u/Technical_Brain1493

Seeking advice getting out of my Achilles tendinosis/tendinopathy (not tendonitis) trap. 

To explain further, I had a bad foot injury which took 4 months to heal, and I lost a lot of condition in my foot over that period. I then had to battle through tendinosis in my posterior tibialis and FHL tendons as I built the strength back up. The solution I found was to very gradually build up strength by using static or foot-weight only exercises and then really weak (homemade) elastic bands. If I went too hard (as one would normally do with muscle building), it would just micro-tear / exacerbate and I'd have to rest it for a couple of days before starting again. This did work and I have no problems with those tendons now.

However, when I was trying this approach with the Achilles/calf, using sitting down heel raises, it's been less than straight-forward. I first tried doing 6 reps of full range of motion heel lifts, but that just exacerbated it. Then tried 1 full rep (after a couple of days of rest) and then 1 shortened range rep and that still didn't work. 

The really annoying thing is that I hadn't even injured my Achilles/calf initially, but during the healing period for my foot, my SEM consultant told me to aggressively (statically) stretch my calves to aid healing, and that I shouldn't worry about overstretching it as it won't do any harm. Turns out I have a high pain threshold, and I definitely did f**k it up by over stretching it, before then falling into the tendinopathy trap as it healed. It was only after this that I discovered dynamic stretching off t'internet, which works much better for me.

Has anyone gone through this themselves, or know of a really gentle way to strengthen the Achilles/calf?

Edit: Just to clarify, I have seen a physio a couple of times, who's a foot specialist and pretty good, but she's a bit of a drive away and I've had some other health issues which has got in the way so thought I would tap into the hive mind here.

The actual meta analysis shows significant increased risk to neurodevelopmental disorders if either of the child's parents had mental health conditions before and during pregnancy, rather than antidepressant use per se. And the study concludes: "Optimising both maternal and paternal mental health is essential for the child's long-term neurodevelopment."

However this has been reported in The Guardian with the sub-heading:

>Researchers say risk comes from ‘other factors, including genetic predisposition to mental health conditions’.

That seems to have been selectively lifted from the quote below, while ignoring the significance of the Oxford comma at the end:

>“Together, this suggests that it is not the antidepressants themselves causing an increased risk in autism and ADHD but it is more likely to be due to other factors, including genetic predisposition to conditions such as ADHD, autism, and mental health conditions.”

With the Oxford comma, it should be taken to mean: "...due to other factors, including mental health conditions and genetic predisposition to conditions such as ADHD, autism.” 

But then it's pretty unscientific for the paper authors to mention "genetic predisposition" where there appears to be no genetic screening studies included in the meta analysis. And I think its telling that The Guardian then focuses on this genetics angle, giving a misleading picture of the whole thing.

This seems par for the course in reporting such things in the media, but is it due to scientific incompetence or their own political conviction that neurodevelopmental disorders aren't affected by environmental factors, as this meta analysis quite clearly highlights?

Ed actually understands what's wrong with rentier Britain, and has been thinking deeply about solutions (evidenced by his podcast and book). What's more, he'll have reflected and learnt a lot from his past experience as leader. And we don't need another PM who spends 2yrs learning on the job.

The next election will be won by a Labour leader who can unite the liberal-left and socially conservative working class. It will be lost if the former split their vote or the latter go to Farage. The liberal-left already likes Ed and my impression is that the socially conservative working class have realised they made a mistake in allowing the press to skewer him over a bacon sandwich.

Is it time?

Would you rather be average build and in the top 5% of intelligence, or other way around?

Please let me know your thoughts, but please try to engage with mechanistic science.

Energy conservation is a fundamental law in physics, but the notion that we can dictate our energy balance with simple food and exercise choices was an assumption which never bore out in the high quality science. This is because it ignores the more significant effect of these choices on our basal metabolic rate, and different types of "calories" have different bio-chemical effects due to their different evolutionary significance. Glycaemic load (from eating carbs) causes insulin (a hormone) to be secreted and this tells the body to reduce metabolic rate, store energy and eat more - useful during fruit season to store up for winter. So much so that in humans, reducing insulin increases basal metabolic rate by 300 calories/day on average (after short-term withdrawal effects have subsided) - that's equivalent to a hour on the treadmill. Mice studies have shown similar. Exercise also reduces metabolic rate, esp in combination with calorie restriction, as the body assumes times are tough and tries to conserve energy. This is why weight loss tapers off during diet and exercise programmes - this cannot be explained with the "calories in vs calories out" hypothesis.

Hence the takeaway point is that the direct effect on energy balance of simple food and exercise choices, such as eating less fat and going for a run, is dwarfed by the greater effect on basal metabolic rate from these changes.

This is the most expensive and highest quality study ever done into diet, published in the highly reputable British Medical Journal, and supports the above: https://www.bmj.com/content/363/bmj.k4583

Edit: Took out line about obesity because it was distracting people.