Running

You evolved to run…

Posted by

It has been said many times before, especially here, that you evolved to run. The combination of an independent respiratory system (via diaphragmatic control), the ability to lose heat via sweat, the nuchal ligament in the neck, large gluteals and an achilles tendon all indicate that we run. There are also evolutionary theories that indicate our brains developed to allow us to predict the behaviours of animals we were hunting.

Running also has a fantastic effect on the skeleton, triggering hormones in the long bones that help control appetite (Lipocalin-2), driving osteogenesis (the continued creation of new bone) and preventing degeneration. It even helps neurogenesis, the creation of new brain cells and nerve pathways, by flushing fresh blood through at a much higher rate for longer, as well as suppressing excessive glucose storage by forcing muscles to use it as fuel.

Many people, including respected orthopaedic surgeons, believe that running is not healthy for the joints, and that it will leave to early degeneration. There is some validity to this concern, but with a certain number of caveats. If you have not run for a significant period of time, or are overweight, then you may experience joint pain when you start. Similarly, if you are not biomechanically efficient, then you find it harder work than you expect. Not only that, if you look at indigenous runners, they don’t do it in the same way we consider standard, rather running and walking, depending on the terrain.

However, a number of studies (https://doi.org/10.1002/art.24840, https://link.springer.com/article/10.1007/s00167-013-2686-6) as well as others, show that there is no detrimental impact on the joints, with some evidence that it actually helps strengthen the tissues.

What is the practical upshot of this? If you can, start running. Carefully, steadily and allowing a great deal of time. The upside far outweighs the downs. If you can’t, cycle or walk.

If you want to start running, do so slowly. Follow the NHS couch to 5k program. Given that any weight over your theoretical optimal (BMI of 23 – 27 depending on muscle mass) is increased load on the joints, limit your long runs to reduce the chance of injury while you work on the weight. And, as you approach a maintainable weight, you will experience the benefits far more than the lows.

If you can’t run, do something that mimics the cardiovascular and skeletal load. Lift weights, row, walk at a rate that leaves you sweaty, it all helps.

Focus on the now

Posted by

Buddists and other meditators claim that there is no past, no future, only now. Yet we spend most of our time ignoring whats in front of us and instead thinking about what has been or what might be, not being in our heads and focusing on the immediate task. This is not to say that planning (an almost unique skill in humans) is not vital, as otherwise we would be wasting ourselves spinning in circles watching a small screen, but this long term plan has to be combined with appropriate action now.

From a movement perspective, when coaching clients in new patterns, I use 2 key words  as triggers. Attention and Intention. What is the attention on and what is the intention. For example, moving the shoulder joint, the attention is on the joint, the way it feels and glides, while the intention is that the arm should move slowly and under control at all times. Many find this very hard to do as the mind tends to rebel against focusing on just one thing. The same is with running, the attention cannot be on the whole activity, as  we cannot cope with such input, but instead on just feeling the push off, or the chest postion, or another skill.

A five minute challenge, when moving next time, ask yourself: Where is my attention? What is my intention? Not just in a movement pattern but when working as well, it may provide some interesting results.

Why walking in their shoes will give you new insights.

Posted by

To understand someone better, it is said that we need to walk a mile in their shoes.

This is perhaps a little extreme but as with many statements, there is a lot of truth buried in there.

Walking in their shoes, or at least picking them up and looking closely at the wear patterns, both inside and out, will tell you much about the person’s interaction with the world. Do they currently have a prescription orthotic, or some form of insole? How has the outsole worn? Are both sides worn in the same way? Can you see the way the foot turns and loads inside the shoe?

By observing and considering the information provided, it can be possible to start gaining a better insight into how the person moves and hence any potential issues they may be adapting for.

If necessary, stand up and attempt to physically mimic their movement, and what leads them to that positioning.

Feeling it in your own body can be an eye opening experience and one that may hugely enhance your own practice.

Here’s why your six pack won’t make you a better runner. 

Posted by

Most core exercises are a waste of time. They will not make you a better athlete. In fact, they could be slowing you down and creating injuries. 

Why? Because for athletic performance in any discipline, one of the most important functions is the ability to connect your upper and lower body effectively and efficiently without shortening your front. 

The function of the abdominal muscles is to link upper and lower body, provide stability to the lumbar spine and pull the rib cage down during certain motions. 

A short anterior (front) from too many crunches or planks will reduce your hip mobility, create an unwanted curve in your back and reduce the power you can produce. 

To overcome this, by all means do your stability and integration work, preferably under professional guidance to give dynamic feedback but then lengthen and mobilise the front again (for example cobra stretch or warrior poses if you have no spinal or other issues). 

By having a long and fluid front, to work with a strong back, you’ll be closer to optimising your performance and breaking that PB. 
And of course, if in doubt, seek guidance from an experienced professional. 

Stability and Mobility

Posted by

Picture a runner on the track, an image of power ready to be released at every stride. If we were to snapshot them mid activity, we would see that:

  • The foot, as it contacts the ground, needs to provide a stable platform
  • The ankle, resting on the foot, requires dynamic mobility
  • The knee, for optimal power transfer, requires both mobility in the ankle below it and the hip above.
  • The hip, being a joint with a high potential range of motion, should be mobile enough to support the function of the knee below and the pelvis / lumbar spine above.
  • The pelvis and lumbar spine, one of the biggest force transfer areas in the body, needs a high amount of stability.
  • The thorax responds to load and stress by restricting, when a more fluid movement pattern would benefit
  • The scapula, floating over the potentially stiff thorax, becomes unstable as a compensation
  • The shoulder joint itself, due to posture and poor use, will be restricted
  • The lower cervical spine may become unstable as a response to the restriction in the thorax
  • Finally, and balanced on top of the stack, the head and upper cervical spine stiffens.

Looking at the above list (initially drawn from the work of Gray Cook) it is possible to see why, if one area is not functioning as optimally as we might like, the areas around it will adapt their own function to compensate, which can eventually lead to the risk of injury.

As athletes and professional practitioners, we can help reduce this risk by reversing the process with a well considered mobility and strength training plan, allowing us help the areas that don’t move and should, as well as strengthening the unstable zones.

From a practical perspective, it is generally faster and more effective to get a restricted area moving successfully, since it tends to respond more positively, as well as naturally allow the unstable areas to relearn their correct function,

It can therefore be recommended that we focus on:

  • The ankle, using ankle circles, calf stretching and getting any old twists or sprains reset
  • The hip, by stretching the glutes, lengthening the hip flexors and ensuring the joint is well aligned
  • The thorax, needs three dimensions of movement, flexion, sidebending and rotation
  • The shoulder, the most inherently unstable joint in the body, often needs professional assessment to ensure it is not guarding a hidden injury to the joint, and can be helped by improving the function of the internal and external rotation most effectively

By improving the range of motion in these, we can support dynamic development in the rest of the body automatically.

Running it off does not work

Posted by

Each week, we see a number of runners and increasingly gym based athletes, who have had an injury for a while and have tried to train through it.

This never works for a number of simple reasons:

  • Unless it was a non traumatic injury, it will have happened due to a chronic issue somewhere, which needs to be addressed before the problem resolves fully
  • If it was traumatic, there will be a knock on effect, which can get worse if you attempt to train through in any way that loads the injured area
  • Training through, even if it does not dynamically load the injured place, demands modifications in your form and movement patterns, which can cause injury later on

The best approach instead is to use the PRICE principles and book in to get it checked by a professional, who is used to working with athletes.

PRICE:

  • Protect: Avoid loading the injured area and strap or support it if you do need to move
  • Rest: Cut back on your workload and give it some time to heal properly
  • Ice: If acutely injured, cold treatment can help reduce the swelling and pain
  • Compression: A simple bandage may help reduce the swelling and pain, particularly in joints
  • Elevate: By raising the effected area to level or higher than the heart, the chance of swelling is reduced, helping the body heal more effectively

Whether you’ve tweaked an achilles, strained your knee or have a chronic lower back problem whenever you run over a certain distance, don’t just ignore it, pop a pill and carry on, call in and get it resolved quickly and effectively.

80:20 Revisted

Posted by

With the forthcoming release of Dr Kelly Starrett’s new book, I have been reconsidering the advice we tend to offer injured (or preferably non injured) athletes. Dr Starrett (a Phd physical therapist) offers practical and applicable advice on injury prevention and recovery, stating that if you cannot perform basic functions safely (squatting, stretching etc) then you need to sort them out before you try running.

These days, with web access virtually ubiquitous in the western world, there is a surfeit of information available at our fingertips. The difficulty is in discerning what works and what doesn’t. With the rise of athletic “biohackers”, who promote tips and tricks for small percentage improvements, finding the signal amongst the noise is even harder.

For most of us, performance improvement comes down to three simple things.

  • Optimise Nutriton / Diet
  • Train efficiently
  • Recovery / Sleep

Dr Starrett covers much of this in his excellent book Becoming A Supple Leopard and reviews indicate he will cover this in the running guide.

Breaking down the above bullet points, optimising diet means ensuring you eat cleanly and sensibly most of the time, getting a suitable balance of proteins, fats and carbohydrates, with plenty of micronutrients. Nothing clever or fancy but by not doing this, you are ensuring that your body is not going to operate effectively. This is the base upon which all the others stand, mentally and physically.

The part we all think about is the training aspect. We plan, prepare and put in the hours and miles to attempt to achieve our goals. But are we doing it in the most efficient manner? Could we save time by cutting out junk miles or hours in the gym, since more is not always better. Is there such a thing as a recovery run, or easy workout? Would that time be better spent with friends and family, which might help improve our mental state, or doing mobility work (as described by Dr Starrett)?

This ties in to point 3, recovery and sleep. Do you recover enough? Are you waking refreshed and ready to go each morning without needing an alarm or two? There is no set formula for this since the factors involved in recovery are complex, including external stressors, but by tracking basic biomarkers (resting heart rate, blood pressure, oxygen saturation (SpO2) etc) and personal reflection, we are able to observe how our bodies are responding to the load we place upon them. If your resting heart rate is elevated and your SpO2 depressed then you are simply not recovering from the load. Another simple test is to attempt to create a change in your heart rate during a training session. If during a run or ride, you cannot easily elevate your heart rate by increasing pace or effort, then there is a possibility that you are neurologically as well as physically tired and as such, backing off would be advised.

Some people are beginning to use heart rate variability (HRV) to track their stress and recovery. Like many tools, this gives a view into the workings of the body, in this case the autonomic nervous system, which can be used to explore the effect training or stress is having. Many researchers and doctors have shown that there is a link between low variability and mortality from a number of causes but these are measured using ECG over a long period of time (24 hours), especially after an acute myocardial infarction. Some work is being carried out with regards to the use of HRV to track physiological changes due to stress and training and although this appears to be useful over long term measurements, such that trends can be visible, it appears to be a back up to the other measurements and as such, outside of the 80% rule of most efficient use of resources.

To conclude, eat to meet your nutritional needs, train efficiently and recover effectively. Then start making the 20% changes.

Power, paths and chains

Posted by

I have been thinking about simplifying stretching processes around exercise. Not when trying to repair or prevent injury but as a general mobilisation. Out of this, it is possible to spot a couple of patterns that are easy to follow, cover all the major muscle groups in the body and allow us to achieve the most benefit from our stretching time.

The body has an anterior and posterior chain (originally and well described in the work of Tom Myers), as well as the basic or prime moves.

By combining the basic requirements for movement (flex / extend / rotate) in all joints together with chain connections (it is possible to open up and stretch the whole body very smoothly.

Starting with the spine, we need to create flexion, extension, rotation and sidebending, focused on the articulation of the intravertebral joints rather than faking apparent range of motion with the peripheral limb movements. Hands on opposite shoulders (crossed in front of chest) and turn spine left and right, then flex forward (from the diaphagm) and arch back. Finally sidebending both directions to finish the moves.

For the front chain, step into a open lunge, keep the pelvis neutral (most important), extend the opposite arm as though stretching the chest and turn the upper body in the same direction. You should feel a gentle tension across the whole line. If you are unable to sustain this, it can be split into sections but needs to be considered part of the whole. The sections being kneeling lunge for upper body to pelvis and quad stretch for lower body. Repeat both sides, of course.

For the back line, a sitting figure 4 stretch (foot into opposite knee and lean into straight leg) covers most of the groups.

Finally, lie on your back, pull your knees up so knees and hips are comfortably angled, then let them drop to one side so that the glutes are stretched, together with the back chain. This can be amplified by putting the opposite arm out and stabilising the upper body.

Of course, these are best demonstrated in a clinical situation, so that they can be tuned to your body, however by paying attention to both your attention and intention, then good results can be acheived.

Wobbly sticks and string

Posted by

Most people have seen a tensegrity model. These are clever constructions of sticks and elastic that use balanced tension and compression to created self supporting shapes.

(Image taken from http://dotensegrity.blogspot.co.uk/2011/01/make-your-own-tensegrity-model.html)

It is possible to consider the body as a tensegrity model, where the bones, muscles and ligaments all act together to support, articulate and move.

Although simplistic and missing huge elements of the effects of fascia, organs, inflammation and so forth, it is a useful analogy to hold, especially when trying to educate patients.

Recently, I have been considering the lumbar spine and the need for good abdominal support around it. The metaphor I use it that of a wobbly stick attempting to link upper and lower halves of the body. The pelvis is a fairly stable, solid object and the thoracic spine is well held with the ribs. This leaves the cervical spine (a wobbly stick with a block on top) and Lumbar spine to do a lot of work. Therefore, we need plenty of active muscles recruited to provide stability, support and movement.

So, no matter how much we may train that six pack and work to get well toned abs, if we cannot recruit them during activity, its fairly pointless.

I have 3 basic exercises I start with for every patient and, if they can do those, move to the next level. These are:

Pelvic control: The patient lies supine, slides one heel up the couch or floor, whilst attempting to maintain a level pelvis, the ASIS not deviating significantly posteriorly. Recruitment of the TA is particularly useful in this.

Cat crunches: On all 4s, the patient pulls their navel towards the spine, attempting to keep everything else still. A count of 5 and release slowly. This helps recruit deep obliques and the thoracolumbar fascia attachments.

Gluteal raises (trendelenburg drops). The patient stands sideways on a step and allows one leg to drop. They raise it back up again, using the opposite glutes, minimising recruitment of QL or lumbar erector spinae if possible.

Once they’ve got these, then the neuromuscular paths are working better and we can progress to more dynamic tests.

No more wobbly stick, less back pain.

The use of compression wear in recovery from injury

Posted by

Many people use compression wear for racing, training and recovery. However, I’ve been thinking about using for recovery from injury.

As of yet, I haven’t been able to design a suitable controlled trial but we have been trialing it in clinic with some athletes and other active clients.

We noted that it seems to help improve recovery time in people with both calf injuries and tendonopathies. It appears that the compression wear (in this case compressport calf guards) helps reduce buildup of oedema when worn overnight and support the muscle during everyday activity during the day.

We are going to continue trialing this and hopefully will have sufficient day to draw a more solid conclusion soon but i thought i’d put it out there for general consideration. We are also going to try the quad guards for hamstring and quad injuries if suitable clients present.