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toxins-cause-exhaustionThink Sleep Doesn’t Matter?  Think Again!

 

Runners tend to enjoy challenges.  How else to explain things like 50 state marathoners and people running in the driving rain or the dark of night?  Many times the daily challenge is how to fit everything into 24 hours, run included (definitely), and sleep included (maybe…some at least).  Runners often rationalize the lack of sleep because it is the only way (often waking up early in the morning) that they can conquer this “24 hour challenge”.  But, does it really matter if you sleep enough?  You bet it does.

 

Dr. Michael Fredericson of Stanford University, long time team doctor for the track and cross country teams, as well as one of the most experienced medical researchers on running related injury patterns, maintains that when compared to time, money, and effort spent on things like vitamins, minerals, supplements “If you get a really good night’s sleep, it outweighs almost everything else.”  To consider why, he encouraged a look at several recent explorations of the effects of sleep on performance for several important points.

 


Running for your health might not erase the health risks from lack of sleep.

Drs. Stephan Esser and Rick Feeney in their recent article “ZZZs for Speed”  (Marathon and Beyond, March/April 2012), relate how studies show chronic sleep deprivation can increase the risk of high blood pressure, depression, certain cancers, and diabetes…just for starters.  It also increases an appetite-stimulating hormone, which might challenge the efforts to use running for weight loss.   Yikes!

 

Sleep has a demonstrable effect on your athletic performance.

We have all survived days or longer periods where we have been sleep impaired.  College or high school finals might come to mind.  However, if you are looking for a PR, extra sleep is more than a marginal concern.    Cheri Mah of the Stanford Sleep Disorders Clinic (along with famed sleep researcher William Dement), conducted a study on the Stanford Men’s Basketball team, where their performance on sprints, shooting accuracy and other measures were charted based on their levels of daily sleep.  Those who slept more during the course of the study found significant improvements in their time on sprints and their accuracy on shooting improved as much as 9%.  Imagine even just a 2-3%% improvement in athletic execution in your next goal race and a 4 hour marathoner gets to the finish line almost a half mile faster!

 

Don’t just take it from basketball players, though.  Esser and Feeney also cite studies that have found a cyclist getting twice as much sleep during a 4800 kilometer event could make the top 10, while spending much less time in the saddle than the other nine.  Another study found that one night without sleep caused an average of an 11% drop in time before exhaustion with a spread of 5-40% (in other words, some folks fell much further off than the average)!

 

Even if you can make it on less sleep, the running usually feels much harder.

Perceived exhaustion also spikes like crazy when sleep is elusive.  Most busy people can attest to this – when the 2pm meeting feels interminable or the key workout just feels more like “5k pace” than the “80% pace” written on the training plan.    David Martin’s oft cited study enforces that believe that even one night of reduced sleep not only decreases time to exhaustion, but time until perceived exhaustion.  Other literature cited by Esser and Feeney indicates that mental fatigue can greatly hinder the drive needed from our brains to require our musculoskeletal system to continue moving.  The limbs might still be able to keep moving with less sleep, but the brain is less inclined to require them to do so, and feel much less inclined more quickly.

 

Lack of sleep also results in the slowing of glucose metabolism, resulting in a lesser ability to draw needed sugars from the muscles during that next bout of exercise following the short night’s sleep.  Most of us in this fatigued situation then turn to some simple sugars to help flood the system and get what we need right now, even if it is not helpful energy for the long term.  You can guess where this leads in terms of diet…..

 

Sleep to recover from and prevent injuries….You can’t run if you can’t run

While your bones are constantly remodeling during the day, important amounts of this protective and ameliorative process take place during sleep.  In one 2008 study cited by Esser and Feeney, bone resorption was increased by 170% when sleep was increased among army recruits under a consistently challenging physical demand.  If stress fractures are a concern, sleep might be a particularly huge and important variable for you.

 

OK, OK, OK….I get it!  Now what should I do?

Most people need 6-8 hours to function regularly and healthily.  However, your individual needs may vary.  If you are using remedies (coffee, sugary foods, 5 Hour Energy, Red Bull) to alleviate sleepiness on most days, then it probably is appropriate to track your typical patterns for several days. Seek to improve upon your amount of sleep if even temporary adjustments result in an improvement on performance or perceived level of exertion.  Even if change is difficult to come by due to structural forces beyond your control, a healthy dose of mindfulness about nighttime habits might yield a more quality level of sleep during the shut-eye you do get.

 

Read Esser and Feeney’s entire article here.

 

Read a detailed summary about the Stanford Basketball Sleep Study here.

 

 



imgresWill Running on Cement Injure Me?

 

 

Many runners run in urban settings for years, logging mile after mile on cement and other hard surfaces without any apparent problems.  Other runners swear by the trail and believe it has prolonged a running career and mitigated many risks of injury.   Still others do the exact same thing, and still fight injury after injury.  Who is right?

 

Force = mass x acceleration

Conventional wisdom would indicate that the hard surfaces found in cement (your average city sidewalk), or asphalt (black top road surface) would increase the risk of injury for runners.  After all, the body creates 2-3x its actual weight in force just during the heel off phase while walking. This increases to 5-8x body weight during running due to the increase speed and the fact you are (for some of us, very briefly!) completely airborne before each foot lands.  Cement is about 10x harder than asphalt so it seems reasonable that cement would be an absolutely horrible surface on which to run.

 

If all your concerns related to problems that occurred due to force alone, then perhaps abstinence from cement would be a wise idea, and indeed, many runners opt for the street instead of the sidewalk, or go long ways out to find trails and grass surfaces.  However, many of the injuries runners suffer have a more complicated genesis.  Are your shoes appropriate for you?  Does your foot strike the ground efficiently?  Are you hips in alignment or do you have muscle imbalances and weaknesses that have left your joints and ligaments vulnerable to forces that your body has not been able to dissipate?  All of these factors come into play, and have been much more easily researched as injury culprits than the surface itself.

 

What is good for the bones might be tough on the ligaments

Likewise, the even, but forgiving surface of a golf fairway (when rarely available) might provide a luxuriously feeling run, as does a well- manicured forest trail.  But when does that desired effect dwindle when the trail become rocky and uneven, or muddy and slippery?  When the grass is long and mushy, or the bark trail too soft, such that you sink perceptibly on each step, or the blacktop road so cambered that you are running on a slant instead of a flat sidewalk next to you, do you receive the same benefit?

 

While these surfaces might provide relief from the abrupt forces of cement, they often demand a great deal more from stabilizing muscles and ligaments and present their own challenges to your goal of staying injury-free.  If tendonitis, muscle strains, or other soft tissue ailments are your kryptonite, you might risk more by continuing to run on these surfaces all the time and may benefit from a steadier ride on a hard surface.

 

Running is healthy for the spirit as well as the body

One of the reasons pavement and cement may get the blame for many maladies is the correlation with the environment where these surfaces are typically found.  Not many runners would prefer the start and stop of a sidewalk interrupted every hundred yards with a stoplight, complete with honking, speeding cars and loud noises, crowds, and the like.  The peaceful environment of a trail deep in the forest, around a lush and green grass field, or along the ridge of a slowly descending dirt path sounds much more reparative to the soul.  Studies show that the body is best prepared to run hard late in the afternoon, or early in the evening.  Potentially a study might show that those who run along peaceful dirt paths can extend their running careers later into middle age and beyond.  But just as not everyone has the luxury to knock off work or family obligations for a 60 minute run in the hills at 4pm, not everyone can get to an idyllic nature setting for their daily run, whenever it occurs.  For them, running along a busy street or the best bike path available most definitely is better than not running at all, and that may mean running on cement or non-ideal surfaces.

 

Look at the whole picture

Rather than automatically assume the risk of the surface one way or the other, a more thoughtful approach is in order.  Consider your problem areas, where injury trouble tends to start or flourish, and then work through each of the other variables:  shoes, foot striking pattern, known muscle weaknesses or misalignment issues, sleep, stress, nutrition, hydration, etc.  It may be that a change to soft surfaces may be in order, but the investigation may uncover other areas where change may eliminate the risk or problem, even if the ground under your feet remains the same.

 

 

 



Superman-Caped-Knee-High-SocksAdam and Micheline Kemist own On Your Mark, a running specialty and performance store.  A certified Pedorthist and Kinesio tape practitioner, Adam provides personalized biomechanical feedback and orthotic services along with retail services. In this edition of Ask the Practitioner, we talk to Adam about an often over-looked element of our everyday running - socks.

rc: We often spend a lot of time considering the right pair of shoes, but we wear socks just as much!  What are the main functions socks can provide (either well or poorly)?
 
AK: Socks are the item actually touching your skin so you want them to be working harder than your shoes at keeping your feet comfortable.  Technical running socks are designed to keep your feet comfortable and dry.  When this happens your feet will have less swelling, fewer hot spots and fewer blisters.

rc: As an avid runner and running retailer, what do you feel are some of the recent innovations and improvements for socks?

AK: Two of the best innovations are anatomically shaped socks.  This means some socks are made specifically left and right.  This puts the padding and durability in the high wear areas and softer materials in non-critical areas.  Another innovation in running socks is a high stitch count. Basic cotton socks are typically stitched at about 72spi (stitches per inch), but a good technical running sock will be at 174spi with some of the best at 210spi.

rc: If you aren't sure what kind of socks would be best for you, what are some tips for ways to find out?
 
AK: Try to buy your socks from a specialty store like On Your Mark in Los Altos, California. The staff will know how each of the socks are constructed and can guide you.  Look for socks by companies that only make technical socks like Balega and Feetures, or running shoe manufacturers that have branched out with socks like Asics and Brooks.  Choose a medium weight sock to start.  As you start to feel the difference, then branch out and try other brands and thicknesses.


runner_in_stormThere will likely come a time when weather will interfere with your running plans. Read on for a few quick tips on how to "weather" the storms with your goals intact.

Safety first, always.
Runners by nature are some of the most stubborn people around.  A lengthy daily running streak, an even number mileage total for the week, or the fear of recording a zero in the log all can be highly motivating factors.  When a huge weather event prevents even a minimal amount of activity, let the visceral disappointment of not following through on plans be a reminder of how joyful you will be to run another day when things are better.  The joy of the future is a wiser and better movtivator for safe behavior than a false feeling of invincibility when conditions are not safe.

Narrow your focus.
Ideally, you would have gotten in both your long run and your track workout.  Ideally, you would have done the tempo run on the usual path that now has a tree lying on it.  Well, things are not ideal, so shed the focus on what can't get done and zone in on what can be done.  If it is Tuesday and the weather is expected to improve by the end of the week, you might not be able to get everything in, but you can probably get one crucial component in.  Focus on doing a good job with that one challenge, and be encouraged that at least one important training element kept you moving the ball down the field.

Avoid running alone.
Slippery streets, snow drifts, gusty winds, power outtages leaving poorly lit paths - if the weather has moderated, but challenging climate elements linger, taking a companion on your run can help ensure both of your families that someone else can help if a problem arises. 

Overestimate your bottled water needs.
Everyone needs to hydrate, but if you are running while power remains out or in a dry winter environment, you will need more than the average person.  Stay ahead of the situation with a periodically replenished water supply in good times.  If supplies are limited during lingering storm conditions, budget liberally for your needs.

Keep a sense of humor and don't take yourself too seriously.
If you are safe, be glad.  If you have to take more than a preferred amount of time off during a storm, think of the early modern Olympians who would have to ride a boat across the ocean on their way to meets and would find their way to the medal stand anyhow.  Remember the Chilean miner.  Be glad you aren't earning your living by running if running is unwise. Plan on impatience, and as necessary, let your stir craziness serve as a source of humor for those with you.  Remember, your running is something that you do affirmatively for your health and well being, not something that is more essential than safety, food, and water. Always look forward to clearing skies- they will come eventually!



calfIn this edition of Ask the Practitioner, we again connect with Mark Fadil, Clinic Director at the Sports Medicine Institute (SMI) of Palo Alto.  SMI is one of Northern California's leading orthopedic and deep tissue massage resources, assisting both world class and recreational athletes since 1996.  

RC: Tight and/or sore calves are one of the most common ailments for new and experienced runners alike.  What exactly is happening when one feels like his or her calves are tight and they have become sore to run on? 

MF: Sore/tight calves are a very common problem with runners.  Generally someone may experience sore calves when running for the first time, coming back from time off, during a period of increased speed work or during a period of increased mileage.  In each one of these circumstances the calf muscles are adapting to the stress from the increase in activity.

RC: When treating runners with sore calves, what are the most commonly reported practices that have potentially led to the problem? 

MF: There is normally some sort of change that precedes sore/tight calves.  In addition to the changes I already mentioned it can come from a change in running shoes (usually a shoe with a lower heel such as a racing flat will put more stress on the calf), a change in running surface or increased hill running.

RC: What techniques do you and your staff employ to address this problem and what can runners to do maintain the work at home? 

MF: I usually focus on three things: massage, stretching and functional strengthening.  Massage can be done by a professional therapist or at home using a foam roller or "the stick."  This can be done on a daily basis for 5 - 10 minutes.  Stretching should focus on both the upper calf (gastrocnemius) using a straight knee calf stretch and the lower calf (soleus and Achilles) using a bent knee calf stretch.  I recommend stretching after massage as well as an additional 2-3 times a day.  Each stretch should be held for at least 30 seconds.  Functional strengthening is one of the most important pieces in preventing sore/tight calves from occuring in the first place.  A great way to incorporate functional strengthening is doing heel drops off the edge of a stair.  These should initially be done on a daily basis and eventually shifted to two to three times per week for maintenance.

There can always be other issues that contribute to calf soreness/tightness.  But this should provide a good overview of the more common causes and effective treatments for most cases.
 

 



 

Rikke Johansen, D.C., is the founder of Health Logic and has 18 years of experience in practice as a doctor of chiropractic medicine.


Dr. Johansen is a Certified Chiropractic Sports Physician (CCSP), a Certified Strength and Conditioning Specialist (CSCS), and has completed the educational requirements to qualify her as a Diplomate of the American Chiropractic Board of Sports Physicians (DACBSP) and as a Diplomate of the American Chiropractic Board of Radiologists (DACBR). She is also a USA Triathlon Level I certified triathlon coach and a USA Cycling Level II certified cycling coach.

rc:  What are the types of physical complaints Graston technique is effective in addressing?
 
RJ: The most common complaints in my practice (we see a high percentage of endurance athletes) where patients specifically come in or are sent by their medical doctors to get Graston are: Plantar Fasciitis, Iliotibial Band Tendonosis, and Achilles Tendonitis. Another common issue is post surgical scar tissue, i.e. after shoulder or knee surgery. The chronic high hamstring tear is also effectively addressed with Graston.

rc: What makes Graston different than other popular techniques, such as manual deep tissue sports massage and Active Release Technique?
 
RJ: It is important to  remember that all techniques are only as good as the overall assessment of the athlete as well as proper diagnosis of the kinetic chain and faulty bio-mechanics. A knee problem is rarely an isolated knee problem.  It is important to correct muscle weaknesses, range of motion challenges, etc. We certainly use a combination of myofascial techniques, but with the Graston instruments we are able to more specifically locate adhesions, get a sense of severity and create the localized controlled 'trauma' that will aide in normalizing the tissues.

rc: What does Graston feel like and how effective is it?
 
RJ: Everybody has different pain thresholds, and different body areas are more sensitive. Graston can be slightly painful, but more often in a 'good' way. It is often described as a rolling pin, when done on the back with a large instrument. Some people describe the smaller treatment edges as metal brushes. The technique is modified to each individuals comfort level and pain is not necessary to get results.  As to effectiveness, generally we take care of 85-90% of chronic conditions, such as those mentioned above, in 4-6 visits.


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Few life changes will have a greater impact than the arrival of a newborn.  Both the physical challenges for mom, as well as the stark changes in family schedule and breadth of responsibility for both parents can justifiably upend priorities.  This can wreak havoc with the comfortable patterns of habitual runners.

Chances are, unless you have had a very quickly moving adoption, you have been well aware that changes in your running routine await the arrival of the new bundle of joy.  Very likely, transitions have already occurred for mom with the ups and downs of pregnancy.  Whether a quick return to work or flexibility for extended parental leave is on the horizon, here are a few tips and ideas for runners in the throes of new parenthood:

Consider how baby gear purchases, such as a stroller, can assist you in the eventual pursuit of a return to running. Yes, that sounds crass – you are about to enjoy one of life’s greatest blessings, and running should come to mind?  Well, if there is anything that you intend to continue doing on a regular basis after your baby comes, it probably saves time and money to anticipate how you can manage that practice within the context of your baby’s first few years at home.

For example, many running families use a jogging stroller (or a stroller with that capability) for their primary stroller.  Initially, it can be used for regular stroller duty, particularly now that many jogging strollers can attach baby carriers and inserts allow for extra padding with newborn babies.  When eventually jogging becomes appropriate with the little one, everyone is used to the new gear, how it fits in the car, the baby finds it to be a smooth transition, and more enjoyable / contented baby running might result.

Moms: set a completion goal, but no sooner than 6-12 months after giving birth.  Dads: choose flexible goals in the first year.

While the experience of every mother is different, having a goal to shoot for can often inspire (to lose weight, to re-grasp a feeling of independent personhood, etc) when life seems completely turned on its head.  Set a goal too soon, and it may become a needless stressor, both logistically, and physically, when the body is out of shape and sleep is minimal.  Set a time goal too soon after giving birth, and the unpredictable physical aftermath of motherhood can create frustration.  By a year, many moms are beginning to recognize their bodies again, and having a date to look forward to (as a return to the experience of being an athlete) can be a very motivational tool.  Just enjoy your first goal race after baby to celebrate how far you have come.  Use subsequent goal races to return to previous fitness and pace levels.

New dads are also saddled/ delighted with the many transitions of fatherhood, but many times must navigate a tricky landscape of an initially supporting role in the physical sense.  Without the obvious setbacks of pregnancy and giving birth, it may be enticing to set a big goal, almost in celebration of the new family member.    However, in this particular instance, it is worth considering flexible goals.  Neither of you quite know how you will feel physically or rest-wise as these dates get closer, and the last thing needed is more stress.   One option to keep dad on track could be to pick a distance goal with three or four options in 60 day range.

Have patience with your body after baby (yes, dads too!)

For many first time parents, the adrenaline of new parenthood eventually wears off, but many nights of limited sleep remain.  Schedules change and keep changing.  Things like foam rolling, stretching, strength routines, and other ancillary activities may be cut out to preserve what little time remains to run.  Unsurprisingly, aches and pains might crop up, and the legs might not recover as fast.  Control what you can control.  Consider occasionally modifying your running routes and other patterns to avoid a fruitless comparison contest with your well-rested self.

For moms in particular, resist the urge to return to serious training until you are cleared to run by your doctor.  Be sure to progress incrementally.  Just like a marathon recovery that is too short, a postpartum running injury may not crop up immediately.  Rather it often surfaces after the premature progression has been established over several weeks or months.

Shop and prepare for running with body after baby.

One of the most common roadblocks to a successful return to pre-baby running fitness can be the first few efforts out the door.  For many moms, postpartum bodies feel like complicated new appliances with misplaced instruction manuals, what with the likely weight gain and the new demands and dimensions of various body parts.  All of us know better than to establish self-esteem from outside appearances, but without a couple running items that fit, it can be that much harder to get out and get started.  Having a high impact / supportive sports bra and shorts that fit your current size can make a difference, and are worth shopping for even in advance when you have more flexibility in your schedule.

When it comes time for stroller jogging, find the bike paths.

Just as parents at their wits’ end will drive a baby around the block, hoping to induce sleep, the stroller experience for your baby / toddler can vary wildly from soothing to disruptive, which in turn may have a direct impact on your ability to reintegrate running positively into your daily life.  Bumpy roads, streets with many stop lights, turns or undulations may be your only options, and by yourself, you might barely notice these parts of the route.  However, the stroller years might also serve as a chance to get to know the flat, off street routes in your region better than you might have before, and allow the jogging stroller experience to emerge as a positive parenting interactive time rather than a struggle of wills.



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