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INTRODUCTION—
My Personal Journey on the Road to Endurance
Life is a journey of endurance, full of unexpected surprises. Little did I know growing up that one day I would become a holistic practitioner who would spend many wonderful years working closely with endurance athletes, ranging from beginners to seasoned veterans, including some of the world’s greatest competitors. These athletes include triathlon champions Mark Allen, Colleen Cannon, and Mike Pigg, world-class distance runner Marianne Dickerson, and the late running guru Dr. George Sheehan.
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The irony is that I started out as a high school sprinter competing in the 220-yard event and shorter distances—a far cry from being an endurance athlete myself, or even knowing much about the human body or understanding its potential through proper training, stress management, and diet.
Through years of trial and error, experience, immersion in the literature of exercise physiology, Eastern philosophy, and treating patients and athletes, I continued to refine and expand upon what I consider the bigpicture approach to endurance sports. But before offering you a wealth of information on how to become a better endurance athlete, allow me to first recount my own personal story, which reflects the reason why, to this day, I encourage all athletes to never neglect their health for the sake of performance. Both fitness and health are intertwined in a deeply significant way, a fact that became entirely apparent to me soon after I ran the New York City Marathon in 1980.
I started running track in high school in the 1960s, and those twenty-two or twentythree seconds going all-out on cinders in my spikes represented the full extent of my endurance. Until the end of my sophomore year in high school, I was not physically active; gym class was embarrassing because I was uncoordinated and could not do the things most other kids did. Even my academic world was disastrous, since I was a poor student just barely moving on to the next grade level each year, only thanks to summer school. But puberty and a surge of natural testosterone fortuitously came into my life, and during the last week of tenth grade, our gym class had a fitness test—running 600 yards. Without training or preparation, I beat everyone. The following year I joined the track team and began a streak of nearly undefeated racing that extended all the way into college.
Along the way, I had a few bad races. In my senior year, for example, I was the only runner from my high school to qualify for the biggest meet in New York State. After a cafeteria lunch of the usual junk food, I left with the track coach for the long drive to the meet. Once there, I ran several heats, easily winning each race to keep progressing until I made the finals. But I hadn’t eaten anything since lunch. The final race was well into the evening and I was famished. Walking to the starting line, I felt weak and shaky from lack of food. And, I didn’t see my starting blocks, which the rest of the sprinters had already set up. The official told me to hurry across the track and fetch my blocks. As soon as I returned, the race started. I sprinted about 150 yards, and, realizing that I wasn’t going to win, I jogged to the finish dead last; the winning time was a slow 23.5 seconds.
After high school graduation, I decided to go to college for one reason—to run track—despite my poor grades. My primary goal was to reach national levels, with thoughts about making the U.S. Olympic team.
Much of my training time at college was spent on my own: an easy warm-up lap or two around the quarter-mile track, ten or twelve short sprints, and a cool-down lap. I don’t recall many of the smaller track-and-field races with nearby colleges. I would just show up and run fast, winning most of them. With what seemed like too much extra time on my hands, I also wanted to use my leg speed and newfound overall athleticism to play football and baseball, but was prevented from doing so by my track coach who thought I’d get injured.
I started out as a sprinter in high school.
I succeeded in qualifying for the nationals during the collegiate indoor track season, having raced on many old wooden tracks to get there. But I had to run even shorter distances like the sixty-yard sprint to accomplish this goal. At the season-ending race, I was one of three runners in a photo finish—I placed third. But after that race, I lost interest in training and racing. I also dropped out of college. Studying wasn’t for me. I was ready to move on with life.
I was now living in the same small upstate New York town where I grew up, ironically near the high school track where I ran so well. I found a good job, with benefits, working for the phone company, which required me to test newly installed equipment inside the telephone buildings. I soon got married, started a family, and tried to maintain as much sports activity as possible, joining an amateur football team as a wide receiver and participating in baseball, playing alternately at most positions. I also swam freestyle, always short distances, and was nearly as good a competitor as in my earlier track days.
During this time I also became interested in exercise physiology and nutrition. Perhaps my childhood contributed to this desire. My mother would often listen to nutrition expert Carlton Fredericks on the radio, and later, my father became fascinated with Rodale’s organic gardening ideas and planted a family vegetable garden.
I read Adele Davis’s books. In the late sixties and early seventies, she was recognized as a nutritional sage. I also worked part-time in a health food store and joined a natural foods co-op. I had already been studying Eastern philosophy, and now it seemed even more important, as the only image of health that personally made sense was the holistic one.
One day I had what could only be described as a powerful vision—that I needed to go back to school and become a doctor to help people. It was so strong an epiphany that the next day I gave my two-week notice to the phone company. I planned to complete my undergraduate work at a local college and found an evening job in a restaurant. My grades improved slightly as I learned more about human biology and could relate it to my own health. Eating better was a significant part of becoming a more attentive student. Still, my poor grades overall made it difficult to get into any professional school. I met a chiropractor who knew the dean of the National University of Health Sciences in Chicago. There I could study nutrition, sports medicine, and other related topics, and its doctorate of chiropractic would allow me to one day practice as a physician.
Uprooting my family, now with two young children, from New York to Chicago was quite stressful. I found a job as night watchman at a factory, the midnight to 8:00 AM shift, and obtained school loans to pay for tuition and other costs. The school offered the option of a summer semester, enabling students to complete the five-year program in three and a half years, and I opted for the accelerated program. The professional school curriculum was twice as rigorous as that of undergraduate work. The extra study time required overwhelmed me. One could not, for example, learn enough about the body from human dissection class without also spending the entire weekend studying the incredibly intricate details of just where each muscle attached, the delicate structure of the body’s joints, and the complex display of nerves running throughout the body.
But it was my disappointment with the philosophy of the chiropractic profession and its narrow range of assessment and therapeutic options that led me to call my old boss at the phone company and ask for my job back. He said my position was there if I wanted it. That evening, while pondering this choice, I went down to the basement of our on-campus apartment complex to do laundry. Accidentally going into the wrong door, I encountered a group of students listening to a lecture on muscles and movement, and how nutrition played a key role. Now I got really excited. Exposure to this kind of information was the original reason I had sacrificed so much.
Despite the long hours of classes, the graveyard factory shift, and my family responsibilities, it was studying topics outside the regular curriculum that became the priority. Chicago was home to a proliferation of weekend professional seminars regularly offered by medical doctors, osteopaths, chiropractors, acupuncturists, and others who taught about natural hands-on healing, diet and nutrition, and exercise. Exposure to all these topics complemented my studies of anatomy and physiology, biochemistry and pharmacology, and diagnosis. While the National University of Health Sciences was considered overly medical by many chiropractors—because it taught in a very scientific way and included much of what medical students study—it still held to rigid ideological views, an unyielding approach that I was uncomfortable with. For example, the school’s curriculum insisted that the spine was the cause of many health problems, and not lifestyle considerations such as nutrition and exercise.
But the learning I picked up at the seminars helped balance my education. The study of anatomy insisted that the bones of the skull were fixed, but now I discovered from osteopathy that the skull’s bones could move with the breath and other muscle motions, which offered important therapeutic possibilities. I learned that the brain, if injured, not only could recover but could improve in cognition and function, and with age. And muscles, which commonly get out of balance and can take weeks or months to rehabilitate, can be corrected easily and quickly through various types of hands-on treatment.
Yet even with all that I was learning, both in school and on weekends, I was still missing something: putting all that information into actual practice. I simply could not wait for graduation, so after a short time, I began treating people in my apartment—a sort of underground clinic. My first patients were fellow students, then people from the local community. I would often see this one classmate jog past my apartment to and from his daily workout. He always seemed exhausted upon his return compared to how he looked when he first started. One day I asked him if I could evaluate him, and he agreed. His body was quite beat up after his run—high heart rate, muscle imbalance, poor gait, and knee pain. I began to study how this could happen and became even more interested in exercise physiology.
Unfortunately, in 1976, with less than a year left of school, I physically, chemically, and mentally fell apart. The cumulative stress had caught up with me. One day I found myself in the hospital emergency room, and the physicians were not going to let me leave because I was so sick. My muscles had severely deteriorated, the intestines had shut down, and I was dangerously anemic. Because my immune system wasn’t working, my whole body was chronically inflamed. Yet I needed to travel to New York to take the state boards in order to get my license to practice. After I spent a week in the hospital, the doctors still would not let me leave. So I removed the IVs in both arms, got dressed, and arranged for a ride to the airport. I took the two-day exam, later finding out I passed, but was too sick and weak to return to Chicago and had to be hospitalized in New York.
I now weighed only ninety-seven pounds—a precipitous loss of sixty pounds in less than a year. Despite being bedridden in the hospital, I wanted to watch the Montreal Olympics on television, especially the track events. Yet I was barely able to reach the television switch and was too weak to turn it on. The nurse came in to help me. Jealously watching these Olympic athletes in action, I wondered how my health could so rapidly deteriorate. I wasn’t even thirty years old.
Soon after my return to Chicago, I made an appointment with a doctor in Detroit, who had taught a seminar I’d attended. Dr. George Goodheart offered to treat me without charge during my three-day visit, and allowed me to closely observe his treatment of patients, most of whom had flown in from other areas of the country and the world. Dr. Goodheart had developed a form of biofeedback assessment called applied kinesiology, which combined manual muscle testing with a variety of hands-on therapies, such as manipulation, acupuncture, and cranial therapy, with nutrition and other treatment methods. I had already used some of these approaches in my illegal student practice with good results, but never imagined I would see such extreme cases of ill and injured patients getting better in such a short time, including me. My initial blood test showed an alarming blood hemoglobin level of 7.1, low enough to require a transfusion (which never helped). But Dr. Goodheart said my blood test would improve. At the end of the third day, my blood test had reached 11—so unbelievable that, soon after returning to Chicago, I had the blood tested again to see if the result was true. Having studied hematology, I knew that it would take months, not days, to improve the blood cells. But mine was now 11.8! I was even more convinced that the methods of evaluation and treatment I was learning were more powerful than I had imagined. And, it provided me with the enthusiasm and confidence I never got from academic studies. This realization coincided with the beginning of my own physical recovery. In a short time, I further fine-tuned my diet and nutrition, and began to walk for exercise. At first, walking an easy ten minutes was almost impossible. But as I progressed, my muscles started to reappear and I continued improving. I gained most of my weight back.
In 1977, I moved back to New York with my family and entered private practice, once again living near the track where I had excelled as a high school sprinter. I soon began seeing a variety of patients, old and young. Some suffered from joint or back pain or had intestinal problems, not unlike my own for so long. My approach was simple: spend all the time necessary evaluating each patient as an individual, and once it was clear what the causes were, the treatment part was often quick and easy. I had a whole “tool chest” of possible therapies, from traditional physical remedies to diet, nutrition, stress management, even employing exercise as a therapy. It was a matter of matching the most appropriate therapy with the patient’s particular needs. Because of my truly holistic approach, and because many of these patients responded quickly, my referral practice built quickly.
The experience of having once been a patient was one of the most important lessons that enabled me to succeed with my own patients. A common complaint of patients is that their doctors don’t listen to them, don’t take their seemingly irrelevant complaints seriously, and simply treat their symptoms without finding the root cause of their problem. This is exactly what had happened to me when my body shut down. Doctors kept treating my symptoms, the reason I never recovered under their care. In some ways, I felt almost lucky to have experienced being a patient as part of my professional training. Health-care professionals who have never been patients are not often able to relate to certain aspects of what a patient really feels. I vowed to be an exception.
Local athletes began showing up at my office. Typically, an injury had sidelined them and they were looking for help. In fact, many visited me as a last resort after seeing different specialists. My approach was always the same: spend all the necessary time assessing them, then apply the most effective treatment.
One day, the president of the local Road Runners Club showed up. He was a firefighter who had fallen through the roof of a burning house. He had multiple physical injuries, especially in his back, yet was determined to run in the New York City Marathon, only several weeks away. I was able to fix his injuries and get him running without pain by using many of the therapeutic tools of evaluation and hands-on treatment I’d learned in recent years, especially by balancing his injured muscles. He completed his race with ease.
More and more distance runners from the region began filling up my waiting room as word spread of my successful and unconventional approach to injury treatment. Gradually implementing various biofeedback tools, I began measuring many aspects of human physiology in athletes, from heart-rate changes and breathing to the brain’s control over muscle function. I also learned another vital component to my work—that eliminating a simple or serious injury was only half of my job. The other half was knowing how the dysfunction happened and how to prevent its recurrence. This meant understanding how an athlete worked out, taking all the information I learned through my examination and treatment, and using that to make appropriate changes in training and competition.
My exposure to more and more runners led me to take up personal coaching, but I made sure that coaching was nothing like the traditional process of giving athletes training schedules and encouraging them to race harder. Instead, my coaching style was to help them be their own coach while providing objective feedback. They would coach themselves with my input, which helped them become more intuitive and instinctual about their body.
As my own health continued to improve, I entertained the notion of running in the New York City Marathon. By then, I had been walking regularly for more than two years. The marathon was six months away, and that seemed like plenty of time to train for it. So I began slow jogging in the middle of my walks, gradually making more of the one-hour workout an easy run. I monitored my heart rate, wore flat running shoes, and always walked at the start and the end of the session for a proper warm-up and cool-down. Eventually, I got up to two hours for my longest run of the week. While I had a sense of the distances I covered, my training was based on time.
It was a cool, overcast morning on race day for the New York City Marathon. The race started with a cannon blast so loud it shook the Verrazano Bridge. The crowd of 18,000 runners began to move and I was among them. All went well through the first ten miles. The excitement swept me along at a slightly quicker pace than I’d planned, yet I felt great. As expected, by fifteen miles I felt tired but was able to continue. Within the next couple of miles, however, I began to shiver. Despite drinking plenty of water, I felt dehydrated. And I was craving cotton candy. At eighteen miles, I stopped to check my feet. They were numb, and I wanted to be sure they were still there. “My hamstrings are cramping,” I said out loud. Suddenly, I realized I wasn’t thinking rationally, and all I could remember was my goal to finish the race and prove to myself and others that I was healthy.
Alarmed by how awful I looked, two paramedics tried to remove me from the course. But I wouldn’t let them. Somehow, I painfully fought my way onward. I have very little memory of those last few miles, but I’ll always remember the finale. It included a minor collision with a television cameraman in Central Park. The crowds got louder, and then I had a clear view of the finish line.
A finisher’s medal was hung around my neck. I cried with joy over the ultimate success of passing my four-hour endurance test. But the next moment I discovered myself herded into the first-aid tent. It looked like a war zone. There were casualties all around me. Doctors and nurses were running in and out. Sick-looking runners lying on cots groaned in pain. Ambulances came and went. I thought to myself, “Are these people really healthy? And am I?” I realized then that running the marathon had not proven my health at all. I was fit enough to run 26.2 miles. But clearly fitness was something quite different from good health. This critical concept will be discussed in much greater detail throughout this book; yes, too many endurance athletes wrongly assume that being super-fit or posting fast times is the same as being healthy.
Soon after the New York City race, I also began lecturing on various topics in holistic fitness and health, first at the local library, an aerobic dance studio, and a health food store, then at running clinics. I also began writing professional papers to present at conferences, where all types of health-care professionals began to adopt my holistic approach and began practicing it with their own patients. Gradually I received more invitations to races, such as the Bermuda Marathon, where I met Dr. George Sheehan, who was also a speaker. A cardiologist and runner, he was a very influential figure in the running community because of his regular columns in Runner’s World and other publications. He was philosophical and humorous when writing about the curious passions and obsessions of runners. He became intrigued with my implementation of heart-rate monitors. Dr. Sheehan later came to my office to see firsthand my work with athletes.
It wasn’t long before I began to be contacted by swimmers and cyclists, and later triathletes. These calls came from all over the United States, including San Diego, California, Boulder, Colorado, and Florida. I eventually set up athlete workshops of varying lengths—a day to a week—in these and other locations, combining one-on-one work, lectures, group runs, and bike rides to evaluate training, and spending time at the pool watching stroke mechanics.
Working with triathletes represented a unique experience compared to single-sport athletes. In this event, an athlete must train in three different activities: swimming, biking, and running. From a physiological standpoint, this type of cross-training has additional built-in benefits over single sports. The three activities are neurologically very different, with the brain responding uniquely to each different sport. Cross-training provided a better-rounded and balanced training response. In addition, each sport could be used to help manipulate the body differently. Clearly, this kind of triathlon training provided more fitness and health potential than the sum of all three sports. Swimming, for example, could also be used to help the body in its physical, metabolic, and other types of recovery following a longer run or bike ride. In particular, a long-distance triathlon was an accumulated increase of physical intensity, maintaining high aerobic activity in the swim and bike, and only becoming anaerobic in the run. These observations became important strategies to help the athletes I worked with succeed.
One endurance athlete who visited my clinic was a young, extroverted, blonde, and supremely talented triathlete by the name of Colleen Cannon. In a short time, she was able to go from a forty-minute 10K to about thirty-five minutes and started performing much better on the triathlon circuit. She also referred other triathletes, including a promising San Diegan: Mark Allen, who had yet to win the Ironman.
Another endurance athlete who came to my office for treatment and coaching was ultramarathoner Stu Mittleman. I had met Stu the day before at the pre-registration for a short-distance triathlon that he planned on entering. But he had a painful foot problem and was going to withdraw from the race. He asked me how long it would take to heal so he could race again. I told him that his problem would be easy to correct, and showed him how, eliminating the pain by manipulating the foot and working on the muscles that caused the problem. The next day, he completed the triathlon without difficulty.
I then began to work closely with Stu. I encouraged him to alter his training, use a heart-monitor, and improve his diet. Like most endurance athletes I’ve worked with, Stu taught me a lot about human performance. Watching him train made me feel like a scientist studying a human lab animal, especially observing him going round and round the track. Any time I saw a minor deviation in his gait or stride, he would take a pit stop and we’d correct the problem. Together, we prepared for the World Six-Day Race Championships in La Rochelle, France. In this, his biggest ultra event to date, he placed second overall out of a field of the world’s top two dozen ultrarunners, reaching almost 100 miles a day for six consecutive days—all while on a 200-meter indoor track. For the entire time he was running, I was stationed just off the track. My job was to keep him balanced as the race progressed—much like the pit-crew in a racecar event. When his energy fell, I would prepare certain food or drink to match his needs. I also monitored his heart rate and breathing, getting feedback about even the most subtle signs and symptoms, and even listening to the sounds of his footsteps as he ran past me on the track. I could associate certain changes in the sounds of his running with specific muscle imbalances.
During this period of working with endurance athletes, I also trained racehorses, using a heart-rate monitor to develop their natural endurance. Despite the obvious differences in structure, horses, if you imagine them standing on their back legs, are remarkably similar to humans. Much of their physiology is similar to human athletes, too. In many ways, horses were easier to treat than their human counterparts.
I was privileged to work with racecar legends Mario and Michael Andretti and numerous other drivers in preparation for such events as the Daytona twenty-four-hour race. I knew that they required significant endurance and fat burning to prevent their heart rates from rising too high during racing. Their brain function was also an important focus, and I helped to improve eye-hand coordination, quick thinking, and focus. I also gave a seminar to the Navy SEALs’ basic training instructors, and spent considerable time teaching the endurance pilots who flew the stealth bombers on very long missions. I even got to “fly” the stealth simulator.
Throughout my growing practice, travel with athletes, lectures, and my newly emerging writing career, I continued with my own running, entering many road races from the mile to the marathon, steadily improving year after year to very respectable age-group finishes. I also added swimming to my routine, and biking, competing in some shorter duathlons, triathlons, and swim events.
Yet as my lecturing and work with athletes took me on the road more often, and on longer international trips, such as Europe, Japan, and Australia, it became more difficult to maintain a high level of fitness. By the early 1990s, I stopped competing; even my training was significantly reduced. I finally had to reduce my work on all fronts by reducing my clinic hours and limiting travel to select events like the Ironman in Kona, Hawaii.
The last time I was on the Big Island of Hawaii was in 1995, when Mark won his sixth and final Ironman. I was in the lead media van (which featured the radio broadcast of the Yankees winning the World Series against the Braves).
In 1997, I closed my private practice and continued consulting and lecturing, while I spent a year writing a textbook called Complementary Sports Medicine. Soon after this book was published, I had another vision of sorts, not unlike the experience that told me to quit my job at the phone company and become a healer. I woke up one morning with an intense desire to become a songwriter, despite never playing an instrument or singing or knowing anything about songwriting. All I had was music in my head, which had been a lifelong activity. Within a week of this epiphany, I got a surprise call from powerful and influential recording music producer Rick Rubin, who wanted to become a patient. I told him I no longer practiced, but that I had just become a songwriter. We agreed to help each other in our respective endeavors. I was soon spending considerable time with Rick in Los Angeles, one of the great music capitals of the world. I was exposed to many great songwriters and his clients, including Neil Diamond and Diane Warren, and to groups who wrote their own music, such as the Dixie Chicks, System of a Down, and Audioslave. I became Johnny Cash’s doctor, trying to save him from declining health and an over-reliance on physician-prescribed drugs. I ultimately recorded my first songs in Nashville. And for a short period, I was the wellness doctor for the Red Hot Chili Peppers, traveling on a world tour with these four great musicians, and treating them like the endurance athletes they were.
During this time I also began measuring brain waves to show music’s significant effect on the brain. Not surprisingly, the production of the brain’s alpha waves, something humans have strived to do for thousands of years, was not just healthy, but important for athletes—for stress management, increased performance, and injury rehab.
While on the fast track to learning guitar and piano, and busy writing songs, I came to realize that my time living in the Hollywood Hills was much too stressful. I eventually reached a compromise by moving to a small mountain town in southern Arizona within a reasonable drive to Los Angeles so I could continue regular music recording and maintain my holistic work with Rick.
At an elevation of 4,500 feet, the area where I live is beautiful; it’s quiet and serene. Planting a large vegetable garden was a wonderful experience, and I continue to work on my music and have so far produced two CDs. Most importantly, I got back in great physical shape by avoiding as much physical, chemical, and mental stress as possible. While I haven’t returned to my former level of ability, I feel that I am in the best health of my life. Depending on time of year and desire, I try to do an hour or two of physical activity every day. This might include hiking and biking in the mountains, swimming, or strength exercises.
And, while writing this on a warm winter afternoon, I occasionally look out from the window in my bedroom office at the majestic snow-capped Santa Catalina Mountains. I hear music playing in my head.
