Sunday, September 18, 2011

pre-race review


Last week when I spoke about race preparation I got a few funny looks when talking about calculating hydration and calorie needs for racing. So I thought I would review a few easy tools to ensure that you have a good race this fall, when weather can be very hot or quite cool.

Performing  a water loss calculation as part of your homework about yourself is easy to do with a bathroom scale. Pre-run, weigh yourself naked. Post-run weigh yourself again and compare the values. Any pound of weight change multiplied by 16oz equals the amount of water lost during your run and you should drink the corresponding amount of water to replace your loss. On future long runs you can seek to drink some of this fluid as you are losing it by sipping every 15minutes. During hot days and heavy sweating most folks need 16-32oz per hour of exercise or 3-6oz every 15-20 minutes. (If you gain weight during your run, you are drinking too much water – this is tough to do and somewhat self-limiting due to sloshing or GI distress, but read the hyponatremia article posted below)

During longer runs you may want to think about eating simple foods to keep calories on board and avoid bonk. Runs over one hour fit into this “long run” category. Runners traveling over an hour need 240Kal/hour to avoid bonk. If you try to eat – use simple, low fiber, no dairy foods and document what agrees with you. The maximum you’ll be able to use is 240-280Kal/hr so you are not replacing everything – just trying to maintain homeostasis. Examples to try include: Energy gels, Bananas, Fruit chews, PBJ sandwich on wheat, Gatorade, Pretzels, Chia seeds etc. and you’ll notice that I use a lot of real foods because of price and nutrient density. See what works for you.  There are 4 Kal/Gram of carbohydrates, so you can work with ingredient panels on your food to estimate what you are getting before you try it.
Here is a simple chart for those of you who do not have a bathroom scale or possibly do not wish to remove those sweaty clothes and get weighed. Read this by body weight and you’ll see an amount of fluid (in ounces) following each temperature range (in degrees Fahrenheit).  So you might estimate this way how much liquid you’ll need per mile. For example I am 155 on race day and if the temperature is 70 degrees, I might need 5.3 ounces/mile of running to stay mostly topped off, without sloshing. How would I know this works? If you said “test it first on a long run” you win the prize. This chart is just an estimating tool and I got it here. http://www.runnersworld.com/article/0,7120,s6-242-302--10084-2-1-2,00.html
Weight 100
Fluid Ounces Per Mile Depending On The Temperature: 50°F: 3.0 60°F: 3.2 70°F: 3.3 80°F: 3.6 90°F: 4.1 100°F: 4.7

Weight 120
Fluid Ounces Per Mile Depending On The Temperature: 50°F: 3.6 60°F: 3.8 70°F: 4.0 80°F: 4.3 90°F: 4.9 100°F: 5.6

Weight 140
Fluid Ounces Per Mile Depending On The Temperature: 50°F: 4.2 60°F: 4.4 70°F: 4.6 80°F: 5.0 90°F: 5.7 100°F: 6.5

Weight 160
Fluid Ounces Per Mile Depending On The Temperature: 50°F: 4.8 60°F: 5.0 70°F: 5.3 80°F: 5.8 90°F: 6.5 100°F: 7.4

Weight 180
Fluid Ounces Per Mile Depending On The Temperature: 50°F: 5.4 60°F: 5.7 70°F: 5.9 80°F: 6.5 90°F: 7.3 100°F: 8.4

Weight 200
Fluid Ounces Per Mile Depending On The Temperature: 50°F: 6.0 60°F: 6.3 70°F: 6.6 80°F: 7.2 90°F: 8.1 100°F: 9.3

Weight 220
Fluid Ounces Per Mile Depending On The Temperature: 50°F: 6.6 60°F: 6.9 70°F: 7.3 80°F: 7.9 90°F: 8.9 100°F: 10.2

Weight 240
Fluid Ounces Per Mile Depending On The Temperature: 50°F: 7.2 60°F: 7.6 70°F: 7.9 80°F: 8.6 90°F: 9.7 100°F: 11.2

race recovery planning


Recovery From Racing - YMCA LTR class 2010
You are an experiment of one, but here are some tested tips to avoid injury after a big race or run.

Run, refuel, stretch, shower, and stretch again, and rest. You are what you eat at this point in training so treat yourself to a great meal that fulfills the nutrient and energy expenditures from your effort.

Stairs can me managed by walking them backwards to help sore quadriceps (be careful, and hold that rail!)

Expect that delayed onset swelling and pain can occur after your event. While the typical swelling curve follows a 12-24 hour timeframe from insult, you may see soreness 1-2 days post event that you did not experience previously. RICE

Pain relievers and NSAID anti-inflammatory drugs may provide some initial relief but loose their effectiveness after several days. Pain is a good guide for when you are able to resume activity and how much activity.

Massage a few days after a race, when point tenderness is going away, is a great rehabilitation tool.

If you can stand it after a big run an ice bath will reduce inflammation in the legs, and is proven to help speed recovery. The secret is that the water need not be iced but can be anything below 50 degrees. Remember to wear a sweater and hat, only soak your lower half, and bring a book to keep your mind off the discomfort. Fifteen minutes in the bath is helpful and is better at fighting inflammation than the NSAIDs, and does not stress the kidneys.

For every mile you race you’ll need a day off – initially. You may choose to change this after you develop a significant mileage base.

While it may feel difficult to hold back on your training you should incorporate rest post-event and use cross training that is a pain free activity to fulfill any need you have to exercise. Recall that exercise is what raises metabolism and transports “groceries in, garbage out” so without this metabolic action of housecleaning, you recover more slowly. Get up and get out, regardless of how tired you might feel the week following.
Walking is called active recovery and should be included in your recovery plan to get you feeling better sooner. I like to walk as much as I can after a hard race effort.

In the first weeks after a big race seek to keep your efforts below PE 7 or 75% or your maximum heart rate to allow your body needed rest and to speed recovery. Stay away from hill work or any speed work as well. Re-starting an aggressive program post event can lead to injury.

Prepare for a let down, the post race blues – use this time to plan another project and to resume running soon - but allow for plenty of time to get ready and train. You cannot judge your success as a runner by this race or this program – this is a beginning for your running – with more challenges ahead.

Look at your process goals and the A, B, C goals you planned to see how you did, and while your mind is fresh from the event; note in your training log your race time and what went well and what you want to do better with the next race. You already have you date to begin running again marked on your calendar so why not plan your next race day too?

If you ran a 6.2 mile race, then 6 days after racing go ahead and check your resting heart rate and blood pressure to see if it matches the values measured the week before your race. If the values match and you are not experiencing muscle soreness it is a safe time to gently return to running, keeping in mind the above ideas.

lesson in salt, water, and advil

Salt, Water, and Advil on your racecourse – or Yes, Yes and NO.

The Average American consumes approximately 3.6 grams of salt daily and current federal guidelines for sodium intake is 2.3 grams per day. The American Heart Association recommends 2 grams. What many folks miss at the cellular level is that both sodium and potassium are the two ions that your body uses every second of the day at the cellular level. While it is relatively simple to get your daily supply of sodium most folks do not get enough Potassium and you need 4.7 grams daily in order to function optimally. Having the optimum ratio of these elements lowers the incidence of cardiovascular disease and allows optimal membrane potential at the cellular level. Bananas, peaches, prunes, apricots, honeydew melon or cantaloupe, and OJ all contain good sources of potassium.

Blood sodium must be maintained at a level of 135mmol/L and this value is typically easy to maintain without any dietary changes. For runners, the complication comes when someone would be running or walking slowly for a long time, while consuming a lot of water. This can create a condition called hyponatremia. While the article Responsible Drinking on the Trail (Dr. M Hoffman, Ultrarunning, March 2010) states that this condition has been responsible for five fatalities in the US and UK they also write that 30% of the runners at 2009 Western States 100 mile run, who participated in the author’s research, were positive for signs of hyponatremia.

For runners, hyponatremia means low salt. We lose salt is sweating and we can (with great effort) dilute the amount of salt that we have in our bodies by consuming large amounts of water. When you have a lot of water and not enough salt in the body, fluids begin to shift in your system and the results can be catastrophic and life threatening. You need not have a complete class in physiology to get a handle on how this works though. If you are sweating a lot, out for a long time, and throwing in the water as you go – then you need to keep your eye open for crucial signs of what is sometimes call ‘water intoxication”.

Dr. Hoffman lists a number of Danger signs: [additions mine] “Your body would not lose the 2% of its weight you would expect on your longest run but would stay the same weight or gain weight during the run. Your body’s water is changing location and you’ll see swelling, [all over], but especially hands, feet, face – [rings and shoes may be tight.] You would see mental status changes as fluid causes brain cells to swell too. [This would look like stumble; mumble, fumble and you would have to look at their other symptoms to ensure you did not think - dehydration. Recall that people call this condition water intoxication because of the mental status changes you see in people.] This person may also feel sick, [feel nausea and be sloshing from all the water they are hauling in their stomach. Urine output would be beyond the “clear, constant and copious” realm that we expect in hydrated folks as the kidneys are now doing all they can to solve a fluid overload condition.] This is an emergency medical condition that requires immediate attention and complications can include kidney failure.” [They need medical intervention and you take them off of water while you get them help.]

NO Pain reliever on race day. I see it all the time and even among folks who should know better but the more I read and listen on this subject the more I feel compelled to advise you to not use pain reliever on race day. Here is a short list of reasons. You need to stay in tune with your body and prophylactic use of pain reliever, particularly NSAID’s, (non-steroidal anti-inflamatories) has been proven DANGEROUS to runners and their bodies. If you are sore the next day you may choose to take OTC pain reliever in standard dosage with water if you and your physician say it’s OK. Running with ibuprofen (Advil), or naproxen (Alleve) in your system may truly hurt you on race day.

By limiting prostaglandins that normalize blood flow you may tax your kidneys. Your basic over-the-counter drugs may seem benign to you, but they do block important biochemical’s called prostaglandins and these do a great number of things in the body – including dilate the blood vessels to your kidney. Remember that your kidneys are something that you need, and rely on, to maintain the electrolyte balance in the body, maintain fluid balances and eliminate wastes. These NSAID’s (by blocking prostaglandins) may increase your blood pressure at a dangerous time to do so – when running – and this could trigger a TIA or CVA (stroke). NSAID’s block the enzyme cyclooxygenase that protects the heart and thus may pose greater risk to the cardiovascular system as well.

Cyclooxygenase helps protect the stomach lining from digestive acids and so when NSAID’s block the enzyme you may experience nausea, cramping, diarrhea or bleeding. Studies indicate that NSAID’s may increase the risk of Hyponatremia or “water intoxication” a problem with electrolyte imbalance.

There is some new research which says that you might take one baby aspirin every day or every other day – see the link at our FB site for the literature on this preventative for everyone to learn more - then ask your DOCTOR.

Saturday, September 3, 2011

Bare foot running

Barefooting – what and why? YMCA, LTR 2011
When I first started this piece on barefoot running several years ago, there was just a bit of material in the popular media about natural running style. I even had a handout from Ultrarunner magazine about adopting some barefoot running, because this was an article that was fresh and addressed the topic in the mainstream. I am happy to say that the world has changed a bit, and now the terms barefoot and natural running have achieved almost “Kleenex” status in the common vernacular and I now only need to give you the basics while pointing you to dozens of great resources on the topic, including an entire book written by Dr. Daniel Howell, about all of the health benefits of not wearing shoes.

While the book Born To Run and the recently published research of Dr. Dan Leiberman seems to have energized the term barefooting – running barefoot did not start in 2009 or even in this century. While I would encourage you to read the work of both of these guys – I’ll take a minute to point out some highlights of how we got to running shoes in the 20th century. I hope to also spark a bit of thought about what things looked like before shoes and how that factors into where we are at today. I kept my shoes through this fervor about bare feet, but I can tell you that my thinking, as well as my shoe choices, continues to evolve over time on this subject. I think that every runner should look at the history of our sport and can take a lesson from what shoeless or minimal shoe training can do for your running.

The feet have 26 bones, 33 joints, 12 tendons, 18 muscles; each foot is an amazing piece of machinery and while it has many things it does not have others – so why it is made this way and what was it for in the first place?

Science has made a great case for a theory that the current form of humans evolved and succeeded as a species due to 26 different, running specific, adaptations. These adaptations allowed us to pursue quarry on the move, at a rate just fast enough to tire that animal out, while we have the innate endurance to finish the hunt and gain groceries. Again, Dr. Dan Leiberman offers a much more through explanation of this theory and it is solidly based in the science of biology and comparative biology. We were able to travel, pretty fast, and fast enough to win food and cross great distances. Clearly, we did this without shoes and anthropologists have not found any evidence of Nikes from this critical time period. 

Until Bill Bowerman, the famous University of Oregon track coach, created the running shoe in America in 1972, just 39 years ago, we all ran in very thin light shoes that offered little in the way of a heel cushion or padding from the ground. I have read that he designed the shoe to accommodate what he felt would be a longer and more competitive stride for his athletes. He could teach them to lead with the heel and the longer stride length would out run the competition. Bowerman was NOT a physical therapist, medical doctor or biologist who may have asked, “what might this lead to, other than winning races?”

Currently in Africa and many parts of the developing world, children are raised without transportation and also without footwear. It is estimated that the average Kenyan child has about 1,800 miles on their legs and feet by the time they graduate from primary school and all of these miles, for the majority of kids, are without shoes of any kind. It has been argued that this contributes to the number of victories for great Kenyan runners at the international level and on the Olympic podium. Early leg development and natural foot strength (at altitude, Kenya is a mountainous region with an altitude similar to Flagstaff, AZ) allow these kids to develop all the capabilities of their legs before serious training ever begins for competition.

Many cultures are able to train and run well without shoes or with minimal shoes. The Tarahumara Indians of Mexico are featured in Born To Run for their great ability and running in very simple sandals – a slab of rubber strapped to their feet for protection from sharp objects. This is a similar style of shoe to many early Nations of the American Southwest and the pre Spanish cultures in South America such as the Maya and Inca who had thousands of miles of roads and very little in the way of shoes to traverse them. In those days a severe running injury would cause you to drop lower on the food chain – a deadly prospect. So it might be safe (or humorous) to assume that if running injuries did occur in Inca runners – these runners did not pass on the genes for any fragile lower legs and knees.

According to Christopher McDougall’s book Born to Run, Alan Webb’s feet where flat and three sizes larger when he started working with his high school coach to become America’s new top miler. In 2007 Alan set the world’s best 1,500 meter time and broke Jim Ryun’s American record for the mile. But his quest began with flat, weak, de-conditioned feet that were in need of rebuilding. McDougall writes about an interview with Alan Webb on page 175 of his book and Webb says “ I had injury problems early on, … so we did foot strengthening drills and special walks in bare feet” McDougall writes that Alan’s feet changed and his arches became higher as muscles strengthened – his shoe size decreased and his injuries abated.
McDougall writes of an Irish Ph.D, Gerard Hartman who is considered an expert in physical therapy and works with professional runners from around the globe to improve their running. He has been a proponent of barefoot running for many years and cites that “the deconditioned musculature of the foot is the greatest issue leading to running injury, and we’ve allowed our feet to become badly deconditioned over the past twenty-five years”. Many folks have advocated that slowly and gently strengthening our feet over time will allow us to run better and with less injury. We may even find that we can run in lighter footwear. Lighter footwear means less effort and perhaps faster or the sensation of faster as the weight on the end of your leg from a heavy shoe creates a pendulum that takes effort in order to keep moving. 

What do shoes do for me? While all seem to agree that having a sole cover your tender skin provides some protection – many experts are currently reexamining what shoes do well and do not do so well. The good news about this controversy is that in the past 38 years, very little substantive research has been done on how shoes truly affect feet and that is beginning to change now. The United States Military is greatly invested in physical conditioning of its personnel and in the past has seen very high rates of injury in basic training and its share of running related injuries. A recent study on determining the appropriate footwear has shown that the type of running shoe had no correlation on injury prevention for the military personnel in the study. This leads us to “well what can I use to control the movement of my foot, for the least chance of injury?” Your gait, how your foot hits the ground and your running technique becomes more important than the type of running shoe that you might wear according to this study. Manufacturers have succeeded in creating footwear that controls movements of the foot and offers important padding from the ground as you begin running. However, seeking to control the movement of the foot by using a shoe will not ultimately be successful in preventing injury, in the long run, according to new studies. Technique will carry the day and great technique; sensitive feet that are aware of what they hit (and strong feet) may lead to using a much lighter shoe down the road. 

So why do we not teach barefoot running in the Learn to Run class? There are three big reasons in my mind, about why we cover this content as a lesson rather than a focus. First is that the process must be very gradual, even more gradual than learning to run, so we do not really have time in class to retrain what 30 or more years of wearing shoes has done with your feet. Second is that all of us have deconditioned feet similar to what Dr. Hartman discusses above – and this means that we have to slowly build up foot strength, even before we start running in minimalist footwear. I think that if you have already come from a culture of shoes that you will want to learn running first and then learn to reduce how much shoe you use. Third is that the only examples of people being injured with natural running come from runners who, in their enthusiasm, progress too quickly in bare feet or minimal shoes. One of my stated objectives for the class is to introduce you to a new lifelong activity, injury free. Therefore I do that with what your feet are already used to, and provide resources, and hopefully a strong dose of caution to you, while encouraging those who want to move their running to the next level to try strengthening their feet.

In the current day a larger percentage of runners are now dedicated to running entirely without shoes. They have run marathons, ultra marathons and farther in bare feet, and a second subgroup simply enjoys being barefoot full time, so they carry flip-flops with them to get into Wal-Mart or a restaurant. You can read their websites and their ideas about what shoes do and do not do for the wearer and how they feel more free with naked feet. There are as many reasons to consider shoeless as there are folks not wearing shoes. I would challenge you to consider the common thinking on this matter and both accept those who forgo footwear, as well as reconsider what you may gain from simply being barefoot at home or in the yard.

Before you assume that the “barefoot guys” are off the deep end in their “foot yogi-mysticism”, take a good look at the number of people from the medical community that advocate the sale of moccasins to children and preach “barefoot is best” for toddlers. The reason for this, they advocate, is that kids walk sooner when they learn to interpret the ground with their feet (proprioception) and build foot strength naturally. They do not want kids to cut their feet and thus sell a light flexible protective moc- type shoe to achieve this. Many parents have subscribed to this idea with the pediatricians blessing and I’ve seen it work for my own kid. (As I was buying lots of shoes for my running, at $80/pair…)

Arthur Lydiard was a cobbler and made shoes before he was a coach. A coach who was very focused on the success of his athletes. He had his runners in the most basic of footwear and preached against anything “more” for his entire career, which extended well into the era of modern shoes. Internationally sought after coach and physician, Dr. Phil Maffetone was suggesting more than a decade ago that minimal footwear was preferable for similar reasons. Even Stanford University’s world class track and cross country coach (the program gets Nike’s for free) has had his athletes running barefoot in the grass, two afternoons a week, for decades. He said to Nike that his guys got hurt less when they subscribed to this method. (This is what drove Nike to work with Dr. Gerard Hartman to create the Nike Free.) Long before the birth of the very popular Vibram Five Fingers shoe – many companies across the country have made a living manufacturing simple moccasins and unstructured footwear that allow the foot to move and muscles to work. Inuit people, north of the Arctic Circle knew that this is what kept their feet warm in winter – that the boot would flex and allow better circulation. 

So before you ever consider running barefoot, simply walking around without shoes at home is a good place to start and walking farther progressively is another. You may choose to try the new Vibram Five Fingers Shoes as well, which offer that slight amount of protection for your tender skin and not much else for padding. I have started using theses on very short runs (by time) and adding minutes each week very slowly. I spent a year reworking my stride before I ran with these shoes so that I am not landing on my heel much at all but using the mid-foot and most of my foot to absorb the impact of each step. To acquire a lighter step you can practice this technique while walking – you need not run in order to learn how to walk more gently and with a light step. Recall what I have said in many in stride analysis sessions – that cadence, how often your feet hit the ground, has everything to do with a light step. Walking or running, your step must be smaller and faster to achieve lower impact forces. 

For two years now the Outdoor Retailer Trade show saw scores of outdoor footwear manufacturers gunning for a piece of the barefoot pie, gearing up to make “thneeds”, or feather weight running shoes for everyone who wants to run barefoot. The marketplace is now flooded with these new shoes, some of them are untested, un-researched shoes as well. You may choose to try them or go barefoot, grab some moccasins, run in cheaper “race flats” or just try your old Chuck Taylor’s like Lydiard ran in for decades. One key criterion for choosing these shoes is that they should not have an elevated heel. Your foot should be neutral from front to back, just as if you were barefoot on the floor. Most of us can adapt to this well if asked to do so slowly – because you have never seen a baby or an east African in high heels.

But think about a deliberate program of gentle foot strengthening for yourself as a possible next step in your program and add it gradually, just like you started running. A foot that “knows the ground” and is most sensitive, may be less likely to sprain an ankle, will run trails better and may run slower at first but that is OK, you’re in shape and will not “de-train” as a part of this process. Your lower legs will continue to develop in a way that may reduce your injuries over time and your stride will adapt to something that is more powerful in the long run. That is what I want for your running – long running for the long run. So run gently out there.



Danny Dryers list of preferred light weight shoes
http://chirunning.com/blogs/danny/2010/02/07/chirunning-recommendations-for-minimal-shoes/comment-page-2/#comment-1330

Interesting article on shoes from a rehab perspective
http://www.chirunning.com/shop/pages.php?tab=r&pageid=18&id=575

I have also added several new links on the toolbar here to assist you in learning more about natural running style. If you ever plan to increase your training volume, or wish to develop further as an injury free runner, you owe it to yourself to look over the current research in this area.