Optimal Athletic Performance

Dr. Elina Chernyak | Vail Colorado

Optimal athletic performance occurs during a synergy of various physical systems operating at peak levels. Any athlete knows the feeling when everything is working together, when they are ‘in the zone’ and it seems almost effortless. When working with athletes, or anyone wishing to improve athletic ability, my method is to integrate the biomechanical aspects of performance with biochemical and nutritional aspects. This approach leads to performance enhancement, reduced risk of injury and minimal down time if a person does get injured, as well as extended longevity of career. When we look at the body, both from the biomechanical and the biochemical aspects, then we are treating the comprehensive needs of each person.

More top athletes are starting to recognize the importance of integrating a functional medicine approach with traditional training methods. As the margins of competition become ever tighter, athletes are looking for additional, and more natural (and legal) ways of gaining an edge. Perhaps the most pertinent example is Lance Armstrong, who has worked closely with several functional medicine Doctors over the course of his career in order to optimize his performance through scientific and natural methods. His understanding and use of “alternative” healthcare treatments and strategies has helped him reach amazing success even after cancer. Last year, in the 2009 Tour de France, Lance finished 3rd after 2 years of retirement and at age 37.

When working with athletes I start by getting important historical background information on both their career and ‘civilian’ life. That tells me where the gaps in the action have been. One of the most frequent issues is having previous injuries that have not healed correctly. Even when the pain goes away, the body is still not functioning the way it’s designed to. We don’t look at a person’s pain as the nature of the problem. We look at pain as the body’s cry that something is wrong and needs to be fixed.

Evaluating the biochemistry, through extensive history and diet analysis, gives us information about what testing we need to do in order to identify the parameters that may be affecting the whole biochemical propulsion, body growth and repair systems. It’s a combination of two approaches based on a biomechanical functional exam, and doing some homework on the biochemical side.

The skeleton doesn’t do anything but sit there. The muscles go from one bone to another; they contract and move the system. The muscles have no capacity to work on their own; they’re under the direct control of the central nervous system. The brain needs to be able to do its job in terms of coordinating and controlling virtually every structure and function of the body. And, the brain can learn to do things wrong. Looking at how a patient or an athlete moves, which is what I do in the functional exam, gives clues to the way the brain is controlling movement. For example, one issue can be “muscle substitution” that leads to energy-inefficient movement patterns that put increased strain and stress on structures that aren’t designed to handle them.

We not only need to look at the hardware—the muscles, bones, ligaments, and tendons—but also at the software — the brain and peripheral nervous system and how it controls movement. If we don’t do that, then we’re not looking at the body in terms of its dynamics. We’re only taking a snapshot of it in one instant of time, and that doesn’t represent how the body is doing its job of life and function.

When you look at the things that are going to sabotage either body chemistry or biomechanics, it’s all the same. You need to look at past history. You need to look at things that were not addressed in a functional way during development or in dealing with a previous injury. You need to develop strategies for supporting functional reserve and making up for functional deficits. The things I always do are based on the history.

If I feel clinical and testing protocols need to be done, I will collect laboratory evidence such as an oxidative stress profile, essential fatty acids and amino acids profiles, comprehensive digestive analysis, and allergy profiles are extremely important for athletes and others I work with. That is generally one of the first lines of hidden breakdown in the body. Based on history, that would serve as our road map for making choices on the biochemical side of things.

Its important to realize that where a person hurts is generally not the problem. (That’s usually where too much stress is going on because other things aren’t working.) Thus I do a series of functional tests that allow us to determine what key link is breaking down in the loco-motor system. I support the person nutritionally from a foundational perspective (good macronutrient and micronutrient balancing and diet analysis), and deal with the individualized needs of the patient in terms of a dietary review and the results that come back from the testing protocols. It’s a winning strategy for everybody.

As far as I’m concerned, if we look at the concept of athletic careers or at people’s lives, it’s all a matter of looking through the lens of what’s happening now as a preview of what is to come. If you wait for things to show up before deciding something is wrong, you have really missed the boat. It becomes a lot more difficult. In today’s healthcare climate, 290,000,000 Americans all need some level of health care along the lines of function. There are enough patients to go around. It’s our job, as clinicians, to create a system that brings a level of awareness to patients that the lives they lead can be greatly enhanced by taking an active role in their decision-making. The technology is there.

The greatest gift we can give is the knowledge and opportunity to have a long, productive life that extends well beyond one’s athletic career. To be active and able into older age is the true reward. The only way we can do that is to look at the reality of the biochemistry and biomechanics from the perspective of what is creating the three-dimensional reality we see. We’ve got to look behind the scenes.

The importance of functional physiology is a concept that emerged from modern research. It’s a cutting edge medicine now and is the future of medicine. Researchers are discovering how many ways we depend on specific nutrients to promote functional physiology. It is extremely gratifying and rewarding to work with people who are as much interested in their health you are in their health. This creates a true partnership model of health care in which the patient comes in and says that she knows the following about her body, and this is what she does daily to help herself. Then the doctor says that he or she has a body of knowledge. He or she acknowledges that the patient has the knowledge of her body and tells her that together they are going to develop a plan that honors the contributions of each side. That's a different model. We've had a parent/child model of healthcare, and now we need two functional adults who get their egos out of the way to get the job done.

Dr. Elina Chernyak, D.O., is an osteopathic physician practicing holistic medicine in Vail, Colorado. She practices integrative and functional medicine, and offers her services as a general practitioner, nutritionist and patient advocate. She is a member of the Institute for Functional Medicine and has studied under some of the most influential holistic and alternative doctors in the United States, Canada and Russia.