Fitness Journey
Introduction and Background
(Written September 12, 2024)Wilson's Disease
My midlife fitness journey began in earnest when I turned 50 in 2020. I had not taken health and fitness seriously at all throughout my adult life. I was a very active kid growing up and played sports until High School, but once I graduated high school, went to college, got married, had kids, had a career, etc., any type of extra physical activity was of zero interest to me.
Then I got sick. I was diagnosed with a rare genetic disorder called Wilson's Disease in 2002 which caused me to have a liver disease caused by excess copper in my liver. When I was diagnosed, I was already in "end stage liver disease", and my treatment options were limited.
Long story short, 12 years later I was very sick and received a liver transplant. After the transplant I weighed about 165 pounds and completely devoid of all muscle tone.
Type-2 Diabetes
Unfortunately, I still didn't take my health seriously. I didn't exercise and I ate poorly. By 2018 I was 240 pounds, had high blood pressure, high cholesterol, and was Type-2 diabetic.
I started to get semi-serious in early 2020. I was on blood pressure medicine, high cholesterol medicine, and a pill for the diabetes. I started walking more. I bought a treadmill. I gave up sugary drinks, I tried to watch my carbs. I got my A1C under 7.0 for a time. Periodically, I'd fall off the wagon and my A1C would balloon again.
Post covid I had the opportunity to move from Western Kansas back to Eastern Kansas where I grew up. I settled in the Kansas City metro where I received my transplant and still was monitored by my liver specialists.
That was a big move for me physically. I got new general practitioner and an endocrinologist in the same health system as my hepatologist. Now my A1C is under 6.0, my cholesterol is good, and I lost 50 pounds since 2020. I won't lie to you—the GLP-1 drugs are amazing.
Improving Cardio Fitness: VO2 Max
(Written September 12, 2024)Tabata igh Intensity Interval Training (HIIT)
During a routine checkup with my GP, I asked about ways to improve my cardiovascular fitness. I had already been walking a couple miles a day and doing resistance training with dumbbells.
She was a runner and, while had not tried it herself, suggested that I research The Tabata Protocol.
The Tabata Protocol Format
The reason this type of HIIT workout works so well is because of the work-to-rest ratio. You only get 10 seconds of rest between each 20-second bout of exercise. That very short interval isn't enough to allow you to fully recover, which is one reason it's great for building endurance and getting you in shape. (From Very Well Fit.)
The Tabata format is as follows:
20 seconds of a very high intensity exercise (e.g., sprints, burpees, squat jumps, etc.)
10 seconds of rest
Repeat 8 times for a total of 4 minutes
I created a customized HIIT workout on my Apple Watch following that format for the treadmill:
Five-minute warmup ramping up to 3% incline and 3.5 MPH
20 seconds of running (I'm at 8.5 MPH now at 4% incline, but I started at 2% incline at 7.5 MPH)
10 seconds of rest (I literally hop onto the rails on either side of belt and stand)
Six-minute cool down lowering the incline and speed.
That makes for a 15-minute workout where I walk and run about a mile.
VO2 Max Readings
The Apple Watch and Fitness app only record the Cardio Fitness (VO2 Max) readings when doing outdoor walks, hikes, and outdoor runs. So, for me to track improvement resulting from my indoor Tabata treadmill runs, I venture out into nature for trail running or hiking. I average 2–3 of these a week where I hike about two miles at a minimum.
Tabata Protocol Results—Six Weeks
I started doing my customized Tabata HIIT workouts on August 5, 2024. Each week I have done four of them per week through August 2024 and did it for six weeks ending September
When I started my "Cardio Fitness" level as reported by my Apple Health app was "low" at 24.8 as measured by VO2 Max on August 11, 2024, after my first week of training. I did not take a baseline reading before starting my training.
I am now in the "below average" range for my age after those first six weeks of training. I'm tracking to cross the "average" line (33 VO2 Max) on about October 9.
However, I have plateaued at 29.0 in my last three Zone 2 hikes. I'm not sure what that means. Now that I'm through the first six weeks of training at the four-per-week intensity, I'm going to back it down. The original Tabata research was conducted over six weeks and I feel like that's a good trial for me. I'm going to shoot for two Tabata runs per week and add multiple Zone 2 workouts (see below) on the treadmill or on the trails.
Improving Muscle Endurance: Muscle Mitochondria
(Written September 12, 2024)Zone 2 Low Intensity Training (LIT)
I read a book titled "The Midlife Cyclist" by Phil Cavell sometime in 2023. There's a lot of great information in it that applies to other training besides cycling. One of the things that stuck with me was the admonition that we middle aged amateurs train too hard with our limited time. We try to make up for lost time by training too fast, too long, and too often without rest days. We injure ourselves and hinder or even reverse progress.
To build muscle endurance he gets into the weeds a bit to talk about staying in the oxidative state below the aerobic threshold to make the mitochondria in your leg muscles larger and more efficient.
He talks about several ways of measuring how hard we're working out that I won't go into a lot of detail here, but he mentions heart rate monitors, power meters and the RPE (rate of perceived exertion) or Borg Scale.
He recommends low intensity training (LIT) at 60–70% of your maximum heart rate. (You calculate your maximum heart rate by taking 220-age=max heart rate. 220-50=170 bpm.)
Other sources agree with this and call it Zone 2 Training. Read this article for some great detail about increasing metabolism efficiency using Zone 2 Training.
My Zone 2 LIT
Keeping the heart rate in Zone 2 is harder than you might think. For me at my current fitness level, it is a brisk walk or hike on flat ground. You need to be deliberate in how fast you need to walk or jog. I'm going to quote directly from the article because it says it better than I can plagiarize:
Zone 2 running is “hard” because most people find it very challenging to stay at a slow pace for a long time. 45 minutes should be the minimum time that you should aim for. Until your aerobic base (and mitochondria) are better trained you will find that you have to run at a painfully slow pace and walk many hills. If you stick with it, you will be able to achieve a faster pace, yet be able to stay in Zone 2.
I don't have a way to quantifiably measure muscle endurance improvement like I do with the Cardio Fitness. Qualitatively, "how to I feel after 3 or 4 miles?" is a question I can ask myself and make note of it, I guess?
My most recent Zone 2 LIT hike was for three miles. I had to very deliberately hike at a very fast clip to get into and stay in Zone 2. Hills would make me bump into Zone 3 and even Zone 4. I'm going to do some personal testing on the treadmill at a couple different inclines and speeds to determine what is optimal for getting me into Zone 2 at my current fitness level.
Rotator Cuff Rehab
(Written November 19, 2024)Zone 2 Runs on the Backburner
I had originally decided to stop the Tabata HIIT runs once it was clear I'd plateaued and incorporate more Zone 2 LIT running try to break the plateau and continue improve my VO2 Max numbers.
However, my left shoulder rotator cuff began hurting at night as I slept, instead of only hurting when I lifted weights. I researched different rotator cuff rehab exercises and start incorporating them into my workouts and backing off the cardio. No, I didn't go to the doctor or seek out physical therapy because I had it looked at over two years ago and once before with an MRI over a decade ago. Yes, I probably should have another MRI, because it probably is arthritis and not just a possible rotator cuff tear.
Saying that, I started doing new flexibility exercises five days a week and new rehab exercises three days a week. I did that for four weeks and can say it has improved but is certainly not pain-free.
This week I'm mixing it up. I'm still going to do the same flexibility exercises, but probably fewer sets of them. I'm going to increase the number of days I do the rehab exercises with resistance bands. Finally, I'm going to add more upper body strength exercises to the rehab ones and see what movements I can do pain free and which ones I need to rethink.
VO2 Max Improvement Anyway
While I was doing the more intensive rehab exercises over the past four weeks, I did get out and run or hike on the trails about 1–2 times a week and surprisingly I broke through the plateau I'd experienced at 29.0 and am now up over a point at 30.2.
New Metric: Average Resting Heart Rate
I went back into my Apple Health records and exported out the average resting heart rate data from August 5, 2024 onwards. There's a nice downward trend to my resting heart rate over the time I have been trying to improve my VO2 Max, showing a slow, but steady on average improvement in cardio health as well.
