Complete Care Family Medicine                            August 2018    
CCFM 2011
6 Things You Should Do After Your Workout   
I Hope Your Summer Is Going Well!
As I said last month, summertime is usually a very active time we spend more time enjoying our beautiful Southern California weather. This month I wanted to focus on what to do post exercise, here are 6 things you should do after your workout for optimum health and exercise results. 
Static stretching (Think: bend and hold) is best reserved for after your workouts. A comprehensive review published in  The Scandinavian Journal of Medicine and Science in Sports  concluded that pre-exercise static stretching can reduce levels of strength, power and explosive performance during the subsequent workout. When performed immediately after your workouts, however, static stretching can help you cool down, increase muscle relaxation and potentially get tight muscles back to their resting length.
"Many exercises shorten muscles and it is important to stretch them out after the workouts," says Todd J. Sontag, a board-certified physician with Orlando Health Physician Associatesin Florida. "For example, runners typically will have tight hamstrings if they don't consistently stretch after their long runs. The tighter the muscles get, the more likely they are to develop injuries and lose their speed."
Immediately following your workouts, when your muscles are still warm, aim to spend 30 seconds to one minute stretching each muscle group that feels particularly tight.
One study, by , found that free weights are covered in 362 times more bacteria than a toilet and a treadmill in 74 times more bacteria than a water faucet. Once trapped on your skin and in your workout clothes, those germs thrive in hot and sweaty environments.
The best way to nix them is to get those sweaty threads off ASAP and scrub up with an antibacterial wash, says Philip Tierno, PhD, clinical professor of microbiology and pathology at the NYU School of Medicine. While taking a shower right at the gym is your best bet for combating any viruses stuck on your skin and preventing yeast infections, it's a good idea to keep shoes on your feet at all times, according to a position statement from the National Athletic Trainers' Association.
If possible, keep your dirty workout wear separate from other belongings and wash them using your washing machine's sanitize cycle (if it has one), hot water or (if you're working with whites) bleach. The heat setting on your dryer can also help kill any germs that weren't washed away.
Ideally, you shouldn't have lost any more than 2% of your body weight between the beginning and end of your workout. (So, if you weighed 150 pounds at the start, you shouldn't weigh any less than 147 pounds at the end.) Weight losses greater than that point to significant dehydration, Sontag explains. Apart from decreasing your exercise performance and putting you at risk of heat stroke, getting dehydrated during your workouts can significantly exacerbate symptoms of delayed onset muscle soreness, per the  Journal of Athletic Training .
While any drops in weight should be dealt with by guzzling fluids (Sontag recommends drinking at least eight ounces of water following any workout) if you find that you're dehydrated, it's beneficial to hydrate with an electrolyte-containing sports drink or coconut water.
"Skeletal muscle is a highly plastic tissue that can undergo rapid remodeling, particularly during the periods following an intense workout," says Neerav Padliya, PhD, vice president of Research Alliances at Qurr . "In order to push the muscle protein balance in the net positive direction so that muscle growth and recovery can take place, it is important to consume adequate protein, including branched-chain amino acids, after a strenuous workout."
As far as how much protein you need - and how fast you need to eat it - it depends. "Exercise like lifting or running tends to lead to more muscle damage than [low-impact] exercise such as yoga," he says. "Therefore, it may be necessary to consume higher quantities of protein and BCAAs after intense exercises that cause more muscle damage in order to promote optimal muscle repair and recovery." Aim to get anywhere between 20 and 40 grams, skewing toward the high end the greater your exercise intensity or body size.
What's more, research published in the Journal of the International Society of Sports Nutrition suggests that the "anabolic window," the post-workout time period in which the body can most effectively absorb protein and incorporate it into its muscle cells, is much longer than previously believed. Researchers conclude that, as long as you aren't working out on empty (which we don't advise in the first place), you can likely get your post-workout protein a few hours after your workout without sacrificing any muscle-building results.
Following workouts, you may actually need more carbs than protein, with most studies showing that post-workout foods and drinks with a 3:1-to-4:1 ratio of carbs-to-protein are ideal for exercise recovery. That means, for every gram of protein you consume following a workout, you likely need three to four times as many grams of carbs.
Why so many? Research published in the Journal of the International Society of Sports Nutrition demonstrates that insulin, which your pancreas releases when you eat carbs, helps amino acids from protein enter muscle cells for repair and recovery. Opt for whole carbs from natural sources including fruit, whole grains and dairy
I recommend for every hour of exercise drinking 20 oz water mixed with a pinch of quality sea salt like Celtic Sea Salt, add a pinch of potassium powder which can both be bought at the store or pharmacy. 

To your optimal health,
Dr. Marcela Dominguez, M.D. 
Dr. Cheryl Thomas, M.D.
Angela Fernandez, N.P.
Alison Gracom, P.A. 
and the CCFM Team 

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