On: Heat

The UK and much of Europe is currently experiencing a heat wave (mid July 2022).

We are, by and large, not used to this although I fear that we may need to adapt, due to climate instability.

For those of us who enjoy activity, being active in the heat is a challenge and can be a medical risk for many.

Because not only do we have to take into consideration the temperature on a thermometer, but we also need to account for the humidity, since this has an impact on the body’s ability to lose heat. It is possible to run marathons in the desert more safely than a humid summers day.

Hydration status, electrolyte balance and other physiological conditions also have a role.

So how do we develop flight rules for exercise in the heat?

Firstly, know your body, and pay attention to it. Getting off the aircraft from a cool region and plunging straight into a desert marathon is asking for trouble. Allowing time to adapt and preferably having mimicked the conditions previously is a much smarter idea.

Secondly, understand your hydration and physiological status. Medically, you should expect a fluid balance of approximately 30ml per kilo per day. This does include the water in vegetables and fruit so is not just liquid water. You will also need to maintain a good electrolyte balance for yourself. If you are a ‘salty sweater’ (your t shirt develops white stains as the sweat evaporates or your lips taste salty) then you will need to replace more of both sodium and potassium in the correct proportions. Most sports electrolyte supplements cover this and advertising aside (we are not sponsored) Succeed caps, SIS electrolyte tabs and High Five electrolyte tabs have always done well during my endurance training career. Others are available and you don’t need the sugary sweetness of most sports drinks for anything under an hour anyway.

The other, under reported element to track during activity is heart rate. In general, if your heart rate is higher than you would expect for a specific workload, then you are possibly dehydrated and certainly accumulating heat stress, with your body finding it hard to stay cool enough. If it is dropping and you are struggling to elevate it to the target ranges then you may be suffering with cardiac fatigue. In either case, back off, drink, reflect and wait for it to settle before making the decision to go or no go. A personal rule is to take off 10 beats from my target heart in non acclimatised heat as a safety margin.

Summary:

  • Heat is a stressor
  • Acclimatise and adapt if possible
  • Hydrate using electrolytes if indicated
  • Monitor heart rate if possible and set yourself safety limits

Onwards and stay cool.

And of course, if you need more detailed input on optimising your training, resolving injuries and improving your health span, contact us.

Note: this article is a generic guide and not specific advice. If you have any health concerns or underlying conditions, seek support from your registered medical professional and care providers.

You evolved to run…

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.

The only person to compare yourself to. 

Not the guy in the next squat rack, not the girl on the yoga mat who can tie herself in knots and always looks perfect, not the professional on the tv. The only person to compare yourself to is….

You. 

Are you a little bit better than you were yesterday? 

Age inevitably degrades our performance slightly over time, with some researchers considering the average value to be 10% per decade, but most of us haven’t achieved our true potential in any decade so there is no reason why most of us cannot at the very least maintain results with improved efficiency and technical skill. 

Rather than using any comparison as an excuse, figure out what you need to do to be 1% better. Harder work is not always the answer, instead see if you need to get out of your own way by working on mobility, becoming more efficient or focusing on a specific movement. 

Gym free workout of the day

Got 10 minutes? Want to change your life for the better? High intensity short interval work has been shown to be highly effective. Try the following:

  • 2 minutes seated wheel breathing 
  • Then complete as many rounds as possible in 5 minutes of: 5 burpees / 3 inch worm pressups
  • 3 mins wheel breathing

Guidelines 

Wheel breathing– sitting comfortably, focus on your breathing. Allow each inhalation to be followed, smoothly and slowly by each exhalation. Picture yourself successfully going through the workout efficiently, effectively and relaxed. Afterwards, just focus on letting each breath flush all the stress and fatigue from your body, so you’re ready to face the day. 

Burpees– start standing straight, squat down hands on the ground, thrust feet backwards to press-up position, pressup, reverse to stand with a jump out of the squat. 

Inchworm pressups– start standing up, bend forward to touch toes, walk hands out until you are in the pressup position, lower down, hands off the ground into a back extension, reverse to get back up. 

Scaling versions

Burpees- 1 burpees is 3 air squats jumps. Squat down, knees behind toes, then spring back up to jump as high as possible. 

Inchworms- kneeling pushups with back extension. Kneel down, lower yourself smoothly, hands off and extend the back, then push back up again. 

Whichever version you do, try to keep going for the whole 5 minutes.

Semper Pergendum!  

The Camford Clinic. Professional osteopathic sports injury and life management in Alton, Hampshire. 

01420 544408

Info@the-Camford-clinic.co.uk

Can’t does not exist

Not only is it a contraction of cannot, it is a word that disempowers us all. You cannot do that, I cannot do this. These phrases mentally weaken us by throwing up barriers that restrict our perspective.

Instead, reframe the statement. From I cannot, move to what is stopping me? With almost every goal and outcome, there are obstructions, whether physical, social or psychological. Some of these are with good reason and purpose (you cannot jump off the top of the london eye, for example), but for almost everything else, with a change in the way the statement is created, a path and a way forward can be discerned. From identifying what you want to achieve, it is possible to understand the knowledge you need to gain, the skills that can be learned and so step by step, move closer to where you wish to be.

We can get better, because we’re not dead yet.

Frank Turner Get Better

 

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

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. 

80:20 Revisted

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.

Unlock your potential

What would happen if you could:

  • Train more effectively
  • Recover faster and more efficiently
  • Heal from injuries quicker
  • Maximise your resilience

It would unleash your performance in every area of your life. You would have more time to spend on relationships, work or play, achieve more when competing and have less noise in your head when the time comes to focus.

The secret? To get out of your own way. Most of us are held back by learned patterns, old injuries and poor habits, trying to do more and more with less and less. Restrictions in one area reduces the body’s capacity to deal with stress in others. A tight hip will shorten your stride and overload the achilles, a stiff upper back will drop your maximal squat, restricted shoulders will limit your press or swim stroke. Mentally, stress at work will reduce your ability to make solid nutritional choices, family concerns will eat into your training mindset, anxiety will limit your performance at competition time.

If you can figure out what is restricting you, then removing those blocks can make huge differences.

Each persons blocks are different. Physically, look first at the ankles, hips and thoracic spine. Any old injuries, scarring or tissue changes (tight, weak, short) can affect the rest of the body in many ways. Can you perform the basic movements (push, pull, bend, squat, lunge etc, cleanly and pain free?)

Another physical issue is not listening when we need to rest, by ignoring the subtle clues in our physiology. Is your resting heart rate elevated, are you feeling more fatigued than normal for this workout, is your nervous system tired? (This can be tested via heart rate variabiity apps and simple biomechanical tests). Are you sleeping sufficiently? Once those areas are cleared, look at specific areas related to your sport or discipline and optimise your strengths and minimise the weaknesses, a process that will take a lifetime of self observation.

Mentally, we are always fighting against the patterns and habits picked up from everyone around us. Fear that we are not training hard enough can lead to overtraining, learning not to listen to the inner voice of weakness during a difficult moment, belief in an internal monologue that tells we are not good enough, often imposed by others, copying or competing with our training companions when we should be backing off.

By reading the cues, listening to ourselves and seeking the support and expertise of professionals, you can unlock your true potential in every domain.

Foot strike, thinking backwards?

There are lots of discussions at the moment on running, foot strike,injury and so forth. These discussions have probably been around for as long as people have gathered to talk about the science of running.

Which is odd, as we have been running for far longer and seem to have got it pretty much right for the majority of that time.

We talk about heel striking, forefoot striking, a midfoot pattern and all combinations in between. Yet it is inevitable that the foot is going to strike the ground, Gravity always wins!

Why not, instead, think about how the foot pushes off again. That, to me, requires far more thought as it has to happen consciously. And a good push off has to have come from a solid foot strike.

Rather than concentrating on how the foot strikes the ground, think about the feeling of the correct area of foot pushing off, the forefoot driving away, the force passing through it and propelling the runner forwards. For this to occur, all the muscular chains have to fire correctly.

So perhaps we should turn it upside down and think about driving forwards, not striking, and see if that makes a difference.

By all means wear minimal shoes, learn to run barefoot (it is bio-mechanically highly efficient when  learned properly) and look after your body, but flip the idea upside down every now and then.

A brief thought on running mechanics and gait

It is generally thought that there are 4 main phases to the gait cycle when running:

Inital strike, stance, take off and forward swing.

Breaking this down into 2 separate sections, we can firstly look at the strike and stance phases. As the foot makes contact with the ground and rectus femoris (one of the quadriceps group of thigh muscles) proactively fires. As the foot touches the ground, the subtalar joint inverts or everts, the midfoot abducts or adducts and the forefoot plantarflexes or dorsiflexes. All these subtle movements combine to allow a small amount of pronation to occur, maximising the foots ability to dissipate shock.From this, we can see that a tight foot that underpronates limits this ability, which may lead to achillies problems, calf strains, lateral knee pain and illiotibial band issues. Conversely, overpronation can lead to tibial strain, anterior calf injuries and medial knee pain, due to the medial rotation occurring in the tibia. 

Swing phase happens at the same time on the opposite leg. The pelvis rotates forwards, with hip flexion initiated by the iliospoas. The Hamstrings start to lengthen, limiting the extension in the lower leg, caused by the quadriceps.The lower leg decends, hitting the surface as the body accelerates, ideally creating a vertical line between head and toe on impact.

During both phases, the core provides stability for the upper body, allowing the forces to be shared and transferred correctly. As the spine can be considered by some researchers a store and transfer for the energy contained within the running motion, core integration is important and if not present, an indicator and predisposition of other issues that need to be addressed.