“Everyone deserves to be an athlete,” begins Dr. Ben Valdecañas. “But most people get injured because they don’t know how to prepare adequately.”
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The sports medicine and rehabilitation specialist says that patient education is vital, and so is getting these would-be athletes or sports hobbyists to condition their bodies for their particular sports. “No conditions are the same for any particular athlete; different people have different levels of flexibility, endurance, muscle tone, and muscle capacity,” he says. “So all of these things have to be taken into consideration.”
But, for an athlete, injuries will come and go no matter what. But as with preparation and prevention, there is a smarter and more efficient way of going about recovery and repair. The Aegle Wellness Center medical director and Klean Athlete ambassador shares some factors you should consider for your rehabilitation.
Sleep it off
Valdecañas says that a lot of athletes neglect rest—and by that he means a good old fashioned snooze. “It is during sleep that the human body recovers and repairs itself.” He adds that your sleep has to be as structured as your workouts. “As much as your training is structured on a day-to-day, hour-to-hour basis, your sleep has to be the same way.”
Since we are still animals, he says that we still rely on the setting and the rising of the sun for our physiologic hormones. “We need growth hormones when we are developing as children to reach our peak developmental stage. In adults, growth hormones are not to be taken for granted. Growth hormones are what signals our bodies to repair whatever worn-out parts we have.”
The doctor says that these hormones are mostly secreted during the hours of 10pm and 2am, which means that you should already be asleep by then. “It only works when you’re asleep, and that’s where melatonin comes in,” he explains. “Melatonin secretion is dependent on the setting of the sun; once sunlight or natural light stops reaching the back of our eyes, which is the retina, our body counts down to the production of melatonin. This occurs three to four hours after the sun sets. So its around 9pm to 10pm.” Once melatonin secretes, the body sets to stage 4 sleep. Once you get into a continuous cycle of deep sleep and REM sleep, those reparative growth hormones start secreting from the brain.
But how about those who are on graveyard shifts—like those in the BPO or service industries—or otherwise compelled to go bump in the night? Valdecañas says that that’s where the challenge lies. “We have to coach them on how to really convert their body cycle. Meaning, when they come home in the morning, their rooms have to be very conducive to sleep. It is as dark as night, it as quiet as sleeping time. Even the room temperature has to be cool, as it is at night.”
He suggests that the person take melatonin supplements just before sleeping to convert the body’s rhythm altogether. “That will train the body in assessing when it actually needs melatonin, and soon enough the body gets accustomed to it, and shifts its function to that cycle.”
Unlike supplements that don’t have side effects according to the sports science specialist, sleeping pills do. “Sleeping pills are drugs or substances that cheat the mind in thinking that it is not active anymore. It affects specifically on the serotonin, your happy hormone production, by blocking its re-uptake, meaning it prolongs the exposure of the specific neurons to serotonin,” he says. If you do this long enough, the doctor warns that your brain might think it doesn’t need serotonin anymore. The pills will lose its effect because the body tolerates and acclimatizes to it.
“Different athletes have different thresholds on overdoing things, depending on their sports, their body type, and their lifestyle,” the former swimmer, and track and field athlete says. “So, most athletes that I know, they tend to overtrain, most professional athletes, at that. You have to listen to your body also.” This brings us to the question that he is frequently asked—when do you know when you are injured, and when can you push your body to perform more?
Valdecañas says that there’s always pain in training, but in different levels. Pain that you feel but could still run on—like an iliotibial kind of pain or soreness after a run—you can still do but you have to adjust to it. “One, stretch more. Second, apply cold compresses after the exertion. And third, you can take supplements or even medicines that can bring down inflammation while the body is still repairing itself,” he advises.
But pain that interferes with your usual functions in sports is a sign that you should stop competing.
A prevalent injury that shows that kind of pain is an anterior cruciate ligament (ACL) tear. But, thanks to advancements in technology, what was once a career-ending mishap can now be treatable within a few weeks. “Back in the day, two or three decades ago, a soccer player can’t be allowed to go back to his or her sport earlier than a year. Basketball player, nine months,” he shares. Now, Valdecañas says they can get ACL reconstructed patients running on a treadmill within four weeks, and doing sports specific drills and exercises after the fourth week.
“Techniques have evolved, the comfort of doing it has minimized down-time if not at all. My particular scenario for my athlete patients is that they get their ACLs reconstructed Friday evening after they finish work. By Monday, they’re back to work doing specific exercises,” he says. “Two or three decades ago, again, we would not recommend ACL reconstruction surgery for a non-elite athlete, or non-professional athlete. But 20 years down the line, we discovered that these athletes, these weekend warriors who did not reconstruct when they had their ACL torn, have earlier bouts of arthritis. So now, we recommend reconstructing ACLs.”
You are what you eat
When working with athletes, Valdecañas makes sure that his patients' nutritional intake is tailor-made for both the person’s background and athletic goals. “First we get the athlete’s body composition. Second, we assess the demands on the athlete’s training and competition status. Third, I go to the athlete’s injury history: what previous injuries has he had in the past, what frequent problems does he encounter while training, or while competing,” he enumerates. “So, all these things go into the mix. My physiotherapists and nutritionists and I all go and confer regarding this data, and then we come up with a program.”
For example, a sprint athlete needs bursts of energy, but giving him or her something like sugar can be tricky. “We can’t give him or her more than what he needs, otherwise it becomes an additional load on his athlete’s body,” he says. But it cannot be lesser than what the athlete needs otherwise he or she won’t have the energy to fuel the burst activity. It all has to be customized.
What is his opinion of diets like Keto and Paleo then? “I hate to use the term ‘fad diets’ because these diets are well based on scientific research, but the thing is, people have the tendency to stretch these indications. For example, keto is a bit extreme because it was designed particularly for cancer patients. People use it now because you lose weight a lot faster, because you really restrict sugar,” he explains. You cannot do that to an athlete, he says, because the athlete needs fuel to power his or her exertions. “A Paleo diet will be a good compromise between keto and a regular diet, but it has so many permutations.”
When coming up with a nutritional plan, Valdecañas and his team start with a macro-nutrient percentage, tweaking along the way. “In school, we were taught that carbohydrates should occupy 50 percent of a person’s plate. We found that with the present degree, or activity level of the athlete, that leaves a lot to be converted to fat as storage. Meaning the athlete really doesn’t use this much carbohydrates.”
For those in recovery, the body tends to need protein more since it is used in muscle building and conditioning. “The longer the athlete tends to recover from the particular competition or exertion, the weaker he becomes in the long run.”
Boost your body
“Supplements are not really bad or don’t have side effects, provided you take them properly. This means you only take what your body needs, and you don’t miss out on what it needs,” Valdecañas says. “Supplements or vitamins are practically what your cells need on a daily basis, so you’re just supplying what your body needs.”
This, of course, does not include performance enhancement drugs. And the World Anti-Doping Agency has a long ever-growing list of substances you have to test for. Being a sports medicine practitioner, Valdecañas needs to make sure that his athletes are free from these substances, not only to test clean, but to ensure that they don’t interfere with other supplements that they need to function and recover properly.
These drugs can also affect the body’s development in training. One of his athletes, the doctor recalls, was concerned that he wasn’t growing muscle mass as fast as his coach expected even with the proper supplements. “Then, we discovered that one of the supplements that he was buying from the black market had testosterone in it. It t was interfering with what we were giving him, supplements for encouraging natural testosterone production,” he says.
The athlete’s compatibility with supplements needs to go through proper assessment, which can be done in a number of ways including blood tests and face-to-face consultations. “We delve into the athlete’s data, and identify which specific limbs or cellular processes that are being hindered by the deficiency, so that we can supply whatever vitamin that the athlete needs.”
Even if you aren’t a professional athlete, you might find yourself playing a sport, or adopting it as a form of exercise. Valdecañas says that knowing what to do and what not to do to prevent sports injuries is a handy knowledge or information to have.
“A lot of my patients have recurrent knee-pain, or back-pain. I recommend that they adopt a regular exercise program. A lot of them try, but a lot of them also fall out, because they try it the wrong way, over-indulge themselves initially, and they feel a lot of pain after the initial first few sessions,” he shares. That’s where his physiotherapists come in; they get a non-athlete started the right way, prevent them from overexerting, and encourage them to stretch more so that they don’t get injured in their initial attempts.
“Exercise cannot be overlooked,” he ends.
The Aegle Wellness Center is on the 6/F of The City Club Alphaland Makati. For more information, visit AegleWellnessCenter.com.