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Jackie Shelton

Terrified of lice? THESE are far scarier

Recently on social media, there’s been an uptick in the uproar about Washoe County School District’s policy on head lice. WCSD, like many other school districts, is following the guidelines of the American Academy of Pediatrics and the National Association of School Nurses who recommend that children who have head lice be allowed to attend school. There are a number of well-thought out, evidence-based reasons for this policy.

Reading through everyone’s comments criticizing the school district, it struck me as odd that some of these same parents weren’t as worried about their child contracting diseases that are certainly more contagious and definitely more life threatening.

Click here to read my thoughts on vaccine-preventable diseases and why we should be much more focused on them.

Sports & Fitness Center New Location and New Team Members

We’re excited to announce that Silver Sage Sports & Fitness Lab has moved to downtown Reno at 400 Mill Street. All Silver Sage Sports & Fitness Lab performance and fitness testing, bike fit and gait analysis services are available at our new location. (Silver Sage Family Medicine services are still offered at 10467 Double R. Blvd.)

Our new building is actually a very cool old one that’s been fully renovated, part of Reno’s downtown renaissance. We share space with Fizio, a new fitness center and athlete lounge. This partnership has proved mutually beneficial, as we serve similar communities.

Silver Sage Sports & Fitness Lab services include:

  • Lactate Threshold Testing
  • Metabolic Efficiency Testing
  • VO2 Max testing
  • Functional Threshold Power Testing
  • Resting Metabolic Rate Testing
  • Dynamic Gait Analysis
  • Dynamic Bike Fit
  • Coaching and Training

MichelleFaurotOur Sports and Fitness Lab team has changed as well. Our new Lab Director and Head Coach is Michelle Faurot. Michelle holds coaching certifications from USA Triathlon and U.S. Masters Swimming. She is a record holder in the Race Across America, repeat Team USA member for age group triathlon, multiple podium winner at USA Cycling masters nationals, and a top ten swimmer at U.S. Masters nationals. Julie Young is now focused on her new venture in the Sacramento area. We wish her the best and thank her for helping grow the Sports and Fitness Lab.

Our new Bike Fit technician Jonnie Diederich hails from Madison, WI and is an avid cyclocross racer. He has studied with and worked for some of the top bike fitters in the U.S. Jonnie holds bicycle fitting certifications from Serotta International Cycling Institute (SICI), Specialized Body Geometry, and Trek Fit Services. He is also proficient at analyzing movement imbalance, and holds both a Functional Movement Screen (FMS) certification and a Selective Functional Movement Assessment (SFMA – Level 2) certification.

Gait analysis is provided by Fizio co-owner Lauren Evans, an ACE Personal Trainer, USA Track & Field Level 2 coach, and a USA Cycling Level 3 coach.

Whether you’re a cyclist, runner, triathlete, or simply interested in optimizing your health, we have services that can help you maximize your personal performance and wellness.

To celebrate our new location, we’re offering all returning clients a 20% discount on all services, if booked by the end of the year.

If you’d like to schedule a test, call (775.204.1038) or email us today. We can’t wait to see you in our new location!

Celebrating 10 Years of Support for 1% For the Planet

Silver Sage  is celebrating 10 years of membership with 1% For the Planet, and has donated more than $116,000 to area environmental groups since January 2007 through this partnership.

By participating in the 1% For The Planet program, member businesses commit to donate one percent of their sales directly to the sustainability-oriented nonprofit(s) of their choosing, after 1% For The Planet has carefully vetted each nonprofit for track record, credibility and impact. For more information, visit

“More than ever, it’s important that we do what we can to protect the environment,” said Dr. Andrew Pasternak from Silver Sage Center for Family Medicine. “Donating to local environmental charities helps us make sure our patients can experience Mother Nature, which in turn helps their own health. It’s essential that we promote conservation in the Reno/Tahoe area.”

Organizations that have benefited from Silver Sage’s partnership include: Headwaters Science Institute, Truckee River Watershed Council, League to Save Lake Tahoe, Truckee Donner Land Trust, Lahontan Audubon Society, Tahoe Institute for Natural Sciences, Animal Ark, Center for Biologic Diversity, TAMBA, Peregrine Fund, Friends of Nevada Wilderness, Great Basin Bird Observatory, Reno Bike Project, Poedunk, and Truckee Trails Foundation.

About Silver Sage Center
Silver Sage Center is committed to providing high quality health care for the entire family. They treat the entire spectrum of medical conditions, ranging from simple ear and sinus infections to more complex problems like heart disease and cancer. For more information, visit

Performance Metabolic Efficiency Assessment

What is it and what can it do for you?

by Paige Galeoto

Like many of you, I’ve been riding and competing for many years (sometimes at a national level, often with friends on the local single track). And like many of you I have been winging it, using my experience and knowledge to try and go faster and tire slower. Whether you are a cyclist like me, a runner or other endurance athlete, you’ll likely agree that the older we get, the more important it becomes to train “smarter,” not just harder or longer.

While I acknowledge (begrudgingly) that I have gotten slower as I’ve aged, I have not lost my desire to compete and be challenged. So, how do I keep moving my own personal bar forward? Science! In the form of physiologic testing at Silver Sage Sports and Fitness Labs.

To get this science-informed training going, I scheduled a metabolic efficiency assessment with Julie Young at Silver Sage one Friday afternoon this past February.

What is Metabolic Efficiency?

Our bodies rely on two sources of energy to perform:

  1. Carbohydrates
  2. Fat

We’ve all heard of carbo-loading before races or big events. The reason we load up on this fuel source is carbohydrates are most quickly converted into energy. However, the body can only store about 2,000 calories of carbohydrates (in the form of glycogen) so you and I will run out of carb energy after 2-3 hours of moderate exercise. In contrast, fats are more slowly converted into energy and the body has tons of fat to draw on (nothing personal, we all have tens of thousands of calories to draw on, no matter our size).

A metabolic efficiency assessment (ME) tells us how well our body utilizes fat as an energy source. Armed with this info, you can improve your efficiency through exercise and nutrition.

The test is particularly valuable for true endurance athletes whose target events are 4 to 6 hours or more, but even for those whose events are shorter (my target events range from 45 minutes to four hours) this information can help us maintain energy and performance levels throughout any event without trying eat constantly. I wanted help tackling these challenges:

  • Cramping at about the 2 ½ hour mark of a race or hard effort
  • Fading near the end of a race (of any length) after a strong start

The test

Unlike a VO2 max test, the ME test is not an all-out, tongue-to-your-knees effort. The test at Silver Sage was done on their trainer, using my bike. You get to wear some fancy head gear with a tube connected to your mouth and your nose plugged (testing your respiration gasses), and a heart rate monitor strap. It’s a bit awkward, but the effort is a low cadence endurance effort so no labored breathing.

You pedal easy, increasing 10 to 25 watts every five minutes. And every five minutes, Julie pricks your ear to take a blood sample and get your lactate level. (It doesn’t hurt, promise.) The whole thing takes about an hour.

Upon completion, this is what you’ll learn:

  1. Caloric expenditure at various heart rates and intensities
  2. How to preserve carb stores to decrease the required fuel replenishment
  3. How to increase fat as fuel, so you can perform workloads faster and longer
  4. Lactate levels for your various metabolic zones

What to do with your data:

A few days later, Julie sent me my results. The executive summary: I do not burn fat — at all. It’s all very math-ey, but the point where I am burning equal parts carbs and fat — which you’d hope would be well into your endurance zone, is 75 watts or 130 heart rate. For me that’s barely moving. In contrast, Sian Turner, a pro-level cyclist and triathlete who is quite efficient in her metabolism, burns equal parts carbs and fat up to 180 watts. And she improved that number from 110 watts, over the course of a year, the same way I will attempt to improve mine:

  1. Exercise more at lower intensities, especially early in a training cycle
  2. Support stable blood sugars by eating more lean proteins, healthy fats, fruits, and vegetables instead of high carbohydrate food


Nutrition as asset

I took this test because I am committed to making an improvement in my cycling performance. For me, the results have led to a pretty significant change in my diet. While I’ve always eaten what I considered good, healthy food, I was very carb heavy and I was consuming more processed carbs than I realized. I spent 6 weeks limiting my carb intake to 25 percent of calories and am now allowing myself about 35 percent (I followed the Always Hungry plan at the recommendation of another endurance athlete). I also started training with Julie, who has me spending more time in low and medium endurance zones than I have ever trained in before in my 25 years of cycling.

I am still relatively early in my process. Seven weeks after adjusting my diet and five weeks after starting my new training program, I had a “test” – a rolling metric century with a group of hard-charging friends. Fueled with almost all fat and protein, I rode four hours and climbed 3,500 feet without bonking or cramping. However, at the final rest stop I ate some potatoes which provided a nice energy surge for the final miles.

This reinforces another point both Julie and Sian made to me — phase your nutrition with your training. While I am doing some experimenting with my diet right now, I am erring on the extreme side and finding the break points. Our daily nutrition needs can and should change with our workouts. On a rest week I can really lower carbs, but for my upcoming race I will fuel the night before and day of with carbs and also use carbs in recovery. An all or nothing approach is not ideal.

Take away

Do less guessing. Let science aid your training efforts by telling you where your deficiencies are and how you can train smarter, not harder. As athletes, we are extremely lucky to have Silver Sage’s Olympic-training center caliber testing facilities available and a testing staff that knows how to help you translate that data into performance gold.

See you at the start line.

Sometimes, it’s more than just listening to your body

Photography by Daphne Houghard

Sian Turner Crespo grew up immersed in sports, from figure skating and field hockey to golf, tennis and cricket.

As a young adult, she discovered competitive cycling and jumped into XTERRA races, qualifying for both the U.S. and World Championships in her first season in 2011. She quickly progressed in the XTERRA ranks, and in 2014 (and 2015) achieved 20161001_CycloX-38national championship titles and 4th places at Worlds.

You could say she knows a thing or two about how her body works and what she has to do to stay competitive.

And one of the things she does is train with Julie Young of Silver Sage Sports & Fitness Lab. “It’s definitely about having someone to be accountable to and to be able to give feedback and bounce ideas off of,” she says. “But Julie also brings the experience and expertise of being a world-class athlete herself. She plans my training workout-by-workout, but also looks at the big picture with an annual plan.”

Crespo has been training with Young for the past four years, pretty much year-round. “We might take a month off every now and then for a mental break, but then we’re back at it,” she says.

Crespo started as an endurance cyclist, but she recently switched to cyclocross, a very short, yet intense cycling discipline. “It’s a totally different deal and my training had to be adjusted accordingly,” she says. “I realized I didn’t have the top-end strength I needed to be competitive so my training plan changed with a specific focus on that kind of racing.”

“Sian is committed — to her sport, her training and herself,” Young shares. “And that was evidenced in her continual improvement in her new sport, resulting in a win of her last race of the year.”

In addition to her regular training, Crespo goes through testing once or twice a year so that Young can measure her lactate levels, bike power and other elements. Then Young tweaks the plan to accommodate any changes the testing reveals.

“Julie knows me and what I’m capable of. She combines that with the science and data she has accumulated to put together a training plan specifically for me,” Crespo says.

Now in her off-season, Crespo is focused on strength-building. “I’m getting in the gym and getting stronger,” she says. “This way my body will be ready to train at a higher intensity when the season starts.”

Young also listens to Crespo’s goals. “She knows what I want to achieve and then helps me get there,” Crespo says. “And she has so much experience herself that she can pass on the tactical aspects of being in the race.”

“Everybody is different and so everybody needs a plan specific to their own abilities and goals,” Young shares. “We look at their current lifestyle, work and family demands and their goals to create a plan that will get them there.”

Young says that communication is key to the training process. “It’s essential that I understand what they’re going through, where they’re struggling and where they’re excelling. I also need to know what in their personal life might be holding them back. This allows me to provide proper motivation that works.”

Crespo echoes that: “She can tell where I’m at and if I’m telling the truth about my workouts. She picks up on signs and will let me know when I need to push harder or back off and rest.”

Young stresses that fitness and improved performance should be a lifestyle not something to tick off a bucket list. “Training is a process that takes consistent commitment and patience,” she shares. “You have to love it for what it does for you on a daily basis which, ultimately, leads to a healthier overall life.”

For more information on Silver Sage’s endurance coaching and training plans, click here. And then contact us at 530-448-0498 for a free coaching consultation.

Maximize Your Off-Season

Fall in to Fitness Special

Maximize your off-season and cash in on this off-season special 16-week comprehensive, training program, including:

  • Daily individualized training program, tailored to each individual’s current fitness, future goals and life schedule, posted on Training Peaks, a web-based coaching platform
  • Endurance focused mobility-stability and strength program
  • Sport-specific strength and endurance base building
  • A metabolic efficiency test utilizing cutting edge technology to determine your individual, well-defined, optimal fat burning zone
  • Nutritional guidance to optimally couple nutritional choices with endurance base training to improve metabolic efficiency

Package Price: $875

Regular Price: $1,200

To redeem this special fall offer, training must be initiated by October 31, 2016.


Does off-season mean we hibernate and curl up in a comatose state on the couch with a bag of chips? Maybe not. Off-season provides an invaluable opportunity to give yourself a mental and physical hall pass from single sport focus structure. It is the time to step back and enjoy the opportunity of mental and physical variety. I like to think of it as, waking up and doing what sounds fun vs feeling obligated to a structured run or ride.

Take a Fall Hike

But in my experience as an athlete and coach, I have realized that off-season provides a valuable opportunity to improve endurance-related metabolism and movement. It is the time of year to prioritize improving the body’s ability to efficiently tap in to existing energy stores (ie fats). It is also the ideal time of year to capitalize on improving our functional movement and strength, so with this foundation in place we ride and run with more unthinking fluid, efficiency and power.

Metabolic Efficiency Testing to capture the individual’s optimal fat burning zone

Off season is the optimal time to couple endurance base training with a more carb restrictive diet to extend our body’s ability to more efficiently metabolize existing fat stores, and train this metabolic efficiency at higher intensities. Replacing calories expended during endurance pursuits with calories in, is not a realistic, but we can train our body to better utilize its infinite existing energy stores (fat). This is applicable for every endurance athlete, of every distance and discipline.

Movement Prep to activate the nervous system

We can also capitalize on the off-season to improve our ability to better control and coordinate our movements as well as boost functional strength. This change of mental focus from single sport specific structure to a more activation-mobility-stability and strength focus, provides invaluable mental and physical variety. But it’s not variety for the sake of variety. In my experience this off-season focus and investment is the secret weapon to in-season performance.

Activation exercises held statically at the end of range

The first-step in developing improved movement and functional strength is improving the brain to muscle communication. This is achieved with a series of research derived and lab tested activation exercises. I need to be able to feel the muscles, before I can strengthen and recruit the muscles in a movement. These exercises are focused on kicking the under-utilized glute muscles, in to action. If I can get the most powerful muscles in the body generating power – that will result in a significant performance gain. Improving glute-recruitment is also a key to injury prevention, as properly firing glutes (and a functionally stable trunk) dictate the hip-knee-toe alignment.

Stretching consistently included in stability-strength circuits

During off-season we can prioritize improving global mobility (not fixating on the single troublesome body part, ie tight hamstring) to move our body as a harmonious unit. Mobility provides appropriate sensory feedback, and biomechanical alignment. For example, most of us due to sedentary lifestyles sitting in cars and at computers are in a constant state of flexion, resulting in tight adductors and internal rotators, which internally rotate the leg, contributing to mal-aligned hip, knee and toe. Counter this constant flexion with a global, consistent mobility practice.

Learn to move well

Improved mobility for improved alignment is just one piece, we also need to ensure proper recruitment and strength from the stabilizers. By investing time in the off-season with an effective stability-focused program, you will develop muscles that create the foundational, stable platform for the prime movers to direct the force and power in the intended direction.

So what’s the point? We have the tools to help you capitalize and maximize your off-season. It is attention to these off-season details that will set your functional foundation in place, and you will reap in-season rewards of injury prevention and improved performance.

Prepare for Donner Lake Triathlon

Silver Sage Sports and Fitness Lab is presenting two clinics to help attendees prepare for the 35th Donner Lake Triathlon, held in Truckee, Calif., July 23-24, 2016.  The event features an epic setting, a beautiful and challenging course and is located very near Truckee and North Lake Tahoe. 2016 also marks the 6th annual Donner Lake Kids Triathlon and the 4rd annual Donner Lake Half Triathlon.

The first clinic will be held at the South Valleys Regional Sports Complex (15650 Wedge Parkway) on May 2, from 5:30-7:00 p.m. It will be a discussion outlining the details and demands of the race and how to properly train for the event. Julie Young, head coach and director of Silver Sage Sports and Fitness Lab and pro XTERRA/mountain biker Suzie Snyder (a Silver Sage-sponsored athlete), will discuss the importance of proper bike fit, performance strategies, common mistakes that athletes make and injury prevention techniques to make sure participants arrive at the triathlon in the peak condition. Attendees are asked to bring yoga mats and mini-bands with them to the first clinic.

The second clinic will be held June 20, from 5:30-7:00 p.m., with the location dependent on weather. The clinic will be an active session leading participants through a mock race day beginning with transition set-up, warming up and finally executing the race. Participants should bring the appropriate equipment and be prepared to swim, bike and run very short segments of each discipline.

A suggested donation of $15 is highly encouraged. It will benefit Bike Like A Girl, a local non-profit group empowering adolescent girls through cycling.


Prepare for Tahoe Rim Trail Endurance Runs

Silver Sage Sports and Fitness Lab is presenting two clinics to help attendees prepare for the Tahoe Rim Trail Endurance Runs, taking place July 16, 2016. The 55K, 50M and 100M races will will be run on single-track trails and dirt roads within Spooner State Park and on the Tahoe Rim Trail located within the state park and on National Forest land all at or above 8,000 feet of elevation.

The first Silver Sage clinic will be held at the South Valleys Regional Sports Complex (15650 Wedge Parkway) on May 9, 2016 from 5:30-7:00 p.m. Clinic attendees will hear from Julie Young, head coach and director of Silver Sage Sports and Fitness Lab and pro XTERRA/mountain biker Suzie Snyder (a Silver Sage-sponsored athlete), who will focus on training principles and injury prevention exercises to teach runners how to prepare for an ultra-distance race in the 10 weeks before the event. Overuse injuries are extremely common among runners so participants should come prepared to move and practice specific exercises and running mechanics drills in order to strengthen their bodies and avoid injuries before it is too late. Attendees are asked to bring their yoga mats and mini-bands with them to the first clinic.

The second clinic will be held June 6, with the location dependent on weather. Participants will learn how to effectively taper their training in the final five weeks before the event and discuss race strategy and logistical concerns for event day. Attendees should come prepared to run.

A suggested donation of $15 is highly encouraged. It will benefit Bike Like A Girl, a local non-profit group empowering adolescent girls through cycling. 


Prepare for XTERRA Tahoe City

Silver Sage Sports and Fitness Lab is presenting two clinics to help attendees prepare for the XTERRA Tahoe City races, which celebrate the natural environment of Lake Tahoe’s excellent terrain, trails and blue water. Both the XTERRA Tahoe City and the XTERRA Lake Tahoe are qualifying races for the XTERRA USA Championship.

The first Silver Sage clinic will be held at the South Valleys Regional Sports Complex (15650 Wedge Parkway) on April 18, 2016 from 5:30-7:00 p.m. Clinic attendees will hear from Julie Young, head coach and director of Silver Sage Sports and Fitness Lab and pro XTERRA/mountain biker Suzie Snyder (a Silver Sage-sponsored athlete) as they outline the details and demands of the race and how to properly train for it over the nine weeks leading up to the event. They will discuss performance strategies and key workouts, while also demonstrating injury prevention and specific strength exercises to build explosive power to help prepare for race day. Attendees are asked to bring yoga mats and mini-bands to the first clinic.

The second Silver Sage clinic will be held Monday May 23, with the location dependent on weather. The clinic will provide participants with a tour of the bike and/or run courses to prepare for event day. Young and Snyder will address technical aspects or obstacles on the bike course and answer questions about proper techniques and strategies. This clinic will involve running and mountain bike riding, and attendees are asked to come prepared to run and ride.

A suggested donation of $15 is highly encouraged. It will benefit Bike Like A Girl, a local non-profit group empowering adolescent girls through cycling.



Prepare for Carson City Off-Road

Silver Sage Sports and Fitness Lab is presenting two clinics to help cyclists prepare for the Carson City Off-Road, presented by Epic Rides. Joining April’s Whiskey Off-Road in Prescott, Ariz., and May’s Grand Junction Off-Road in Grand Junction, Colo., the Carson City Off-Road is scheduled for June 17-19. The race will feature three graduated distance course offerings, from professional to amateur, including the recently opened Ash to Kings Trail along west Carson City, and will offer a Pro Purse of $100,000 across all three events — the most significant cross-country mountain bike purse worldwide.

The first Silver Sage clinic will be held at the South Valleys Regional Sports Complex (15650 Wedge Parkway) on April 11, 2016 from 5:30 – 7:00 p.m. Attendees will hear from Julie Young, head coach and director of Silver Sage Sports and Fitness Lab and pro XTERRA/mountain biker Suzie Snyder (a Silver Sage-sponsored athlete), who will discuss: the importance of  proper bike fit; how pelvic and spinal posture directly affect injury prevention and performance; efficient pedaling technique; off bike exercises to prevent injuries and improve performance; and key workouts to help riders prepare in the nine weeks leading up to the event. Attendees are asked to bring yoga mats and mini-bands to the first clinic.

The second Silver Sage clinic will be held May 16, 2016, from 5:30 to 7:00 p.m. with the location dependent on weather. The clinic will help riders prepare for race day by discussing and possibly riding parts of the course, depending on weather and trail conditions. If the trail is in good condition, riders will be led on a course preview with discussion of technical considerations and riding technique demonstrations. In case of poor trail conditions, a road ride may be substituted and attendees will learn a key training workout that can be implemented for the remaining four weeks prior to event day. This clinic will take place on mountain bikes and attendees should come ready to ride.

A suggested donation of $15 is highly encouraged. It will benefit Bike Like A Girl, a local non-profit group empowering adolescent girls through cycling.