for the amateur athlete who wants to reach his potential, but is not paid to do so, there is always a risk of injury.  Professional athletes spend as much time in recovery as they do working out.  They use massage, stretching, ice baths and other techniques to aid the muscles, ligaments and tendons recover and ready them for the next grueling workout.

Amateurs simply don't have the time to dedicate to both grueling workouts and time consuming and expensive recovery sessions such as used by professional or semi-professional athletes.

So, given the limited time and resources available to an amateur athlete who still wants to reach their natural potential, what does the evidence indicate is best to enhance recovery.

 Many elite athletes and their trainers encourage the use  of ice baths as a way to flush lactic acid out the muscles immediately after a workout.  Done soon after a vigorous workout for about 20 minutes in 10 to 15 C water, an ice bath causes intense vasoconstriction in the muscles.  This pushes the lactic acid out of the muscle.  The reduced blood flow also reduces the inflammatory response in the muscle and decreases swelling.  After rewarming, oxygen flows back into the muscle free of lactic acid.

However, while a couple of studies have been able to show improved performance when done workouts are performed back to back, many other studies have not been able to demonstrate any benefit.  For example, in 2007, a study using water at 1 to 5 degrees C did not reduce muscle pain, swelling or performance.  Some believe that inhibiting the natural inflammatory response associated with a vigorous workout impairs the bodies natural efforts at adapting to the routine and getting stronger.  At this point, most believe that the best place for ice baths is to speed recovery when an athlete must perform at a high level the following day; but this method should be used sparingly and not as a routine.  Of course, ice baths require time and resources to do it properly.  The easier and more convenient method for the amateur athlete is to put water into small paper cups and freeze them.  After your work out, massage the muscle with the ice end and peel away the cup as the ice melts.  Do this ice massage for about 20 minutes. 

Other methods to reduce muscle soreness include compression tights.  Research has found that wearing  compression tights reduces post exercise lactate levels which eases muscle soreness.  Also, in 2005, another study looked at massage therapy after exercise.  This study found that delayed onset muscle soreness was reduced with massage therapy.  There is limited research in this area however.  

There are two important pieces of research that define what should definitely be avoided if what can be recommended is shaky.  In 2009, a study found that pre-exercise stretching can cause muscle injury so most now recommend stretching be done post workout.  minimal warm up stretching is probably not an easy, but a vigorous stretch routine is out.  Also, using heat after a your workouts is out.  This increases blood flow to the muscles and leads to increased inflammation and swelling.

Lastly, active recovery can be useful. This simply means, on your non training days, a very mild workout, i.e. easy jogging or maybe just a brisk walk for 15 to 20 min. Biking, body weight exercises (i.e. push ups), or sports could also qualify for active recovery workouts as long as the intensity is low and lasts no more than an hour. Here's a brief article discussing this more in depth.

Also important in recovery is proper nutrition. A good source of easily digestible protein and carbohydrate should be consumed soon after your training session.  Also, post workout is the ideal time to consume creatine and whey protein along with glutamine.  Post workout, blood flow to your muscles is at its peak; therefore, consuming carbs, protein, and creatine will maximize muscle tissues levels.

As you progress in your strength and build up your intensity, injury will be a recurrent concern.  If you suffer a tendon injury (very common with weight lifting), the only solution is to rest the sight.  Trying to work through it is pointless.  The acronym RICE is the only real method to overcome most injuries related to weightlifting and sprinting.  R=rest, I=ice (reduce inflammation), C=compression, and E=elevation to avoid swelling.  Of these, the Rest and Ice are probably most relevant and important.  If it is a chronic low grade injury, using Ice after workouts and a deep heat cream before workouts is best.

Avoiding injury is best of course.  This is best accomplished but by putting a premium on technique.  As you add weight to your routine week in and week out; don't compensate for increased weight by sacrificing technique.  Ensure adequate recovery time between vigorous workouts.  Flexibility is a must as you progress; therefore, end each work out session with flexibility work.  If you feel even a small amount of pain; don't work through it, STOP.  Find and exercise that you can substitute that does not aggravate the sight of injury.  Maybe you need another week off.  That is far better than making a low grade injury worse.

In the mean time, get motivated by checking out the Speed Strength combine video here:

See how you compared with others by entering in your numbers in Bench, Dead Lift, Squat or Military press, 40 yd dash, 400m, and Broad jump or 60 yard shuttle.

See the video; understand the challenge!

I thought it might be easier to understand the Combine if seen in visual.  So here is a video with a compilation of different athletes all who contribute one event to make up a total.  Obviously, the combine is not meant to have different athletes compete in different events to create a total.  But, I thought it would be interesting to see how different athletes would compare across the events in their point totals for each event.


See the video <HERE>! 

Here is the video of my last combine: Dec 2012.    I used an outdated scoring system in that combine, so the point total will be slightly different than it would be if you'd entered my stats into the current scoring sheet, but this gives you an idea of what to expect.  Also, I ran the 40 yd dash on the track, and ideally it should be run on the grass.  Oh well.

Why test speed and strength! the ultimate athlete

Just two days ago I was in the Gym doing my chest, shoulder and tri workout.  I was doing bar bell flat bench press and had 290 lbs on the bar.  I needed a good spot as this is a heavy weight for me.  I noticed a guy sitting on the incline bench with 315 lbs sitting there.  He looked like he needed a spot so I offered and he accepted.  He cranked out 4 reps.  I was astonished.  He looked strong, but I didn't think he'd get 4 reps.
I asked him to give me a spot and I got 4 reps on flat bench.  Clearly, he was immensely stronger than I was in the bench.  But, I had that nagging question, what does that mean?  Would I compensate for lack of bench strength with leg strength or perhaps in speed and agility on the track enough to claim title over him.  Another way of wording my question is; Does his strength in bench out do my edge in speed?  Or perhaps he is fast too.  These are the questions that led me to develop a competition that allowed the strong man to compete with the swift man and find out overall who comes out on top.  He showed me videos of him benching 405 for 7 reps (and various other weights and reps).  So for fun, I made a guess at his numbers and plugged them in to the score sheet.  Please see here to see how I stacked up with him.  Of course, I don't know what he runs the 40 yard dash in nor the 400m.  However, looking at him and knowing what I know about typical times, I feel my educated guess is in the ballpark.

So please go here and see the numbers.  Also, put your numbers in, then train hard and repeat and see how you improve.  See how you stack up against people across the world in this unique competition: The Speed Strength combine.

In reality, the key is to stay healthy.  Just yesterday doing a 100 m sprint at 90% speed I strained my hamstring.  This is somewhat devastating because this puts me behind in my training as I will need at least a week to recover.

Training for the Speed Strength Combine

While I don't claim there to be one best way to prepare for the events in the Speed Strength combine, there is one main element that is critical.  Consistent intensity.  To achieve a score of greater than say 150 pts in this particular fitness test, you must be inherently genetically superior or you have to work hard over a long period of time.

I believe that consistancy and intensity can go along way.  Since there are 6 events that must be competed in this fitness contest, you must do something at least 4 days a week if not more.  I train chest, shoulders and tris once a week.  I then work my legs twice a week, but using a split that allows sufficient recovery.  If I perform Squats on Wednsday; I wait at least til Saturday prior to goint to dead lift. This gives my lower back (the slowest to recover), and my hamstrings and legs enough time to recover before hitting them again.  After a heavy deadlifting session my lower back is usually quite sore the next day.  Therefore, I won't hit squats again until the 4th day.  So, if I squat wed, dead lift on Saturday, I won't squat again until wednsday.

For the strength portion in bench my work out is as follows:
Exercise 1: Flat bbell bench press: Warm up (WU) x 6 to 7 sets (i.e. 135 x15, 185x7, 205x4, 225x3, 245x2, 265x1 +/1 275x1)   first working set:  290 x 5 (goal) x 2 sets, then 275 x 6 (goal) x 2 sets, then 250 x 7 (goal).  I record what my weight and reps and if I reach my goal, the next session I increase the weight by 5 pounds.  For example, if I achieve 290lbs x 5 reps on both sets, next week I move to 295 lbs and attempt to achieve 5 reps x 2 sets.  I do this at each weight.

Exercise 2:  Sitting Military Press: 190 x 6 x 2 (goal), then 170 x 8 x 2 (goal).  If I do not achieve this goal, I keep the weight the same next week until I achieve the goal set.

Exercise 3: Incline Bench drop set: 205 x 6 x 1 set drop to 135 to failure x 1 set.  Likewise, I increase the heavy weight by 5 lbs each week if I get my goal of six reps.  The drop set lower weight, always stays the same.

Excercise 4:  Close grip bench press superset with push ups:  190 lbs x 8 to push ups to failure.  The close grip bench weight is increased each week by 5 lbs when the rep goal of 8 is reached.

Exercise 5:  Super set with DBells 70 lbs:  Over head press to incline press, to flat bench press.  I attempt to achieve one rep more at each position.  This works endurance.

Exercise 6: Tris-laying tris and push downs for 3 to 4 sets.

Exercise 7: Dips x 2 sets to failure.

As you can see, I only do 7 exercises for chest, shoulders and tris.  If I hit a plateau for several weeks in one particular area, I may add an additional exercise for that area.  If you are training only for getting a massive chest, or only to have a huge 1 RM in bench; this may not be ideal.  My goal is to get super strong, but I need to be balanced with speed.  Therefore, I limit the number of reps and exercises to save time for cardio conditioning.  However, one key point to this regimen; it is done at max intensity.  If I hit my goal in the rep on the first of two sets at that rep goal, I stop.  But, I push through that goal to failure on the next set if I can. As I move along in the program, the weight starts to get incredibly heavy and the goal for reps is rarely pushed through.

Mentally, having a goal to reach each week helps focus you on diet when out of the gym.

Next, I'll discus my running regimen.  Speed is a big part of this contest. So you've got to get to the track.

Diet: Nut and Bolts

For any fitness buff, it is well known that you must consume adequate protein, with a diet that is low in sugar and not high in saturated fats or "bad" fats.

However, what are some of the best or perhaps easiest ways to get the micronutrients you need.  Obviously, fruits and vegetables.  But, if you are like me, eating large quantities of veggies, or fruit may be difficult.

Although, you must consume some amount of veggies and fruit, another alternative is to get the proper types of fats and proteins through nuts.  I find nuts to be a good source of nutrition because they don't go bad and are so portable.  Furthermore, because they tend to have a relatively high fat content as compared to fruits and vegetables, they are more satiating.  Research has found consumption of small amounts of nuts or peanut butter is linked to decreased risk of heart disease, certain kinds of cancer, gallstones, type 2 diabetes and other health problems.

 One caveat, you should consume them raw or dry roasted; don't consume the nuts embalmed in the sugary or oily substances that make them delicious, but less useful for heart healthy purposes. Once exception to this is a cocoa dusted almond from Emerald.

Almonds are a good example of a nut that contains the important micronutrients you need if you want to compete at the best of your body's ability. Almonds contain (assuming a serving of 24 almonds) 163 calories, with 6 Gm of protein and 14 Gm of fat.  The good news is that only 1 Gm of that fat is saturated "bad" fat.  Most is mono unsaturated or "healthy" fat that helps lower LDL "bad" cholesterol and raise HDL or "good" cholesterol.   Studies seem to indicate that this type of diet reduces the risk of stroke and heart disease.  This serving size of almonds also contains 6 Gm of carbohydrates, but only 1 Gm of that is sugar.  But, in addition, almonds are a great source of fiber, B complex vitamins (riboflavin, niacin, thiamine, pantothenic acid, vitamin B-6, and folate).  Vitamin E is abundant at 170% of recommended daily allowance (RDA) and is an important fat soluble antioxidant used in the maintenance of cell membrane integrity.  Last but not least, they are rich in minerals such as manganese, calcium, iron, zinc, magnesium, potassium, and selenium.

Although the almond is probably the best all around nut, pistachios provide many of the same benefits.

Pistachios are a good source of phyto chemicals like carotenes that are beneficial because of their antioxidant properties. They also contain Vitamin E and polyphenolic antioxidants. Pistachios like almonds contain most of the Vitamin B complex vitamins like thiamine, riboflavin, niacin, etc.  Pisachios are also a rich source of minerals, i.e  zinc, iron, and in particular copper (144% of RDA). Like Almonds, Pistachios contain a large amount of mono-unsaturated fats (like Oleic acid)  which can reduce LDL cholesterol and raise HDL cholesterol.  Because of their high protein content (an ounce of pistachios contains as much protein as one egg), eating them post work out is a good choice.

Peanuts are technically not nuts (they are legumes), but contain the same ingredients to qualify them from a functional standpoint.  Peanuts are high in protein (about 7 Gm per ounce) and also contain heart healthy lipid lowering mono-unsaturated fats.  Eating Peanuts (or natural based peanut butter) prior to a work out is a great source of energy. Ounce for ounce, peanuts have a higher content of bioflavanoid resveratrol than grapes which has been shown to reduce a number of maladies including cognitive decline and may help stave Alzheimer's disease through this and other vitamins like Niacin.

Walnuts are key to any diet.  They contain a large amount of the antioxidants that heavy training athletes need.  They also provide the highest amount of Omega-3 fatty acids of any of the nuts.  One of these is alpha Linolenic Acid, which is very good at reducing the level of inflammation in the body. Several studies have shown that walnuts provide a  litany of health benefits from improved heart function to reducing the incidence of diabetes to reducing the chances of certain types of cancer (prostate and breast).  It is believed that most of the health benefits from walnuts result from their antioxidant and anitinflammatory effects.

Brazil nuts are large and high calorie.  Because they have a high calorie count and are a great source of vitamins and minerals they are a staple food in amazonia where their fruit trees are native.   The high caloric content of this nut is from the large amount of fat.  Fortunately, like the other nuts discussed above, the fat in the Brazil nut is mostly mono unsaturated fats like palmitoleic acid and oleic acid. They are also rich in vitamin E.  Brazil nuts are particularly noted for their very high selenium content. At 3485% of RDA for selenium, this is the best natural source for this mineral.  In reality, only 1 to 2 nuts per day is all anyone really needs.  Brazil nuts are also a good source of B complex vitamins and many important minerals like: copper, magnesium, manganese, potassium, calcium, iron, phosphorus and zinc.


I've highlighted just a few of the best nuts; but, all have some redeeming qualities.  I believe proper nutrition is a huge key in achieving big score in the Speed Strength Combine.

Diet for the athlete-the macronutrients

To compete at the highest level that your body is capable requires that you provide it with the proper building blocks of nutrients.  Your diet is more than just fuel for energy output during exercise or competition, but, also must provide the necessary chemicals for repair, maintenance and ongoing metabolic activities.  A nutritional diet is divided between the macronutrients and the micronutrients.  Macronutrients include proteins, carbohydrates, and Fats.  Micronutrients are the vitamins and minerals.

Their is much confusion about how much protein one should consume, how much fat, and what percent of your diet should be carbohydrates.  In general, those attempting to gain lean muscle mass, particularly in the early phase, when most gains in strength are made and the intent is to add muscle mass, protein is consumed at 1.2 to 1.7 g/kg of body weight each day [see calculator].  This can be difficult to achieve in some diets and must often be achieved by using a protein shake supplement.  Whey protein powder is one of the most popular forms of protein as it is easily digested and rapidly absorbed into the blood stream from the gut.  Thus, it is ideal to consume directly after an intense work out session.  Obviously, high protein intake without vigorous exercise can result in this protein being simple converted into fat, which the body readily does when there is no better use for it.  The amount of protein as a percentage of total  energy intake is recommended to be between 10% and 35%.  For the athlete, especially the athlete looking for gains in strength, the higher end of 35% of consumed calories should be the target.

Fatty acids are critical to a successful diet and for maintenance of the body.  The real issue is the quality or type of fatty acids consumed by the typical american.   Fat consumption should comprise 20 to 35% of caloric intake each day.  However, 10% should be saturated, 10% polyunsaturated, and 10% monounsaturated and include sources of essential fatty acids.  The ideal source of fat comes from sources such as fish which are rich in Omega-3 fatty acids, as well as nuts such as almonds and peanuts.

So how in the world do you keep track of the percentage of macronutrients you are getting in your diet?  The obvious way would be to read labels and weigh food.  Of course, for practical use this is less than ideal. My rule of thumb is to understand that I get carbohydrates without trouble.  So, I make a conscious effort to introduce proteins into my diet.  I try to eat plenty of eggs, of fantastic source of both protein (white portion) and fat (yellow portion).  Eggs are also a good source of many other micronutrients.

So the quick breakdown of the Egg.  The Egg white contains 6 gm of protein per egg.  The yolk contains about 5.6 gm of fat, but only 1.6 gms are saturated fat, or the "bad" fat associated with heart disease.  Egg yolks also contain a good amount of cholesterol.  However, dietary cholesterol is not directly related to blood cholesterol levels.  It appears that blood  cholesterol levels are more closely linked with your genetic makeup.  Lastly, the yolk contains dense quantities of Vitamin A, B12, D, E, K, zinc, calcium, DHA, and more.  Consequenlty, most mornings, I try to get a large amount of eggs into my breakfast, while avoid carbohydrates.

Optional Speed Events: Broad Jump and 60 yard Shuttle

The Broad Jump is probably the simplest event requiring the least amount of time.  It is, however, a great test of explosiveness and lower body strength.   This is a quick and easy test of pure athleticism and thus a part of the NFL combine.  The NFL combine record in the broad jump is an incredible 139" (almost 12 ').
check out this video of his performance and notice the incredible explosiveness combined with great flexibility.

The 60 yard shuttle is the event that seems to be most skipped at the NFL combine.  While virtually all of the athletes run the 40 yard dash, only a few at the skilled positions run the 60 yard shuttle.  This event tests quickness, but also tests conditioning.  This event requires quickness, leg strength, flexibility and excellent balance.  I searched and could not find a single video posted of this event at the NFL combine, but here is a video link showing a super fast time.  Notice, the competitor has to touch the line each time.

Start the time on the first move of the runner.   You get three attempts taking your best time.

Speed Events: The 40 yards and 400m.

The 40 yard dash is the premiere event at the NFL combine.  It is a measure of speed with some emphasis on quickness as the faster the start, the lower the time.  This event also is a measure of explosiveness, leg strength, flexibility and quickness.

In the Speed Strength Combine, there is no requirement for electronic timing.  The only requirements are as follows:

1)  minimal wind (no actual wind speed gauge is required)
2) performed on the football field from goal line to 40 yard line (turf or grass)
3) Any shoe you want to use.
4) Timing should be done by two different people simultaneously, and take the average.
5) Timer starts are first movement and ends when first body part crosses the 40 yard line.

You should take three attempts.

Obviously, these rules are self policed.  However, for those who are in the top 5% of overall scores, a video must be submitted via you tube (or other means) to be qualified and recognized.

Cheating really makes no sense since the objective of this competition is to find out how you compare to others and to see how fast you are.  Cheating hinders that objective and there is NO reward for the fastest 40.
The fastest 40 yard dash electronically timed was by Chris Johnson.  see here.

The 400m is similar.  This event is run on a track and is 1 lap on the inside lane.  Only one timer is required and time is to the nearest second.  Any shoe type (including spikes) is fine to wear.

This event tests speed, flexibility, anaerobic capacity, but also aerobic capacity.  This race is also a test of a competitors mental toughness, and conditioning.  This is not event you should attempt all out if you are not sure you are in good physical shape as it will stress the cardiovascular system to its absolute maximum.

The world record in this event is 43.18s held by Michael Johnson.  Times in the sub 45s area are absolutely mind boggling for those who do not run track.  So be prepared to see a significantly slower time for yourself.
Here is Michael Johnson in Atlanta.

Please post your times on the web enabled score sheet:

What pro athlete would most excel in the Speed Strength Combine?

See the first blog to find out what the SS combine comprises.

Bo Jackson is likely to be the pro athlete to achieve the greatest score in this combine.  While I don't have data on how much he lifted, by extrapolating and using conservative numbers when doing so we can see that he would have produced an eye popping score of well over 300 pts.  To understand how other worldly this score is, understand that getting a score over 200 pts would likely put you in the elite athlete category.

Event 1: Bench Press-425 lbs (likely more than this).  He did not lift weights prior to college.  His room mate state that Bo Benched 400 lbs without having worked out prior.

Event 2: Dead Lift-I could find no data on this for him.  It is likely that he never even attempted this.  However, given his incredible strength, he could likely have pulled at least 500 lbs without to much trouble.  

Event 3: Squat-Once again, I have no data on this, so I will go conservative guess 425 lbs.  Likely, he would have been able to do much more.  

Speed events: 

40 year dash-  Bo ran a hand clocked 4.12 s at the NFL combine in 1986. This is THE fastest time on record.  However, because it was not electronic, it has an asterisk.  Either way, this is incredibly fast by any measure.

400m- Bo has a clocked time in the 100m of 10.44 s.  Using a web based calculator we can estimate his time in the 400m. The time calculated is 45.41s.  This, of course is incredibly fast and since Bo was not a 400m runner, we will be conservative and bring that back to 47 s.  

60 yard shuttle:  I have no time in this event for Bo.  Using times typical of running backs we can guess that he would have done at least 11.6 s.  This is in the middle of the running backs at the 2012 combine.

This produces a score in the Speed Strength Combine of 314.32 pts.  If he were to train specifically for this competition, he would probably break 350 if not 375 pts.  Truly, mind boggling.