Begin With The End In Mind

The wisdom of Stephen Covey. PK

THE 7 HABITS OF HIGHLY EFFECTIVE PEOPLE  

HABIT 2: BEGIN WITH THE END IN MIND

So, what do you want to be when you grow up? That question may appear a little trite, but think about it for a moment. Are you–right now–who you want to be, what you dreamed you’d be, doing what you always wanted to do? Be honest. Sometimes people find themselves achieving victories that are empty–successes that have come at the expense of things that were far more valuable to them. If your ladder is not leaning against the right wall, every step you take gets you to the wrong place faster. Habit 2 is based on imagination–the ability to envision in your mind what you cannot at present see with your eyes. It is based on the principle that all things are created twice. There is a mental (first) creation, and a physical (second) creation. The physical creation follows the mental, just as a building follows a blueprint. If you don’t make a conscious effort to visualize who you are and what you want in life, then you empower other people and circumstances to shape you and your life by default. It’s about connecting again with your own uniqueness and then defining the personal, moral, and ethical guidelines within which you can most happily express and fulfill yourself. Begin with the End in Mind means to begin each day, task, or project with a clear vision of your desired direction and destination, and then continue by flexing your proactive muscles to make things happen. One of the best ways to incorporate Habit 2 into your life is to develop a Personal Mission Statement. It focuses on what you want to be and do. It is your plan for success. It reaffirms who you are, puts your goals in focus, and moves your ideas into the real world. Your mission statement makes you the leader of your own life. You create your own destiny and secure the future you envision.

 

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Rocked-Up!

I’ve said it before and I maintain that Pole Vaulters are THE model to follow, especially for women, who want to have the-most-crazy rocked-up body going. I’m going to expand on this theory with a full article very soon, until then here’s “Exhibit A” for your perusal. PK

Get Your Nutrition Right!

I want to drop a nutrition article in here that address’ a fundamental obstacle in developing strength/muscularity or for you women who prefer ‘tone’ (which is another way of saying hypertrophy). The issue at hand is failure to consume enough protein aka the nutritional building block(s) of building muscle tissue. Protein makes up 13% of an average Americans caloric intake which is woefully inadequate to build a strong, dense physique. To optimize strength training induced protein synthesis one must make protein 31% of their caloric intake. This is especially important for those interested in loosing fat, as protein is far more satiating than carbohydrates. PK

THE ROLE OF POST-EXERCISE NUTRIENT ADMINISTRATION ON MUSCLE PROTEIN SYNTHESIS                               AND GLYCOGEN SYNTHESIS
by Chris PoolColin WilbornLem Taylor and Chad Kerksick
Nutrient administration following an exercise bout vastly affects anabolic processes within the human body, irrespective of exercise mode. Of particular importance are protein and carbohydrates whereby these two macronutrients portray distinct functions as anabolic agents. It has been confirmed that protein and/or amino acid ingestion following resistance training is required to reach a positive protein/nitrogen balance, and carbohydrate intake during recovery is the most important consideration to replenish glycogen stores from an exhaustive exercise bout. Several factors play significant roles in determining the effectiveness of protein and carbohydrate supplementation on post-exercise protein and glycogen synthesis. Improper application of these factors can limit the body’s ability to reach an anabolic status. The provided evidence clearly denotes the importance these two macronutrients have in regards to post-exercise nutrition and anabolism. Therefore, the purpose of this review is to discuss the impact of dietary protein and carbohydrate intake during the recovery state on muscle protein synthesis and glycogen synthesis.Key words: Protein supplementation, carbohydrate supplementation, anabolism.

Introduction

In recent years, post-exercise nutrition has evolved as an imperative part of training regimens among athletic populations. Athletes of all ages, abilities, and skill levels are adopting some form of post-exercise nutrition to improve performance and enhance the body’s recovery processes following exercise. Athletes in particular are highly susceptible to the detriments of heavy training regimens, because they are constantly depleting their energy substrates and stressing skeletal muscle tissues simultaneously. The macronutrients that have drawn much attention, in reference to the recovery phase of exercise, are protein and carbohydrates. Protein and carbohydrates have their own distinct functions, yet both work to generate an anabolic state within the body when ingested after the completion of an exercise bout. It is necessary for individuals who seek to gain lean muscle mass to induce a positive protein turnover as often as possible. It has been confirmed that protein and/or amino acid ingestion is required to reach a positive protein/nitrogen balance (Borsheim et al., 2004a; Koopman et al., 2006; Tipton et al., 2004), and carbohydrate ingestion alone provides marginal benefits on protein synthesis rates (Roy, 1997). Carbohydrate intake during recovery has been shown to replenish depleted glycogen after intense or exhaustive exercise (Ivy et al., 2002; Ivy et al., 1988b; Reed et al., 1989). The addition of protein can further enhance this process (Ivy, et al., 2002), but only in situations when an inadequate amount of carbohydrate is made available in the diet (van Loon et al., 2000). A lack of glycogen stores in the muscle and liver will limit the performance capacities of the body during prolonged or higher intensity bouts of exercise (Coyle et al., 1986). The provided evidence clearly denotes the importance these two macronutrients have in regards to post-exercise nutrition and anabolism. Therefore, the purpose of this review is to discuss the impact of dietary protein and carbohydrate intake during the recovery state on muscle protein synthesis and glycogen synthesis. 

Resistance training and protein turnover
It is of paramount importance to delineate the role that resistance training plays in protein turnover. The work of Biolo and colleagues (Biolo et al., 1995b) examined protein synthesis and degradation rates before and three hours after resistance training in healthy untrained men. Three hours after the exercise bout, protein turnover and amino acid transport increased in addition to increases in protein degradation above baseline levels, resulting in a net negative protein balance. Similar findings were reported by (Phillips et al., 1999), as they measured fractional synthesis rates (FSR) and breakdown rates (FBR) in resistance trained and untrained individuals. FSR values increased when measured immediately following the resistance training bout. However, FBR values were also elevated in response to resistance training, concluding that protein turnover rates remained negative (protein degradation rates remained higher than synthesis rates). One interesting note of this study was that FBR, following the training session, increased higher in the untrained subjects. This demonstrates that trained individuals with adequate resistance training experience will undergo reduced protein turnover rates when compared to untrained counterparts. The duration of elevated protein synthesis rates following resistance training was analyzed by Chesley and colleagues (Chesley et al., 1992). Their results show a 50% and 109% increase in protein synthesis rates at four and 24 hours post- exercise respectively. This elevation seems to diminish and return to near baseline values between 36 hours (MacDougall et al., 1995) and 48 hours (Phillips et al., 1997) after the exercise bout. Several other previous investigations have also supported these findings on the relationship between resistance exercise, void of nutritional intervention, and protein turnover (Biolo et al., 1995a; Durham et al., 2004; Hasten et al., 2000; Phillips et al., 2002; Pitkanen et al.,2003; Tipton et al., 1996).

Protein intake
A number of studies have identified the effects of dietary protein intake, void of any exercise intervention, on markers of protein synthesis. Tipton and colleagues (1999b) supplemented four healthy volunteers with 13.4 g of essential amino acids (EAA) and 35 g of sucrose which elevated arterial EAA concentrations between 100% and 400% between 10 and 30 minutes post-ingestion. This demonstrates that the combination of a small quantity of amino acids coupled with a carbohydrate (an approximate 3:1 ratio) can effectively stimulate protein synthesis at rest. Furthermore, an EAA dosage similar to the Tipton investigation (15 g) increased protein (fractional) synthesis rates in young (10.3%/hr) and older (8.8% hr) adults in a parallel fashion measured by arterial phenylalanine concentrations (Paddon-Jones et al., 2004). Absorption speed of amino acids is a critical factor in regulating post-prandial protein accretion. Whey protein was superior to that of casein in upregulating protein synthesis (Boirie et al., 1997) due to its ability to digest more rapidly than casein protein. Free form amino acid ingestion acts similarly to whey by displaying a rapid and strong increase in aminoacidemia (Dangin et al., 2001). This is especially important in elderly populations, because a quickly digested protein can increase protein synthesis/stores sufficiently and provide some alleviation against protein losses accompanied with aging when compared to a slower digested protein (Dangin et al., 2003). In the larger scope of things, it appears that protein synthesis rapidly increases for up to two hours after amino acid administration (Bohe et al., 2001), and that a dose-dependent response between amino acid availability and protein synthesis exists up to a point of complete saturation and possible inhibitory mechanisms of amino acid uptake by muscles (Bohe, et al., 2001; Monneret et al., 2003). Several other previous investigations have also supported these findings in regards to protein ingestion void of exercise intervention (Kobayashi et al., 2003; Paddon-Jones et al., 2003; Tang et al., 2009; Volpi et al., 2000;2003).

Protein intake and resistance training
The intervention of dietary protein or amino acid supplementation in conjunction with resistance training has proven to effectively increase protein synthesis rates. An original investigation in this area of research (Biolo et al., 1997) evaluated the effects of intravenous infusion of amino acids (alanine, phenylalanine, leucine, and lysine) at rest and following a lower extremity resistance exercise bout. Their findings revealed a 291% increase in protein synthesis following the exercise bout, while protein degradation remained unchanged from baseline quantities, a response most largely influenced from the 30% – 100% increase in amino acid transport to the active muscle tissue following exercise. Similar protocols in the elderly resulted in augmented rates of protein synthesis accompanied with unchanged rates in muscle protein breakdown which generated a positive protein balance (Volpi et al., 1998). The practicality, however, for these study designs comes into question due to difficulties associated with intravenous infusion of amino acids after resistance training. Therefore, other researchers have assessed the efficiency of oral administration of amino acids and protein following resistance training. Borsheim and colleagues (2002) found that 3g of EAA ingested one and two hours following a resistance training bout increased protein balance in a similar fashion. Furthermore, it has been established that post-exercise EAA supplementation stimulates protein synthesis, in conjunction with a positive protein balance, comparable to that of intravenous infusion of amino acids (Tipton et al., 1999a), and non-EAA are not necessary to achieve post-exercise anabolism (Borsheim et al., 2002; Tipton et al., 1999a). Esmarck and colleagues (2001) investigated the effectiveness of an oral supplement containing 10g of protein, 7g of carbohydrates, and 3g of fat when taken immediately after or two hours following resistance training on muscle hypertrophy and strength in thirteen elderly men. The cross-sectional area of the vastus lateralis following twelve weeks of resistance training increased when subjects ingested the post-workout supplement immediately upon completion of all training sessions, whereas when taken two hours after completion, no changes in muscle cross-sectional area were observed. In this study, it was not necessary to measure protein synthesis levels, since the increase in muscle cross-sectional area (hypertrophy) is indicative of a net positive protein balance. Also, these conclusions give insight on the possible time course for consuming post-exercise protein and/or amino acids, as hypertrophy resulted only when protein was immediately ingested upon cessation of resistance training. A more recent study (Tipton et al., 2004) explored the acute protein balance after exercise when two different proteins were consumed following resistance training. Twenty three non-resistance trained subjects ingested a placebo, 20g of whey, or 20g of casein one hour after completing ten sets of eight repetitions of leg extensions at 80% of their respective one-repetition maximums. Casein and whey protein ingestion yielded similar values of net positive protein balance, and thus an overall increase in protein synthesis (see Figure 1). A later analysis revealed that soy protein increased protein synthesis in rats similar to that of whey after a treadmill exercise protocol (Anthony et al., 2007). A human trial, however, concluded that milk proteins (caseins and whey) in comparison to soy promoted greater muscle protein accretion when they were ingested after regular resistance training (Wilkinson et al., 2007); a response linked closely to their known impacts on splanchnic and peripheral metabolism, respectively (Fouillet et al.,2002). Whey hydrolysate ingested after a resistance exercise bout acutely stimulated mixed muscle protein synthesis 31% greater than soy (Tang, et al., 2009), and post-exercise ingestion of fat-free milk significantly increased lean body mass to a greater extent than soy protein after 12 weeks of resistance training (Hartman et al., 2007). In addition, protein plus amino acid supplementation can up-regulate muscle protein synthesis in conjunction with resistance training (Willoughby et al., 2007), but it seems unnecessary to combine protein and amino acids in an attempt to further stimulate muscle protein synthesis if an adequate amount of protein (20 g) is ingested (Tipton et al., 2009) immediately before or after a resistance exercise bout (Tipton et al., 2007).

Up to this point, several conclusions can be determined from the previous studies: 1) Resistance training increases protein synthesis as well as protein degradation, 2) This increase in protein synthesis is overshadowed by a corresponding elevation in protein degradation, resulting in a net negative protein balance, 3) The intake of dietary protein and/or amino acids after completion of a resistance training bout augments a net positive protein balance, resulting in the potential for skeletal muscle hypertrophy over time (Cribb and Hayes, 2006; Cribb et al., 2007; Hayes and Cribb, 2008; Kerksick et al., 2006; Willoughby et al., 2007), and 4) The intake of dietary protein and/or amino acids immediately following resistance training is more effective in inducing hypertrophy than if nutrient intake is postponed. Figure 2 illustrates the information discussed up to this point regarding the possible nitrogen balance states.

Carbohydrate/protein intake and resistance training
Researchers have additionally defined the functions that carbohydrates carry out in relation to post-exercise nutrition, specifically pertaining to resistance training and protein synthesis. Studies have looked at the effectiveness of carbohydrate consumption alone following exercise, as well as in combination with protein and/or amino acid supplementation. Roy and colleagues (1997) investigated the effect of a glucose supplement administered immediately and one hour after resistance training on anabolic and catabolic markers in resistance trained men. Subjects completed four sets of approximately 8-10 repetitions each of unilateral leg press and knee extension exercises at 85% of 1RM, and either received a glucose supplement (1g·kg-1) or placebo following the exercise bout. Fractional muscle protein synthesis rates in the exercised leg muscle increased 36%, where only a 6% increase was observed in the placebo condition. Urinary urea excretion
and 3-methlyhistidine (markers of muscle protein degradation) were lower in the treatment group (urea excretion: 8.6 g·g-1 creatinine, 3-methlyhistidine: 110.4 μmol·g-1 creatinine) compared to placebo (urea excretion: 12.3 g·g-1 creatinine, 3-methlyhistidine: 120.1 μmol·g-1 creatinine), signifying a reduction in protein degradation. The overall effect of the glucose supplement caused a suppressed protein degradation rate compared to the placebo group, resulting in a more positive protein balance. These results were supported by a later analysis that concluded 100 g of carbohydrates improves overall protein balance when ingested one hour following a resistance exercise bout (Borsheim et al., 2004b).

Borsheim and colleagues (2004b) determined if an amino acid, protein, and carbohydrate solution elicited a greater anabolic response following resistance training than carbohydrates alone. Eight recreationally active subjects completed two trials of 10 sets X 8 repetitions of leg extensions, and ingested either a solution containing 77.4g carbohydrates, 17.5g of whey protein, and 4.9g of amino acids or 100g of carbohydrates for each trial, one hour upon cessation of exercise. Arterial phenylalanine concentration increased rapidly in the protein/amino acid/carbohydrate group and remained elevated until 210 minutes after the completion of exercise, causing a net positive muscle phenylalanine balance for a short period. Phenylalanine concentrations remained close to baseline levels in the carbohydrate group, inhibiting net muscle phenylalanine balance from reaching a positive state. Therefore, the addition of protein and amino acids to a carbohydrate solution increases net muscle protein synthesis to a higher degree than carbohydrates alone and shifted the overall balance of muscle protein metabolism to a positive state. A more recent study (Tang et al., 2007) elicited similar results to the Borsheim investigation after eight resistance trained males completed two unilateral trials in random order and ingested either a whey mixture (10g of whey and 21g of fructose) or carbohydrate mixture (21g of fructose and 10g of maltodextrin) following the completion of each trial. In both nutritional conditions, muscle protein synthesis after the exercise bout was elevated in the exercised leg when compared to their respective resting legs. Moreover, fractional synthesis rates were significantly higher when whey protein was ingested when contrasted with only carbohydrate ingestion. These studies provide solid evidence that carbohydrates only have a minimal effect on protein synthesis in the absence of protein ingestion, but can be depended upon as a nutrition source to minimize protein breakdown when ingested alone. With this being said, a small amount of whey protein in addition to carbohydrate consumption in the recovery phase of exercise is a more sufficient means of increasing protein synthesis. Koopman and colleagues (2007) found supporting evidence, as they examined the effects of ingesting differing amount of carbohydrates with adequate protein intake on post-exercise protein synthesis. Healthy volunteers completed three resistance training bouts, separated by one week of rest, and consumed protein (3 g·kg-1·hour-1) with 0, 0.15, or 0.6 grams of carbohydrate/kg/hour respectively for each trial during a six hour time period following exercise. Protein synthesis, protein degradation, and net muscle protein synthesis values were constant across all groups. This suggests that carbohydrates, when supplemented with adequate quantities of dietary protein, do not heighten the anabolic response when consumed during the post-exercise period. The interested reader is encouraged to read these additional studies pertaining to the effects of combining protein with carbohydrates following resistance training on muscle protein synthesis (Koopman et al., 2005; Rasmussen et al., 2000; Tipton et al., 2001).

This group of studies has given insight on several important components related to anabolism in the post-exercise state. Carbohydrates alone seem to have a minimal effect on the net protein balance following exercise. Whether they marginally reduce protein degradation or slightly increase protein synthesis, carbohydrates unaccompanied by protein are unable to generate a positive protein balance and stimulate skeletal muscle hypertrophy. Different forms, sources and/or quantities of protein supplemented with carbohydrates can interact to create a greater anabolic environment in the post-exercise state by elevating protein synthesis levels far greater than carbohydrates alone could initiate. If a positive protein balance and subsequently muscle hypertrophy is desired, protein must be added to carbohydrate supplementation in order to fuel these processes. The combined effects of carbohydrate and amino acid/protein supplementation on protein synthesis are equivalent to their independent effects (Miller et al., 2003).

Glycogen synthesis
Glycogen is a vital fuel source for high intensity and prolonged exercise, and the dependence of this energy substrate increases as exercise intensity rises (Bergstrom and Hultman, 19661967). Consequently, glycogen synthesis during the post-exercise time period is essential for replenishing energy stores and aiding the body in the recovery process. It has been determined that glycogen synthesis following exercise occurs in two distinct phases. The rapid phase lasts approximately 30-60 minutes and does not require the presence of insulin (Maehlum et al., 1977). This phase likely transpires when glycogen reserves have been depleted to extremely low levels (Maehlum et al., 1977), or if carbohydrates are ingested immediately following the exercise bout (Ivy et al., 1988a). The other phase of glycogen synthesis is the slow phase, which can last up to several hours if carbohydrate availability is high and insulin levels remain elevated (Ivy, 1991).

Timing of nutrient intake
The timing of post-exercise nutrition is an important factor to consider when attempting to replenish glycogen stores that may have been depleted from exercise. Ivy and colleagues (1988a) demonstrated this phenomenon by evaluating the effectiveness of a 25% carbohydrate solution given to cyclists immediately or two hours after 70 minutes of nonstop exercise on a cycle ergometer. During the initial two hours of recovery, glycogen synthesis was much higher in the individuals who consumed the solution immediately after exercise. The cyclists who ingested the solution two hours after the exercise bout saw an increase in glycogen synthesis during hours three and four, but this elevation still remained below those who ingested carbohydrate at the earlier time point. Ivy concluded that delaying nutrient (carbohydrate) intake by two hours after a prolonged exercise bout decreases muscle glycogen synthesis by 45% when measured four hours after the completion of exercise. Parkin and colleagues (1997) evaluated the effects of delaying nutrient intake on muscle glycogen synthesis following a strenuous exercise bout in endurance trained men. A total of five high glycemic meals were fed to the subjects over a 24 hour period in a manner that allowed one treatment group to receive nutrients roughly two hours after the other at all time points. At eight and 24 hours after exercise, both treatment groups displayed similar muscle glycogen stores. These findings imply that delaying nutrient intake by two hours after a prolonged exercise regimen has no effect on the rate of muscle glycogen synthesis. This is an area in the literature where some conflict and gray areas have presented themselves. Ivy et al. ‘s work measured glycogen synthesis rates up to four hours post-exercise, where the work by Parkin and colleagues determined glycogen synthesis rates over an eight hour period but changed the amount of carbohydrates ingested in the immediate feeding group from 0.8 g·kg-1·hour-1 in the first four hours to none thereafter. It is not unreasonable to believe that if the feedings remained constant, glycogen stores might have been higher at the eight hour time point. Other investigations have demonstrated mixed results as well. Additional work by Ivy and colleagues (1988b) showed delayed glycogen synthesis rates of 22% and 24% from hours two to four during exercise recovery in contrast with the immediate two hour window following exercise and carbohydrate ingestion. On the contrary and in agreement with the Parkin et al. study, no differences in glycogen synthesis rates have been reported between the first 60-120 minutes after exercise and the 60-120 minutes thereafter (Jentjens et al.,2001; Reed, et al., 1989). The dissimilarities observed in these studies are possibly attributable to the amount and composition of the carbohydrates ingested along with the degree to which the individuals participating in these investigations were glycogen depleted. Also, a participant’s fitness level may play a factor, as endurance trained individuals have shown an ability to replenish glycogen stores more rapidly than untrained counterparts (Hickner et al., 1997). Due to the inconsistency in the Parkin study and possible limitations of others, it can be assumed that athletes should intake nutrients immediately or soon after the completion of a prolonged or high intensity exercise bout, especially if quick replenishment of glycogen stores is required. If fast glycogen recovery is unnecessary and the goal is long-term maintenance of carbohydrate stores, a daily carbohydrate intake greater than 8 g·kg-1·day-1 is recommended to effectively maintain glycogen stores during repeated days of endurance training (Kirwan et al., 1988; Sherman et al., 1993).

Type and form of nutrient intake
Different types of carbohydrates initiate different outcomes on glycogen synthesis and ultimately muscle and liver glycogen storage. The Glycemic Index (GI) was created to distinguish the blood glucose response, and corresponding insulin response, of a specific food after its digestion in comparison with the glucose response of a standard amount of glucose/white bread; the GI is intended to resemble the rate at which a particular food is digested and absorbed into circulation (Wolever et al., 1991). Researchers have scrutinized different GI foods in relation to their ability to accelerate glycogen synthesis. Blom and colleagues (1987) evaluated muscle glycogen synthesis rates when glucose, sucrose, and fructose were ingested at zero, two, and four hours after an exhaustive cycling bout. Glucose and sucrose supplementation initiated a greater increase in glycogen synthesis when compared to fructose ingestion. Fructose must be catabolized in the liver before it can enter circulation through the blood and contribute to glycogen synthesis within skeletal muscle. It would appear that fructose reduces the availability of circulating glucose compared to other sugars even though contradicting evidence exists (Wallis et al., 2008), and in one case, sucrose replenished glycogen stores to a lesser extent when contrasted with a glucose polymer solution (Bowtell et al., 2000). Kiens and colleagues (1990) explored the effects of ingesting a high or low GI meal, containing 70% of calories from carbohydrates, following exercise on glycogen synthesis rates. Subjects who consumed the high GI meal experienced a 61% larger increase in muscle glycogen synthesis rates. These studies conclude that high GI foods/carbohydrates are more promising in replenishing glycogen stores in the early hours following exercise, and in addition, the mode of nutrient application (oral or IV) does not seem to matter (Blom, 1989).

Other research (Keizer et al., 1987; Reed, et al., 1989) has focused on the effects of ingesting a solid or liquid meal following exercise on the rate of glycogen synthesis. Both of these inquires reached similar conclusions by determining that carbohydrates in liquid and solid form are equally effective in replenishing glycogen stores after exhaustive bouts on a cycle ergometer and that gastric emptying does not impede the process of glycogen synthesis following exercise.

Amount of nutrient ingestion
Another factor that is of upmost importance in determining the rate of glycogen synthesis after exercise is the amount of carbohydrates (determined by body weight) ingested. The typical rate of muscle glycogen storage after carbohydrate supplementation immediately upon cessation of exercise is 20-50 mmol/kg dw/h (Blom, 1989; Blom et al., 1987; Ivy et al., 1988a; Jentjens and Jeukendrup, 2003; Maehlum et al., 19771978; Piehl Aulin et al.,2000; Reed, et al., 1989; Tarnopolsky et al., 1997; Zachwieja et al., 1991). Little research has focused on the direct rates of carbohydrate supplementation and its effects on muscle glycogen synthesis. Blom and colleagues (Blom, et al., 1987) first demonstrated this phenomenon by increasing the rate of muscle glycogen storage approximately 150% when increasing the amount of carbohydrate intake from 0.18 to 0.35 g·kg-1·hour-1. More recent studies have analyzed the effects of higher quantities of carbohydrate consumption on glycogen storage rates. Ivy and associates (Ivy et al., 1988b) utilized dosages of 0.75 and 1.5 g·kg-1·hour-1 over a four hour period following a 120 minute cycling bout. The results indicate similar rates of glycogen synthesis for both treatment dosages which alludes to a possible cap or maximum rate of nutrient consumption that can effectively increase glycogen storage. Nonetheless, it has been found that increasing post-exercise carbohydrate intake to 0.8 to 1.2 g·kg-1·hour-1 results in higher rates of glycogen synthesis (van Loon, et al., 2000), and it seems that a carbohydrate dosage of 1.2 g·kg-1·hour-1 is optimal for reaching maximal post-exercise muscle glycogen synthesis rates (Jentjens and Jeukendrup, 2003; Jentjens, et al., 2001; van Loon, et al., 2000). Many studies display similar findings and support the notion that increasing the amount of carbohydrate intake above 0.35 g·kg-1·hour-1 can further stimulate glycogen synthesis (Casey et al., 1995; McCoy et al., 1996; Piehl Aulin, et al., 2000; Tarnopolsky, et al., 1997; van Hall et al.,2000).

Intervention of protein
The addition of protein to carbohydrate consumption in the post-exercise period has led to mixed results. Zawadzki and colleagues (1992) investigated the effects of carbohydrate, protein, and carbohydrate plus protein supplements on muscle glycogen synthesis after two hours of cycling. Participants ingested either 112g of carbohydrates, 41 grams of protein, or 112 grams of carbohydrate and 41 grams of protein immediately, and two hours after three separate exercise bouts. Supplementing carbohydrates and protein together resulted in higher glycogen stores than the carbohydrate and protein groups. Original research in this area concluded that the increase in glycogen synthesis is directly related to the upregulatory effect that certain amino acids have on insulin (Floyd et al., 1966; Knopf et al., 1966). Therefore, it is reasonable to believe that carbohydrate plus protein intake following exhaustive exercise will further enhance glycogen synthesis over carbohydrates alone. On the contrary, the study design of Zawadzki limits the generalization of the findings due to the variation in caloric values provided to the treatment groups. Glycogen stores may have been further replenished in the carbohydrate + protein group, because additional calories were consumed. A more recent study took a second look at the possible impact of protein + carbohydrate supplement on glycogen synthesis when compared to a carbohydrate solutions of equal caloric value and equal carbohydrate content (Ivy, et al.,2002). Cyclists completed two hours of exercise on three different occasions to analyze all treatments. Supplements were ingested immediately and two hours following exercise. Four hours after the completion of the exercise bout, 47% of glycogen depleted during exercise bout was restored in the carbohydrate + protein group. The equal caloric value and carbohydrate content groups experienced 31% and 28% glycogen restorations respectively. The conclusions of the Ivy study help to support the inferences made earlier by Zawadzki and colleagues. It is apparent that protein can further augment glycogen synthesis when ingested with an adequate amount of carbohydrates. However, conflicting evidence does exist. van Loon and colleagues (2000) concluded that the ingestion of ample carbohydrates is the limiting factor in determining the magnitude of glycogen synthesis after exercise. When protein was added to a sufficient carbohydrate solution, glycogen synthesis was not further stimulated. Other investigations have seen enhanced rates of glycogen synthesis during the post-exercise period (Berardi et al., 2006; Bowtell et al.,1999; Tarnopolsky, et al., 1997) whereas others disagree (Carrithers et al., 2000; Jentjens, et al., 2001; Yaspelkis and Ivy, 1999). In conclusion, it looks as if glycogen synthesis can increase with the addition of protein under certain circumstances, although some evidence lacks in supporting this claim. A summary of factors affecting glycogen synthesis immediately after exercise are displayed in figure 3.

Conclusion

The purpose of this review was to discuss the impact of dietary protein and carbohydrate intake during the recovery state on anabolic markers such as muscle protein synthesis and glycogen synthesis. The anabolic processes of muscle protein synthesis and glycogen synthesis are affected by many different variables. Resistance training alone is not potent enough to stimulate a positive protein balance where protein synthesis exceeds protein degradation. The supplementation of protein and/or amino acids following a resistance training bout results in a net positive protein balance that enables skeletal muscle hypertrophy to take place. Carbohydrates play a limited role in protein synthesis, and thus are probably not necessary to prompt hypertrophy training effects. However, carbohydrates are vital to replenish glycogen stores diminished from prolonged or high intensity exercise. Past research has clearly defined that timing of ingestion, GI value of the food, amount ingested, and nutrient composition of the food are all important factors in determining the effectiveness of glycogen synthesis rates. Future research is needed to elucidate the equivocal findings surrounding the combination of protein and carbohydrate supplementation in reference to glycogen synthesis after exercise.

Key Points

  • Post-exercise nutrient intake is essential for promoting protein synthesis and glycogen synthesis.
  • The timing and amount of protein and/or carbohydrate ingested affects the rate and amount of synthesis.
  • The type/form of protein and/or carbohydrate ingested after exercise alters anabolic processes during the recovery period.

Applied Biochemistry and Molecular Physiology Laboratory, Department of Health and Exercise Science, University of Oklahoma, OK, USA, Human Performance Lab, Department of Exercise and Sport Science, University of Mary Hardin-Baylor, TX, US

What Happen When An NFL Player Dies On The Field?

This is a MUST READ for those interested in football, popular american culture, brain injury, politics, ethics, billion dollar business, money, greed and politics. It will help explain the complexity of the greatest issue facing the biggest sport in history. PK

“NFL players don’t have guaranteed contracts, and they’re paid less than you think. Chris Johnson is the best running back in the NFL, and he makes just $2 million. That sounds like a lot, but the best shooting guard in basketball makes $20 million. But NFL players are quite literally spare parts in a much bigger machine. Teams invest as little as possible in them, use them until they break, and then they get a new one. Fans root for their favorite player until he gets cut to create cap space, and then they get a new one. Most of the players lack the education necessary to manage their money, leaving them with little to show for after it’s all over. Oh yeah, and the shelf life for pro football players gets shorter every year, all while ticket prices skyrocket and the NFL signs billion dollar TV contracts, and franchises appreciate by the hundreds of millions. When you look up close, it’s not pretty.”

The Concussion Problem: The Asterisk Next To NFL’s Skyrocketing Ratings

PHILADELPHIA - OCTOBER 17:  DeSean Jackson #10 of the Philadelphia Eagles is laid out by Dunta Robinson #23 of the Atlanta Falcons during their game at Lincoln Financial Field on October 17 2010 in Philadelphia Pennsylvania.  Both players were injured on the play and had to be helped off the field.  (Photo by Al Bello/Getty Images)

By Andrew Sharp – Editor

After a number of brutal head injuries this weekend—including the vicious hit that knocked Desean Jackson and Dunta Robinson out of the game—the NFL has announced it may start suspending players for “devastating hits.” But what if the problem isn’t football players? Maybe it’s football.

Oct 19, 2010 – The National Football League is the most popular sport in American history.*

We know this anecdotally and statistically. What does the majority of America do on Sundays? From my experience, they watch football. The ratings bare this out. This week, a terrible Monday Night Football game outdrew a New York Yankees playoff game. But the league’s greatest asset is also its achilles’ heel.

The NFL’s influence is so massive and all-encompassing that when something polarizing happens—good or bad—it’s pretty easy to just skip the portion of the discussion where we talk about exactly what happened. Because whatever it was, with all the highlights and halftime shows and news alerts, you know that everybody saw it themselves. So we take the event for granted, skipping ahead to what it means for the future, how it compares to the past, or what effect it has on the present. Everything gets analyzed within a much larger framework.

That’s sort of what we all did on Monday. In Monday’s Designed Rush, Mike Tunison talked about the Great And Unavoidable Helmet-to-Helmet Freakout:

With a spate of helmet-to-helmet shots and resulting concussions seen on Sunday, the full-on hue and cry about the dangers of head injuries in professional football is back at full pitch for the first time in probably… days? Weeks? It’s going to be a regular discussion for a while. Every time this happens, the debate will start anew. This is at once predictable, completely understandable and also incredibly frustrating because no one really has a sound idea about how to fix the matter.

It’s not a bad thing, but as we prepare to dig in and discuss what can be done here, we should remember what prompted the discussion in the first place. So, here are three separate stories from this past Sunday that made me feel guilty for loving football.

1. Todd Heap Laying Motionless on the Field. The Ravens-Patriots game was pretty much perfect for a football fan. Two well-coached teams going back-and-forth, battling to a tie after 60 minutes, with New England prevailing in OT. Even a victory for evil-Bill Belichick couldn’t dampen my enthusiasm; that was just a kickass game.

But toward the end of the first half, it looked like Todd Heap was dead on the field. It came just a few minutes after Patriots’ Brandon Merriwether had barely missed on a head-first spearing attempt that would have A) Broken up a Ravens touchdown and B) Risked serious injury to both players. Fast-forward a few minutes, and there he was again, leading with the head. But this time he connected.

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After a few harrowing minutes with Heap splayed out motionless on the turf, he left the field, and we could all breathe a sigh of relief. When he came back later in the game, we could even take it as a reassuring sign: He’s back. He must be okay. It wasn’t as bad as it looked.

But how do we know how bad it was, and whether he should have been out there?

2. Dunta Robinson and DeSean Jackson and War. Here’s a perfect example of something that’s prompted a much bigger discussion, obscuring a more basic problem: Robinson’s hit wasn’t that special.

Kevin Kolb hung DeSean Jackson out to dry over the middle, and Dunta Robinson did what a defensive back should. Light. Him. UP. Like they say on NFL Countdown, “BOOM!” Football players are taught to do it, and football fans are taught to love it. Last night on Monday Night Football, they ran a highlight reel of Chuck Cecil hammering opponents during his career, and Jon Gruden waxed poetic, football style: “He would KNOCK. YOU. OUT. Chuck Cecil was a tone setter. There was fire and brimstone in that body.” For better or worse, brutal hitting is woven into how we understand the game.

And Cecil’s hits were awesome. But Sunday’s hit knocked both players out of the game.

The officials later ruled that DeSean Jackson was defenseless, but that’s not a reflection on Dunta Robinson. Or it shouldn’t be. He was a defensive player trying to do his job, with a split second to make a decision. Look at Dunta Robinson’s eyes in this picture, while Jackson sits dazed in the background. With this stuff, even the villains are victims.

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A lot of people like to use war analogies to glorify the “battle” that takes place on the football field each Sunday. But here we had mutually assured destruction in a literal sense. Not a “war in the trenches” with NFL Films music playing in the background, but two spectacular, impossibly graceful athletes staggering off the field bleary-eyed and beaten. A lot closer to real war than the war analogies, no?

3. Aaron Rodgers played. A week after suffering a concussion against the Redskins, Aaron Rodgers was out there in Green Bay, starting for the Packers. He’s on my fantasy team, and had 22 points this week. He gave the Packers a chance to win. But in a year when the whole NFL’s supposedly getting serious about concussions, it makes you wonder.

Is there an exception when it’s a star player that’s essential to victory, or did Aaron Rodgers just happen to recover faster than all the other quarterbacks that have been sidelined with concussions this year? That’s not a snarky rhetorical question. It’s genuine, with genuinely unknowable answers.

And it’s a microcosm of what’s hanging over the NFL right now. Are players risking their own well-being by playing football? We really don’t know the answer, but more and more, the answer looks like, “Probably.” And you can’t blame us if pictures like this scare us into fearing the worst.

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Even though each incident gave me pause as a fan, they’re remarkable not for the concussions or some glaring lack of precaution, but because ultimately, none of it is that remarkable. That’s just the game.

The defensive players that laid people out this weekend may have been leading with their head, and Desean Jackson may have been hung out to dry by Kevin Kolb, and Aaron Rodgers may have been toughing it out for his team. But the problem isn’t football players, football equipment, and maybe not even football’s rules. The problem is that those guys were risking injury by playingfootball.

It’s not a bunch of demonic defensive backs out there wreaking havoc on these poor “defenseless receivers.” On the whole, NFL players get hurt because there are certain physical realities that come into play when you put a bunch of gigantic, high-speed athletes on the field at once. When everyone runs a 4.5, everyone’s stronger than ever, and they’re all wearing helmets, helmet-to-helmet hits will happen, and they will do serious damage.

The NFL can fine and suspend players for vicious hits, but suspensions won’t change how big and fast the players are, and it won’t change the culture that compels players to return to the field earlier than they should, or fans to clamor for bigger hits and more games. This is football.

Star-divide

On Monday I took a break from thinking about concussions and the 1-4 Cowboys and Brett Favre’s penis to talk to a friend that’s not a sports fan. We were debating the merits of a program in Great Britain that was offering drug addicts about $320 to be sterilized, ensuring that they won’t have kids and then raise those children in a broken home, ultimately creating more problems for society.

Depending on your perspective, it’s either pragmatism at its best or cynicism at its worst. You can make convincing arguments for both sides. And it’s more analogous to the NFL than you’d think. As football continues its evolution in the 21st century, the moral gray area typically reserved for debates like “addict sterilization” has begun to creep into football, one arena we could always count on for an escape. These days, the NFL makes us feel just as uncomfortable as the real-life dilemmas we want to escape.

For instance, NFL players don’t have guaranteed contracts, and they’re paid less than you think. Chris Johnson is the best running back in the NFL, and he makes just $2 million. That sounds like a lot, but the best shooting guard in basketball makes $20 million. But NFL players are quite literally spare parts in a much bigger machine. Teams invest as little as possible in them, use them until they break, and then they get a new one. Fans root for their favorite player until he gets cut to create cap space, and then they get a new one. Most of the players lack the education necessary to manage their money, leaving them with little to show for after it’s all over. Oh yeah, and the shelf life for pro football players gets shorter every year, all while ticket prices skyrocket and the NFL signs billion dollar TV contracts, and franchises appreciate by the hundreds of millions. When you look up close, it’s not pretty.

And that’s all before we talk about the head injuries that prompted an ex-player to explain:

The headaches come in the morning. Tylenol, half a pot of coffee, and then hope they subside by lunch. Standard procedure for most NFL veterans who have had concussions. The price of admission, really, when you play on Sundays.

Even five years ago, I would have heard the NFL’s proposed 18-game schedule and said, “More football! What could possibly be bad about that?” But today, we know too much. The danger’s obvious to anyone that saw the Desean Jackson hit on Sunday. On some level, football ensures destruction for the people that play it. And now we’re going to play more? As Colts President Bill Polian explained the 18-game schedule:

I think that the owners, and principally the commissioner, have decided that it’s the way to go, and so the debate, such as it was, is over.

“I think it’s a win-win all around,” said Patriots owner Bob Kraft. Indeed, NFL ratings are higher than ever, and America wants more. So an 18-game regular season looks like the next logical step. The debate, such as it should be, doesn’t seem to be happening.

Literally and figuratively, football’s only getting bigger. The players, the popularity, and the money that mitigates everyone’s reservations. But then, with the league getting more exposure every year, the evidence becomes harder and harder to ignore. Football isn’t just dangerous. It’s potentially life-altering for the players. So as the NFL’s growth continues, what happens?

Do we trust a billion dollar corporation to look out for the best interests of its employees? If not, does Congress step in and change the rules? Do we need a fleet of independent doctors to oversee the care of NFL players? Whose jurisdiction is it to tell millionaire players how to take care of themselves? Are we worshiping a bunch of players that are ultimately disposable?

And right now, are we paying NFL players to sterilize their brains, rendering them useless for future generations, but priceless for as long as they can make the Pro Bowl?

The answers aren’t clear, but these questions aren’t going away. The scale will only grow. The money will only get harder to resist. For players afraid of losing their jobs, for owners seeking an extra two games, for networks reluctant to focus to much energy dwelling on the ugliness of the most popular sport in American History.*

All the while, the game gets bigger. But so does the text accompanying that asterisk.

*Pro football may cause serious, life-changing head injuries. We don’t know what the effects are, and we don’t know how to solve the problem.

The bigger the NFL gets—bigger and faster players, more highlights, 18 games—the more unforgivable that asterisk becomes. The NFL’s greatest asset is its greatest enemy here. We all see the hits, we all see the famous, punched-out veterans losing sanity in retirement. If it’s not Ted Johnson, it’s Junior Seau. And for now, we can look past it all. Desean Jackson’s severe concussion will subside, and he’ll be back soon. In the meantime, we’ll watch Jeremy Maclin.

But what happens when someday, somebody dies playing the most popular sport in American history?

The NFL Reacts To Former Players With Brain Injury

This is a considerable play by the NFL in the ongoing chess match were former players health is involved. PK

N.F.L. Agrees to Help Ex-Players Who Have A.L.S.

By ALAN SCHWARZ

Two months ago, Boston Universityresearchers found that some deceased athletes who had been found to have A.L.S. in fact had a different disease that, the doctors said, caused similar degeneration of the central nervous system. That discovery, bolstered by data that suggested that N.F.L. players had been found to have A.L.S. at rates about eight times higher than normal, led the researchers to link the players’ condition with athletic brain trauma.

The N.F.L. and the players union said in a release that players with A.L.S., similar to those with dementia, do not “need to demonstrate that the condition was caused by their participation in the NFL.”

Asked whether the program implies a connection between football and the conditions, the league spokesman Greg Aiello said in an e-mail: “It does not address the issue.”

The 88 Plan has awarded $9.7 million toward the care of 132 former N.F.L. players, according to the release. One year ago, a union lawyer’s analysis of the ages of 88 Plan recipients indicated that the prevalence of dementia among N.F.L. retirees was several times that of the national population.

Chris Nowinski, a member of the Boston University research group, said that the inclusion of players found to have A.L.S. into a plan run by the N.F.L. and its players union sent an important message.

“I think it’s an acknowledgment that there is strong evidence that the reason N.F.L. players get A.L.S. much more often than the general population is the trauma they endured in sports,” Nowinski said. “We still have a lot more to learn.”

Several studies have identified members of the United States military — particularly combat soldiers — at heightened risk for A.L.S. The disease is considered related to military service in the determination of veterans’ benefits.

NFL Feeling Pressure to Take Action on Concussion

The NFL is feeling pressure from the media – which is good news for player safety. PK


NFL players might start receiving suspensions for helmet-to-helmet hits

October 18, 2010 | 10:34 am  by Chuck Schilken

NFL players might soon be suspended for dangerous helmet-to-helmet hits, vice president of football operations Ray Anderson told the Associated Press on Monday.

Sunday’s games provided several possible reasons why Anderson might be talking about the subject. Here’s one, Philadelphia’s DeSean Jackson getting drilled by Atlanta’s Dunta Robinson during the Eagles’ 31-17 victory over the Falcons:

Here are two more, both provided by Pittsburgh’s James Harrison, who knocked Cleveland’s Joshua Cribbs and Mohamed Massaquoi out of the game in the Steelers’ 28-10 victory over the Browns:

“There’s strong testimonial for looking readily at evaluating discipline, especially in the areas of egregious and elevated dangerous hits,” said Anderson, who added that the changes could come quickly, after approval from Commissioner Roger Goodell and consultation with the players union.

“Going forward there are certain hits that occurred that will be more susceptible to suspension. There are some that could bring suspensions for what are flagrant and egregious situations.”

Study Shows Concussion Is Common In Youth Hockey

The latest on youth hockey and concussion. PK

With Focus on Youth Safety, a Sport Considers Changes

The Sabres’ Jason Pominville was concussed after a blindside hit against the glass on Oct. 11. A Mayo Clinic conference will discuss steps to prevent such injuries. 

By JEFF Z. KLEIN
Published: October 17, 2010

From the N.H.L.’s top goalie to the parent of a 12-year-old who sustained head and spinal concussions from a body check, calls are proliferating for changes to the culture of a sport that many see as too accepting of reckless body contact and serious injury.

The movement for change in hockey comes before a medical conference on Tuesday at the Mayo Clinic in Rochester, Minn., where representatives from the N.H.L. down to youth leagues will meet to discuss recommendations aimed to reduce the occurrence of concussions and other serious injuries, primarily in youth hockey.

Prompted by statistics indicating a high rate of serious injury among players ages 11 to 14, the measures are expected to include pushing back the age at which body checking is introduced in the United States and some Canadian provinces to 13 from 11.

Another measure would encourage the establishment of nonchecking recreational leagues for youth players. Such leagues are virtually nonexistent in areas of the United States where hockey is popular.

Among the recent findings from medical studies to be presented at the Mayo Clinic conference is this statistic from Alberta, where body checking is allowed for 11- and 12-year-olds: among the 9,000 players of that age in the province, an estimated 700 concussions occur each season.

The findings come from a study conducted by Dr. Carolyn Emery of the University of Calgary of 2,000 11- and 12-year-olds in Alberta and Quebec. It showed that Alberta players sustained four times as many concussions as the Quebec players and three times as many serious injuries, those that sidelined a player for a week or more. Quebec does not allow body checking until 13. It further found that if body checking in Alberta were pushed back to age 13, the annual number of serious injuries among 11- and 12-year-olds there would fall by an estimated 1,000, and concussions would fall by an estimated 400.

“Why are we insisting that our boys play the game in a way that we ourselves as adults would not, because we don’t want to get hurt?” said Dan Pinti, a Buffalo parent whose son, Zach, sustained head and spinal concussions after being checked into the boards as a 12-year-old four years ago. Pinti called the play “a perfectly reasonable, legal, bang-bang play.”

Pinti said his son missed almost a week of school and the rest of the hockey season. The next season, when the Pintis could not find a nonchecking youth league in western New York, Zach gave up the sport.

“You can’t play recreational, noncontact hockey in the Buffalo area until you’re 18,” said Stephen Sementilli, a USA Hockey-certified coach in the city. Jeff Hughes, another Buffalo-area coach who has been involved in efforts to establish noncontact house leagues, said they had been voted down because of a shortage of available ice and because of a belief that delivering and receiving hits at a young age builds character and makes for better hockey players.

Dr. Michael J. Stuart, an organizer of the two-day conference at the Mayo Clinic Sports Medicine Center, said that the meeting was the latest in a series of similar conferences in North America and Europe prompted by a steady rise in reported concussions in hockey in the last decade.

“The whole sportsmanship and mutual respect thing is in every facet of the game,” said Stuart, a professor of orthopedic surgery at Mayo and the chief medical officer for USA Hockey. Stuart supports a ban on body checking until 13, when players are more physically mature, have been taught better balance and body control and, presumably, are inculcated with the principles of fair play.

“We need to continue to emphasize sportsmanship and mutual respect, to not take advantage of a vulnerable opponent, to not throw a check at the expense of the health and safety of an opponent or yourself,” he said.

The Mayo conference, which will be attended by officials from USA Hockey, Hockey Canada, the N.H.L., the International Ice Hockey Federation and equipment manufacturers, comes at a time when the N.F.L. is also studying the severity of concussions and how to best prevent them.

The N.H.L.’s traditional culture of hard, injurious hitting versus changing notions of fair play was in the spotlight last week after the Buffalo Sabres’ Jason Pominville sustained a concussion when the Chicago Blackhawks’ Niklas Hjalmarsson sent him into the boards with an illegal check from behind. The N.H.L. suspended Hjalmarsson for two games.

After the game, Sabres goalie Ryan Miller, the Vezina Trophy winner last season as the N.H.L.’s top goalie, said, “That’s what we have to get away from in hockey right now, is the culture of ‘I was trying to make a play; therefore it’s not my fault.’ ”

Miller, who is a member of the N.H.L. rules committee, added: “No matter if it’s unintentional, we have to change the culture of it if we’re ever going to change the situations we’re seeing, where guys on the ice are bleeding and missing time with concussions. It’s completely an unnecessary play.”

This season the N.H.L., responding to pressure from the players union, passed rules — including banning blindside checks to the head — intended to reduce the number of head injuries.

This week, reducing head injuries in the game will be the focus for all levels of the game. Among the findings to be presented at the Mayo conference, all from academic studies over the past three years:

¶Concussions account for 18 percent of all hockey injuries.

¶Women’s hockey has the highest rate of concussions among N.C.A.A. sports, despite not allowing body checking.

¶The rate of reported concussions for youth players (23.15 per 1,000 player game hours) is only slightly lower than that for N.H.L. players (29.59).

Zach Pinti, the Buffalo player who quit hockey, is now 16 and playing lacrosse.

“It’s a good deal safer than hockey but still a risky sport, so I think it’s proof that I’m not an overprotective parent,” his father, Dan Pinti, said, adding: “The thing that was so difficult in hockey was the attitude among so many people. They just weren’t taking seriously all the statistical research and medical evidence that showed there might be something wrong with 12-year-old kids playing like it was the N.H.L.”

What I Think …

“I speak the truth not so much as I would, but as much as I dare, and I dare a little more as I grow older.” ~Michel de Montaigne

In an NFL game between the Eagles and Falcons, there was an extraordinary collision that spoke to all that I love and despise about football, the sport that was and is a great part of my life. It was a play run countless times each football weekend: the quarterback throws a pass to his receiver running a crossing route, wherein said receiver DeSean Jackson  is greeted – violently – by  cornerback Dunta Robinson. The result of the high-speed tackle was unconsciousness, times two. A double knockout blow that stopped the game, emptied both team sidelines of their medical teams for assessment and players for hand-holding prayer. Seventy thousand spectators watched  and prayed and hoped that their Hero’s would arise. That scene, that violence that level of injury – and yes I assure you their were two brain injuries –  is the part of the game that I despise .

Finally, after a relative eternity  in which helpless fans, coach’s and players quietly waited,  both players were helped to their feet, then off the field as the crowd applauded in relief. As Dunta and DeShaun passed each in route to respective sidelines, they paused and asked one another if they “were okay?”  That profound display of respect and sportsmanship, just minutes after play that damaged both, is the part of the game that I love. PK