Meet Clarence...
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Photo of Clarence Bass at 60!
(See what he looks like at 69 under the
one year update tab!)
THR with Anterior Approach
Dr. Kruezer, Jan. 2006
Long-time Muscle & Fitness columnist Clarence Bass,
a lawyer and bodybuilding champion, has been called "the most articulate
and well-read spokesman in America for an all-round fitness lifestyle."
Author of nine books, he believes in combining weights, aerobics
and sound nutrition to achieve total fitness and permanent fat loss, and preparing
for and recovering from surgery!
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As I begin writing, my new hip has been in place for only 10
days. But what an amazing 10 days it has been. As the Blond Bomber, Dave Draper
(27 & 60, Personalities) might say, I’m soaring high above the clouds in
bright sunlight. Thanks to the marvelous new approach pioneered and perfected
in this country by Los Angeles-based Joel Matta, MD, the mentor of my surgeon
Swiss-born Stefan Kreuzer, MD, I’m more optimistic about the future than ever.
I can’t wait any longer to begin telling you about it.
Carol and I flew into Houston Sunday afternoon, and I checked
into Memorial Hermann Memorial City Hospital the next morning. I was taken into
the operating room about 12:30, and my surgery was completed about 3:20 (longer
than usual because of my musculature).
I was out of recovery and in my room at
approximately 6. By 9 that evening, the nurse had me out of bed and on my feet.
I was able to put full weight on my new hip, with no pain. I then made a full
lap around the orthopedic wing with the aid of a walker. I was a little uncomfortable
and shaky, but nothing that could be called pain.
The next morning I was walking with a cane, again with some discomfort
but no pain. A physical therapist had me do some exercises and showed me how
to navigate stairs with a cane. He also gave me "A Patient's Guide to Rehab
After Anterior Total Hip replacement." Later that morning, Dr. Kreuzer came
by to see me. After we talked, at my request, he jotted a progressive week-by-week
rehab plan on a paper towel. Knowing that I'm more eager than most patients,
he added, "I won't be disappointed if you do less."
After lunch, Dr. Zoran Cupic, Kreuzer’s partner, who assisted
in the surgery, came into the room, checked my incision, and asked if I wanted
to go home. I did, of course. The nurse gave us some instructions on changing
the dressing and a few other things.
I was released from the hospital at mid-afternoon, almost exactly
24 hours after completion of the surgery.
This was a little faster than usual, probably due to my physical
condition (more on that below), but not much. The typical hospital stay after
the new procedure is two to three days, according to Dr. Kreuzer's office.
Carol and I were back in our hotel room by dinner time.
On Wednesday, I practiced walking in the hallway with a cane.
The next morning, Carol and I took a walk outside, with me still using the cane.
That afternoon I went up and down the stairs in the hotel, again with aid of
the cane.
On Friday morning, before my first post-op appointment, I walked
without the cane for the first time. At the doctor’s office, I absent-mindedly
left the cane in the X-ray room! The technician walked down the hall and returned
it to me in the examining room, where Carol and I were waiting to see Dr. Cupic.
Forgetting the cane was a good sign, they said. We thought so too. (According
to Dr. Matta, the median time of first walking without an assistive device is
eight days.)
I used a cane to walk through the airports, but needed no other
assistance. Carol and I were home in Albuquerque on Friday evening. Our trip
to have my hip replaced, round trip, took a few hours over five days.
I used a cane to walk in the street in front of our house on
Saturday—but never used the cane again. (The median time when patients stop using
an assistive devise, according to Matta, is 15 days.) On Sunday, six days after
the surgery, I walked down and up the two flights of stairs in our house, without
favoring my new hip or using the handrail. I did the stairs five times on Monday
and 10 the following day. On Tuesday, I walked down and up the hill below our
house.
I’m stiff, of course, and sore. It would be next to impossible
to extract my old hip and put in a new one without inflicting some trauma. I
am working with bruised and stretched muscles (not cut, as I will explain momentarily),
and complete recovery will take time. In addition, the bones in my thigh and
hip were cut and reamed, respectively, to accommodate my new hip. Dr. Kreuzer
says “no lower-body weight training for six weeks,” to give the bone time to
grow solidly around the new joint in the thigh (femur) and the hip socket (acetabulum).
After that, I should be able to gradually resume my training virtually unimpaired.
(See 6-week and 6-month follow-up reports below.)
The only word for the whole scenario is amazing.
Judge Dan Sawyer,* who told me about the new procedure, has had
both hips replaced, first the old way and last year using the new approach. After
his first hip, about two years ago using the traditional approach, Dan says he
felt like a mummy and couldn’t turn over in bed without help for about eight
days. With the new method, he went into the hospital on Thursday morning and
was released about noon on Saturday—and he’s 78. (He’s a lifetime weight trainer
and looks much younger.)
A newspaper article on Dr. Kreuzer’s website says after traditional
surgery, where an 8- to 12-inch incision is made on the side or rear of the hip,
some patients are barely able to walk using a walker two or three weeks later.
Another article I read online says full recovery may take three to six months.
I’m not a doctor and don’t know all the technical details, but
the basic difference is that the new approach goes in from the front and cuts
no major muscles; it goes between them. The quads and glutes remain intact. Dr.
Kreuzer gave me a brochure prepared by his office which says, “The hip is exposed
by following a natural plane between muscles and without detachment of muscles
or tendons from the bone.” There is almost no chance of dislocation, because
the muscles are still working to stabilize the hip joint, just like before the
operation. The technical name for the new procedure is “minimally invasive anterior
approach.” According to Matta, a special table is the key to doing an anterior
approach. The table and X-ray fluoroscope are used to position the leg to expose
the hip joint, and then line up the new joint with the other hip and leg. (More
about the new approach below.)
Frankly, I don’t know why my hip went bad. No one can say with
certainty. Many factors were probably involved. Fifty-five years of steady training
may have simply taken a toll on my hip. An unusual curvature of the spine inherited
from my mother may have helped the process along. Doing the split snatch, with
my right leg extended far to the rear, in my early years of Olympic lifting and
later when a shoulder problem prevented me from using the squat style, probably
contributed as well. On the other hand, many athletes have their hip or knee
replaced decades earlier. For example, a front-page story in The Wall Street
Journal, from the Winter Olympics in Turin, Italy, reported that 1996 U.S. figure
skating champion Rudy Galindo had both hips replaced at age 33. It may be that
my hip would've worn out earlier without training. Who knows?
My training was clearly a benefit when I needed a hip replacement.
Lean, active people are the best candidates for the anterior approach (all approaches
actually). Overweight people and those with brittle bones are more problematic.
The procedure is not appropriate for deformed hips or when repairing an existing
replacement, according to Dr. Kreuzer.
Excess fat makes it more difficult for the surgeon to see the
operative field. Some or most of the procedure is done with specially designed,
small surgical instruments under indirect vision on a TV monitor. “Active X-ray
control is used to ensure correct position, sizing and fit of the artificial
hip components,” explains the brochure given me by Dr. Kreuzer. “Side by side
television monitors compare the X-ray image of the patient’s opposite hip to
the operated hip.” A tiny camera and light source are typically inserted into
the incision site. Visibility is one of the reasons why many surgeons steer clear
of the procedure. Other reasons are the $150,000 cost of the special table, and
the steep learning curve. To the best of my knowledge, no one in New Mexico,
where we live, does the anterior approach taught by Dr. Matta. That’s likely
to change--in New Mexico and elsewhere--as more patients become aware of the
minimally invasive approach.
"It is true that patients who are obese or have fragile
bone have at least slightly higher risk with anterior hip replacement," Dr.
Matta told me in a personal communication, "but they are still candidates
and I think anterior hip replacement is still their best choice." What's
more, he suggests quite logically that "the obese unfit person" may
actually be the most in need of the "rapid rehabilitation" afforded
by the anterior approach.
Sounds like something to be decided by doctor and patient on
a case-by-case basis.
In addition, Dr. Matta offers the slide presentation on his website
(see below) as evidence that "visualization of the bone is actually very
good" in small incision surgery using the anterior approach. (The incision
averages four inches; mine is three inches.)
Another reason why the anterior approach is best suited for healthy
people is the length of time under anesthesia. The fact that the surgery is not
done under direct vision makes it take longer (1.2 hours average, according to
Matta's website), which increases the risk, especially for people with health
problems. It may be an exaggeration, but another article suggested that some
doctors prefer the old way because they can do two or three replacements in the
time it takes to do one the new way. “Why do two cases a day when you can do
six?” said a Stanford University orthopedic surgeon, who has done 50 hips using
the special table.
The time difference may not be as great as suggested. It probably
varies from doctor to doctor and case to case. Dr. Matta wrote in an email: "Every
Wednesday I usually do 6 hip replacements in 2 operating rooms--I perform the
surgery in one room while the patient is anesthetized, positioned, and prepped
in the other--and I am typically done with the 6 surgeries by one-thirty or two
in the afternoon. Fast is good as long as it is precise and high quality."
I don’t know exactly how long my surgery took, but Dr.Kreuzer
told Carol in the waiting room afterward that it was longer than usual. Remember
that my muscle mass prolonged the procedure. Special care was required to avoid
cutting my muscles. (Dr.Kreuzer told Carol I had the biggest tensor muscle in
my thigh, near the point of incision, he’d ever encountered; in fact, I seemed
to have two tensors.) It was more than five hours between the time I was wheeled
into the operating room and when I was moved from recovery to the orthopedic
ward. General anesthesia makes some people sick, but I felt okay when I got to
my room. No pain and no nausea. (I was relieved that the surgery was over. I
told Carol I loved her, our son—and Dr. Kreuzer.)
Another problem is that many patients, perhaps most, come to
hip replacement surgery in a debilitated condition. Their muscles are weakened
from pain and disuse. Understandably, they avoid movements that hurt. “This leads
to an imbalance where the stronger muscles become shorter, thereby stretching
and lengthening the weaker muscles,” says a handout I received from the rehab
people at the hospital. “These imbalances change the way the hip joint usually
works. An imbalance of the hip muscles can significantly affect the way you walk
or perform other physical activities.” This makes rehabilitation take longer.
In addition to recovering from the surgery, they have to spend time regaining
strength and correcting the imbalances; they basically have to learn to walk
and move again. I managed to avoid that problem almost entirely.
I avoided movements that hurt, but still managed to preserved
most of my muscle mass. It hurt to walk more than a short distance, climb stairs
or lift my leg to get in a car--but not to squat. I worked my lower back, glutes
and hamstrings using a terrific hyper-extension bench made by Bigger Faster Stronger
in Salt Lake City, Utah (see photos), and my quads by squatting and doing leg
extensions. I also used The Frank Zane Leg Blaster to good effect. The only muscles
that suffered are those that pull my right leg and knee forward and up, the hip
flexors. The movement that hurt most was lifting my leg to get in the car, especially
the high seat in our Jeep. Those muscles are sore and weak, and I am now working
to rehab them. Fortunately, prior to the surgery, I lost little, if any, muscle
or strength in my lower back, glutes or quads, where many hip-replacement patients
have imbalance problems.
Dr. Kreuzer says I will lose some muscle mass during the quiet
period required after the surgery. At four weeks, I can see a slight deficit
in my right thigh, but everything else looks and feels pretty good. I’m working
to keep the loss to a minimum. My pre-op training gives me a substantial advantage
in the rehabilitation process. When my hip flexors heal and regain strength,
my thigh and everything else should come back rapidly.
Back Raises (below) |
Glute Ham Raises (below)
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My dad was a wonderful doctor and I know a wonderful doctor
when I see one. In this case, I had at least three that fall into that category.
Matthew Rounseville, DO, is my primary care provider. Having
cared for and been a friend to our family through good times and bad, life and
death, he knows more about me than any other doctor (with the possible exception
of Arnie Jensen and Lynn McFarlin, my former and present doctors, respectively,
at the Cooper Clinic). Talk about bedside manner, Matt’s got it in spades. When
I went to see him about the pain in my hip, he didn’t refer me to a general orthopedist,
he sent me to a sports medicine specialist.
That’s how I had the good fortune to see Robert Wilson, MD. It
took Dr. Wilson only a few minutes to realize that I’m not the run-of-the-mill
fitness minded 67-year-old. After five weeks of Hyalgan injections failed to
restore the function of my hip, he encouraged me to explore the new procedure
popularized by Dr. Matta. With the help of a list of doctors in adjoining states
provided by Dan Sawyer’s surgeon (Cambize Shahrdar, MD), I did some research
on the Internet and zeroed in on Dr. Kreuzer. Wilson urged me to go see him and
wrote an insightful and extremely helpful letter of introduction. Describing
me as “an unusually fit body builder and fitness writer who finds it extremely
important to be able to maintain his exercise program, maintaining muscle mass
and range of motion,” he asked Dr. Kreuzer to consider me for “the minimally
invasive surgical option.” Needless to say, that letter gave me a huge head start
in explaining myself to Dr. Kreuzer.
Kreuzer is an extremely busy man. Each room in the orthopedic
ward where I walked after the surgery had the patient’s name and that of the
doctor. It seemed to me that his name was on every other door; Carol made the
same observation. Nevertheless, on our first visit, he walked into the examining
room where Carol and I were waiting, calmly sat down on a step used to help patients
up on the examining table, and listened to us like we were his one and only concern.
“If you took the time to come here to see me, I’ve got as much time as necessary
to discuss your problem,” he told us. I decided in a matter of minutes that he
was the guy to do my hip. Carol, an astute judge of character, usually takes
longer to decide, but she readily agreed.
During that first appointment with Dr. Kreuzer, I emphasized
that I expect to continue hard training, weights and aerobics, after having my
hip replaced, recognizing, of course, that some adjustments may be necessary.
He asked if it was important to me to be able to squat. I said, “Yes, absolutely.”
He promised to “make some calls” to determine the best femoral head and socket
cup to meet my requirements.
Several weeks later, I received a call from Dr. Kreuzer. He explained
the basic choices (metal on metal, ceramic on ceramic, and Oxinium on polyethylene),
and outlined the pros and cons of each option. His favorite, he said, was the
Oxinium femoral head. He said it was probably the best option “in view of my
exercise habits.” He gave me the name of the company that developed Oxinium and
the new head, UK-based Smith & Nephew, and suggested that I check it out
and let him know. I was impressed. That told me that he was making a special
effort to meet my needs.
I was even more impressed when I learned about the properties
of Oxinium. Smith & Nephew, which holds the trademark on the name, says Oxinium
is the result of a process that allows oxygen to absorb into zirconium changing
its surface from a metal to ceramic. The ceramic surface reduces friction, while
the metal remains super strong.
A News Release from Smith & Nephew says that people under
sixty have often been denied a hip replacement because “implants currently used
are not expected to withstand the wear and tear placed on them for longer than
10 to 15 years.” I assume that means normal wear and tear. Yikes! I’d probably
be in trouble.
“The ultimate quest is to find a hip replacement that lasts a
lifetime in order to prevent the need for further surgery,” UK orthopedic surgeon
Fares Haddad is quoted as saying.
Hip replacements with the Oxinium head “could last twice as long
as standard devices,” says the News Release
“Compared to the traditional cobalt chrome implant, Oxinium is
4,900 times more resistant to abrasion, 160 times smoother and twice as hard.”
There’s more to an implant than the head, of course. Hip implants have three
components: A socket cup, a femoral head, and a stem that fits into the femur.
The socket cup wears faster if the surface of the head is scratched or roughened.
The cup recommended by Kreuzer is made of polyethylene, a form
of plastic. The News Release says, “Even a single scratch on the [traditional]
cobalt chrome surface can increase the rate of plastic wear by 10 times, and
substantially reduce the life span of an implant.” That, of course, makes the
wear-resistant properties of the Oxinium head extremely important
An Oxinium head in a polyethylene cup, both made by Smith and
Nephew, sounded good to me.
But Dr.Kreuzer wasn’t done looking for the best combination.
He called me in the holding area at the hospital on the morning of the surgery
to say he’d found a better socket cup made by Stryker Orthopaedics, a U.S. company,
and that it was on the way. I’d be well rewarded for waiting a few extra hours
for it to arrive, he said. So Carol and I waited.
The surgery, originally scheduled for 8:30, didn’t get under
way until about 12:30. Seeing patients (and their loved ones) come into the holding
area, and then, be wheeled off to the operating room all morning was like being
on the set of General Hospital. Kreuzer drew a picture of the new cup (thinner,
but stronger, with substantially more surface) on a paper towel for Carol and
me shortly before I was wheeled off into the operating room. The last thing I
remember is getting a glimpse of the special table.
A miracle in Houston? I think so. A sturdy new hip, a new life!
* This article is dedicated to Judge Dan Sawyer, whose counsel
and encouragement were tremendously helpful before and after my replacement surgery.
Thanks Dan! You’re one of the best friends a guy ever had.
[Editor: Medical information on the surgical procedure for doctors
can be found on Dr. Joel Matta’s website (www.hipandpelvis.com); includes a 60-frame
slide presentation on the procedure showing multiple views through the small
incision (not for the squeamish). Both Matta’s website and the website of Drs.
Kreuzer, Cupic and Dutta (www.memorialboneandjoint.com) contain additional information
for patients. Dr. Kreuzer also has a new website devoted entirely to anterior
hip replacement (www.anteriorhip.net); includes patient testimonials and much
more.]
I saw Dr. Wilson for my 6-week follow-up exam. "Clarence
is doing quite well at this time, progressing through his physical therapy as
prescribed and now gradually getting back to training," he wrote in a file
note provided to Dr. Kreuzer and Dr. Rounseville. "He demonstrates a very
easy range of motion [in his hip] .... He has good muscle development in right
quad and hamstring compared to the left. He apparently is biking now with no
pain. I repeated x-ray ... and there appears to be no loosening of the joint
components."
In short, I'm doing well. The only problem is that my hip flexors
are not coming back as fast as I expected. Both Kreuzer and Wilson urge me to
me "take it easy" and give my body time to rebuild the strength and
range of motion in this area. As explained above, my right hip flexors were sore
and weak, the only muscles debilitated prior to the surgery
Dr.Wilson's report after 6-month follow-up exam: "Clarence,
now 68 years of age, is feeling and appearing quite fit having recovered very
well from his right total hip replacement. His surgical scar at this point is
normal, about three inches long and well-healed. He has developed good strength
in the gluteus and hamstrings, the quadriceps, the abductors and adductors of
right hip. He walks without a limp and he has a range of motion which is nearly
equal that of his normal left hip. He has the ability to internally and externally
rotate about 45 degrees in a 90/90 seated position. He has flexion at the hip
to 135 degrees, he has extension to10 degrees from the neutral and all of this
is very tolerable. X-ray shows excellent fit and adherence to bone in both the
acetabular and femoral components.
ASSESSMENT: Excellent result, right total hip replacement for
osteoarthritis."
My report: I've made good progress since 6-week exam. My hip
flexor strength and range of motion are almost back to normal. I can lift my
right leg to get in our Jeep with no discomfort; you'll remember that this was
a painful maneuver before my surgery. I can pull my knees up and do a hanging
hip curl for my lower abs with only a little lag in my right leg. I can do a
full squat comfortably, as shown below.
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I'm doing the Lifecycle and Airdyne
at close to intensity levels achieved before the surgery. I started out slowly,
of course, and my hip has responded very well as I increased the load from week
to week. As you might expect, I got too enthusiastic at times and had to back
off a bit. But I'm now doing intervals at very respectable levels with minimal
complaints; I have a little stiffness in the hip, but it warms up well and doesn't
hurt. (My experience may offer encouragement to Floyd Landis. I realize, of course,
that stationary cycling hard for about 30 minutes twice a week is hardly the
same as cycling up and down mountains every day for three weeks in the Tour De
France. Nevertheless, it's a step in the right direction. Go Floyd!)
I have resumed doing the Back Raise and Glute-Ham Raise on the Glute-Ham Developer,
as planned. (See text and photos above.) It feels good and my lower back, glutes
and hamstrings are quite strong. I'm also doing Nautilus leg extensions and leg
curls; again, it feels good. I haven't started doing barbell squats yet, but
for reasons other than my hip. As mentioned, free squats feel good; I do them
almost every day. The problem is that compression of my lumbar spine causes tingling
and numbness in my left foot (new hip is on right); that's why I've decided to
forego weighed squats for the time being. It's not a problem because I'm working
low back, hips and legs quite effectively with the other exercises mentioned.
(I may add the Zane Leg Blaster next; it's designed to minimize pressure on the
lower back. I haven't decided.)
My only complaint is that I still have some numbness in the area of my new
hip and my upper thigh. The numbness comes and goes, but is present to some degree
all the time; it's worse after sitting for long periods and better with exercise.
My hip works fine; the numbness has no effect on function. I wish it would go
away, of course. Dr. Kreuzer is optimistic that most of the numbness will eventually
disappear. Dr. Matta says some permanent numbness in the area of the incision
is not unusual, but the rest usually goes away with time.
All in all, I'm very happy with my new hip. As Dr. Wilson says, I've had an
excellent result. Dr. Kreuzer did a superb job. My scar is beautiful.
Check-out my range of motion in the photos to the left. |
I flew to Houston on January 30, 2007, for my one-year follow-up
exam. I've been in contact with Dr. Kreuzer by email and phone--he's very accessible--but
this was the first time I've seen him since the hip-replacement surgery exactly
one year earlier. It's been a good year for him. Having performed more than 350
anterior-approach hip replacements, he is second only to Dr. Matta in experience
with the procedure. What's more, he is involved in a number of exciting research
projects, including design and development of a new and less costly "special" operating
table, which will lessen one of the main objections to the approach and, hopefully,
make it available to many more patients. (For more information on the new table,
visit www.iotiot.com )
Dr. Kreuzer has written a comprehensive report comparing
the various approaches: Minimally Invasive Hip Surgery--Are They All Created
Equal? The article is relatively short and easy to understand. He concludes: "The
anterior approach appears not only to affect fewer muscle groups, but also maintains
good function of the important muscle groups of hip extension, abduction, and
external rotation...and the clinical data appears to show a clear benefit for
the recovery of patients."
PDF download of articles by Kreuzer
"Minimally Invasive Hip Surgery - Are they created equal?"click here
"Single-Incision Anterior Approach for THR: Smith-Petersen
Approach"
click here
The exam itself didn't take long. X-rays
show that the bone has grown in nicely and the new hip is perfectly positioned. As
noted in the earlier exams, my range of motion and function is excellent. The
only negatives are numbness in my upper thigh, which may be permanent, and weakness
in my hip flexors, which continues to improve; both are probably related to stretching
of the hip flexor and the tensor fascia lata muscles during the surgery. The
numbness and weakness are most pronounced after sitting or standing for long
periods, and are considerably better after moving around. When I go up stairs
two-at-a-time--which requires considerable hip-flexor action--I can't tell the
difference between the right hip and the left hip. A less active person probably
wouldn't notice the weakness. I am aware of the numbness, more or less, all the
time, but it doesn't affect function. All in all, I've had an excellent result.
I'm now doing leg presses with substantial poundage with
no discomfort. Check out my age-69 photo at right and compare the development
of my right hip and thigh in the earlier photos. You'll see that there is no
difference. |
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First, I believe every person is conducting an experiment
of one. We all have different backgrounds, needs, goals and abilities. I
would never blindly follow anyone else's diet or training regimen, and I don't
expect anyone to blindly follow mine. That's why I always try to explain not
only "how" I eat or train, but "why" as well. That's so readers
can understand and evaluate my methods, weigh my advice. I expect you to take
what rings true, makes sense - most of it, hopefully - and adapt it to your special
situation. Leave the rest.
Diet
The word "diet" has a negative connotation. It conjures
up thoughts of hunger and deprivation. Diets don't work very well, because they
make people unhappy. That's why I never diet. I follow an eating style. I believe
the key to permanent body fat control is eating satisfaction. There's no need
to eat foods you don't like - I never do - and there's no need to ever leave
the table feeling hungry.
That doesn't mean there's no discipline involved. There is. It
takes effort and planning to eat the sensible, no-hunger way. Still, master my
style of eating, and you can look forward to a lifetime of eating satisfaction
- and leanness.
The secret lies not in how much you eat, but what you eat. If
you eat the right things you can almost eat as much as you want and still lose
fat; it's actually hard to overeat. What happens is you become full and satisfied
before you take in more calories than you burn.
The details are in my books. But here's a brief summary: my eating
style is low in fat (not too low), high in natural carbohydrates (carbs, the
right kind, are not fattening) and near vegetarian (small amounts of meat and
fish). Still there's plenty of good quality protein for the hardest training
athlete. All the macro- and micro-nutrients are there. It's healthy, balanced
- and satisfying.
Finally, I almost never count calories. You won't have to either,
once you master the "Ripped" style of eating.
Exercise
I started exercising regularly when I was about 13 - and never
stopped. So, it should come as no surprise that, as in the case of diet, I look
on exercise as a lifestyle. I believe your body tends to mirror your lifestyle.
That's nature's way. The body seems to sense that an active person needs to be
lean and, conversely, that a sedentary person does not.
In the same vein, I am convinced that exercise gets more important,
rather than less, as you get older. Therefore, I take a long-term approach to
exercise, an approach designed to keep you training - and improving - year after
year.
I admit to being a "muscle head." Weight training has
always been my first love. But I recognize that one cannot be totally fit without
aerobic exercise. As a result I follow a balanced exercise program: strength
and endurance. A dual approach, weights and aerobics, is not only the route to
total fitness, it's also the best way to become lean and stay lean. In my books,
you'll find all the details - they're fascinating, I believe - on the specific
and distinct roles weights and aerobics play in becoming lean and totally fit.
Enjoyment, believe it or not, is the key ingredient in any really
successful exercise plan. That doesn't mean the program must be easy. To the
contrary, productive exercise is often brutally hard. What it does mean is that
the regimen must be satisfying.
In my view exercise satisfaction comes mainly from two things:
variety and goals. Both the body and the mind respond best to a varied exercise
approach. You'll find plenty of variety, change, in the workouts I recommend.
You'll never be bored. What's more, variation is essential to long-term progress.
Goals, realistic goals, are equally important,
because they keep you motivated. Nothing is more satisfying than to set an exercise
goal or target, work hard, and then achieve that goal. But a goal achieved is
a goal lost, so you must continually challenge yourself with new goals. That's
why I recommend - and follow - a goal-oriented training approach.
Finally, I don't have all day to spend in the gym. I have a life
outside the gym, and I know my readers do as well. Fortunately, that's never
been a problem, because in my opinion best results come from short, hard and
infrequent training. Believe it or not, that applies to both weights and aerobics.
Interested? The details are in my books, which you'll find on my website:
www.cbass.com
Customer Service: Phone (505) 266-5858
[M-F, 8-5 Mountain time],
FAX: (505) 266-9123, e-mail: cncbass@aol.com
Ripped Enterprises: 528 Chama, N.E., Albuquerque,
New Mexico 87108, USA
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