Happy Pi Day!

I had a pretty busy last two weeks with cross country travel, climbing some stairs in support of Multiple Sclerosis, studying, having a student, and just plain life. This week - I'm bringing 5 random thoughts your way...

1) Happy Pi Day Everyone!  In case you're not familiar with Pi, it's a mathematical number that is used in a bunch of equations and is approxmiately 3.14159... so since today is 3.14 - it's Pi Day.

2) A friend told me that the way we know I'm still young is that I can still tolerate red eye flights home to Connecticut.  Ha!  I have it down to a system now, but read a few articles, like this one,  that made suggestions for how to make this the best travel option:

• Get a window seat - always - and I prefer to lean left, so I always pick an A seat - but this way you don't have to get up if someone in your row needs to use the bathroom and you've chosen the aisle. 
• Take the latest flight out possible so you're staying up past your normal bed time and will be tired enough to sleep on the plane.
• Consider your travel attire to optimize sleep on the plane.  I personally have a travel pillow, travel blanket, and face mask to block out the light and usually wear a hoodie to make sure I'm warm.  Airplanes are cold and I hate sleeping cold. 
• Sleep aids.  I personally take Nyquil to fly on my red eyes and as long as I take it early enough, I'm pretty much good to go on the other end.  

3) I went to the eye doctor today.  I've been trying to get contact lenses but I've had previously two eye surgeries that may have impacted the shape of my eyeballs and it has been challenging to find a pair that is comfortable and lets me see well.  The current trial lenses I'm in are the best I've had yet, but I keep feeling them in my eyes, which suggests my eyes are dry.  It's not them (contacts)... it's me.  So my eye doctor took some photos of my eyelids and told me all about how oil glands in your eyes work and should look on this picture.  The glands are the white stripy things and they're supposed to be pretty straight, but mine are bending a little, which isn't too bad but does impact the lubrication of my eyes and may impact my success with contacts.  Cool pic?  Or creepy?

4) It's National MS Awareness Week!  This was my fifth year participating in Climb to the Top (of Rockefeller Center) raising funds for Multiple Sclerosis.  I've previously written about MS here and the work that this fundraiser alone has done is so inspiring.  My team captain was featured here doing some awesome things to raise funds, awareness, and hope for those who live with MS. 

5) Tonight I'm hosting my first PT Pub Night, since Seattle hasn't had one in a few months and I wanted to see my favorite PTs from around the city.  I previously wrote about the top reasons you should attend PT Pub Night here, but right now, the top reasons to attend in Seattle tonight are that you could meet the PT Student I have working with me and tell her all your favorite things about being a physical therapist... so she doesn't have to hear it all from me.

That's all for now... hopefully the photo of my eyeballs won't give you nightmares!

Stair Training 101

ID 839654

 

© Mylightscapes

 

| Dreamstime.com

It's that time of year, again!  Time to stair train for the annual Climb to the Top for Multiple Sclerosis. I've previously written about this fundraiser here where I describe climbing New York's Rockefeller Center's 66 flights of stairs. This will be my fifth year participating with Team Kapniss - the Top Fundraising Team - in honor of my friend Leigh, who has MS.  Interested in donating? CLICK HERE.

Last year I completed the Climb in 23 minutes and 45 seconds and it is always my hope to do it faster than the previous year.  Over the past four years, I've cut seven minutes off my time, improving annually,  so now I've had four previous rounds of trying different training methods to see what has worked and what hasn't.  While everything has helped me improve - I think the biggest benefit has come from strength training - ie lifting weights - along with stair intervals and what helped the least was working on running endurance.  I had listed out in this blog post my 2018 training program - which was going really well until summer came and I just wanted to enjoy the sunshine and my kayak.  So now I'm back to developing my training program for this upcoming climb, mostly starting in a de-conditioned state, I'm definitely up in weight which will also be something that can slow me down.  I decided I'd use this opportunity to share more about the health benefits of stair training and discuss the ways I use stairs in patient care.

Livestrong.com has a nice article here that describes many of the health benefits of stair training.  It's cardiovascular exercise, so it helps build up your endurance and burns calories, but it also requires strength to propel yourself upwards against gravity!  Stair training is a difficult activity that can burn a lot of calories in a short time. Depending on how you're using the steps - you can target your aerobic or your anaerobic training systems using stairs.  If that's unfamiliar to you - a brief explanation is that your muscles make energy in different ways.  With long distance activities over a longer period of time, you will use oxygen to make the energy for your body to function - an aerobic activity.  For shorter bursts of energy, your body will make energy without using oxygen - an anaerobic training system.  (There are actually three systems the body uses for this, but for now - that's probably all we need to discuss).  Depending on your daily activity or the demands of a sport or activity you participate in, you may benefit from training aerobically or anaerobically or focusing on both of these systems.

In the clinic, I use step up and step down variations for numerous reasons.  We have steps of varying heights ranging from about 4 inches to metal boxes that are 18 inches high as well as a small stair case.  We use them to help with strengthening one leg at a time with optimal form. For example, someone who has knee pain or recently had surgery on their knee might not yet be strong enough to climb the stairs "normally."  But they may be able to go up and down a smaller height, so by practicing, they can improve their strength and form with the activity to progress up to higher steps until they are back to their usual level of function.

Stepping up onto one foot also challenges balance.  To stand on one foot on the ground requires control at the joints in your foot, ankle, knee, hip, pelvis, and core.  That's a lot of things to control!  Sometimes I work on balance from the ground-up... standing either on the floor on one foot or on various objects like a wobble board or bosu ball or airex pad. This makes you control all of those things at the same time, unless you're working on one of those activities sitting down and taking out the joints above the knee.  A step up exercise also works on balance from the ground up.  Sometimes I also train balance from the core/pelvis downwards - working in kneeling or quadruped (on hands and knees) positions so that you're taking the knee and foot out of the activity.  Either way, every time you go up a set of stairs, you're standing on one foot at a time and need to be able to balance and control all those joints - or you need to hold on to prevent yourself from falling over.

Recently I was working with someone who is recovering from an ACL reconstruction who is getting close to returning to soccer.  When thinking about soccer, it's easy to picture a lot of running and kicking, but people often forget about the amount of jumping that is involved.  You jump to head the ball or to kick the ball higher in the air or to change directions or to avoid an opponent. So we were working on some box jumps in the clinic.  With two feet, he could easily jump up onto the 12 inch box.  Piece of cake.  With his non-surgical leg, he could jump 12 inches on one foot.  But he couldn't get himself to jump up 12 inches on his surgical leg alone.  I've written about my own experience being unable to jump onto a 12 inch box before in that same post linked above - but watching a patient experience that block and then overcoming it was different than dealing with it myself.  We worked our way up to it two inches at a time, both jumping up and down, until he was able to jump that high.  Part of this is a confidence issue - where your brain doesn't think it can be successful, so it inhibits you from trying.  How cool is it that if your brain doesn't think you can land - it (usually) won't let you jump? By learning that he could land from a jump that high and from progressive heights below it, he was ultimately successful.  It was a big win for him and fun to see such a change in ten minutes in the clinic.   Even better was that he was still able to do it at his follow up visit - and right away!

When training on stairs, you have to consider going both up and down.  So basically you're going to be using all the muscles in your legs and core - and if you use a hand rail or swing your arms - you're going to get the upper body and chest and back involved too!  All those joints I mentioned before that are involved in balancing - the muscles around those joints are needed to stabilize you and propel you up or control your descent.  The other thing to consider is that one leg is moving while the other is holding you up.  So it's a complicated activity that also requires coordination.

So, if you're looking for a new training activity to try out - stair climbing is an option you can consider.  Today I did a short training session of 450 stairs in 10 minutes on a stair climber machine and I'm convinced that the machine is considerably more difficult than being outside on the stairwell, but I didn't have to go back down when I ran out of stairs because on the machine, they just keep coming! 

Again - please consider a donation to the National MS Society in support of my Climb to the Top.  Link above.  And if you want to go climb some stairs around Seattle together, just let me know!

UConn Connection and Human versus Animal

Last week I had the pleasure of a lunch meeting with the University of Connecticut College of Agriculture, Health, and Natural Resources (CAHNR) Interim Dean of Students Dr. Cameron Faustman while he was visiting Seattle.  This was an unexpected meeting, but connecting with with the Physical Therapy program newly housed in CAHNR, I've felt limited connection between the University and the Physical Therapy Alumni which I was looking forward to discussing. There were several purposes to our meeting - but primarily it was an opportunity to discuss ways for CAHNR to connect with alumni, learn more about changes going on in Storrs, CT, and see if there are opportunities for collaboration and relationships with the school.  (As a side note, CAHNR just recently released a beautiful write up on my PT classmate and friend regarding her work with MS that you can read about here.  She's the reason I Climb to the Top for MS every year and wrote about here.  I can see that they're trying to get us involved, and I appreciate that).

The meeting started out discussing each other's backgrounds and some scholarly interests.  Dr. Faustman is a native of Wallingford, CT - which is basically next to my hometown of Cheshire, CT.  He went to UConn for his undergraduate schooling where he studied Agricultural Education and Natural Resources Conservation before ultimately continuing his studies at the University of Wisconsin where he studied Animal Science.  He told me that his current interests lie in working to improve food waste, but that his initial research involved looking at the color of meat - which directly relates to muscle tissue. He has previously published papers on several topics, but we discussed his work with myoglobin quite a bit.  Myoglobin is the protein found in muscle tissue that uses iron to bind oxygen which is needed for energy. I explained that I did all of my studies at the University of Connecticut with an undergraduate degree in Exercise Science and then later my Doctorate in Physical Therapy.  My undergraduate research interests were childhood obesity and muscle fiber typing and my graduate research was women's basketball lower extremity injuries, which you could be the fifth person to read that publication if you clicked here.  Common bond: we both studied muscles!

http://nosetotailapp.com/meat-cuts.php

We discussed a recent conversation I had with a local surgeon who told me about comparing meat cuts to human "cuts" where if you ever were stuck in a situation where you had to be a cannibal, the hamstring would not be the optimal choice of meat... (we never reached the point of determining what part of the human body you should eat if faced with these conditions).  I recalled the way the hamstrings felt if I treated them with manual therapy interventions in the clinic: fibrous, gristly, and tough.

I wanted to learn more about this, and found this article by Bret Contreras which summarized muscle fiber analysis of the hamstrings.  It states that while most research finds the hamstrings to be predominantly fast twitch muscle fibers (type II fibers that don't require as much oxygen and are used for short bursts of energy), the distribution of type I (aerobic oxygenated fiber which would have a higher blood supply and capillaries nearby also contributing to the color) to type II fibers varies between people and is not exactly known, but probably at least tilts more toward those type II fibers.  In simpler terms - most research says that the composition of the hamstrings is made up of about half of fibers that don't use much oxygen, but oxygenated fibers are the ones that look bright red (or dark in chicken) in meat sources.  This directly relates to the work Dr. Faustman does concerning the color of meat.  When you buy a chicken leg or thigh, the dark meat, these are muscles that the chicken is using constantly, running around, and as such they use more oxygen - compared to the breast muscles which would flap the chicken's wings occasionally - but they rarely leave the ground in their flight.  These concepts apply similarly to the cow and your beef cut - the leg muscles that are used most often or continuously look different and ultimately have a different texture and flavor.  Interestingly, I found this article which outlines how you should cook your meat based on the color because this can indicate the composition of what you're about to eat - and what type of method will optimize its moisture.

The conversation shifted onto fish.  Now, I personally do not consume red meat, but I do eat poultry and fish.  Considering which human pieces of meat would be optimal for consumption may have cemented my stance as a non-beef/pork/lamb eater... but until having this lunch meeting, I had never considered that when I ate fish, I was also eating muscle.  The few people I've discussed this meeting with in the past week have been pretty 50/50 split on whether they had previously considered this idea. It makes sense - I just hadn't thought of it.  Fish don't bear weight through their tiny bones and are suspended in water so their structure is different.  The muscle structure of a fish is called a myotome (which has a totally different meaning in the physical therapy world - though I would be willing to bet that the PT version is named after the fish structure). Where the other creatures previously discussed have muscles that are structured as fibers that are collected into bundles, like this:

https://en.wikipedia.org/wiki/Muscle#/media/File:1007_Muscle_Fibes_(large).jpg

the muscle structure of fish is layered.  Think of what it looks like when you flake apart your salmon and you can consider what each muscle layer looks like.  Or here is a picture of a tuna steak where you can sort-of see the layers.

http://star-gazypie.blogspot.com/2010/06/behold-power-of-tuna-recognize.html

Want to know what makes that tuna steak look red?  Myoglobin! The same stuff in humans that helps our muscles optimize oxygen use.  Tuna has more of it than some of the more white-colored fish because they swim faster and more extensively.  Salmon's pink flesh is not from myoglobin, though.  It comes from the food that salmon consumes, just like the flamingos.  So for the past several days I've been looking into animal muscle structures and tissues and gaining an understanding of similarities and differences between people and animals and it has been really interesting to think about the way the human body works from this different perspective.  How I failed to gain this understanding during my whole undergraduate course of Animal Physiology is beyond me!

So where I focus on human movement, including muscle tissue, Dr. Faustman focuses on animal muscle tissue which is food.  These are surprisingly very similar concepts and it was fun to think in a new way.  It helps to make sense of why the Physical Therapy program and the Department of Kinesiology would fit well into the College of Agriculture.

We concluded by discussing some of our current projects.  I knew there was a lot of wasted food in the US, but when looking further into it, I came upon Feeding America, which estimates that almost half of the food grown, processed, and transported in the US is wasted!  This is terrible.  It's not just food, either.  There's tons of fresh water used to produce food, so if the food is wasted, that's a lot of water waste, too.  Interestingly, I learned from Feeding America that unsold food at Starbucks at the end of the day is brought to food banks to reduce waste... so now I feel a little better about my occasional splurge of a $7 grilled cheese and $5 frappuccino at Starbucks if part of my purchase supports less food waste.

Thanks for lunch, UConn!

Stair Challenge!

Richmond Beach Park steps - Shoreline, WA

How is it almost June?!  That mean's it's time for the Shoreline Million Stair Challenge!  The purpose of this event is to have the community collectively climb one million stairs to increase fitness competing with neighbors. According to the site, last June I completed 11,444 steps!  The challenge was started in 2012 for community awareness of health as well as to bring more people out to the park near my house where there is a long stair case (188 steps) that can be broken down into portions as well as a smaller set of stairs nearby.  I use these when I train for my March stair climb for Multiple Sclerosis which I've previously written about here!

This year my goal is to complete 15,000 steps in the month of June.  That's an average of 500 steps per day or 3500 stairs per week.  I don't work out 7 days per week, so this seems like a lofty goal, but I'm excited to work towards it and spend more time outside.  Additionally, on the side of this blog, I've been tracking my miles walked and stairs climbed all year... and I'm a bit behind in my 75,000 stairs goal, so this should really help get me more on track!  Fortunately, the sun stays out a lot longer in June so post-work stairs will be in order!

I urge others to join me in this challenge and climb some extra stairs this June.  It might help you start a new exercise routine or change your daily habits.  Since I started training for stair climbs, I definitely notice myself taking stairs more than alternatives... and I've gotten stuck in a few stair wells for doing it! You can climb stairs anywhere and still participate in the challenge. We can motivate each other to train and get stronger and more fit!  I want to see photos of the stairs you climb - so if you sign up to join, I'll match your stair count (up to 1000 additional stairs!).  Seattle area friends, if you want to head to a local stairwell - there's a whole network of them listed on this website - let me know and I'll climb some stairs elsewhere! I won't race you - because it's not about doing them quickly.  It's about being active... and I'm slow!

Happy Summer and Happy Climbing!

Climb to the Top for Multiple Sclerosis

Today I climbed to the top of Rockefeller Center for the fourth consecutive year. Why would I do such a thing? Because it’s a fundraiser for Multiple Sclerosis and that cause is important to me- and because I can!

View of NYC from the Top of the Rock

The Climb is 66 flights of stairs- 1215 steps- that today took me 23 minutes and 45 seconds. Those 24 minutes were grueling.  My legs started to feel like lead around the 10th flight and my lungs were gone around the 20th- not to recover for several hours because it’s pretty cold at the top and they burn as I tried to catch my breath. This year’s preparation included a lot more weight lifting along with regular stair training steady pace and intervals including at least 11,500 steps in the past 8 weeks.  I endured one ridiculous training session in an apocalyptic hail storm in Seattle just a few days ago.  There was some foam rolling - because #RecoveryDays.  There was biking and running and circuits.   Last year it took 26:05.  The year before that 28:13.  And the year before that, my first effort in 2015, it took me 30:59.  So, totaling up all the minutes of training, and all the minutes of climbing for these events - I've collectively suffered maybe one week’s worth of discomfort.  Perspective: my friend who has MS (who also makes this climb every year and rocks it!) deals with so much more and on such a larger scale. Every ache I've experienced for this is such a small reminder of a much greater cause- and motivates me to fundraise and train harder. 

Let me be clear - this event is not sad.  It's raising money for a serious health condition, Multiple Sclerosis, which a friend lives with every day.  Having sick family members and friends may be sad- but this event is not. It’s empowering! And it’s challenging It's a bit of a party with an MC and DJ and free t-shirts and Pom Poms. An indoor vertical 5-K road race with lots of bananas and granola bars and weird drinks to sample and pamphlets and tracking bibs and both a start and finish line. I love it.  I love flying to the East Coast to visit with my family and friends for the weekend.  I love that it is an annual event that I regularly train for and fundraise for.  I love that my friend has a huge group of people rallying with her and collectively climbing up those 1215 steps.   I love that it is something that benefits a serious health condition.  And I love that the event raises tons of money!  As my friend said when she greeted the team at brunch following the climb, “Let’s keep raising these funds every year until we no longer have to!” 

Here are a few facts about Multiple Sclerosis (MS) from the National MS Society Website:
1) The cause of MS is unknown - but it is thought to be impacted by environmental factors.  It is more difficult to find a cure when a thorough understanding of a cause is unknown.
2) MS is an immune condition in which your body fights off it's own central nervous system.  The central nervous system includes your brain and spinal cord, so when this occurs, a variety of symptoms can occur depending on where the degeneration occurs.
3) MS is most often diagnosed in people between the ages of 20-50 and is two to three times more common in females. It is most common in caucasians with northern European descent.
4) According to this website, the Pacific Northwest has the highest rate of MS in the world.  There are studies looking at geography, vitamin D and environmental factors such as bacterial infections in an effort to determine the cause.
5) There are numerous types of MS.  Commonly, the condition is broken down into four types, but in actuality, because each person presents differently, there are many more than are generally outlined.
6) What can you do to help?  You can donate here to support further research, or you can join me to climb next year and raise money with me!

Overall- a successful training season with improved climb time compared to last year, much better fundraising, and a fun time had by all!

"If it ain't broke - don't fix it" - Workout Programming Edition

They tell you in PT School that you need to be able to properly demonstrate any activity you're going to have a patient or client do. I'm 5'5" and I was working with someone over 6' tall for return to sport after an ankle sprain.  I set up a series of objects to jump over or onto in various directions including a 12" box.  I went to demonstrate the obstacle course, but when I reached the base of the 12" box, I completely chickened out.  I was glued to the floor.  I then spent my lunch working on box jumps. (And yes, I nailed that 12" box jump, and yes, I made all my coworkers watch repeats as witnesses, and no, I can't do it again unless I work my way up from a 6" box - but at the end of the day, I still can do it!)

Being a physical therapist is an active and physically challenging job.  When I worked with the geriatric population, there were numerous times when I found myself holding up 200+ pound adults who thought they could stand, but ultimately could not.  When I'm working with basketball players, if I go to stretch someone, I'm lifting a leg that is solid muscle.  When I work with really little kids, I have to make it fun which often means ball activities with balance on various apparatuses and obstacle courses.  Not only do I need to be able to demonstrate, I also like seeing what my body is capable of and I like that I get to stay moving for my job.  I also need to work hard to keep myself healthy so I don't hurt myself.

One of the changes I made in 2017 was to program my own workouts and schedule them on my calendar leading up to a stair climb event I have in March 2018. This was the first time I have ever programmed for myself in such a manner and I really enjoyed the experience.

Here's what I learned:
1) Planning made me more compliant with my workouts.  I planned 3x/week over 6 months and when I looked back, I only missed four.  Not too shabby for someone who has previously struggled - A LOT - with workout consistency and rolling out of bed to put the work in.  And, though I was frustrated each of those times, I felt that the sickness I was feeling on 2 of those days and the snow on the ground for one of them were legitimate excuses for three out of the four.  But having a plan meant I was able to get back on track, quickly, and get over regretting missed workouts.
2) Scheduling workouts into my weeks eliminated daily early alarm clocks to see if I would, in fact, drag myself out of bed - because when a workout was scheduled - it happened.  I planned them at the times that appeared to be best for the week, mostly on a regular basis, with enough flexibility should something pop up during my usual time.  I stopped making myself feel guilty, because I wasn't missing workouts unless it was truly what my body needed.  On the few occasions I did miss, I knew I had another workout scheduled in about 48 hours to get right back on track.  Let it go.  Move on.
3) I also learned that I grossly over-estimated my ability to progress my endurance training activities.  Because endurance training is not something I enjoy and I'm not entirely sure my body is built to be running long distances, my program had me increasing mileage every 2 weeks but I was only running once per week so it was too fast of a progression.  It didn't mean I stopped running... it just meant that I had to revise my program early on because my targets weren't appropriate.

Now I'm coming upon the end of my original six month program (5 weeks left) and have been doing some research on how to better write my program for the next period of time. I have a lot more learning to do in this area - definitely a weak spot of physical therapy education, but I consistently came across articles that outlined steps to writing a training program such as goal writing, determining your primary intent (increased muscle size/increased strength/increased endurance/weight loss), determining which exercises to include and at what volume (frequency/reps/sets). But this article on T Nation by Paul Carter had a sentence that really struck me: "You don't need to overhaul a program that's largely working... The worst thing you can do is overhaul an entire program that's producing results. Keep what's working and make minor adjustments to what's not."

I've been on the same program for six months: one day per week each of strength training, interval running, and stair training with the upcoming last four weeks a ramp up of the stair training leading to my event.  I like the variety, my body seems to be recovering from each workout pretty well, I can feel and see the changes, and I'm being consistent.  My primary goals for the last six months were to get into the habit of working out three days per week (not a focus on strength, weight loss, or any other physiological changes) and to be prepared for the stair climb in March.  Period. Since I'm still seeing progress in the physiological changes that weren't even my target - and I'm able to be consistent with the program - despite weeks of trying to more meticulously plan the next program - I'm sticking with it.  It ain't broke... so I'm not fixing it.

So - Step 1: Write Goals for 2018
1) Continue training three times per week.  Get the schedule onto my calendar.  We're forming a habit here. This is my top priority.  The other goals are either ways to try to spend my time to achieve this goal or hopeful side-effects of achieving this goal.
2) Cover 1000 miles for the year (tracker located on the right of this page - tracked by FitBit, updated when blogs are posted.)
3) Climb 75,000 stairs for the year (tracker located on the right of this page)
4) 60 second plank.  Because #core and #strengthgains
5) Of course I have a weight loss goal, as well - but this requires my training program combined with an eating plan which is an entirely different blog post.
Step 2: Volume: Continued plan of 3x/week.  Reps and sets to be planned ahead of time because this is what training looks like.  It's not an arbitrary workout where I get to the gym and think "what am I doing today?"  There's no guessing.
Step 3: Exercise components: The next six month cycle has been broken down into smaller pieces, unlike the last six months. Seattle summer is gorgeous and once the sun comes out, we only get about 90 days to enjoy it for the whole year so you won't likely find me lifting or on a treadmill once that happens.  Summer is for kayaking and hiking with my favorite hiking pal.  And my stairs are outside - so they get to stay in the program.  As long as there's an active activity 3x/week for more than 30 minutes - it'll be ok to skip the weight room if I'm kayaking.  Flexibility is permitted in the workout content as long as there is consistency.

The plan:
January through March 5th - completion of the previously planned cycle.  Includes ramping up stair training and endurance training for my annual Climb to the Top of Rockefeller Center fundraiser for Multiple Sclerosis.  Can't wait to see how this year's training pans out in comparison to previous years which weren't planned.  Goal time for completion is 25 mins.  If you want to donate to that cause, click here.

March:  Recovery from stair climb with more soft tissue work, lower volume of stairs, and lots of core/planking.

April through May: Ramp up strengthening days using this program from Bret Contreras, "The Glute Guy" that has consistently been kicking my butt (pun intended) along with cardio days of  running and stairs as I ramp back up for:

June: June is the Shoreline Stair Climb Challenge and I'll be aiming to climb 15,000 stairs during the month of June.  Last year I made it just past 10,000. Stairs will be supplemented by hiking and kayaking and sunshine.

July: Recovery again with increased soft tissue work and decreased volume with core and planking.

August through September: back to the progressed cycle.

That will bring me back to the time when I will determine if I'll be Stair Climbing again in 2019 and when I would start my training program/what it would look like as we enter the gray days of Seattle for winter.

Why would I share this?  First off - accountability.  Second - sometimes it helps others to plan their training program by seeing how someone else has structured it.  If you're hoping to increase your glute size or strength, you could review Bret's program that I've included. If you want to start a workout program for the first time in a long time - or ever, the ideas I've used to get into a routine may help you.  Or you can come join me on the stairs.  They never seem to get any easier but the view from the top is gorgeous.