I started this one a few weeks back and then forgot to finish it.... I've been made aware that people are actually reading this blog, so I'll try to be more timely!
So the 'Boston Effect' from the last post has turned into what we're calling the 'Boston Massacre."
It seems that just about every runner we worked with leading up to the Boston Marathon has had a new issue pop up since the race. In talking with one of the survivors yesterday, we came up with some reasons that I thought I would share, especially since I know thoughts of fall marathons are on many people's minds.
Staying healthy is all about balance. Training balanced with rest. Athletic goals balanced with family and work. Gluts balanced with hip flexors. Balancing the checkbook in such a way that justifies yet another new pair of shoes.... you get the idea.
Training for and running a marathon on the road is probably one of the most challenging things that most runners can take on (no offense to the trail runners out there!) Boston in particular, due to the time of year it's run, the qualifying standard, the course, the pre and post zoo, and the stress this all creates, is more challenging than most.
Training for a marathon is hard enough, but to maintain balance through the process is especially tough. I know one guy getting ready to do Burlington this weekend, who sold his business about a month ago and is otherwise unencumbered, and is still feeling the pressure. Keeping up with appropriate strength training, stretching, seeing your sports chiropractor, and getting enough rest becomes tough particularly when you're training volume gets high in the run up to the race. Quite often something has to give, and then you go and race 26 miles on pavement, creating the perfect storm for injury.
I think there are lessons here for anyone considering training for and running their first marathon, or doing that distance with a PR time goal in mind:
1. There is a certain amount of strength training, particularly core work, necessary to prevent injury when training for distance. My unscientific observation is that a minimum of twice per week of this type of cross-training, coupled with somewhat consistent stretching, helps to keep people out of trouble. Ensure that you factor in the time/energy required to keep up with this non-running work when planning your training.
2. Even when you do appropriate cross-training, any lurking imbalances that you have are more likely to manifest when you take on training for distance. If you have small nuisance type of injury that you've been able to manage with the foam roller, don't be surprised if it gets worse when you increase your volume of training. It's always easier to address something early on than waiting a few weeks before your race when the pain threatens to shut you down.
3. Factor in increased rest time. If you already have a busy life and sleep less than 8 hours per night, your body might not hold up to this type of training if you can't carve out the appropriate recovery time.
I'm all for marathon training (my kids need braces after all), but just be sure to take into account the big picture before signing up. For me, my initial enthusiasm for another marathon in the months leading up to Boston have been reduced to trying to set a new 5K PR this year.
Friday, May 21, 2010
Saturday, April 10, 2010
The Pendulum Effect
So life has been laughing at my attempts at writing a book lately, so I'll let that go for now. However I do have some new thoughts to share, as I increase my own training, and with an influx of runners lately (I call it the 'Boston Effect'- which fortunately coincides with tax time.)
Last running season for me was all about the minimalist movement. Reading 'Born to Run' capped three years of experimentation with barefoot and minimal shoe running, and made me a believer. I was able to finally find my true natural running form, something I had spent years looking for. Having previously been dependent on stability shoes to run, the pendulum had swung all the way in the other direction. Running was fun and life was good again..... right up until getting a stress fracture running in Vibram FF's on the road.
This season the pendulum has come back to a happy medium. I have been more focused on increasing my pace, hoping to improve upon some of last year's MOP results. I have still been incorporating barefoot running, doing my speed workouts on grass soccer fields near my house. If I had the time or inclination to build up sufficient skin toughness, I would probably do a lot more barefoot running. But I'm just a gringo living in a place with cold winters, so for most other runs I've been using very flat road (NB rc230's) and trail (NB 790's and just got some NB MT 100's). I still like Vibram's but will not wear them on the road anymore, and they don't provide enough protection to go fast on trails I run on anywhere but Pineland.
This morning's long run has really helped put things in perspective. I drove to Baxter Blvd. (something I hate doing, but oh well), hoping to run in Vibrams to get the best of both worlds: skin protection to run at pace, but still the barefoot feeling. After two laps however, I thought I started to feel pain on the top of my left foot, triggering stress fracture flashbacks from last year, and I thought, "Screw this!" and immediately took off the Vibrams (of course just in time for a bunch of unavoidable gravel and the bridge, all at 38 degrees.) As I had hoped, the skin sensitivity factor made me land a lot lighter and I did my last lap with no foot pain. It was fun, especially the looks you get (ranging from smiles to incredulity to outright disgust.) However, I had to slow way down, which kind of defeated the purpose of the run.
People develop certain views of the world based on their occupation. EMT's wear seat belts, E.R. nurses don't drive motorcycles, and insurance agents know that stuff happens. Based on my experiences I've come up with a new philisophy about my running. I'm training for Boston, for Western States, for Lake Placid...... 20 years from now. My point being, I still want to be healthy and in the game then, doing the things I love.
Last running season for me was all about the minimalist movement. Reading 'Born to Run' capped three years of experimentation with barefoot and minimal shoe running, and made me a believer. I was able to finally find my true natural running form, something I had spent years looking for. Having previously been dependent on stability shoes to run, the pendulum had swung all the way in the other direction. Running was fun and life was good again..... right up until getting a stress fracture running in Vibram FF's on the road.
This season the pendulum has come back to a happy medium. I have been more focused on increasing my pace, hoping to improve upon some of last year's MOP results. I have still been incorporating barefoot running, doing my speed workouts on grass soccer fields near my house. If I had the time or inclination to build up sufficient skin toughness, I would probably do a lot more barefoot running. But I'm just a gringo living in a place with cold winters, so for most other runs I've been using very flat road (NB rc230's) and trail (NB 790's and just got some NB MT 100's). I still like Vibram's but will not wear them on the road anymore, and they don't provide enough protection to go fast on trails I run on anywhere but Pineland.
This morning's long run has really helped put things in perspective. I drove to Baxter Blvd. (something I hate doing, but oh well), hoping to run in Vibrams to get the best of both worlds: skin protection to run at pace, but still the barefoot feeling. After two laps however, I thought I started to feel pain on the top of my left foot, triggering stress fracture flashbacks from last year, and I thought, "Screw this!" and immediately took off the Vibrams (of course just in time for a bunch of unavoidable gravel and the bridge, all at 38 degrees.) As I had hoped, the skin sensitivity factor made me land a lot lighter and I did my last lap with no foot pain. It was fun, especially the looks you get (ranging from smiles to incredulity to outright disgust.) However, I had to slow way down, which kind of defeated the purpose of the run.
People develop certain views of the world based on their occupation. EMT's wear seat belts, E.R. nurses don't drive motorcycles, and insurance agents know that stuff happens. Based on my experiences I've come up with a new philisophy about my running. I'm training for Boston, for Western States, for Lake Placid...... 20 years from now. My point being, I still want to be healthy and in the game then, doing the things I love.
Friday, March 19, 2010
Bullet-Proof Runner: General Principles of Running Injuries
Here is the second installment of "The Bullet-Proof Runner." This is tenatively Chapter 2, although this is still a pretty rough draft (but hey, its free!):
In general most non-traumatic distance running injuries reflect a body that is out of balance.
Many running injuries tend to follow a consistent pattern. Often they are the end result of a chain of events that begins with a musculoskeletal imbalance of the core and hips. (In this context the “core” includes the lower half of the spine, pelvis and supporting muscles.) During running, this imbalance leads to the generation of asymmetric and/or excessive loading of the lower extremities. The body can withstand or compensate for these forces up to a point. Eventually however a threshold of soft tissue inflammation and damage and sometimes joint restriction is exceeded and pain ensues. If training continues from this point a true injury can develop that hampers or makes it impossible to run at all.
Musculoskeletal imbalances are inherent in most individuals, whether they run or not.
Being a chiropractor I have seen my share of back pain. Over the years I began to recognize common “patterns” of core and hip muscle and joint imbalance that were present in those with back pain. For example, in individuals with lower lumbar spine pain, the right hip flexor seemed weaker than the left the majority of the time. These types of findings were so ubiquitous that it seemed logical they must stem from fundamental issues such as posture, hand-dominance, one’s occupation; essentially the net effect of what a person has (or hasn’t) done with their body.
From the beginning of my career I have always been drawn to the sports medicine side of things. However in the beginning I found working with runners frustrating. Their injuries quite often seemed resistant to what I had to offer. Over the years as I continued my education and learned new treatment methods my success rate improved. I practiced the holistic truism of always looking at the joint above and below the injured area. I did again learn to recognize particular commonalities in injured runners, such as the fact that lower extremity injuries tended to affect the left side greater than fifty percent of the time. However I still never felt like I could quite wrap my mind around why certain injuries happened in the first place. Consequently I continued to have cases in which my treatment wasn’t as successful as I (or the patient) would have liked.
For many years my patternistic approach to back pain and my treatment of running injuries remained somewhat separate concepts in my mind. However one day, after performing a gait analysis on a runner with lower back pain, I had one of those light-bulb moments where these two ideas suddenly synapsed together. This person had no issues with her lower extremities (or so she thought,) just her back. I was able to look at her gait though and explain not only why her right lower back hurt, but also to predict issues in her left lower extremity. On exam we found overtly painful spots in her left knee and heel that I knew were the beginnings of adductor tendinits and plantar fascitis.
It finally dawned on me that: We all have the same basic body design. Injured runners are just people with the same types of imbalances as anyone else, only they run. Running is very physically demanding, particularly to the lower extremities. Consequently these imbalances, even when subtle, become magnified and are quite often the underlying cause of running injuries.
Sources of Imbalance
Body composition, muscle tone, and flexibility are a function of genetics and lifestyle (nature and nurture.) Your body is a reflection of your genes, but just as importantly what you do with it. Not only is it true that ‘You are what you eat,’ but also ‘You are what you do.’
In my opinion the biggest source of musculoskeletal imbalance derives from the fact that we are using our pre-historic body design to function in today’s modern world. Most of us sit too much, and move our bodies too little. Our daily tasks have become much less physically demanding than they used to be, but on the other hand much more repetitive. In the case of the average runner, when they do move it’s usually on an unvarying, unyielding surface, in thick-soled shoes that don’t allow their feet to feel and respond to the ground.
Due to our modern lifestyle our hips tighten, our postural muscles weaken, and it becomes an effort to stand up straight with a level pelvis. Our dominant side tightens up to the point where muscles start shutting off and it actually becomes our weak side. Our feet become weak and can no longer support our weight without the support of the same shoes that made them weak in the first place. When we do run our cushioned shoes dampen the pain signal to our feet, allowing us to run in a style we could never sustain if barefooted.
Now you take an individual who lacks the core strength or endurance to support their frame, whose pelvis is twisted, whose feet are weak, and you ask them to run. You ask them to perform an activity that requires perfect synchronization and coordination of the entire musculoskeletal system. You make it socially awkward (and even medically inadvisable) for them to run without shoes so that they can find their own form, but on the other hand give them no advice on how to go about this activity. Is it any wonder virtually every runner is guaranteed a significant injury at some point?
In general most non-traumatic distance running injuries reflect a body that is out of balance.
Many running injuries tend to follow a consistent pattern. Often they are the end result of a chain of events that begins with a musculoskeletal imbalance of the core and hips. (In this context the “core” includes the lower half of the spine, pelvis and supporting muscles.) During running, this imbalance leads to the generation of asymmetric and/or excessive loading of the lower extremities. The body can withstand or compensate for these forces up to a point. Eventually however a threshold of soft tissue inflammation and damage and sometimes joint restriction is exceeded and pain ensues. If training continues from this point a true injury can develop that hampers or makes it impossible to run at all.
Musculoskeletal imbalances are inherent in most individuals, whether they run or not.
Being a chiropractor I have seen my share of back pain. Over the years I began to recognize common “patterns” of core and hip muscle and joint imbalance that were present in those with back pain. For example, in individuals with lower lumbar spine pain, the right hip flexor seemed weaker than the left the majority of the time. These types of findings were so ubiquitous that it seemed logical they must stem from fundamental issues such as posture, hand-dominance, one’s occupation; essentially the net effect of what a person has (or hasn’t) done with their body.
From the beginning of my career I have always been drawn to the sports medicine side of things. However in the beginning I found working with runners frustrating. Their injuries quite often seemed resistant to what I had to offer. Over the years as I continued my education and learned new treatment methods my success rate improved. I practiced the holistic truism of always looking at the joint above and below the injured area. I did again learn to recognize particular commonalities in injured runners, such as the fact that lower extremity injuries tended to affect the left side greater than fifty percent of the time. However I still never felt like I could quite wrap my mind around why certain injuries happened in the first place. Consequently I continued to have cases in which my treatment wasn’t as successful as I (or the patient) would have liked.
For many years my patternistic approach to back pain and my treatment of running injuries remained somewhat separate concepts in my mind. However one day, after performing a gait analysis on a runner with lower back pain, I had one of those light-bulb moments where these two ideas suddenly synapsed together. This person had no issues with her lower extremities (or so she thought,) just her back. I was able to look at her gait though and explain not only why her right lower back hurt, but also to predict issues in her left lower extremity. On exam we found overtly painful spots in her left knee and heel that I knew were the beginnings of adductor tendinits and plantar fascitis.
It finally dawned on me that: We all have the same basic body design. Injured runners are just people with the same types of imbalances as anyone else, only they run. Running is very physically demanding, particularly to the lower extremities. Consequently these imbalances, even when subtle, become magnified and are quite often the underlying cause of running injuries.
Sources of Imbalance
Body composition, muscle tone, and flexibility are a function of genetics and lifestyle (nature and nurture.) Your body is a reflection of your genes, but just as importantly what you do with it. Not only is it true that ‘You are what you eat,’ but also ‘You are what you do.’
In my opinion the biggest source of musculoskeletal imbalance derives from the fact that we are using our pre-historic body design to function in today’s modern world. Most of us sit too much, and move our bodies too little. Our daily tasks have become much less physically demanding than they used to be, but on the other hand much more repetitive. In the case of the average runner, when they do move it’s usually on an unvarying, unyielding surface, in thick-soled shoes that don’t allow their feet to feel and respond to the ground.
Due to our modern lifestyle our hips tighten, our postural muscles weaken, and it becomes an effort to stand up straight with a level pelvis. Our dominant side tightens up to the point where muscles start shutting off and it actually becomes our weak side. Our feet become weak and can no longer support our weight without the support of the same shoes that made them weak in the first place. When we do run our cushioned shoes dampen the pain signal to our feet, allowing us to run in a style we could never sustain if barefooted.
Now you take an individual who lacks the core strength or endurance to support their frame, whose pelvis is twisted, whose feet are weak, and you ask them to run. You ask them to perform an activity that requires perfect synchronization and coordination of the entire musculoskeletal system. You make it socially awkward (and even medically inadvisable) for them to run without shoes so that they can find their own form, but on the other hand give them no advice on how to go about this activity. Is it any wonder virtually every runner is guaranteed a significant injury at some point?
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