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Q1: Can caffeine help me perform better in the gym?

Q: I see people around my gym guzzling caffeinated drinks before their workouts. Do they really improve performance?

A: It’s more than hype: Caffeine is one of the few legal substances that unquestionably enhances many types of athletic performance. According to a 2008 study published in Applied Physiology, Nutrition, and Metabolism, even a moderate amount of caffeine — about two 8-ounce cups of strong black coffee for a 180-pound man and about one cup for a 130-pound woman — can improve performance in many different activities, including swimming, rowing, and tennis. A report in the Journal of Strength and Conditioning Research concludes that experienced athletes can get an average stamina boost of 3 percent from taking a similarly moderate dose before exercise. And while shorter-duration, higher-intensity activities like sprints and strength training seem less directly affected by caffeine, some improvements have also been reported.

Although the exact mechanism is unclear, caffeine seems to improve athletic performance by increasing blood flow to working muscles and helping burn fat for energy — a fuel that is plentiful throughout the body — while sparing glycogen, a less abundant fuel, which is partly stored in the muscles. Caffeine also stimulates the adrenal glands, which secrete fight-or-flight hormones, giving people additional energy to power through their workouts.

As anyone who’s knocked back a pot of java to pull an all-nighter knows, though, too much caffeine can leave you anxious and unable to relax — all of which can negatively affect athletic performance. So if you’re inclined to try caffeine to give yourself an edge at the gym or in your workouts, family physician Spencer Nadolsky, DO, stresses that moderation is key. “Most of the problems associated with caffeine can be improved by dosing it correctly.”

People who consume caffeine just two to three times a week, but ingest it 30 to 60 minutes before an event, may get a bigger boost in performance than those who take it more regularly, says Nadolsky. So, for best results in the gym, you may be better off avoiding it for all but your most important workouts or events. (The Applied Physiology study found that the biggest improvements came from taking caffeine after abstaining for a full seven days before an event.) If you’re a regular coffee or tea drinker, Nadolsky suggests you consume no more than 300 to 400 mg — about three cups of coffee — every day.

While some people may experience a diuretic effect from caffeine, recent studies have called into question the long-held claim that coffee causes dehydration. As with any activity, however, Nadolsky recommends proper hydration.

As to the ubiquitous “energy drinks,” most of them are filled with sugar — up to 60 grams, or about 15 teaspoons of the sweet stuff — per serving. So for the best preworkout caffeine fix, avoid the drinks in shiny cans and go with conventional caffeinated drinks like black coffee and tea.

Q2: What is rhabdomyolysis?

Q: I’ve just started a high-intensity exercise program and keep hearing about the dangers of rhabdomyolysis. What is it? Should I be worried?

A: Rhabdomyolysis, or “rhabdo,” is a potentially deadly condition that can result from extreme overexercising.

“When individuals tax themselves to the breaking point, in rare cases, muscle tissue can start to die,” says Byron Patterson, MD, a team physician for the L.A. Galaxy soccer team and medical director of Primary Care Sports Medicine in Encino, Calif. Spent muscle tissue enters the bloodstream and releases a protein called myoglobin, stressing the kidneys and sometimes causing them to fail.

Rhabdomyolysis feels different from the soreness that can occur during a productive workout. “The muscles become extremely painful, and swell up within a few hours of the workout,” says Patterson. “Your urine turns dark from the protein filtered from the blood, which can lead to fever or nausea.” If you experience these symptoms during or soon after exercising, get medical help immediately.

To avoid this dangerous condition, always progress your workouts gradually and listen to your body. “Intense pain is an indication that you’ve done something wrong,” says Patterson. “Don’t try to work through it.”

On the other hand, don’t let the slim chance of contracting the condition scare you from getting a good workout. Most people are able to differentiate between good-for-you muscle soreness and intense pain.

“Usually, it shows up in competitive personalities and underconditioned athletes who are coming back to exercise after a long layoff,” says Patterson. “They remember where they used to be and try to get back there too fast.”

Fitness Fix: Improving Your “Wheel” Pose









The wheel pose, a common yoga pose also known as a backbend in gymnastics, is a double challenge. You need both the strength to push yourself off the floor, and sufficient mobility to extend your arms overhead and behind you. “Most people overarch the lower back and underarch the upper back, which limits the action in the shoulders,” says yoga and Feldenkrais instructor Roland Mathews, GCFP. “They need to learn to extend the upper back while spreading the ribs in front.”

Mathews recommends preparing with the following Feldenkrais-based movements. Perform each one slowly and effortlessly two to three times a week, before or between yoga classes.

1. Rolling Fists









  1. Lie on your back with your knees bent and your feet flat on the floor.
  2. Extend your arms straight out to the sides, palms up, hands in loose fists.
  3. Keeping your arms in contact with the floor, slowly turn your palms downward, and simultaneously lift your head and upper back a few inches off the floor.
  4. Reverse the movement, lowering your head to the floor and turning your palms upward while simultaneously lifting your hips a few inches off the floor.
  5. Slowly repeat the movement 12 to 15 times, resting as needed and breathing easily throughout while focusing on the movement in your shoulders and upper back.

2. Prone Upper-Back Twist










  • Lie face-down with your left hand on top of your right, your head turned to the left, and your right cheek on top of the back of your left hand.
  • Keeping your hand in contact with your cheek, slowly lift your head and left arm a few inches off the floor as if to look over your left shoulder (don’t strain!).
  • Repeat this movement 12 to 15 times, resting as needed and breathing normally throughout.
  • Pause for 30 to 60 seconds and repeat the movement on the other side, switching hand positions so the right is on top.

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