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Performance Mouthguards, Belly Bulge, Protein Bars, Knee Pain Fixes

Q1: Performance Mouthguards

Do performance mouthguards really make you stronger and faster?
A: A little bit, if they improve your jaw’s position, says Chad Boger, DDS, a neuromuscular dentist based in Plymouth, Minn. “Your jaw position is related to head position, and head posture is related to body posture,” Boger explains. “Your brain spends a lot of energy on balance, and any amount of energy that can be directed away from aligning the teeth or the head can be used on other activities.”

A 2008 Rutgers University study sponsored by mouthguard company Makkar demonstrated that the right mouthguard can enhance peak power output and performance in explosive, short-duration bouts of exercise.

“Before setting the mouthguard, it’s important to test basic strength and balance exercises with the jaw in several different positions,” Boger says. “It’s easy to determine ideal position based on the results.” Seek out a neuromuscular dentist in your area to administer the tests and find the right jaw set.

“Jaw clenching [encouraged by the device] improves cerebral blood flow,” says Dena P. Garner, PhD, professor of health, exercise and sport science at The Citadel in Charleston, S.C., and research partner of Under Armour. “Our theory is that increased blood flow leads to a decrease in stress hormone response.”

It’s important to note, however, that a mouthguard won’t morph you into a pro athlete. At most, you can expect a 3 to 5 percent improvement, Boger adds.

Q2: Belly Bulge

I’ve had kids, and now, no matter what I do, I have a bulge of fat below my belly button. Is there anything I can do about that?
Probably, says Jason Stella, NASM-PES, CES, Life Time Academy program manager for Life Time Fitness in Chanhassen, Minn. But you may first have to come to terms with the fact that your current body-fat percentage is higher than you think, he says, noting that he often witnesses midsection magic occur in women when their body fat dips below 20 percent. To hit that mark, Stella recommends upping your intake of good fats, protein and vegetables, and cutting way back on refined carbs.

Also, while the idea of spot reduction is mostly bogus, there may be a way to trim from your middle. There’s evidence that people who hold excess body fat in their abdominal area have a history of chronic stress. More cortisol (a stress hormone) is created in abdominal (visceral) fat than elsewhere, and also appears to trigger fat accumulation there.

The best way to determine your cortisol levels is to take a four-point, saliva-based cortisol/DHEA l lab test, says Stella. To lower your levels, he suggests cortisol-reducing supplements such as magnesium, fish oil, phosphatidylserine, probiotics and glycine. More sleep can also help, as can meditation and yoga. And since regular, long-duration, low-intensity aerobic exercise has been shown to elevate cortisol levels, Stella suggests sticking to shorter-duration, high-intensity interval and resistance training instead.

If you try these tips and still see no improvement in that region of your body, I’d be surprised. But in that case, it may be time to get comfy with your memento of childbearing and count your many maternal blessings.

Q3: Homemade Protein Bar Recipes

Do you have any good recipes for homemade protein bars?
A: I hit up Melissa Joulwan, author of Well Fed: Paleo Recipes for People Who Love to Eat (Smudge, 2011) for advice. She says: “A great protein bar needs to include natural sources of protein and fat, be low in added sugar, and include no grains or dairy. At least 30 percent of the calories should come from protein and the carb content should remain low.”

Consider following these other rules of thumb: 1) The less sugar, the better. 2) Seeds like sunflower and sesame are high in omega-6 fatty acids, so use them for flavoring only. 3) Lots of recipes include oatmeal as a binder; replace with almond meal to avoid excess carbs.

Joulwan adapted this protein-bar recipe from Each bar has 184 calories, 14 grams of fat, 6 grams of carbs and 13 grams of protein.


  • 1/2 cup slivered almonds
  • 1/2 cup macadamia nuts
  • 1/4 cup unsweetened shredded coconut
  • 1/4 cup nut butter (almond, cashew, walnut, hazelnut)
  • 1/4 cup coconut oil
  • 11/2 tsp. pure vanilla extract
  • 1/2 tsp. sea salt
  • 1/4 cup almond meal
  • 3/4 cup unsweetened whey protein powder
  • 2 large eggs
  • 1 large egg white
  • 1/2 cup dried cranberries or blueberries
  • 1/4 cup unsweetened shredded coconut, to sprinkle on top


  • Preheat oven to 325 degrees F. Cover a large baking sheet with parchment paper. Spread almonds, macadamia nuts and 1/4 cup shredded coconut in a single layer and toast until golden, about five to seven minutes. Set aside to cool.
  • When cool, place nuts and shredded coconut in food processor and pulse until nuts are chopped and the mixture becomes coarsely ground, the consistency of breadcrumbs.
  • In a mixing bowl, melt coconut oil and nut butter in the microwave, about 30 seconds. Remove from microwave and stir until smooth. Add vanilla extract and sea salt; mix thoroughly. Fold in the ground-nut mixture, almond meal and whey powder; mix until blended.
  • In a small bowl, beat the eggs and egg white until frothy, then stir into the nut mixture. Fold in the dried berries.
  • Press the mixture into an 8-inch-by-8-inch baking pan. Bake for 10 minutes. Remove from oven, sprinkle the untoasted coconut on top and place under broiler until top begins to brown.
  • Let cool for 10 to 15 minutes. Cut into 12 bars. Stack on wax paper or parchment and store in an airtight container.

Fitness Fix

No-Pain Knees
Patellofemoral Pain Syndrome, or runner’s knee, can often be resolved by strengthening the core and glutes. 

Patellofemoral Pain Syndrome (PFPS), also known as anterior knee pain or runner’s knee, is the single most common form of knee pain, yet it remains the most inexplicable.

Unlike other injuries, it doesn’t involve obvious structural damage to the knee joint. The pain itself, which can range from mild to stabbing, is the condition. This chronic irritation of the nerves under the kneecap is a result of a complex interaction between anatomical and training factors, explains Margarita Sevilla, MD, a sports medicine physician for the Ironman World Championship in Hawaii. “Overuse is often a factor, as is misalignment of the patella in relation to the hips, muscle imbalances and trauma.” Running style may also be a factor; heel strikers have a higher incidence of PFPS.

While you can’t control biomechanical factors that contribute to symptoms, there’s plenty you can do from a training perspective. “In my experience, one of the two main causes of PFPS is excessive use of shoe orthotics,” says Sevilla. “I analyze my runners’ gaits and help them find the right running shoes. And for bikers, it’s very important to have a good bike fit and make sure to use the right pedals. Everyone has different needs.”

The other common cause she points to is weak core and glute muscles. Sevilla recommends seeing a physician to rule out other sources of knee pain, such as meniscus damage or osteoarthritis, but for PFPS, she suggests doing the following exercises four to five times per week to see improvement.

Monster Walks

monster walk

  • Stretch a mini band around your knees.
  • Bending both knees slightly, take small, lateral steps.
  • Continue for one minute, switching directions at the 30-second mark. Do three sets.

Assisted Single-Leg Squats

single leg squat

  • Face a waist-high railing, grasping it with both hands. (You can also use a suspension trainer.)
  • Shift your weight onto your left foot.
  • Keeping your right foot off the ground in front of you, push your butt backward and perform a deep squat on your left leg.
  • Keeping your torso upright, drive through your left heel to bring your body back to the starting position.
  • Do three sets of 12 to 15 slow, controlled repetitions.

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