“I believe that sports and exercise are the true fountain of youth,” says sports medicine specialist Dr. Ben Valdecañas. “It retards aging, and keeps everything in the body balanced.” As one of the leading specialists in regenerative medicine research in the country, he wants to optimize the health and athletic performances for his patients—which includes everyone from pro basketball players to triathlon hobbyists.
After completing his orthopedic residency at Saint Luke’s, Valdecañas flew to San Antonio, Texas to undergo a two-year fellowship training. Later, he returned to the Philippines and worked on becoming one of the most prominent figures in the field of sports medicine in the country. He said he was inspired to enter his field due to the beauty of exercise, and the positive effects that it can have on the average person. “I consider everyone to be an athlete, and everyone deserves to be an athlete,” he opines.
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Currently, Valdecañas has a team of nutritionists and physiotherapists and some of the best technology available to give his patients the best care and advice as possible. This includes laying down individual training programs in an effort to maximize their athletic potential and hinder their deficiencies. These programs include proper nutritional diets, workouts, cross-training exercises, and more.
As a former athlete, Valdecañas understands the importance of physical fitness, and how much it can better one’s lifestyle tremendously. The doctor is also an advocate of proper supplementation, and is, in fact, a member of the Klean Athlete Team. This is a group of athletes, trainors and key opinion leaders that are ambassadors and consultants for the global brand.
We sat down with the good doctor at the Aegle Wellness Center, his massive clinic at City Club Makati to chat about professional athlete health and weekend warrior fitness.
So, tell us a bit how you got into this field, how did you choose athlete fitness?
Well, I have two distinct fields of practice, one is the sports medicine part where I do surgeries and repair, and I have the preventive and the regenerative medicine. Fortunately, both of these are closely intertwined. Since my specialty is sport’s medicine, I not only deal with professional athletes, but also what you call the weekend athletes—these are people who play in the weekends or whenever they can. The toughest challenge of my job is getting them to be conditioned to be able to play without getting injured. Not only do I listen to their complaints, I have to lecture them and educate them on how not to get injured, how to maintain the proper lifestyle to get them to be able to play even until middle age.
You used to be a competitive athlete when you were younger. What did you get into?
I was on the track and field team, and the swimming team. I noticed that my body started deteriorating when I stopped, so I picked up any sport that I could, when I went through medicine, residency, and fellowship.
How do you go about preparing an athlete for minimizing or preventing sport injuries?
Most people get injured because they don’t know how to prepare adequately, or they don’t do it at all. And even if they do, they don’t know the importance. So patient education is vital. I have to get them prepared by making sure they know how to condition their bodies for their particular sport.
Different people have different needs for stretching, or preparing or conditioning, and I usually get them on a program, that’s personalized. That means no two conditioning programs are the same for any particular athlete, even if it’s the same kind of sport. Also, different people have different levels of flexibility, endurance, muscle tone, muscle capacity, so all of these things have to be taken into consideration. Not to mention of course, nutrition and supplementation, which also differs from person to person. One person may absorb supplements readily, another person may not. One person may get fat from this particular diet, another may lose weight, so it has to be personalized.
And with professional athletes?
It's more or less the same, except that you take it one or two notches higher. You become more aggressive. You become stricter. You talk with a coach. You talk with a team, a manager. It’s a team effort. Pardon the pun.
How do you prepare nutrition plans?
Basically, this is why I employ and train my own nutritionists. Each program has to be personalized for the athletes. First, we get the athlete’s body composition. Second, we assess the demands on the athlete’s training and competition status. Third, I go through the athlete’s injury history: what previous injuries has he had in the past, what frequent problems does he encounter while training, or while competing. All these things go into the mix. My physiotherapists and my nutritionists, we all confer over the data, and go through a program based on my nutritionist’s recommendation. For example, a sprinter needs bursts of energy; we have to make sure that he has the energy that he needs, whenever he has to go into these bursts that is demanded of his sport. So, sugar is a picky thing as far as he is concerned. We can’t give him and her more than what he needs, otherwise it becomes an additional load on the athlete’s body. But it cannot be a lot less, or lesser than he or she needs, otherwise you won’t have the energy to fuel the burst activity.
What do you think of diets like keto, etc?
I hate to use the term, “fad diets,” because they are based on scientific research. But the thing is, people have the tendency to stretch these indications. For example, keto diet, it’s a bit extreme, because it was designed particularly for cancer patients. People use it now because you lose weight a lot faster, because you really restrict sugar. You cannot do that to an athlete. Where would he or she get the fuel to power her exertions? Paleo diet will be a good compromise between keto and a regular diet, but again, there’s so many permutations of the paleo diet. We basically start with the macro-nutrient percentages, although we tweak it from the get-go. So for example, back in school, we’re taught that carbohydrates should occupy 50 percent of the person’s plate. We found that with the present degree, or activity level of the athlete, 50 percent of the carbohydrates on the plate, leaves a lot to be converted to fat as storage. Meaning the athlete really doesn’t use this much carbohydrates. He or she needs more protein, not only for conditioning and muscle building, but also for recovery. The longer the athlete tends to recover from the particular competition or exertion, the weaker he becomes in the long run. So, we need to put more protein rather than carbs on his plate.
What is something that a lot of athletes neglect to do to remain in peak condition?
Rest. That's number one. They take rest for granted. It is during sleep that the human body recovers, and repairs itself.
So by rest, you mean sleep?
Sleep talaga. It has to be structured. As much as your training is structured on a day-to-day, hour-to-hour basis, your sleep has to be the same way. We are still animals; we still rely on the setting and the rising of the sun for our physiologic hormones. You’ve heard of growth hormones I’m sure. We need growth hormones when we are developing as children to reach our peak developmental stage. In adults, growth hormones are not to be taken for granted, because they signal our bodies to repair whatever worn-out parts we have. And growth hormone is mostly secreted during the hours of 10pm and 2am.
You should be really be asleep by then?
Yes. It only works when you’re asleep. That’s where melatonin comes in. Melatonin secretion is actually dependent on the setting of the sun. Once sunlight or natural light stops reaching the back of our eyes, which is the retina, our body counts down the production of melatonin. This occurs three to four hours after the sun sets, around 9pm to 10pm. Now once your melatonin secretes, the body sets to stage 4 sleep. Now once you get into that well-rested, uninterrupted sleep, which is actually a continuous cycle of deep sleep and REM sleep, your growth hormones starts secreting from the brain. And in the presence of growth hormone, everything starts repairing itself.
How about those people with graveyard shifts?
That’s where the challenge lies. For example, call center agents who have a 12 hour shift in their body clock. We have to coach them on how to really convert their body cycle. Meaning, when they come home in the morning, their rooms have to be conducive to sleep. It is as dark as night, it as quiet as sleeping time. Even the room temperature has to be cool, as it is at night.
You’re cheating it?
You’re cheating your body, you’re making it believe that it’s nighttime. That’s where melatonin comes in also, we give them their melatonin supplements at when they go to sleep at 8AM. So its converting the body’s rhythm, all together.
You can’t cheat melatonin production, but you can take melatonin supplements.
Yes, that trains the body in assessing when it actually needs melatonin. Soon enough the body gets accustomed to it, shifts its function to that cycle. Melatonin is different from a sleeping pill. Melatonin is a natural hormone that your brain produces when the sun sets. Sleeping pills are drugs or substances that cheat the mind in thinking that it is not active anymore, so it affects specifically on the serotonin, your happy hormone production, by blocking its re-uptake, meaning it prolongs the exposure of the specific neurons to serotonin. If you do this long enough, your brain thinks it doesn’t need serotonin anymore. Instead of being able to sleep, the sleeping pill loses its effect, because the body tolerates and acclimatizes to it. Supplements are not bad or don’t have side effects, provided you take the proper supplement. This means taking only what your body needs. Supplements or vitamins are practically what your cells need on a daily basis, so you’re just supplying what your body needs.
What do you think athletes should do less of? What are they doing too much that could harm them?
That’s a pretty general question. Different athletes have different thresholds on overdoing things, depending on their sports, their body type, and their lifestyle. So, most athletes that I know, they tend to overtrain, most professional athletes, at that. So you have to listen to your body also. This brings us to the question that is frequently asked of me, when do you know when you are injured, and when can you push your body to perform more.
Differentiating the pain?
There’s always pain in training, but it has different levels. Pain, which actually interferes with your usual functions in sports, is a sign that you should stop competing. Pain that you feel, but you could still, for example, run on it is different. When you become sore after a run, but you can still do the motion, you have to adjust to it. How? One, stretch more. Second, apply cold compresses after the exertion. And third, you can take supplements or even medicines that can bring down inflammation while the body is still repairing itself.
In terms of supplement use as you said a while ago, where are the general guidelines, what should you be asking yourself?
As far as the sports committees are concerned, the lines that you shouldn’t cross is taking performance enhancement drugs or substances. That’s why you have the WADA. They have a specific list of substances that you have to test for, and these lists keeps on growing, but fortunately these lists have been allowing certain substances to be taken by the athletes. That being said, I have to make sure being a sports medicine practitioner, that my athletes are free from these substances. This is not only for the testing proper, but because taking these drugs usually interfere with other supplements that they need more, for proper functioning and proper repair. These drugs also affect the body’s development in training.
Off the top of my head, I can recall one athlete who was concerned about not being able to grow muscle mass as fast as he or his coach expected. Then, we discovered that one of the supplements that he was buying from the black market had testosterone in it. It was interfering with what we were giving him, which were supplements for encouraging natural testosterone production. The extraneous testosterone from the black market product suppressed his natural secretion of testosterone.
How does the consultation process go? Can you walk us through it?
Well, you have to have a very good understanding of cellular function because it is the basis of athletic performance. We spend time, sometimes up to two hours, discussing his present lifestyle habits, his training program, his history, health history, and his training history as well. We start with a five page global health questionnaire.
You have a checklist?
Yes. That includes present dietary habits as well, so it helps our nutritionists build a baseline of where to start. From there, we also go into the athlete’s history of injuries, and we extrapolate from the training program why these happen. If we can identify specific training patterns that lead to specific injuries, we dissect that further, and we can see what in the athlete’s body constitution makes him prone to these injuries, given to the training program. So it’s a strict and scientific algorithm that we follow.
From the information we get from the consultation, and on conference with our nutritionists and physiotherapists, we recommend certain tests to confirm actual deficiencies that we suspect. When the blood tests come out, we recommend formulations for supplements, modifications of the training program, and actual modifications of his or her lifestyle habits.
What’s the first few questions you ask?
“How long have you been doing this?” and “Where do you want to go with your athletic career?”
How important is cross training?
Very. Specific sports, specific athletic activities train specific muscles. One of my patients is this triathlete who always has problems with her medial quadriceps. So we recommended her to do plyometrics, to focus on the medial quadriceps muscles. And what sport is closely related to those cutting movements? Soccer, Frisbee, rugby, so we made her participate in those.
What medical advancements, like rehabilitation techniques have been discovered recently that you are employing now?
Medical technology for sports medicine has evolved by leaps and bounds. First, we have started by measuring the oxygen utilization capacity of the athlete, by VO2 max, or the oxygen utilization of the athlete given a particular sport. Now we are able to train athletes by what we call hypobaric training, meaning limiting his oxygen use for the body to evolve into that VO max capacity. Second, although it is a relatively old technology, the hypobaric oxygen chamber has helped athletes recover from specific injuries, now we are able to examine nutrients from the athlete’s blood, urine or saliva. We are able to examine or assess to the closest integer the level of hormones the athlete has, also. These things are actually not measured in the past before, but the understanding has been coupled with these advancements in technology, that we can use both in helping an athlete personalize his training program, his nutrition and supplementation.
Specific injuries in the past few years have been more treatable, for example ACL tears used to be a lot more devastating, what examples are there of injuries that are less threatening?
ACL tears back in the day used to be a career-ending injury. It's not necessarily the case anymore these days. We have techniques in arthroscopic surgery that help us repair or reconstruct the ACL, and techniques and protocols in rehabilitation that help us get the athlete back to his or her sport in a shorter period of time.
Like in about eight months?
About wo or three decades ago, a soccer player can’t be allowed to go back to his or her sport earlier than a year. Basketball player, nine months. Now, we can get ACL reconstructed patients running on a treadmill within four weeks. And doing sports specific drills and exercises after the fourth week.
The techniques have evolved, the comfort of doing it has minimized down-time to none at all. My particular scenario for my athlete patients, they get their ACLs reconstructed Friday evening after they finish work. By Monday, they’re back to work doing specific exercises...
Yes. So, it’s an outpatient procedure, and we do it for almost anyone with an ACL tear. Two or three decades ago, we would not recommend ACL reconstruction surgery for a non-elite athlete, or non-professional athlete. But 20 years down the line, we discovered that these athletes, these weekend athletes who did not reconstruct when they had their ACL torn, have earlier bouts of arthritis. So now, we recommend reconstructing ACLs.
There's been a rash of ACL injuries in the past five years, are athletes pushing themselves too much, or is it a wrong technique? Do you think ACL injuries are more common these days?
Well, it is not more common. If it is, it’s because a lot more people are indulging in sports now. That being said, a lot of those people indulging in sports now are a lot more trained, and a lot more prepared, hence they are predisposed to injuring their ACLs more. So an apparent increase in ACL tears might actually be an increase in volume, because of the indulgence of ill prepared people. So that’s where we come in, we have to educate even the coaches and the trainers. You can not take these preparatory trainings for granted. They have to have the proper strength for these sports.
What are the benefits of understanding sports injuries even if you're not into sports?
Even if you are not in the athletic field, one time or another, you might find yourself playing a sport. You might eventually decide to adopt a sport as a regular form of exercise, which is what we recommend, because exercise really cannot be overlooked. Everyone has to have a form of exercise. Knowing what to do and what not to do when preventing sports injuries is a handy knowledge or information to have, even if you are not doing any exercise right now.
The Aegle Wellness Center is on the 6/F of The City Club Alphaland Makati. For more information, visit AegleWellnessCenter.com.
Photographs by Jack Alindahao