Ice Age: Rethinking Icing Injuries and Sore Muscles

I remember when I went to the nurse in high school for a medley of ailments, and it seemed like no matter what the symptom was, a pack of ice was the associated prescription. Headache? Put ice on it. Muscle pain? Put ice on it. The building was on fire? Throw ice on it. Okay, the last one was a pretty lame joke, but somehow ice became a panacea in my nurse's eyes. It seems that in the sport and exercise world, such is also the case.

Ice Baths for Recovery

I just started watching Game of Thrones,
and I couldn't resist using this meme...

The most common use of ice that I hear people tout is its recovery healing powers. Are torturous ice baths as effective as we make them out to be?

We have evidence of the early Egyptians using early forms of cryotherapy in 2,500 BCE to treat a medley of ailments. Fast forward to 2018 and you see people immersing themselves into futuristic-looking cryotherapy chambers filled with liquid nitrogen. As you can imagine, extensive research on the subject has been done since ancient Egyptian times.

Now, one study done by Fonda and Sarabon (2013) did find that participants who utilized whole body cryotherapy reported feeling less sore than those with no intervention. While this is more qualitative rather than quantitative evidence, it does show the potential for a decrease in the perception of DOMS with cold immersion.

Hausswirth et. al. tested runners and also found a reduction in pain and subjective fatigue 24 and 48 hours after their runs in participants using cryotherapy chambers. While this is also a qualitative measurement, researchers also found an increase in strength when compared with the control group (2011).

Contrarily, Costello et. al. measured MVC (maximal voluntary contraction of a muscle) 24 hours after an eccentric exercise protocol and found no significant differences in muscle soreness in participants who were immersed in -110° C temperatures and those who weren't immersed (2012). 

Overall, the current body of research does seem to suggest that cold immersion can help reduce subjective measurements of fatigue and soreness in athletic populations, but the verdict is still mixed as far as I'm concerned. Many of the measurable, physiological markers of recovery were unchanged, but the participants simply reported feeling better. My thought process is that a lot of the attributed markers of recovery are due to a placebo effect. Effectively, if you feel like an ice bath helps you feel like you're being active in the recovery process, then keep on as you were. It may not be efficacious, but it's worth a try!

Ice Baths for Treating Injury

Going back to my high school nurse who would use ice as a cure-all, many people still assume that icing is the best protocol for soft tissue injuries. Let me start by saying that ice works as an anti-inflammatory and also a vasoconstrictor (meaning your blood vessels constrict). The downside here, is that we societally regard inflammation as a negative thing, when it is in fact your body's line of defense. Inflammation is necessary to jumpstart the healing process. The more blood flow you get to an area, the quicker the repairing process can start. Gary Reinl, author of the book "Iced" which covers this topic more in-depth, notes "the inflammatory cells remove debris and recruit cytokines and other growth factors toward the injury site." As such, swelling and inflammation are not symptoms to fear or reduce in this case. He goes on to say, "In a healthy healing process, a proliferative phase consisting of a mixture of inflammatory cells and fibroblasts naturally follows the inflammatory phase. The fibroblasts build a new extracellular matrix and persist into the final phase of repair, the maturation phase, where, if all goes well, functional tissue is laid down. The key point is that each phase of repair is necessary for the subsequent phase."

Additionally, the University of Pittsburgh Medical Center (my alma mater) noted that "…ice may not be the best treatment for aching muscles — in fact, it could even be detrimental to recovery" (2011). The British Journal of Medicine reached a similar conclusion, stating that "ice is commonly used after acute muscle strains but there are no clinical studies of its effectiveness" (2012).

Summing it All Up

Icing injuries has become a staple in workout and recovery protocols for people all across the globe for ages. As it turns out, the effectiveness as icing for both decreasing muscle soreness/damage and for aiding in the healing process of an injury seems to be unfounded. The body of research denouncing the usage of ice on both accounts seems to outweigh the papers that support its application.

I personally don't use ice in either instance, and I believe that rest, sleep and proper nutrition can be some of the most effective recovery strategies! Next time you go to jump into the ice bath or wrap an injury in a bag of ice, ask yourself why, and decide whether or not it's actually going to help you or potentially hinder you.

Stress Less to Lift More

You wake-up abruptly to the sound of your alarm clock. You press snooze, and then jolt up about 5 minutes later. Then, you scramble to find clothes to wear, brush your hair, brush your teeth and race out of the house to the car. While you're driving to work, you are constantly checking the time, getting exasperated by every stop light, ever car that's going too slow on the highway, and all of the detours that send you off route. When you finally make it to your job, just on time, you gasp a sigh of relief. Now you can begin to attack your "to-do list," which seems to be never-ending. Overwhelmed, you sit at your desk and take a big sip of coffee and get to work.

Does your day closely mirror the scenario I've described above?

No, I'm not a psychic, and I haven't been watching you on a hidden camera. So many of us, regrettably, spend our days on auto-pilot. Our heart rates rise along with our blood pressure, and we constantly complain that there aren't enough hours in the day.

Impending deadlines, hectic work schedules, familial responsibilities, and other stressors, can make it hard to allow yourself to relax and just let go of all of the craziness for a bit. With a little bit of meditation, however, you'll find that your workouts will improve, you will recover faster, and your daily life might just be a bit more manageable.

To understand recovery and stress, you need a little bit of background about the central nervous system. The chart above illuminates the hierarchy of the nervous system, but for the scope of this article, I'm going to talk about the divisions of the autonomic nervous system: the sympathetic and parasympathetic nervous systems.

The parasympathetic nervous system allows us to "rest and digest." When you are relaxing or meditating, your heart rate decreases. The PNS promotes recovery from stress and healing. At the other end of the spectrum, you have the sympathetic nervous system. The SNS is known for the "fight or flight" state. If you trip on the stairs, you're going to enter the sympathetic nervous system. Your heart rate elevates, your blood pressure increases, and your breath may become shallow and infrequent.

Many of us are quite familiar with the sympathetic nervous system, as we spend our days in frequent bouts of stress and anxiety.

Now what does all of this have to do with exercise? Well, as you know, exercise will do quite a number on your body. Your connective tissues take a beating, and they need time to repair so that you can attack your subsequent workouts. If we stay in the SNS, then, you're just not going recover optimally, if at all. In fact, you may even enter a state of catabolism (breakdown of muscle proteins). There's no sense in busting your butt in the gym if you're ultimately gonna stress away all your hard work, is there?

The diagram on the left talks a bit about Hans Selye's General Adaptation Syndrome. There are three stages: alarm, resistance, and exhaustion. Without adequate rest after repeated bouts of stress, one may reach the exhaustion stage, in which their performance regresses and they experience frequent injury. The body needs adequate rest in order to continue to train hard.

Here's an interesting study on high school swimmers: Jiang and colleagues had the athletes use meditation for recovery from intense training sessions. "Mood states, anxiety, and heart rate measures served as the dependent variables." They found that "meditation training as a mental warm down combined with a physical warm down are more effective to facilitate acute and long-term heart rate recovery, lower mood disturbance scores, decrease cognitive anxiety compared to just taking a rest after vigorous training and during the recovery period." Furthermore, "the experimental group demonstrated significantly lower scores than the control group in fatigue, depression, and anger." The meditating students had a more regulated mood, and they were recovering better from practices!

Another study, with Stults-Kolehmainen et. al. found that "in all analyses, higher stress was associated with worse recovery. Stress, whether assessed as life event stress or perceived stress, moderated the recovery trajectories of muscular function and somatic sensations in a 96-hour period after strenuous resistance exercise."

When considering the stresses felt by our body in exercise, we must also remember all of the other factors at play. If you're regularly working 70+ hour work weeks, or leading a lifestyle of stress, that will undoubtedly affect your workout recovery time. Every stressor accumulates a greater demand for recovery on the central nervous system, and dictates more time to return back to your baseline.

In my experience, meditation is a wonderful practice that can help you wind down after a tough day. Even 10-15 minutes a day will help you maintain your equilibrium and channel your inner Dalai Lama. Different types of meditation work for different people, but I prefer to just lay on my back, taking big, diaphragmatic breaths, and thinking positive thoughts. I let all of the negativity escape my mind, and remind myself not to let trivial things consume me.

Find a way to allow your brain to unwind after a tough day or tough week, and you may find yourself to be more at peace, less injured, and performing at an all time high. Allow your body to recover from all of the demands you have placed on it, so that you can get back to working out in half the amount of time!

As my father always says "don't write checks that your body can't cash!"

Sleep: The Missing Part of A Workout Routine

Training and adequate nutrition are two integral ingredients in the recipe for health and wellness. In our culture that thrives around going at all hours of the day, we can easily forget the most important element of the list: sleep!

It's quite typical, now, to brag about how little sleep we get. "Oh man, I got home from work at 10:00, and then I had to wake up at 5:30 AM to get back to the office!" That is just one of many such comments I've heard from friends of mine. Somehow, sleep, or the lack thereof, is supposed to be a trophy of our busy lives. Sleep is this ever-elusive wonderland that we rarely get to enjoy.

If you're living an active lifestyle, your poor sleep schedule could be depriving you of your hard-earned efforts! Evidence repeatedly suggests that minimal sleep can negatively impact performance, while, on the other hand, ample sleep can act as a natural performance enhancing drug!

If only we could all snooze like this little guy...

Skein et. al. performed a study on young men. The control group was instructed to sleep adequately, while the experimental group did not sleep for 30 hours leading to the sprinting test. They found that "sleep loss and associated reductions in muscle glycogen and perceptual stress reduced sprint performance and slowed pacing strategies during intermittent-sprint exercise for male team-sport athletes."

While that study measured sprinting performance, another study with Reilly et. al. tested the biceps curl, deadlift, leg press, and bench press. No noticeable change occurred in the biceps curl, but the participants saw a huge drop in the bigger compound movements. "...A significant effect was noted on maximal bench press, leg press, and deadlift. Trend analysis indicated decreased performance in submaximal lifts for all the 4 tasks: the deterioration was significant after the second night of sleep loss."

The last three movements have a bigger effect on the central nervous system, because they require bigger muscle groups. Therefore, it makes sense that there was no significant change in the biceps curl, but the other three exercises changed dramatically.

The lack of glycogen is going to have a detrimental impact on performance in multiple different activities. The muscles will not be able to produce the same amount of power as they would with adequate sleep. Similarly, low glycogen can effect cognition and focus, which are essential for all sports. If an athlete cannot focus, then he will not be able to optimally execute what is asked of him. For a sport like pole vaulting, which requires absolute precision, insufficient focus could be dangerous.

Satisfactory sleep, on the other hand, can have some pretty ridiculous benefits. During sleep, the pituitary gland produces Human Growth Hormone (HGH). HGH allows for improvements in body composition and aids in the repair of damaged muscle tissue. If we lose out on a full sleep cycle, then our recovery, and therefore, subsequent performance, will be subpar.

Cheri Mah, M.S., performed a series of studies on athletes at Stanford University.  "Over three seasons, from 2005 to 2008, the scientists looked at 11 Stanford basketball players. For two to four weeks, the Cardinal kept to their normal schedules. Then for five to seven weeks, they watched what they drank, took daytime naps and tried to sleep for 10 hours every night. After increasing their daily rest, the players sprinted faster and said they felt better in practices and games. Their aim got better too: Their three-point shooting jumped 9.2 percentage points, and their free throw percentage increased by nine points." These high level athletes all reaped the benefits of extra z's every night.

It can be hard to find the time to get extra sleep every night, but the benefits of doing so are tremendous. Even if you have a busy schedule, try to set a time to go to sleep each night that will allow for a minimum of 8 hours. You'll notice improvements in your mood, focus, and your performance in the gym!

The Ab Exercise You're Doing Incorrectly

You work these muscles 23,000 times a day, on average, but chances are, you're using them incorrectly. In our sleep-deprived, high stress lifestyles, many of us are breathing incorrectly several thousand times a day, everyday over the course of our lives.

The core musculature like the rectus abdominis, diaphragm, internal and external obliques also allow for efficient breathing. If you're not breathing correctly, the sequencing and integrity of all of these muscles will be compromised. Your hours of "ab circuits" will all be for naught.

In my opinion, emphasis on proper breathing while training (or just normal daily function) is paramount. Here's why:

• Improved intra-abdominal pressure (core stability)
• Prevents facilitation (overuse) of trapezius, scalenes, and sternocleidomastoid muscles
• Teaches proper diaphragmatic activation
• Proper core sequencing for all activities
• Improves ability to return to parasympathetic nervous system (reduce stress)
• Better recovery and reduced risk of injury

Intra Abdominal Pressure

In any big lift like a squat, bench, or deadlift, creating sufficient intra-abdominal pressure is mandatory for safety. To quote Dr. Yuri Verkohansky, "Without breath-holding, far greater pressure  is exerted on vulnerable structures of the lumbar spine, in particular the intervertebral disks and ligaments." Basically, if you're not breathing correctly, you risk herniating a disk or placing additional shear forces on your vertabrae. I see far too many lifters getting under (or over, in a deadlift) a loaded barbell without sufficient abdominal bracing.

Shoulder Stability

If you breathe through the neck and chest, as many people I interact with do, your shoulders are going to remain in a shrugged or elevated position. This means the shoulders are unstable and you will have an increased risk for rotator cuff tears, dislocations, pectoralis major/minor tears, or labral tears. If the muscles normally used to stabilize your shoulder, like the serratus anterior, are forced to help you breathe instead of performing their primary roles, your shoulders are in danger.

Hip Stability

Similarly, the stability of the hips will also be compromised without proper breathing. Muscles like the quadratus lumborum may become overactive if the rectus abdominis or external obliques aren't firing correctly.

Conditioning

If you're training your aerobic energy system, which requires oxygen to function, and you're not getting sufficient oxygen into your lungs, guess what? You're not going to be able to run/bike/swim as hard or quickly as you would otherwise. Shallow, chest breathing is not optimal for oxygen uptake. Rather, deep breaths through the diaphragm are ideal.

Recovery

Chest and neck breathing is the result of the sympathetic,"fight or flight" nervous system taking over, while diaphragmatic breathing brings the body back to the parasympathetic "rest and recover" nervous system. Remaining in the sympathetic nervous system = increased recovery time. If you're trying to train hard and improve performance, you need adequate recovery.

Have I convinced you just how important your breath is to all facets of training and general health yet?

Now, take a moment to monitor your own breaths. Are you breathing through your mouth? Does your chest expand as you inhale? Do your traps constantly feel tight?

The ideal way to breathe is through the nose, with the tongue on the roof of the mouth (which will encourage diaphragmatic expansion) and expand the belly and the ribcage with each breath. Your ribcage should expand 360 degrees with each inhalation. We want lateral expansion of the ribs at the same time as it expands forward and backwards.

Now, I'm going to give you some tips on how to improve your breathing habits. Here are three of my favorite "core" and breathing exercises:

• Crocodile Breathing

• Lay down on your belly with your hands crossed in front of your head
• Take a big breath in through the nose with the tongue on the roof of the mouth
• Focus on expanding the stomach and the lower back as you inhale
• Exhale slowly and completely through the mouth

• Manual Resisted Breathing

• Lay on your back and have a partner sit next to you.
• The partner should place his/her hands on your stomach
• As you inhale through the nose, keep the tongue on the roof of the mouth
• Partner provides gentle resistance to your diaphragm during inhalation
• Hold your breath for 1-2 seconds at the top
• Exhale slowly and completely through the mouth

• Kettlebell Breathing Drill

• Place feet hips distance at a right angle against the wall
• Hold a light dumbbell or kettlebell on the belly (10-15 lbs)
• As you inhale, focus on pressing your stomach up against the weight and expanding the rib cage
• Count to ten as you inhale, pause at the top, and count to ten as you exhale through the mouth

These are three fantastic exercises to bring your body back to the parasympathetic nervous system and find some peace from your chaotic day. If you take these simple steps to improve your breathing, I can guarantee you that the results will be profound. You will improve your mechanics, become more stable and mobile, and, most importantly, inch towards a more stress-free lifestyle.

Just breathe!

Training Hard VS. Training Smart

For some people, finding the motivation to get to the gym can be incredibly difficult. Others, I have found, seem to have the opposite problem. Perhaps you've found that you feel guilty if you don't workout one day. Maybe you constantly feel sore, but you don't want to stunt your progress.

Last week, in one of my classes, one of the members came up to me and said "I'm feeling really out of it today; I'm not sure why!" I looked and her and asked, "What did you do before this?" She responded "Well, I took spin class for an hour and then went for a swim." I had a pretty good idea of why she was feeling tired! She went on, "Well yesterday, I was able to run for two hours and then swim without a problem!

This woman was tough, but maybe to the point of stupidity. She was a former Iron Man competitor, and never gave herself time to recover. She was wearing herself down day after day, thinking she was doing something positive for her body, when her body desperately wanted some rest.

After class, I puller her a side and tried to explain to her the value of rest. I told her that without allowing the Central Nervous System and her muscles the chance to recover, she was doing her body a disservice. Unfortunately, my explanation with her seemed to go over her head.

More isn't always more!

Exercise places stress not only on the muscles,
but also on the Central Nervous system.

Trust me, I've been there. Usually on my rest days, I just want to go to the gym and lift. I've lifted when I should've taken a day away from the gym. Now, I've decided to try listening to my body and taking days off as I need them.

Exercise places a tremendous stress on the body. The muscles need to rebuild themselves and adapt. If we keep wearing them down without allowing them to repair, depriving ourselves of sleep, and then getting up and doing it all over again, over time, your body will send you to a screeching halt.

If you feel constantly sore, exhausted, and your results are plateauing, perhaps you need to have a little more down time!

I know you have goals. Whether you want to compete in your first figure competition or lose 10 pounds for your wedding, you have to be patient. You will see results if you put in the work. If your body needs some rest, though, there's no need to feel guilty for obliging. You're not going to be able to make progress if you're injured! It's one thing to push yourself through a grueling workout, but it's another when
you have to do that day after day. If you still want to be active, go for a hike or try a yoga class. Chill.

Think about it this way: if you've had some time to recover, you can push yourself even harder the next day, because you'll have more energy during your workout!

Train hard and train smart.

My List of Product Recommendations!

My clients and friends often ask me what type of supplements/fitness products I use. Here's my list of product recommendations for you holiday wish list! Please note that, aside from GoMacro, I do not endorse any of these products, so I do not receive anything for writing these reviews. The items on this list are simply products I use myself and have found to be the most effective and helpful.

Supplements:

• RawFusion or PlantFusion are both delicious, dairy free, plant-based brands of protein powder. I've tried countless different protein powder brands. Whey has never been kind to my stomach. I was always left with bloating and cramping afterwards, so I decided to switch to dairy free alternatives. Both of these brands taste absolutely delicious, and have no artificial crap (which seems to be pretty uncommon for protein powder). Although I like all of their flavors, I recommend RawFusion Natural Chocolate and PlantFusion Cookies 'n' Cream. Some plant-based protein powders taste grainy and leaf-like. Both of these brands have an incredible taste and mix easily with water. You can buy 2 pound tubs of these brands on bodybuilding.com for around $26, which is about $0.87 per serving. Not bad!
• GoMacro bars are a clean alternative to many of the bars I've tried in supplement stores. All of the ingredients are organic, plus they're gluten free, dairy free, and refined sugar free. They have higher protein options as well! My favorite flavors are the Protein Pleasure and Protein Purity. You can buy them on Amazon for $38.99 for a box of 15 bars.
• NutriForce Glutamine is an excellent product to help expedite the recovery process. If you're training hard, glutamine should be a staple in your recovery arsenal. I prefer to mix mine right into my protein shake. Cost is about $20 for 10 ounces.
• BSN AminoX is another excellent product to speed up your recovery. The fruit punch flavor is the best, in my opinion. This product contains 6 essential BCAAs (branched chain amino acids) to aid in muscle repair and minimize catabolism. A tub is only $37.84 for 70 servings! Take these both before and after your workouts for maximal results.

Food:

• Daiya Cheese is a yummy alternative for those, like me, whose stomachs do not respond well to lactose. Daiya is also soy free, if you like to avoid soy! The cheese melts and stretches, just as real cheese does, and it comes in a ton of different flavors. You can buy it at most Whole Foods or other similar grocery stores.
• Feel Good Foods chicken dumplings are the bomb! They're gluten free with great ingredients, unlike many other frozen meals. I buy these from Whole Foods!
• I'm obsessed with Cashewtopia ice cream. Ice cream is my weakness, and I don't need to feel guilty about eating this brand, because it's made from organic, clean ingredients. The "cream" is made from cashews, and it's incredibly rich and decadent. If you have a sweet tooth like me, I recommend checking out this awesome dairy-free alternative. I love the vanilla bean and chocolate flavors!

Apparel:

• The Inov8 F-LITE shoes are great for anyone who's looking for a more minimal sneaker. I mentioned these shoes in my previous article on barefoot training. I think these sneakers are a great transition for someone who was wearing really bulky sneakers beforehand, and doesn't want to commit to the ridiculous-looking toe shoes. They're light (as the name dictates), comfortable, and they last a really long time! I'd say they're pretty well-fit for any activity, whether it's running, weight training, or just playing basketball in the park.
• Elite FTS  Heavy Knee sleeves are great for those (like me) who squat often and heavy. I chose these because the price is the best out of any other brand I've found and they're excellent quality. You can buy these on eliteFTS.net for $23 per pair! Most brands cost more than that for one!

Books:

• The Weightlifting Encyclopedia: A Guide to World Class Performance by Arthur Drechsler is a great text for anyone who's looking to get more into the sport of weightlifting! Lots of excellent cues and anecdotes for fixing common problems in the lifts! This book sells for around $56 on Amazon, and it's worth every penny!
• Original Strength by Tim Anderson is a short, but informative read on how to regain the strength you had as a child. He teaches you how to rock, roll, and crawl your way to an injury free lifestyle. I love his videos as well, and I'd recommend checking out OriginalStrength.net for more information from him. This book is one of several he's written, and it only costs $11 on Amazon.
• Which Comes First, Cardio or Weights?: Fitness Myths, Training Truths, and Other Surprising Discoveries from the Science of Exercise by Alex Hutchinson is another easy read that looks to dispel common fitness myths and covers topics such as the effectiveness of compression gear, static stretching, and running sneakers. Also around $11 on Amazon!

Rest and Relaxation: How Often Should You Rest?

A lot of people get so eager to see results in the gym, and they spend 6-7 days a week putting themselves through grueling workouts. While dedication in the gym is important, we must also make sure we give our bodies enough time to recover.

I think it's pretty safe to say that many of you are not professional athletes. Elite athletes are paid to train for their sport--all they are doing is eating, training and sleeping. For everyone else, exercise is just supplementary to improve our quality of life. We have full time jobs and families to support. Most of the population is lucky to get 6-7 hours of sleep every night.

All of these external factors in our lives place stress on our bodies. Typically, we need about 8-9 hours of sleep to fully recover. We spend so much time working hard, but we rarely step back and give our bodies the opportunity to relax. During sleep, our bodies release HGH (human growth hormone) and start to repair our damaged muscle tissue. If we don't get enough sleep, then we simply can't reap the full benefits from our workouts.

Recently, I was working two jobs, training with my coach, and sleeping minimally. My joints were achy all of the time and I was exhausted. As a result, my workouts suffered greatly, and I was on the verge of injury. Once I was able to step back and listen to my body, I was able to start devoting more time and energy to my workouts again.

I'm a big fan of active rest days. Active rest allows us to get our heart rate up without continuing to wreak havoc on our joints. Personally, I love taking long hikes in the reservation near my house. I can maintain an active lifestyle and allow my body to recover in the meantime. Yoga is another great activity that will keep you sweating without any negative consequence. Not only does yoga help you stretch out tight areas, but you will also learn different breathing techniques to reduce stress. You should find an activity that you enjoy (I'm always an advocate of trying new sports) that will not introduce a lot of stress to your body.

Just how many rest days do you need? The answer is going to vary from person to person. Some people only need one rest day a week. I've found recently that 2 is usually more appropriate for me. Some days, I will lower the intensity of my workouts so that my body can recover. I'm an advocate of self-regulation: if your body is exhausted and everything hurts, maybe you should relax a little bit.

Rest is an incredibly important regimen for anyone who exercises regularly. Listen to your body, and your body will thank you.

“In the midst of movement and chaos, keep stillness inside of you.” -Deepak Chopra

6 Ways to Overcome a Plateau and Start Getting Stronger Again

In fitness, as in life, we are always looking to move forward. If you're putting in the hard work in the gym, you should only continue to progress, right? Well, ideally, yes. Many, unfortunately hit a plateau somewhere along the way that may leave them feeling unmotivated or discouraged. If you approach your workouts the right way, however, you will only continue to progress and grow.

Here's a really helpful (not) diagram of a plateau for science.

Here are 6 reasons you aren't progressing in the way you want:

1. Intensity- Are you giving your workout your all, or are you texting in between sets? Each week, you should try to add more weight or increase the number of reps you're performing. If you just continually squat 135 lbs week after week, how do you expect to get stronger? If you're not gasping for air at the end of your sprints, you're not pushing yourself hard enough. The only way we can create adaptation is to give our bodies something to which it can adapt! It's important to make sure you enter your sessions in the gym with 100% effort. (Well...most days, anyway. We all have our "off" days...)
2. Variation- It's nice to have a set split or program and follow that week after week, but if you're only doing the same handful of exercises ad nauseum, it can get pretty dull. Every once in a while, add a few new exercises into your routine and get rid of a few of the older ones. Not only will it keep your workouts interesting, your body will find a completely new way to challenge itself with a new task.
3. Muscle imbalances- A weak or underactive muscle might be preventing you from advancing as you'd like. Let's say you have really strong quads, and you can squat 300 pounds for reps. Just imagine how much more you could squat if you actually learned to use your butt! When our muscles work together in force couples as they're supposed to, beautiful things happen.
4. Program- Maybe it's time to either ask a friend for help programming your workouts (preferably one with lots of experience) or do some research online. Unfortunately, strength doesn't progress linearly, so it's important to make sure you account for that when you write out your program. Play with the number of sets, reps and the amount of weight you're using and find out what works best for you.
5. Planning- My father always tells me "If you fail to plan, you plan to fail!" You need to set real, tangible goals for yourself. For example, one of my goals is to deadlift 300 lbs before the end of the year. As you can see, I gave myself a set number and a date by which I want to achieve it. Your goal might be to lose 10 pounds by June. Whatever those goals may be, make sure you've clearly articulated them to yourself and written them down so you can hold yourself accountable.
6. Recovery- Perhaps you're not giving yourself enough time to recover between workouts. Make sure you're eating enough food to sustain your activity level and drink a lot of water. A lot of people I meet have a tendency to deprive themselves of the food their body so desperately needs to rebuild and repair itself. Remember: food and water are fuel!

When you start to see a flatline in your progress, it's time to step back and reassess your approach.

"Insanity: Doing the same thing over and over again and expecting different results."

-Albert Einstein