Category Archives: Running

15 Myths and Facts for Runners

runningRunners are a very particular type of athlete and will try almost anything to run longer, faster, and remain injury free. Unfortunately, there is a lot anecdotal and pseudoscience being pulled from the internet that leads runners astray. In this article I talk about the biggest myths and facts in running.

  1. Static stretching decreases performance.

MYTH: A study done a few years ago demonstrated static stretching reduced power output and performance. Suddenly, performance experts started saying “Static stretching is the worst thing you can do.” This is not true! These people just misinterpreted the facts.  The data stated that performance decreased when the muscle was stretched for 45 seconds or longer… When a stretch was held for 30 seconds or less – as recommended – there was no performance loss.  A recent study published in the Journal of Strength and Conditioning confirmed this (1). This study found that the threshold of continuous static stretching in which muscular power output decreased was 60 seconds. Static stretching for a short-duration (30 seconds) had a negligible influence on performance.

  1. Static stretching can increase tightness.

stretchFACT:  Muscle is made up of two types of fibers, intrafusal and extrafusal.  Inside the intrafusal fibers is a receptor called the muscle spindle. It’s like a spring-loaded sensory detector. It is a protective mechanism that when over stretched sends a signal to the brain and spinal cord telling the muscle to contract and protect itself, thus making the muscle tighter. Some muscle spindles are overly active causing chronic tightness. So, when you stretch a muscle that already has over active muscle spindle, the tightness can increase. I wrote an article about this phenomena, if you want to read more about that.  I understand this can be confusing, but when you read #3 you will see how all of this comes together.

  1. You should foam roll after running.

Foam Roll TFL

MYTH: Foam rolling or self myofascial release is one of the most effective tools to improve motion and prevent muscle injury. Unfortunately, many runners foam roll after a run. It is just as important, or even more important, to foam roll before a run. As I mentioned in #2, muscle spindles create tightness when stretched. Due to the repetitive nature of running, runners are very susceptible to developing hyper-active muscle spindles. Foam rolling or self myofascial release targets the muscle spindle and inhibits it (hence the term release in myofascial release). Foam rolling overloads the muscle spindle and the nervous system and gets it to relax and turn off. This allows the muscle to be stretched without the muscle spindle becoming overprotective. Every client I see is directed to foam roll first, stretch, then exercise.

  1. Icing or an ice bath after a run helps injury and speeds recovery

MYTH: Inflammation is REQUIRED for the body to bring supplies to worked areas, clean up any debris and help rebuild tissue. When we ice that sore knee, aching Achilles, or painful plantar fascia after a run or workout we are delaying our body’s innate ability to repair that tissue. Yes, icing is not all it is cracked up to be. Even the physician who coined the term RICE (Rest, Ice, Compression and Elevation) has said that icing is wrong. I’ve written many articles about this, but the most recent, explains why RICE is no longer accepted as the cure-all.  If you want to recover, cool down with foam rolling and stretching, and have a few days of light exercise or rest.

  1. Drinking extra liquid will prevent heat illness.

MYTH: In general we overhydrate. Tim Noakes, MD, a long-time researcher of water balance and author of “Waterlogged:  The Serious Problem of Overhydration in Endurance Sports,” says we have been misled to believe that we need to drink to stay ’ahead of thirst’.  Hydration prevents dehydration, but it does NOT prevent heat illness. Dehydration and heat illness have very similar symptoms and often we use the two interchangeably, but they are not the same. If someone is suffering from heat illness, giving them water is not the answer, cooling their body temperature is. Giving excessive water to a person suffering from heat illness can cause a serious or fatal event called exercise-associated hyponatremia encephalopathy (EAHE).   Marathoners and distance runners who drink at every aid station or drink excessively before a run put themselves at risk for this condition. Dr. Noakes states we should aim for ingestion rates that never exceed 27 ounces/hr (2). 20140501More about our hyper-hydration nation can be found in this article.

 

  1. Dehydration kills performance.

MYTH: It’s long been held as fact that losing more than 2 percent of bodyweight to dehydration will hurt performance. But several recent studies, as well as anecdotal evidence from the world’s top runners, suggest it’s possible to lose more than 2 percent with little to no detriment to performance. A study in the British Journal of Sports Medicine found that current hydration guidelines are erroneous and that dehydration does not impair performance (3). In this article the authors found weight loss of up to 3 percent did not slow down athletes (cyclists, in this case) or lower their power output.  Finally, in 2012 a study found that Haile Gebreselassie lost a whopping 9.8 percent of his bodyweight during the 2009 Dubai Marathon—and still won, in 2:05:29 (4).

  1. Energy chews prevent bonk or fatigue.

FACT: But don’t be fooled: Energy chews do work to prevent fatigue during long distance running events, but so do raisins!  A study published a few years ago compared raisins vs. energy gummies. There was no difference in performance between the raisin group and the gummy group. In addition, the raisin group showed a lower insulin spike when compared to the gummy group, a win for the raisin. Plus, the raisin group demonstrated higher free fatty acid content in the blood post activity, demonstrating more fat metabolism. So, for the same performance gains, you can gain additional benefits from raisins over energy gummies.

  1. Bananas prevent cramps

MYTH: While bananas are a great source of nutrition and do contain many electrolyte replacing nutrients, they alone do not prevent cramping. Cramping can be caused by a large number of reasons, including over hydration (see above) or poor conditioning. Tim Noakes, MD, in Lore of Running, 4th Edition, suggests muscle cramps are caused by muscle fatigue and that cramping has more to do with not training properly than nutritional or hydration deficits.

  1. Runners need to strength train.

FACT: Running strengthens your muscles, but it only strengthens certain muscle fibers to a certain degree. A total body strength training is imperative for running performance. Strength and stability of the core and shoulder help translate to lower body power and efficiency. If you need a kick to climb a hill faster or sprint to beat an opponent to the line, strength training is imperative. Proper strength training and targeting specific muscles will also prevent injury. John Martinez, the assistant head doctor for the Ironman World Championships says “You can run five days a week and you’ll finish a marathon, but if you want to PR or qualify for Boston you need to have some kind of strength training in there. It’s about improving our performance.” Always add a strength training component to your training program. Running alone is not enough.

  1. Running is the best way to lose weight.

Graphics like this misguide those seeking weight loss.

MYTH: You’re being duped folks! Long duration cardio training does not make you lose more fat or weight. Running in the “fat burning zone” as depicted on a cardio machine does NOT burn more fat. If you want to lose weight, you need to burn calories. What burns calories? Intensity! Higher intensity requires more oxygen demand and thus a greater oxygen debt.  High intensity training has a caloric after burn that lasts for 12-24 hours. Standard steady state running only has a caloric after burn of 1-4 hours. You can burn more calories in a 20 minute high intensity interval training program than you can running for 60 minutes at a steady pace. If you want to lose weight, get off the treadmill!

  1. Minimalist shoes improve running mechanics and prevent injury.

vibram-shoes1MYTH: Will the minimalist running trend ever end? Minimalist shoes do not prevent injury. In fact, those who jump from a normal shoe to a minimalist shoe without proper training or adaptation are at an increased risk for injury. Five separate studies presented at the annual meeting of the American College of Sports Medicine “found no significant benefits, in terms of economy, from switching to minimalist, barefoot-style footwear.” Minimalist shoes also do not magically improve your running mechanics. There are no quality studies that show running in a minimalist shoe improves mechanics. In order to improve mechanics, you need a quality strengthening and flexibility program that encourages appropriate muscles firing. If you want to go the minimalist route, walk first. Adapt to the new style and supplement with a structured training program.

  1. Getting a shoe that matches your arch height will prevent shin splints.

MYTH: Shin splints are not caused by a high or low arch. Many runners with a high or low arch can avoid shin splints. Similarly, runners with a “perfect” arch can develop shin splints. The cause of shin splints is multifactorial and correcting musculoskeletal dysfunction through a structured program prevents shin splints. The article Shin splints 101 demonstrates how to prevent shin splints. A systematic literature, published in the Journal of Sports Physical Therapy found that selecting running shoes based on arch height had little influence on injury risk. (5)

  1. A midfoot strike is best for performance.

MYTH: If you run slower than a 5-minute mile, it may be most efficient to heel strike. A study published in Medicine and Science in Sports and Exercise found that rear-foot strikers are up to 9.3 percent more economical than midfoot strikers (6). Lead author Ana Ogueta-Alday believes the reason for the improved efficiency stems from the increased ground contact time the study observed in rearfoot strikers. More contact time with the ground allows for more force to be applied, while also decreasing the metabolic cost of running. If you’re a heel striker and haven’t been chronically injured, there’s no need to change your ways.

  1. The more mileage you run per week the better your performance.

MYTH: If you want to improve, you need rest, recovery, and varied training. I challenge you to find an elite marathoner who trains only by running. The elite runners have rest and cross-training built into their weekly programs. See the importance of strength training in item #9 above.  Two of the best known experts on running, Jack Daniels and Hal Higdon, provide run training programs. There programs stress the importance of recovery days and strength training days. In fact, Jack Daniels says that when training for long running events, train for time, not mileage. Getting 20+ miles is not the best for all runners and could cause injury.

  1. Preventing injury is a matter of not doing too much too fast.

FACT: There are many things that can cause injury, but one of the biggest determinants of injury is doing too much too fast. A study in the Journal of Sports Physical Therapy evaluated progression of running distance and its relation to injury. The authors found novice runners who progressed their running distance by more than 30% over a 2-week period seem to be more vulnerable to distance-related injuries than runners who increase their running distance by less than 10% (7). Owing to the exploratory nature of the present study, randomized controlled trials are needed to verify these results, and more experimental studies are needed to validate the assumptions. Still, novice runners may be well advised to progress their weekly distances by less than 30% per week over a 2-week period. So stick with the 10% rule.

If you are a runner and look to increase performance or prevent injury, please feel free to contact me for a free consultation.

References:

  1. Pinto, MD, et al. Differential Effects of 30- Vs. 60-Second Static Muscle Stretching on Vertical Jump Performance. December 2014. 28:12. p 3440–3446.
  2. Noakes, T. Waterlogged: The Serious Problem of Overhydration in Endurance Athletes. Human Kinetics. Champaign, IL. 2012.
  3. Wall, BA, et. al. Current hydration guidelines are erroneous: dehydration does not impair exercise performance in the heat. Br J Sports Med. 2013 Sep 20.
  4. Beis, LY, et. al. Drinking behaviors of elite male runners during marathon competition. Clin J Sport Med. 2012 May;22(3):254-61
  5. Knapik JJ, et, al. Injury-reduction effectiveness of prescribing running shoes on the basis of foot arch height: summary of military investigations. J Orthop Sports Phys Ther. 2014 Oct;44(10):805-12.
  6. Ogueta-Alday, A, et. al. Rearfoot striking runners are more economical that midfoot strikers. Med Sci Sports Exerc. 2014; 46(3):580-5.
  7. Nielsen RØ, et. al. Excessive progression in weekly running distance and risk of running-related injuries: an association which varies according to type of injury. J Orthop Sports Phys Ther.2014 Oct;44(10):739-47.

 

 

Season of Running and Injury

Illinois MarathonIn April, the Boston Marathon kicks off yet another season of running. Whether it is 5k or a Marathon, from April to October running enthusiasts have no trouble finding a running event to participate in. Here in my town of Champaign, some 20,000 participate in one of the Illinois Marathon events. With these races comes training and where there is training, you can find injury close by. Continue reading

The Great Toe

When you think of the most common lower body injuries, you think ankle sprains, shin splints, runner’s knee, jumper’s knee, fasciitis, or Achilles tendinitis. When you have these injuries, you treat the injured area. We might be overlooking a little, but big deal.  Dysfunction in the big toe influences every step you take, every lunge, every jump, and every stride of every run. Ultimately, it can be a direct result in many of the aforementioned common lower body injuries. If you have dysfunction (pain, instability, or hypomobility) at the first big toe joint (MTP joint), it could wreak havoc on the entire kinetic chain.

Normal range of motion of the big toe is 40° flexion, 80-90° extension, and 10-20° abduction and adduction. Lack of motion, especially extension, will create compensatory movement at other joints. Common big toe issues such as, hallux valgus (bunion), hallux rigidus, turf toe, sesamoiditis, and gout will limit toe mobility. Below is an image of a client who demonstrates normal range or motion on the right and limited toe extension on the left.

N ROM   Limited ROM

Continue reading

Low Back Pain in Runners: In a Battle of Muscle Supremacy, Evil Prevails

Introduction:Chronic-back-pain-image

When we think of running injuries we immediately think lower extremity, IT Band syndrome, Patellofemoral Pain Syndrome, Achilles Tendinopathy, Medial Tibial Stress Syndrome, Plantar Fasciitis, and the like.  However, one of the most common and debilitating injuries in runners is low back pain.  So why are runners so at risk of developing low back pain? Most musculoskeletal injuries are multifactorial, but more often than not many chronic injuries result from underlying movement dysfunction.

Vladamir Janda (1928-2002) revolutionized human movement dysfunction and rehabilitation in 1979 when he described three compensatory movement syndromes.  These syndromes were a result of pattern overload (i.e. running) and static posturing. Janda recognized that certain muscles were prone to weakness while others were overactive. He continually investigated these movement syndromes and later learned that the muscle imbalances were systematic, predictable, involved the entire body, and a common cause of injury. Continue reading

A Runner’s Story: From Pain to Performance

Photo_shoot_runningIn 2010, I left clinical rehabilitation and performance training. While I love my current job, I do miss the clinical aspect, which is why I seize opportunities to take on random clients with complex issues.  I’ve never written about my clients, but this case is so common, yet complex, that I thought my readers might be challenged with similar clients/athletes, or might be experiencing similar issues themselves. Here is a runner’s story that went from marathon training, to painful walking and an inability to run. Her experiences with continued failed treatment and the road we have taken to get her back to training and setting personal records. Continue reading

Kids and Distance Running

By now, some, if not most, have read the article of the 6-year-old girl who became the youngest ever to complete a half-Half marathonmarathon. Not only did she become the youngest ever, she finished 5th out of 10 in a group of competitors aged 14 and under – she was the only competitor under 12 years old. Race announcer said “she seemed to be barely even breathing hard at the finish line.” So the question being asked – is this safe and appropriate? The question I ask: is this a real concern or more of an excuse? Continue reading

A Blog Inspired By and Dedicated to Runners

I have been looking for something to blog. No idea surfaced that said, “Yes, that is a great blog idea.” That was until yesterday’s tragic Boston Marathon bombing. Runners are a rare breed. You cannot keep them down. A runner’s passion for sport, resilience to challenge, and unique characteristic to rise above is unparalleled by any other athlete. I am not a runner. In fact I am the antithesis of a runner. I go in to anaphylactic shock just hearing the word aerobic exercise, but have many friends who are passionate runners. I dedicate this blog to my running friends, competitors of the Boston Marathon, the friends and family of those impacted by yesterday’s events, and runners everywhere from the competitive to non-competitive. I will keep it true to my blog site and remain sports medicine focused. I hope you find the information useful.

Running is one of the most popular recreational sports in the US. Race events can be found in almost every town. My town – Champaign, IL – has 2 events in the next 4 weeks. Some estimates say 20% of the population is runners and 10% of these people participate in race events. The benefits of exercise are well documented. Running has shown to build confidence and character, reduce stress and improve mood. However, the due to their very nature – the unwillingness stop – running does bring about an increased incidence of musculoskeletal injury.

You don’t need to be an astrophysicist to know running injury is secondary to cumulative overload. Running injuries are multifactorial; neuromuscular imbalance, poor arthrokinematics and other things such as age, nutritional status and environment are to blame. From a biomechanical point of view frontal plane knee adduction moments play a significant role in lower extremity injury. Q-angle – a measure of knee alignment – can indicate risk for running injury. An increased Q-angle can be a result of many neuromusculoskeletal inefficiencies from poor muscular hip control to limited ankle dorsiflexion and excessive forefoot pronation.

Running brings about many injuries, but the most common are Patellofemoral Syndrome, Iliotibial Band Syndrome, Medial Tibial Stress Syndrome / Tibial Stress Fracture, Achilles Tendinitis, Plantar Fasciitis, and Sacroiliac Joint Pain. What is interesting is that all of these injuries can be caused by biomechanical breakdown and neuromusculoskeletal inefficiency. The good is the dysfunctional patterns are identifiable, preventable and correctable. Below is a sample 15 minute injury prevention program from a blog I wrote in Sept 2012. Yes, 15 minutes is all you need to prevent many running injuries.

Step 1: Decrease neurological drive to hypertonic tissue – 3 minutes

  • Self-Myofascial Release (foam roll) or Manual Trigger Point Therapy
    • Gastrocnemius/Soleus – 60 seconds
    • Adductors – 60 sec
    • TFL/IT-band – 60 sec

Step 2: Lengthen hypertonic muscle or joint tissue – 3 minutes

  • Static stretch or joint mobilization
    • Gastrocnemius/Soleus Stretch – 1 set @ 30 sec
    • Kneeling Hip Flexor Stretch – 1 set @ 30 sec
    • Adductor stretch – 1 set @ 30 sec
    • Posterior joint mobilizations at the ankle – 90 seconds

Step 3: Increase neurological drive to hypotonic tissue – ~ 6 minutes:

  • Exercise: Isolated Strengthening or positional isometrics
    • Resisted Ankle Dorsiflexion – 2 sets x 15 reps (slow) (2 minutes)
    • Resisted Hip Abduction and External Rotation- 2 sets x 15 reps (slow) (2 minutes)
    • Resisted Hip Extension – 2 sets x 15 reps (slow) (2 minutes)

Step 4: Integrated Dynamic Functional Movement – ~ 3 minutes

  • Box step-up with overhead dumbbell press – 2 sets x 15 reps (slow)

Beyond the correction of movement dysfunction there are alternatives to treat running injuries which are effective and gaining popularity. This table highlights a few.

Prolotherapy This has been around since the late 1800’s, but has since become popular. The basis of prolotherapy is that it expedites healing by increasing fibroblastic activity and collagen repair.
Autologous Blood Blood is the medium that carries tissue repairing materials to injury sites. However, sometimes, blood cannot deliver adequate amounts of material to the injured area. Thus, injections directed right at the injury site deliver tissue repairing material.
PRP Like autologous blood, Platelet Rich Plasma (PRP) is injection of a concentrated mix of tissue repairing blood components, specifically platelets, which facilitate tissue repair healing.
Bone Marrow Aspirate Concentrate Despite the negative press and belief that stem cells are only derived from an unborn fetus, stem cells do come from other sources – such as bone marrow. By taking stem cells from bone marrow and injecting in to damaged areas will facilitate tissue repair.
ESWT Extracorporeal Shock Wave Therapy might best be known as lithotripsy. Lithotripsy is a procedure in which sound waves blast and destroy kidney stones. ESWT is the use of sound waves to destroy calcific tendons and ligaments.

I prefer preventing and rehabilitating injury through correcting neuromuscular inefficiencies and dysfunctional movement. The problem with the above treatments is that they are treatments. If an injury is caused by dysfunctional movement patterns and those patterns are not corrected it is likely the above treatments will simply serve as a Band-Aid because the true problem was not fixed.

If the person(s) responsible for the Boston Marathon bombing were looking to put fear in people, they chose the wrong population to target. Runners are the most stubborn and prideful athletes. No means yes, and yes means do more. If you took a graphical representation of marathon registration numbers from last night through the end of this week I would bet you’d find a spike, rather than a decline. Social media is exploding with a rise of the runner. A quote from a friends Facebook page: “If you’re trying to defeat the human spirit, marathoners are the wrong group to target” –unknown. Other movements like, wear a race shirt tomorrow, donations, and wear yellow and blue (Boston Marathon colors) have already begun. So, thank you runners for inspiring this blog post!

Holistic Approach to Improve Running Endurance

Before I begin let me start by saying- I do not think supplements are needed. I believe the body’s physiological response to exercise, disease,
or whatever is best supported through good diet and fitness training. But, this is just me and I am certainly not in the norm. Most people – sedentary, recreational athletes, and elite athletes – consistently look for the quick and easy ergogenic aid designed to improved performance or enhance weight loss.  It’s not just sports performance or weight loss, individuals will seek out herbal supplements to enhance everything from concentration to vitality.  Echinacea is one such supplement.

For years, Echinacea has been used as an immunostimulant. In other words, to prevent colds and decrease the intensity or duration of cold/ flu symptoms. Although many studies have been done to examine these claims, the data is at times shoddy, inconsistent, unreliable, or insignificant. However, I just came across a new study and very interesting study that looked at the effects of Echinacea supplementation on improving our ability to perform endurance exercise.

In the most recent Journal of Strength and Conditioning Research (reference below) the authors study the effects of Echinacea supplementation on running economy. The authors set out to find if Echinacea improved maximal oxygen consumption (VO2Max), erythropoietin (EPO), running economy and red blood cell count.  Why is this important? The Tour de France and the Olympics have just completed and you probably heard about many athletes being tested for elevated EPO levels. Basically, EPO produces red blood cells, red blood cells carry oxygen, oxygen is needed to feed cells. Thus, more oxygen equals improved cardiovascular endurance.

This study is interesting because it shows that following 4 months of 8,000 mg/d supplementation of Echinacea resulted in significant increases in VO2Max, EPO, and running economy.  Now, 8,000 mg / day is a lot of Echinacea, almost double the normal dosage amount. I am not saying that is a bad thing – but it is much more than the typical recommended dosage. To my knowledge there has been no scientific evidence showing that Echinacea is negative side effects. This study did not mention any side effects or subject dropouts secondary to side effects. There have been some reports of nausea and dizziness, but only in individual cases and not nearly enough to make a general consensus.

As I stated in the beginning – I, personally, do not take supplements. But, others love and swear by them. This study shows pretty significant evidence that Echinacea supplementation will improve your cardiovascular endurance. With little known side effects, if I were interested in improving my running economy I would give it a whirl and see what happens, but that is up to you. It may improve your time and heck you can become the next Roger Bannister and break the 3 minute mile. Ok, maybe not.

Article reference:

Whitehead, MT, Martin, TD, Scheett, TP, and Webster, MJ.  Running economy and maximal oxygen consumption after 4 weeks of oral Echinacea supplementation. J Strength Cond Res. 26(7): 1928–1933, 2012.