In Motion

I'm back

2011-05-15T18:09:00.004-04:00

Hello again. Is anybody out there?

With high school cross country summer training just a couple of rest weeks away I thought I would share a link I came across in Running Times magazine. It is a video link for a progressive general strength and mobility for runners. GSM Running Times by Jay Johnson

Myth Busting Links

2010-08-02T08:16:00.004-04:00

Here is a link to a couple of good posts: myth busting on latic acid and stretching.

Hamstring strain recovery

2010-03-21T12:39:00.008-04:00

Here is my post on recovery after a hamstring injury. Check out my previous post on hamstring strains for structure, function, signs, symptoms and risk factors.

Recovery:

When a hamstring injury is suspected it is advised to seek early medical attention from a sport medicine physician and physical therapist. They will be able to identify the severity of the injury and prescribe a very careful rehabilitation program. They will also be better is assisting you with return to sport thus minimizing the chance for re-injury. I see many patients that have made a minor injury significantly worse by trying to run too soon after the initial injury. They often feel the need to “test it” with a short run even though they don’t have a pain-free and unrestricted normal walking stride.

In the early stages of recovery stretching is avoided, as this actually slows the healing process by prohibiting muscle regeneration. I use the analogy of pulling the edges of an open wound apart. We don’t do that as it slow the healing process. When many “ old school” family practitioners diagnosis a hamstring injury, they often tell the patient to rest, heat and stretch. The research shows this is definitely the wrong approach and will likely lead to re-injury.

Restricted mobility of the hamstring is addressed by moving in the pain-free range of motion. Ice will help if it is done 2-3 times per day. The duration of ice depends on how the ice is delivered./ 5-8 minutes with an ice cup and up to 10 –20 minutes with a cold pack. Early stage exercises are done in a pain-free range of motion without direct resistance to the injured hamstring (no hamstring curl machines).

When pain-free and normal walking stride is achieved more functional strengthening is added. Aggressive stretching to end range should still be avoided. Core work and gluteal strengthening are emphasized. Hamstring curl machines are avoided as this is not strengthening the hamstring in a functional manner. Exercises that work the hamstring eccentrically (contracting but lengthening) are recommended. Speed of movement is gradually introduced and is one of the last things to improve. Return to running programs begin with downhill walks and uphill jogs progressing to continuous jogging to running over several weeks.

Hopefully this is helpful. Remember to seek help early, ice, avoid stretching an injured hamstring, avoid hamstring curl machines and don’t try to return to running too early!

Hamstring strains

2010-03-21T12:24:00.009-04:00

Hamstrings strains are a very common running injury. These can be serious injuries, slow to heal. Nearly one third of these injuries return in the first year. The high chance for re-injury may be the result of the failure to identify several factors such as the underlying muscle imbalances, weakness, mobility and faulty movement patterns.

Structure:

The hamstring consists of the semimembranosus, semitendinosus, and the biceps femoris muscles. The long head of the biceps femoris is the most often injured.
These muscles originate at the back side of the pelvis off of the ischial tuberosity. The ischial tuberosity is the part of the pelvis that we sit on. The semimembranosus, semitendinosus insert on the inside of the lower leg and the biceps femoris inserts on the outside of the lower leg.

Function and mechanisms of injury:

When most of us think of the hamstring function we think hamstring curl or bending the knee to bring the foot toward the buttocks (knee flexion) and bringing the thigh backwards (hip extension). However, with movement (walking and running) the hamstring primary function is not knee flexion. Think of the hamstring in terms as reigns of a horse. With movement, the primary function of the hamstring is to decelerate the lower leg as it swings forward. The hamstring is contracting but lengthening(eccentric contraction). This is when most hamstring injuries occur with running. In other words, the hamstring is not strong enough to handle the velocity of the lower leg before the next heel strike.

Other severe injuries, such as partial or full ruptures, may occur with sudden hip flexion with the knee extended. This commonly happens with water skiing when the skier falls forward over the skis. Dancers, yoga enthusiasts and gymnasts also often rupture the hamstring with an extreme stretch.

Signs and symptoms:

When a hamstring is injured a "grabbing" sensation is felt, followed by pain, which may limit activity. A normal stride may not be possible. When the injury is near the ischial tuberosity (sit bone)it usually indicates a severe injury which is very slow to heal. With sitting the injured hamstring will tighten up and often body weight is shifted off the injured side. If excessive ecchymosis (bruising), severe tenderness to touch and significant loss of range of motion are present, the hamstring may be fully or partially ruptured. However, even in the absence of these signs, hamstring strains are very difficult to heal and shouldn’t be taken lightly. Even after rest, normal everyday activities such as kneeling, squatting and walking may be limited and may easily re-strain the hamstring.

Risk factors:

Age and prior history of hamstring injuries
Hamstring eccentric weakness with fatigue
Muscle imbalance
(very strong quadriceps to weak eccentric hamstring and glutes)
Lack of mobility
Hip flexor tightness with lower abdominal weakness

In my next post I will discuss the recovery process.

Momma Knows Best

2010-03-16T18:04:00.003-04:00

Over the years, I've had many patients that complain of middle back, low back, neck and shoulder pain. Many of these patients also happen to be competitive or recreational runners/exercisers. A disturbing trend is developing where these clients aren't always adults. More and more, we are seeing children and teens with legitimate pain from poor posture not only in running and athletics, but in just day to day activities.

Postural weakness and pain develops from muscles being continuously put into a lengthened state (think slumped over at a computer). These muscles in between your shoulder blades and down into your lower back are much less effective in this state. They work much harder and fatigue much faster. This may result in muscle pain, trigger points, shoulder pain, back pain, or neck pain.

Now consider running. If these same muscles that are supposed to support your upper body, trunk, hips, and most importantly, your legs, are getting tired after 10 minutes of running, your body is going to fatigue much faster. Not to mention the fact that if you're slumping during a run, your lung capacity and overall breathing is going to be compromised, making your body work that much harder.

The next time you watch a race on TV, notice the form and posture of the some the world's greatest runners. They are all running with great form and posture. Now, I'm not saying that if you change your posture, you're going to be an olympian, but it will improve your stamina, prevent injury, make you more efficient over time.

Remember some of the things we talk about in this blog: core strength and functional strength. Most people think of abdominals when they hear the word "core". But, your abdominals are not the only part of your core. The muscles between your shoulder blades and throughout your trunk are all part of your "core". Your core is only as strong as the weakest link.

In the future, I will post some pics of simple postural exercises. Until then, remember what mom (or dad) said: Sit up straight! Stand tall! They were right, after all!

2010-03-13T19:58:00.003-05:00

Here are some cool lyrics to 2 of my favorite running related songs.

"Middle Distance Runner" by Sea Wolf

Well I'm so sad tonight
And the words won't come out right
It's been a long day on the track
And its stamina that I lack

So won't you run to me tonight?
Tonight we could pretend that we're just lovers
But I'll only ever be a middle distance runner

Well my heart is beating hard
And I'm off with a shot at the start
And my legs tremble from strain
But by the finish line I am drained

So won't you run to me tonight?
Tonight let's not talk about next summer
Cause I'll only ever be a middle distance runner

Well I'm so proud tonight
Of the woman you've become
And I'm just too tired to fight
So my darling, I'll succumb

But you'll have to run to me tonight
Tonight I will love you forever
But I'll only ever be a middle distance runner

"Slowpoke" by Neil Young

I got some medals
hanging on my chest,
I've seen some good ones,
but I missed the rest.
Lady luck don't you turn on me,
I'm just a student of your history,
I'm just a student of your history.

Slowpoke I'm gonna run with you,
Wear all your clothes and
do what you do.
Slowpoke
we got some things to find,
When I was faster,
I was always behind,
When I was faster,
I was always behind.

Let the body adjust

2010-03-13T19:07:00.006-05:00

With further reading of the April edition of the Running Times, I found a another way for us to increase our mileage after lay off or an injury. Jack Daniels (the exercise physiologist) suggests that the old 10% a week rule is arbitrary. He recommends staying at a certain mileage for 3-4 weeks then adding approximately 10 more miles in the next week. He suggests adding 1 mile or 10 minutes to each run you do in a week. Then you would stay at that level for 3-4 weeks before the next jump. This method give s the body a chance to adjust to this stress level before a new level is introduced.

More on dynamic warm-ups

2010-03-12T20:22:00.007-05:00

I just got my April edition of the Running Times magazine. This issue is full of some great articles, one written by Mackenzie Lobby on the benefits of a dynamic warm-up rather than static stretching. This author shares more on how static stretching inhibits muscles action. Static stretching actually relaxes muscles which is obviously counter productive when you are about to run a hard workout or a race.

Dynamic mobility exercises will better prepare the muscles involved in running to begin their work and help to avoid injury. Static stretching is better suited for post workout routines. St. Vincent Sports Performance suggests a pre-race /workout routine of slow jogging then performing dynamic mobility exercises followed by some up tempo striders.

This has been my approach for several years. I no longer do any static stretching before any work-out or race. I also avoid static stretching after a hard race or workout as well. It is my opinion that it is safer to stretch a least 1 day after a heavy load is place on muscle. Give the sore muscles groups a chance to naturally stretch during your average day. It has been my experience that runners who stretch after a hard run or race actually predispose themselves to injury.

Here is a link to view what they are doing at St. Vincent Sports Performance.

Learn to read/injury prevention

2010-01-17T13:07:00.004-05:00

Learn how to read

January. Time to start our spring Mini Marathon training. For some of us this means building on our winter base training. For others it is time to find our shoes and our winter gear and to head out the door for the first time. Over the next several weeks we will be adding miles and possibly introducing some quality (speed). During any change in our training, which requires an increase in effort, it is important to determine how our bodies are responding to this change in work load and give them time to adapt. We need to know when to push and when to back off. In other words we must learn to read our aches and pains to determine what we can ignore versus what may be trouble brewing.

I would like to clarify this with a scenario that occurs every year.

“Jeff” decided to begin his Mini Marathon training program. He has been active over the winter doing the elliptical and spinning classes. He found the same shoes that he wore in last year’s race. They have about 400 miles of wear on them.

In the first two weeks of the training program he ran 2 miles on Monday, Wednesday and Friday. He continued to do his Friday spinning class. Later that day he felt a dull ache on the back of his heel where the Achilles tendon is attached. Saturday when he woke up he felt fairly stiff and noted that his Achilles was even stiffer and a little sore. He stretched his calf muscle really hard. By the time he started his scheduled 45 minute tempo run his aches had gone away. He was really feeling good, so he pushed the pace. Half way into his run he felt that ache again. He stretched really aggressively but it seemed to make the aching worse. Sunday was a scheduled rest day but he decided he would run anyway. His Achilles ached the entire run. On Monday morning he was almost limping on the way to his spinning class. His Achilles was sore the entire class and during his day at work. He really had to push himself to finish his Monday night run.

On Tuesday he could barely stand and walking was very painful. When he tried to stretch he thought he felt a “pop” on the back of his lower leg. Jeff now has a very severe injury to his Achilles tendon.

Where did Jeff go wrong in this scenario? How could he have avoided this injury?

First Jeff should have started out by purchasing a pair of new running shoes. Wearing shoes that are worn or have greater than 300 miles on them increases the risk of injury significantly.

Sunday he should have stuck to his training schedule. Rest is rest and is just as important as a training day. Our bodies need rest in order to recover and remodel so we can become stronger. Ignoring rest days will lead to burn out and injury. Jeff may have benefited from decreasing the intensity and frequency of his spinning class as he is starting his Mini marathon training. Spin class should be considered as a hard training day. It is not to be considered as a running rest day just because it isn’t running. They have very similar demands on the legs and in Jeff’s case, spinning continued to load his irritated Achilles tendon. Cross training is generally fine but sometimes doing an activity that doesn’t load the legs is a safer option. Swimming with a pull buoy is a good choice.

Jeff’s biggest mistake was his inability to read and listen to his symptoms. When he felt the aching the first time, he should have used ice on his heel/Achilles and avoided the aggressive stretching. When symptoms are felt during a workout and they don’t go away or if they worsen, STOP. At least slow down and shorten the work out. ICE and avoid aggressive stretching. If an area is aching, stretching needs to be gentle and non painful. Stretching aggressively may make a minor injury much more symptomatic.

If the symptoms go away and don’t return, a work out may be completed. It is still prudent to shorten the workout and ice. If symptoms are felt during the day just walking around, it is better to not workout. REST or cross train without loading the sore area. ICE frequently. Do no running until pain-free during everyday activities. Then the return to running needs to be short and easy and should be followed by a rest day. This will allow Jeff to evaluate how the Achilles is handling the return to running with less chance for re-injury.

Learn to read your body.
I hope this is helpful!

Log it

2010-01-17T12:40:00.006-05:00

2010!

This marks my 31st year of using the Complete Runner's Day by Day Log. Sure there are some great online logs such as RunningAHEAD and Active Body.org but I still enjoy having a hard copy of my running data. A hard copy allows for a quick reference of past workouts,splits, times and long forgotten races. It is useful to look back and see training errors and past injuries. I have also use my running logs to record important events in my life such as family accomplishments and vacations.
What ever log you use, I hope you find it useful and enjoyable.
Happy New Year!

the aging runner

2009-11-15T18:26:00.007-05:00

I read an excellent article in the November issue of the Running times by Richard Lovett on the Science of Aging. I will summarized some of what I read and add some of my thoughts as well.

the bad news

Runners will slow approximately 7% per decade starting in their 40's/ 50's/ 60's and then more quickly. Why? VO2 max declines, flexibility and strength declines, body fat may increase, max heart rate drops 1 beat per minute each year and we (the aging) have a reduced ability to clear lactic acid.

the good news

VO2 max in sedentary people declines by 10% per decade after age 30. VO2 max in runners who stick with training can cut that decline in half. Long runs of at least 1 hour at a moderate pace and continuing to race can help maintain VO2 max. We should maintain the intensity of our harder workouts but we may need to reduce the frequency our of hard runs. We need to allow more time to recover/ more rest days.
I swim twice a week with a pull buoy. This allows my legs to rest while I still get a cardio workout.

Flexibility and strength: We must keep our functional mobility or in other words our ability to squat and kneel. How many of our peers can't get out of their chairs without using their arms or squat to check their tire pressure? If functional mobility/strength is lost our running will suffer. We will be at a higher risk for injury. We should work on dynamic stretching, foam rolling and careful static stretching. We need to use the range of motion that we have during everyday activities. Use or lose it! Strength training with manageable amount of weight to the point of moderate fatigue or "burn" will help maintain our baseline strength.

"Long may you run"
Neil Young

2009-11-15T17:16:00.005-05:00

"Cherish it. Its a beautiful thing, when you can click the miles along. Its a beautiful thing, and you better cherish it." Meb Keflezighi

So true. We sometimes don't realize this until its gone. Train smart, seek help early and stay healthy.

Meb wins New York!

2009-11-03T13:12:00.001-05:00

Check out this link about MEB.

Cross Country is the best!

2009-10-21T19:30:00.005-04:00

New 5k American record

2009-08-28T22:16:00.003-04:00

12:56!

Ritz breaks Bob Kennedy's 13 year old 5 K American Record.
The race video
Flotrack interview

An amazing race and effort!

Runner or a gymnast?

2009-07-26T10:09:00.023-04:00

Over the years of working with athletes, I have observe that many of our physicians, physical therapists, trainers and coaches seem to be trying to turn runners into gymnasts. They are very good at finding tight muscles and telling the runners to stretch. However, we need to be aware of why a muscle group is tight and what the impact of stretching may have on the the body. Care must also be taken on when stretching is performed and on the intensity of the stretch.

For example a runner may have tight hamstrings. Is that runner tight because they are hamstring dominate from too much time on a hamstring curl machine or from muscle imbalances?

In the case of hamstring dominance, the hamstrings are tight likely because they are too strong as compared to the gluteals (buttocks muscles). This along with a rapid growth spurt can lead to further muscle imbalances (as seen in the picture). The core muscles become weak, especially the lower abdominals. The back extensors (lower back) and hip flexors (front of hip) are tight. These two groups work together to tilt the pelvis into an anterior position which increases the curve in the lower back

This runners hamstrings are tight partially as they are trying to help prevent the pelvis from tilting even further (increasing the low back curve). Aggressively stretching the hamstrings alone to improve their length just because they are tight may not be successful because of these muscle imbalances. Furthermore great care must be taken with the intensity of stretching and when it is done. All runners should avoid going into an aggressive static stretch (strain). Static stretching should graded in the gentle to moderate intensity range and should never be used as a warm-up.

A more wholistic approach would be to include core strengthening of lower abdominals, internal/external obliques and the gluteals without overloading the tight hip flexors. Stretching the hip flexors should be done while engaging the core.

Why are some runners stretching when they are already too flexible? Running performance is not a stretching competition. Runners require stability. An example of this is the female teenage runner who can stretch her hamstring over her head. These runners often say, " I don't feel a stretch" or must lean way into the stretch.

As this highly flexible athlete runs she displays a swing leg hip drop (as seen in the picture) which creates an un-level pelvis. On the stance leg, her femur and knee rotates inward. As her leg goes through swing, the knees almost touched. In other words she has a lot of wasted motion and it all started with the hip drop (Gluteus Medius weakness). These issues could eventually lead to injury. I have seen this gait pattern many times, especially in flexible young female runners. This type of runner is, dare I say TOO flexible! She could improve her running mechanics and prevent injury by actually spending more time strengthening. She needs to work on hip stability/ NOT flexibility.

A visit to a Physical Therapist with experience treating runners is the best way to identify muscle imbalances and the muscle groups which may need more flexibility.

Check out the posts which Lou and I have written on the importance of hip stability.
Gluteus Medius Be hip

All-comers track meets

2009-07-07T21:12:00.004-04:00

I had the pleasure tonight of participating in an small town All-comers track meet. This was a well organized low key event. Just show up, sign up, warm-up and go fast! These types of events are a lot of fun regardless of your skill level and are usually free. They serve as an opportunity to run distances which we don't often get to run. When some competition is added fast times usually will follow. Tonight I jumped in the 1600 with some high schoolers and was able follow them to a pretty good result. In previous meets, I would also run the 800 and sometimes the 400. In larger meets, they will have a fast and slow heat. These events are a great way to introduce kids to running. So check out your local running calendars or check with the high schools and give one of these meets a try. They are a great way to spend a summers evening, especially if you get some ice cream on the way home. Don't be afraid to try something different!

Now that is a kick!

2009-06-08T20:30:00.002-04:00

Check out this link to the 1500 finish at the Pre Classic. Jenny Barringer is the real deal.

Stuff in our food...

2009-06-08T19:40:00.004-04:00

Well sorry the previous posted link to the 11 worst additives didn't work but here they are:

1. Acesulfame Potassium (Acesulfame-K)
2. Artificial Flavoring
3. Aspartame
4. BHA and BHT
5. High Fructose Corn Syrup (HFCS)
6. Interesterified Fat
7. Monosodium Glutamate (MSG)
8. Partially Hydrogenated Vegetable oil
9. Red #3 and red #4
10. Saccharin
11. Yellow #5 yellow #6

Most of these are nearly impossible to avoid. Good Luck!

Energy Drinks

2009-06-08T18:19:00.004-04:00

Here is a link to a Men's Health article on The Truth About Energy Drinks on Yahoo

Here is a link to the 11 Most Controversial Food Additives

Food(or drink) for thought....

Stay sharp!

2009-05-19T19:15:00.009-04:00

Track is winding down and it is time to maintain your peak. It is often hard to stay sharp without over working the quality. Check out this link to the High School Runner. There you will find a great workout which will help keep your acceleration in the days before a big race without a negative impact on your legs.

2009-04-29T13:56:00.006-04:00

This Saturday at 7:33 am I will be joining 35,000 of my fellow runners for the One America 500 Festival Mini Marathon. This is the largest half marathon in the country. Let us hope for cool and dry weather. I just did my last run with short race pace pick ups. Overall, I am taking it real easy this week as it is better to go into a half marathon well rested.

Good Luck to everybody and I will see you at the beer tent!

Boston Finish

2009-04-20T19:51:00.003-04:00

Check out this post race interview with Kara Goucher and Ryan Hall on Flotracker.

Ryan Hall

Boston Elevation

2009-04-14T20:06:00.002-04:00

Here is a good visual on why running a more conservative early pace at Boston is prudent. Check out the total elevation of the Boston Marathon from Marathon Guide.com.

Tips for a better Boston Experience

2009-04-14T19:33:00.003-04:00

Good Luck to everybody who will run that little race on Patriots' Day. You may want to check out this excellent post on fueling for race day by Nancy Clark "Don't make any drastic dietary changes that might upset your intestinal tract."

In the 100th, I learned this the hard way. I spent too much time at a crowded expo trying to get all the cool gear. I didn't make plans for dinner and settled for a really lousy meal that I would normally never eat. I shared a hotel room with non-runners who insisted on staying up late. Needless to say, I woke up tired and ran a poor race with GI issues.

Remember to go out easier than you would in a different race. I wish would have gone out slower in the first half of the 1983, 1984 and the 1996 Boston Marathon! The first several miles are cumulatively downhill, it is easy to get tricked into a pace that is faster than you would normally attempt. At Boston, this is a much more costly mistake. The wall could hit much earlier which makes for a miserable last 6-8 miles.