Small Change, Big Gain

A few weeks ago The Fartlek was asked to contribute to an info graphic about the small, daily habits that lead to a healthier and better life. The instructions were pretty simple. They were looking for favorite personal wellness tips from several health conscious bloggers to use in the graphic – anything from a morning exercise routine to an afternoon meditation session, or even a favorite pre-bedtime smoothie.

The exercise resulted in an interesting thought process for me. What would you say are the most important daily habits that lead to a healthier life? Is it diet, a particular  exercise routine? My dad could be granted a patent on the unique combination of ingredients for his morning smoothie. My husband would say that ‘healthy’ is a lifestyle; that an exercise routine has to become an integral part of your day.

My answer came from the perspective of my favorite sport of running, although I realized everyone’s answer would vary depending on their own personal goals.

The challenge seems to be the same for everyone: to find a routine/diet/exercise that works and somehow convince our minds to stick with it. Within that challenge are three things that help me stay on track from day-to-day which could be applied to health-conscious folks of every age:

1. follow an easy-day/hard-day schedule – for example, in my sport of running, a slow, easy run would follow a hard, speedwork session; this schedule can keep things from getting too monotonous as well.

2. respect the rest days – your body becomes stronger with rest, so the best way to continually improve and avoid injury is to give the body adequate recovery time; something that becomes even more important as we age.

3. eat fresh and be adventurous with ingredients – use fresh, not packaged ingredients and vary what you eat from day-to-day instead of getting stuck in a routine of the same meals. My favorite saying is “good in, good out” because it’s so true, but studies also show that athletes who eat the most variety of healthy foods perform the best.

The hardest thing seems to be simply getting started with a healthy routine, whether that’s exercising or eating right. We have to remember that most of us never reach our full potential because our minds won’t let us – our most difficult challenge is harnessing the mind.

One of the most effective ways to ‘override’ these negative thoughts is to establish a routine you can stick with, and remember that N=1. In other words, you are your own best test subject. What works for others, may or may not work for you. Experiment until you find your best solution.

What’s your #SmallChangeBigGain? (Elysium Health)

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The Heart of the Home

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The kitchen of our current home featured 1970s-era dark cabinetry, a linoleum floor, dated wallpaper and an adorable french chandelier. There were stainless double ovens, a black dishwasher and a white refrigerator. And despite its dated decor, there was something intriguing about this house. It had soul, I suppose. History.

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The adjoining Keeping Room ‘before’

It has taken a good long while to reach a point that I was willing to reveal pictures of the remodeled version of our home. Every inch of space, inside and out, seems to need more work. And work is not something that always happens fast.

We spent the first few weeks living in this house with no kitchen at all because the cabinets were delayed. Even after they arrived, we spent a few more weeks without a sink or countertops. When all the pieces were finally in place, it would be another 6 weeks before the backsplash was installed.

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I saw the refrigerator on Pinterest and we ordered it immediately. It was probably the first thing we bought. My husband picked out the stove, which was more modern than I anticipated. We picked out the countertops together, but he was almost ambivalent toward the cabinets. I, on the other hand, spent hours ensuring there was a drawer or cabinet for everything: deep drawers for the pots and pans, shallow drawers for the utensils, two pullout trash cans – one on each side of the kitchen because he’s always standing in front of one of them.

It took awhile to find that perfect color of gray cabinet, and when I brought a sample door to the house to see it in the room we realized it was the same gray that was in the original linoleum floor. I had also wanted to use a dark gray for the backsplash grout, but was overruled. He realized I had been right all along when the grout was still wet and looked dark gray. Of course.

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Gold seemed to be the right finish for everything in this house, although it was a little tricky to find a matching faucet, soap dispenser and filtered water dispenser in a style we liked. The light fixtures came from Pottery Barn in antique silver. We sponge painted them gold, including the chain.

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I thought the keeping room would be one of the most used rooms in the house. It hasn’t worked out quite that way, although it’s still one of my favorite rooms. We mounted the tv so that it pulls out and swivels toward the kitchen so my husband can watch the news while he cooks. The sun shines so bright in that window that the begonias I put in the planter over the summer actually bloomed.

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It’s always a mystery to me how a room becomes the first room to be finished, and it’s no different for the Keeping Room. How it came together so quickly I’ll never know, but it has looked just the same until a few weeks ago when we found the andirons at the Habitat for Humanity Restore for $4 (they’re solid brass!), and I found the animal print pillow on Amazon for $7.

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My husband found the muntins for the windows and the sliding door in an upstairs storage room, and we thought they changed the room. The hydrangea along the patio just outside the kitchen door swallows the other plants all summer, and in less than a years’ time it has provided enough dried flowers to fill every container in the house.

The kitchen is the heart of our home with memories to last a lifetime.

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After I snapped this picture I realized Bentley was in one of his favorite spots – under the table by the window watching for the neighbor that walks her dog every morning.
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Bentley

 

Cycling through Summer

There is no crying in baseball. . .” It’s my husband’s favorite response when my life runs amuck, so there was no whining at my house when I came home black, blue and bloody from what started out as a delightful morning bike ride.

Cycling is not my primary sport, although it has been my favorite cross-training for several years. After running two marathons (and remodeling two houses) last year, there has been little time for cross-training of any kind, and this year I vowed to reintroduce cycling to my training regimen. It’s had its ups and downs.

The best part of my re-entry to cycling is location. I can leave my driveway and cycle for just over an hour with relatively few climbs. The downside of my cycling is what I have learned to be toe-overlap; where your toe hits the front tire when turning. It seems this is a common problem for road bikes with racing geometry. Racing bike = racing geometry = short wheelbase.

The online advice is fairly consistent: get used to it. When you go fast, you don’t need to turn the wheel – just lean. But what about when I want to do a u-turn in the middle of the road to head back home?

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My simplest route is an out-and-back: 3 right turns, 3 left turns, 1 u-turn.

Two years ago I traded the standard pedals that came with my new bike for the clipless style pedal. These rocket-science style pedals have special cleats that attach to your cycling specific-shoe soles, which serve to hold your feet in proper position and will not let them go. Of course, I was given instructions at the time: just step down to click into the pedals and twist your feet to the side to exit. It has never been that simple.

Throughout this past winter I left my bike locked into a trainer upstairs in the gym and spent several minutes of every ride clicking in, and twisting out. Surely by the time summer came around it’d be a piece of cake. You would think.

So, in celebration of the 200-year anniversary of the bicycle, I thought I’d share a few of my thoughts on the art of cycling; lessons learned during this blissful sometimes torturous summer of cycling.

Look the Part.

Nothing gives a rookie away faster than a black streak of grease on their calf. And when my chain fell off one day during a poor gear change, I realized it would look even worse should I finish that ride with grease on both calves, both hands, possibly my face, and blood running down one arm. Avoid looking like a rookie at all costs.

Follow the Leader?

Cars fly past at unconscionable speeds. Trucks roar by with all their might threatening to blow you right off the road. An interesting phenomenon seems to happen, however, when these vehicles pass you on your cycling journey.

If a driver is particularly respectful of your space and moves to the outside lane, chances seem good that the next car after will do the same. Likewise, if a car remains in the right lane and passes you with only inches to spare, hold your breath for dear life because there may be a string of these cars yet to come. Once in a great while a driver will see this infraction, think on his own accord, and break rank from the leader to once again make things right. God bless these brave souls. They are a valuable example for all walks of life.

Don’t Stop Pedaling!

I have read that one of the easiest ways to determine the experience level of a cyclist is to see how early they clip out before coming to a stop. A novice rider will clip out as much as a block before a stop sign or red light (that’s me). To look cool, they say, let the bike come to a full stop before clipping out. To look Eurocool, never clip out. Track stands are the only acceptable way to wait at a red light. Maybe next summer.

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The first bicycle was devised in 1817 with a front wheel capable of being steered, a padded saddle, and armrest. Although pedals were eventually added in the late 1850s, only the front wheel could be pedaled until the chain was invented in 1869.
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The Future. . .  Photo Courtesy “History of the Bicycle: A Timeline” at brown.edu

Where We’ve Been

Marriage is not always pretty. It can be downright fussy. Until you realize without warning, it’s perfect. I’ve walked down the aisle four times, and ran out the front door three. Maybe it’s not the perfect record, but I’ve always said, I am where I am because of where I’ve been.

The anniversary of my last walk down the aisle was last Monday. Eighteen years ago, at 39 years old, I knew from the get-go this marriage would not go down in the Guinness book of records for the longest marriage ever – we wouldn’t live that long. What I did hope for was a ‘good’ marriage. I felt certain I could accomplish this small feat with the perfect partner.

For those first few years it was obvious you don’t pick the perfect partner – you create one. Then I realized he might be feeling the same way about me. Getting the little things right seemed incredibly urgent. I couldn’t believe he didn’t understand how important it was to turn the lights off when he left a room. He found it amazing I couldn’t be happy with the same cleaning service, gardener, or dry cleaners.

I asked him what he had learned the most after being married to me for 18 years. He said patience. After we I laughed, he told me he’s learned that I’m hard-working, thoughtful, a good listener, and that he appreciates that I have what he calls positive ambitions. The funny thing is I would have said all the same things about him.

He holds my hand when we walk together, and kisses me before he leaves to go anywhere. I think he’s the smartest person I’ve ever known. . . and the last time I wrote glowing things about him to this blog, his ego got so big I could hardly live with him for a solid year.

The first marathon I ran was 10 years ago, which means he’s spent more than half our married life enduring my long-run days, and the resulting middle-of-the-night gimps to the bathroom. It crosses my mind that we’re both getting older and you never know what these middle-of-the-night gimps may be preparing us for.

Our resolve has been tested at times, but our best decision seems to have been to approach everything as partners. We would end up being partners in businesses, investments, as parents to each other’s children, and with our families – although we both agree the most important partnership has been in life itself.

The fast-paced and adventurous early years have transitioned to simple, sometimes lazy days of retirement where it seems more important than ever to be at peace with yourself and each other. We are here, after all, because of where we’ve been.

 

The Anatomy of a Runner: Pain

The sixth in a series of posts about what makes runners uniquely equipped to run. This post explores why it hurts. . . and how to make it stop.

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Photo: Jonathan Moore/Getty Images

Being a distance runner is about handling pain. If you can’t manage pain, you probably won’t end up as a distance runner.”

KARA GOUCHER, American long-distance runner

There are many ways to categorize pain, but a broad definition would be acute vs chronic. Acute pain comes on suddenly, has a limited duration, and is often caused by damage to tissue (bone, muscle, organs). Chronic pain lasts longer and is more resistant to medical treatment, such as with long-term illnesses like osteoarthritis.

IMG_33971 of 3 graphics from totalinjury.com: How the Brain Responds to Pain

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WHY IT HURTS

IMG_3374Recurring pain is normally caused by:

  • mechanical injury, such as a fall or twisted joint;
  • repetitive micro trauma, as with overuse injuries that cause stress to the tendons or bones, or micro tears to the skin, as with calluses or blisters; or
  • muscle imbalances – weak glutes, overdeveloped quads, or not having a strong core, for example.

The medical community says “pain is what you say it is” because pain is subjective. A person’s general health, previous experiences, stress, anxiety, depression, and motivation can influence how we perceive pain.

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Totalinjury.com

Soreness vs Pain

Muscle Soreness

Everyone gets sore with intense exercise. Pain from sore muscles is usually felt the next day and comes from microscopic tears in the muscle fiber. Rebuilding of the muscle damage creates larger, stronger muscles.

If soreness seems especially severe and lasts for several days, it’s probably delayed onset muscle soreness (DOMS), and may be a result of performing new exercises at a relatively high intensity. Studies suggest theories to explain the mechanisms of DOMS, including lactic acid, muscle spasm, connective tissue damage, muscle damage, inflammation and enzyme efflux.

Muscles build up resistance to DOMS with multiple sessions, but new runners who can’t shake the burn after a day or two can try massage or light exercise. Cryotherapy, stretching, homeopathy, ultrasound and electrical current modalities have demonstrated no effect on the alleviation of muscle soreness or other DOMS symptoms.

Reference: Cheung K, Hume PA, Maxwell L. Delayed onset muscle soreness: treatment strategies and performance factors. Sports Med. 2003;33:145–164

Sharp Pain

A sharp pain during exercise – in contrast to muscle soreness – can be indicative of an injury. This type of pain can be located in the muscles or joints, and may linger without fully going away even after a period of rest. Runners should not push through a sharp pain since it can exacerbate the injury.

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Source: American Physical Therapy Association (APTA)

ATTACK AND HEAL

IMG_3449The body’s response to injury is inflammation, which is designed to attack and heal. The early stages of inflammation enlist the immune system to protect the body and control infection. Like pain, inflammation is categorized as acute or chronic.

John Hunter (1728–1793, London surgeon and anatomist) was the first to realize that acute inflammation was a response to injury that was generally beneficial: “But if inflammation develops, regardless of the cause, still it is an effort whose purpose is to restore the parts to their natural functions.”

Increased blood flow to the area causes redness and heat; the accumulation of fluid causes swelling, pain is due to the release of chemicals that stimulate nerve endings, and loss of function is a combination of factors.

Inflammation is part of the natural healing process; without it wounds and tissue damage would never heal. Reducing inflammation may be necessary in some cases where inflammation has caused further inflammation – becoming self-perpetuating, which may lead to chronic inflammation.

When joint tissues have not been given adequate time to fully regenerate between workouts, they may become chronically inflamed and/or degenerate to the point of serious injury. Overuse injuries, such as runner’s knee, develop in this manner. It’s the harder than normal workouts that cause significant tissue damage and post-workout inflammation. For this reason, most training programs increase duration and/or intensity more slowly to allow the body the necessary time to recover and adapt.

Note: Scientists at Emory University School of Medicine in Atlanta, Georgia, found in a study that poor sleep quality, and short sleep durations are associated with higher levels of inflammation.”which in turn increases the risk of developing heart disease and stroke.” What drives the inflammation in the first place is still a mystery.

Pain Management

Physiologists at the University of Wisconsin used spinal injections of a powerful painkiller to block lower-body pain in a group of cyclists; the cyclists actually got slower. They initially felt great and started out faster than normal, but then faded. Without the feedback of pain, they couldn’t pace themselves properly. Training to live with pain: What we can learn from Olympic athletes 

Everyone reacts differently to pain, which means how each person manages their pain will also be unique. Complicating each approach is the fact that injuries themselves react differently to treatment therapies. Following is at least a partial list of pain management therapies, in no particular order.

Ice or Heat? If the injury is sudden and acute, ice is preferred for the initial two or three days post injury – 20 minutes each two to three hours until the ‘heat’ comes out of the injury. Ice will also reduce inflammation and provides pain relief by reducing the blood flow to that area.

Heat should be avoided in the first 48 hours as it encourages bleeding. Once the ‘heat’ is out of the injury, heat packs can be used to stimulate blood flow, which will aid healing, help muscles relax and ease the pain – 20 minutes a few times a day using a heat pack, or alternatively take a warm bath or hot shower. Heat stimulates sensory receptors to block the transmission of pain signals to the brain.

Post Exercise: Ice, Heat, or Both? Although light exercises or gentle stretching may be equally effective in reducing pain after a hard bout of exercise or race, ice baths, or cold water immersion, has long been a popular interventional strategy (the ideal temperature range seems to be between 50 and 59° F for 10-15 minutes).

There is some reasoning that the benefit has less to do with the temperature of the water than the immersion itself, however, and the deeper underwater the body is, the better (in other words, jumping in a lake or swimming pool is even better than soaking in a tub).

Read more:  Ice, heat or a little of both? How do you recover from a hard workout?

Tart Cherry Juice: Researchers have found tart cherries reduce a type of inflammatory activity in the body by about 38% (Naproxen, a powerful NSAID, provides a 41% reduction). Long-distance runners drinking cherry juice before marathon-level events have less muscle damage and up to 1/3 less post-event soreness compared to those who did not drink cherry juice. Students given 12 ounces of tart cherry juice before and after strenuous resistance training suffered only a 4% reduction in muscle strength the next day, compared with a 22% loss in exercisers drinking a placebo.

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1 of 5 graphics from RunnersWorld “Where it Hurts”

Meditation: studies show that meditation increases immune function, decreases pain, decreases inflammation at the Cellular Level, decreases anxiety, depression and stress, increases grey matter of the brain and cortical thickness in areas related to paying attention, improves focus and memory (see all the studies at psychology today.com.) Lebron James, Kobe Bryant, Misty May-Treanor and Kerri Walsh are a few of the athletes that meditate to improve their game.

Strapping tape vs supportive tape: taping can stabilize and support the injury, provide pain-relief via de-loading of the vulnerable or painful structures, and facilitate normal movement, muscles or postural patterns.

  • Rigid strapping tape is commonly referred to as ‘sports tape’ or ‘athletic tape’.
  • Elastic strapping tape can be used when less rigidity or support is required.
  • Kinesiology tape is an improved version of elastic sports tape that acts to dynamically assist muscle function.
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RunnersWorld
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RunnersWorld

Massage: Massage has been utilized in the treatment of illness and injury for thousands of years by health care practitioners as a treatment for reducing stress, pain and muscle tension. Nonetheless, research has generally failed to demonstrate massage significantly contributes to the reduction of pain associated with delayed onset muscle soreness, enhances sports performance and recovery, or plays a significant role in the rehabilitation of sports injuries. The most successful treatments combined a massage therapy program that also included stretching, walking, swimming, aerobics, strengthening exercises, and education on posture and body mechanics. (Reference: The Role of Massage in Sports Performance and Rehabilitation: Current Evidence and Future Direction – Jason Brummitt, MSPT, SCS, ATC  North American Journal of Sports Physical Therapy)

Three forms of massage are frequently reported in sports medicine literature: effleurage, petrissage, and deep transverse friction massage (DTFM).

Massage therapy modalities can include Swedish, Deep Tissue, Sports Massage, Trigger Point Therapy, Thai Massage, Thai Herbal Compresses, Hot Stone, Lymphatic Draining Therapy, Shiatsu, Cupping, and Reflexology, among others.

Acupuncture: Dating back more than 2,500 years, acupuncture is based on the premise that there are more than 2,000 points in the human body connected by bioenergetic pathways, known as meridians where Qi, or energy, flows. When a pathway is blocked the disruptions can lead to imbalances and chronic disease.

In various studies, acupuncture has proven beneficial in the treatment of chronic health conditions, and has been found safe for children. It works, in part, by stimulating the central nervous system to release natural chemicals that alter bodily systems, pain and other biological processes.

Proprioception / Balance Exercises: These exercises teach your body to control the position of a deficient or injured joint. A common example is the use of a balance or wobble board after an ankle sprain. Unpredictable movements provoked by the balance board re-educates the body to react without thinking, restoring natural balance and proprioceptive reactions.

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RunnersWorld

Stretching: In its most basic form, stretching is a natural and instinctive activity. Considered a form of exercise, stretching improves the muscle’s felt elasticity and achieves comfortable muscle tone. The result is a feeling of increased muscle control, flexibility, and range of motion.

There are five different types of stretching: ballistic, dynamic, SMF stretching, PNF stretching, and static stretching. (Read about each one here.)

Athletes stretch before and after exercise in an attempt to reduce risk of injury and increase performance, although these practices are not always based on scientific evidence of effectiveness, and depending on which muscle group is being stretched, some techniques may be ineffective or even detrimental. A study in 2013 indicates static stretching (vs dynamic stretching) weakens muscles, or “stretch-induced strength loss,” which you would want to avoid too close to exercise or competition. (Note: other studies have found that reducing the amount of time a static stretch is held (say 15 seconds instead of 30) is beneficial to some individuals pre-exercise.)

Muscle “tightness” results from an increase in tension from active or passive mechanisms. Passively, muscles can become shortened through postural adaptation or scarring; actively, muscles can become shorter due to spasm or contraction. Regardless of the cause, tightness limits range of motion and may create a muscle imbalance – which we have learned will eventually lead to acute or chronic pain. (Source: International Journal of Sports Physical Therapy)

Static stretching is more effective than dynamic stretching for those recovering from hamstring strains, and they seem to recover faster by performing more intensive stretching than less intensive stretching, and a gentle, static stretch relieves the pain associated with a sore Achilles’ tendon. Patients with knee osteoarthritis can also benefit from static stretching to increase knee range of motion. Researchers have shown that 12 months of stretching is as effective as strengthening exercises or manual therapy in patients with chronic neck pain.

The effectiveness of stretching is very individual, but most research concludes a routine of regular stretching, especially as you age, is beneficial in overall conditioning, can alleviate pain, and will improve muscle strength over time.

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Yoga & Pilates: Pilates is a form of exercise that focuses on the activation of the deep core muscles, while yoga is a mind-body workout that combines strengthening and stretching poses with deep breathing and meditation or relaxation. Both exercises will improve flexibility, core stability, overall body strength, postural alignment, balance, reduce the chance of re-injury, and help correct muscle imbalances that created the pain initially.

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RunnersWorld

Bergamot: Bergamot essential oil reduces the feeling of pain in the body by stimulating the secretion of certain hormones which lessen the sensitivity of nerves to pain. Massage a few drops into the affected area for temporary relief. (Read more.)

Arnica: dating back to the 1500s, Arnica is used topically for bruises, sprains, muscle aches, wound healing, joint pain, inflammation and swelling from broken bones. Arnica is available in gels and creams, but should never be applied to an open wound or taken orally, except in an extremely diluted form.

Aspirin: A standard (325 mg) or extra strength (500 mg) dose is an effective pain killer and also works as an anti-inflammatory, making it a possible treatment for rheumatoid arthritis, osteoarthritis, lupus, and mixed connective tissue disease. (People at increased risk of bleeding should avoid aspirin. Contact your health professional to discuss possible contraindications before beginning any pain management therapy.)

Over-the-Counter Pain Relievers include:

  • Acetaminophen (Tylenol)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Motrin, Advil) or naproxen (Aleve, Naprosyn)

Both acetaminophen and NSAIDs reduce fever and relieve pain caused by muscle aches and stiffness, but only NSAIDs also reduce inflammation. (Inflammation is a necessary part of the healing process, and reducing injury-related inflammation may not always be an effective treatment therapy.)

Acetaminophen (Tylenol) works on the parts of the brain that receive the “pain messages.” NSAIDs relieve pain by reducing the production of prostaglandins, which are hormone-like substances that cause pain.

Using NSAIDs increase the risk of heart attack or stroke and have also been known to cause stomach problems. (Source: webmd.com)

One study on the effects of Ibuprofen on skeletal muscle showed that taking ibuprofen during endurance training canceled running-distance-dependent adaptations in skeletal muscle.

Another study confirmed in the laboratory that the use of NSAIDs after exercise slowed the healing of muscles, tissues, ligaments and bones.

During the first 2 to 3-days of an acute injury, taking a NSAID is advised, but once you exceed this window, general advice is let the body do the work. No evidence shows that a NSAID will provide benefits during a run or race, and may hinder.

A list of possible side effects of NSAIDs can be found at nhs.uk.

A Montane athlete, Marcus Scotney, had a potentially life threatening experience following the 2014 Iznik Ultra in Turkey. Read an interview following that event with UK’s key specialist on kidney function, Dr Richard Fluck, regarding the impact of NSAIDs and Sport.

Note: People given a placebo for pain control often report that the pain ceases or diminishes.

 

This post is meant for informational purposes only. It is not intended to provide medical advice. Please consult a physician to discuss your specific pain/injury, the treatment options most appropriate for you, and to ensure there are no contraindications in the treatment options you may adopt.

Read more:

Before You Take Ibuprofen, Try This (Time.com)

Ibuprofen and Running: Anti-Inflammatory Drugs Hurt Your Training

What Are the Best Anti-Inflammatory Spices? Outside Online

How Exercise Works (HowStuffWorks)

RUNNERSWORLD: articles related to stretching for runners

Stretching: The Truth (New York Times)

Main Types of Chronic Pain (verywell.com)

Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise

Best Essential Oils for Pain: EssentialOilExperts.com

 

 

Isn’t this fun? Isn’t fun the best thing to have?

Four laps around the track and I was already negotiating with my training schedule. Maybe I’d make tomorrow a rest day. Maybe I’d cut this run short and add the miles to Sunday’s run.

Six laps around, I had earned the upper hand in the negotiation and settled the dispute – I’d take two weeks off. A few steps later I said out loud, “What am I waiting for?” I stopped running and began a two-week holiday.

It’s a double-edged sword – learning to push the envelope of training without getting injured – although I’ve decided being downright pooped may be a form of injury in and of itself, and knowing when to hit the pause button is the next lesson to be learned in my journey as a runner.

Last year, when I got thoroughly pooped, I threatened to go to the doctor for a full set of blood work. Or was that the year before? A few weeks ago I finally went. The nurse called, “Everything is within normal ranges.” It wasn’t my thyroid, and I wasn’t deficient in this or that (although I could still blame it on menopause).

As usual, my husband was right. It’s training error. Fine.

Cross-Training 2017

On the first day of holiday, I went for a long walk around Lake Junaluska where the landscaping is positively inspirational. My husband went with me. This little slice of paradise is less than a mile from home. I did not even contemplate wearing running gear for this lovely walk.

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Lake Junaluska is a conference and retreat center (part of the Southeastern Jurisdiction of The United Methodist Church) that first opened in 1913.
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There’s a 3.8-mile walking trail around the lake via sidewalks, paved trails, and a wooden bridge.

There were several days of all-day gardening while my bike enjoyed a full tune-up at the local bike shop. Then I rode my bike.

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After a brief 1-mile torturous trek along Hwy 19 into Maggie Valley, my bike route turns right onto Jonathan Creek Road, which is amazingly flat.
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The fog hangs just below the top of the mountains in early morning. That’s a lumber yard and log cabin builder across the street. There’s also farms, old barns, cows, a produce co-op, oodles of churches, RV ‘parks’, a creek, and a few weeks ago, a fox that ran just off the road alongside my bike for several minutes.
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Much to my delight, this route can extend for more than 30-relatively-flat-miles by turning left onto Cove Creek Road. I used the parking lot of this adorable church as my turnaround on yesterday’s ride.

My husband and I decided paddling would be fun and spent several afternoons searching for canoes on Craigslist – until I went for another long walk around Lake Junaluska and realized we could rent a kayak or canoe on the shores of their sandy beach for just $5/hour. A whole new world was opening up all around.

Then my friend, Maria, and I went for a hike – 1-1/2 hours up the mountain to Waterrock Knob and 1-1/2 hours back down again. It was delightful. We’ve already planned another even longer hike for next week.

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The view from my Jeep on the ride up the Blue Ridge Parkway to the trailhead.

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We stopped along the trail to take a picture.
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Maria and I at Waterrock Knob – the highest peak in the Plott Balsams and the 16th-highest mountain in the Eastern United States.

My two-week hiatus from running ended about six weeks ago, but I haven’t forgotten the lessons learned from being too narrowly focused on running: there’s lots of fun things to do, and isn’t fun the best thing to have?

The Anatomy of a Runner: the Wall

Hitting the Wall: In endurance sports such as cycling and running, hitting the wall or the bonk is a condition of sudden fatigue and loss of energy which is caused by the depletion of glycogen stores in the liver and muscles. (Wikipedia)

Alternative Definition: a collapse of the entire system: body and form, brains and soul.

Etymology, usage, and synonyms: The term bonk for fatigue is presumably derived from the original meaning “to hit”, and dates back at least half a century. Its earliest citation in the Oxford English Dictionary is a 1952 article in the Daily Mail.

The term is used colloquially both as a noun (“hitting the bonk”) and a verb (“to bonk halfway through the race”). The condition is also known to long-distance (marathon) runners, who usually refer to it as “hitting the wall”. The British may refer to it as “hunger knock,” while “hunger bonk” was used by South African cyclists in the 1960s.

It can also be referred to as “blowing up”.

Possible Symptoms: a fast or pounding heartbeat, cranky/irritable, headache, dizziness, light headedness, nausea, hunger, extreme and debilitating fatigue, shaking or trembling, unclear thinking, poor coordination, possibly hallucinations and/or mental confusion, a complete absence of energy.

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Endurance athletes experience indescribable ‘pain’ as a result of glycogen depletion: a complete or a near-total depletion of glycogen, the storage form of glucose which is the source of human energy derived from carbohydrates consumed through food.

Glycogen is a molecule derived from the carbohydrates in our diet, which is stored in the body and used as a source of energy. The amount of glycogen stored in the body mostly depends on physical training, basal metabolic rate and eating habits, but the average body stores approximately 2,000 kilocalories of glycogen at any given time – just about enough glycogen to support the average adult for 12-14 hours, or up to about 2 hours of exercise.

Why do marathon runners ‘Hit the Wall’? (Yahoo Answers)

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Athletes engaged in endurance exercises produce energy via fat metabolism and the breakdown of glycogen into glucose – both facilitated by oxygen. How much energy comes from each source depends on the intensity of the exercise.

Activating the fat-burning process takes longer (and more oxygen) than burning sugar, which is why the body generally uses glucose unless it has a compelling reason not to. (In extreme cases, such as severe hunger, the body can also use protein for energy.)

Note: Carbohydrates – foods such as rice, potatoes, bread, tortillas, cereal, fruit, vegetables, and milk – are the body’s main source of glucose. If you eat more glucose than you need, your body will store it in your liver and muscles or change it into fat so it can be used for energy when it’s needed later.

IMG_3386With intense exercise that pushes the limits of VO2 max, most energy comes from glycogen and is burned off quickly. Lowering the intensity will also lower the amount of energy burned per unit of time, which is why runners learn not to start a race too fast. Elite runners practice maintaining their ideal race pace with an even effort to extend their glycogen stores for as long as possible – hopefully to the end of the race.

The brain uses glucose exclusively – in fact, it is said that seventy-five percent of the glucose available to the body is used to service the energy requirements of the brain and the central nervous system. Stored glycogen is also used to regulate blood sugar levels in the body between meals.

Once the glycogen is stored in the muscle for fuel, however, it is not flexible in terms of its deployment in the body since muscle-stored glycogen isn’t capable of being shared with or transported to other areas that might require fuel. It must be used at the point of storage.

If the body were to rely solely on glycogen for energy, 31 kg (67.5 lbs) of stored glycogen would be required as compared to 4.6 kg (10 lbs) of fat.

As people become more fit, it has been thought the muscles shift from burning carbohydrates (glucose) to burning fat; in fact, this shift in substrate utilization from glucose toward fat has been a traditional hallmark of trained muscle. In other words, it has been long believed that training improves endurance because it allows the muscles to more effectively burn fat as an energy source.

There are several issues with using fat as the predominant source of energy, however:

  • Fat is slow to digest and be converted into a usable form of energy (it can take up to 6 hours).
  • Converting stored body fat into energy takes time. The body needs to break down fat and transport it to the working muscles before it can be used as energy.
  • Converting stored body fat into energy takes a great deal of oxygen, so exercise intensity must decrease for this process to occur.

Hitting the Wall

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Hyvon Ngetich, 29, was leading the pack of top female runners at the 23-mile mark of the 2015 Austin Marathon when the Kenyan’s body began shutting down. Race volunteers brought a wheelchair for her, but she refused it and began crawling toward the finish line.
(1 of 3 photos courtesy of: DailyMail)
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Even as she crawled she had to pause to summon more strength, ultimately finishing the race in 3rd place in 2:34:42.
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After the race, Ngetich said she does not remember how she crossed the finish line, but hearing from a race volunteer that she was almost there gave her the strength to stay the course.

Top-level athletes get closer and closer to their real physiological maximum,” says Dr. Samuele Marcora, a fatigue researcher at the University of Kent in Britain, “but they never quite reach it: the brain applies the brakes before the heart, lungs or muscles fail.”

Findings in a study released in May 2017 (PPARδ Promotes Running Endurance by Preserving Glucose) shows that rather than training the body to use fat more efficiently as previously believed, training actually teaches the body to burn less glucose (remember, the body simultaneously burns a combination of glucose and fat depending on the level of intensity).

In other words, the body prioritized energy derived from fat (FA catabolism) thereby lowering the conversion of glucose to energy (glycolysis) with the net effect of preserving systemic glucose reserves in the body. This new thinking is that training progressively re-programs muscle to burn less glucose, preserving it as an energy source for the brain.

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In the top part of this image, muscle consumes glucose and fatty acids during exercise. In the bottom part, muscle that’s been stimulated by PPARδ consumes mostly fatty acids, leaving more glucose for the brain. (Courtesy: inverse.com)

A focus of the study was to better understand ‘hitting the wall’ – their results show that when the brain runs out of glucose, the body shuts down. . . the wall is made of sugar.

In endurance sports, ‘hitting the wall’ is a dramatic demonstration of sudden and complete exhaustion. You become disoriented, maybe dizzy, overtaken by sudden and overwhelming fatigue – the symptoms of hypoglycemia, or low blood sugar.

The surprise of the science here is that the longer the brain stays active, the longer you will be able to run. And so it’s more about the brain and sugar than we previously thought.”

Ronald Evans, co-author of the study, American professor and biologist at the Salk Institute for Biological Studies in La Jolla, California and a Howard Hughes Medical Institute Investigator.

Note: The next logical question for the scientist of this latest study was whether a drug could trigger the body’s exercise gene to instruct the muscles to burn fat and preserve glucose. The chemicals (mimetics) given to the mice in their study improved performance by 70%. Their goal now is to quickly transition this into a drug for people (currently known as the ‘exercise pill’), which has been taken on by a Boston-based company, Mitobridge. The study’s abstract concludes by saying, “Collectively, these results . . . highlight the potential of PPARδ-targeted exercise mimetics in the treatment of metabolic disease, dystrophies, and, unavoidably, the enhancement of athletic performance.”

Moving the Wall

It may not be that you have simply hit the wall, maybe there’s a blister on your foot, you’re dehydrated, or worse, your stomach is having its own moment of distress, and no matter how hard your mind wills your legs to move, they refuse. How endurance athletes convince themselves to keep putting one foot in front of the other despite the pain requires that we understand ourselves, and how committed we are to what motivated us to be here in the first place.

There was a good article about pushing through the wall in RunnersWorld a few years ago where one expert was quoted as saying the biggest challenge in pushing through the pain is to understand that this kind of pain won’t kill us. “After a lifetime of avoiding pain or being protected from it, the reason a runner won’t push through a wall of exhaustion could be good old-fashioned self-preservation.” Instead of pushing through the pain, our natural instinct is to stop.

Dealing with pain can be learned; it’s one of the objectives of our marathon training programs. There’s a few different approaches to consider – marathon pace runs help prepare our minds for race day, as will speeding up for the last third of a long run, for example. Another option is to eliminate carbs the day before a long run, or go all the way with a ketogenic diet. If you typically run with music, try turning it off completely for your next long run, or, as some coaches recommend, go for a run when you’re hungry, or tired – something that may not require a lot of planning for some of us. (Thoroughly research the strategies you deploy to understand risks and recovery.)

Whatever the approach, the intent is to prepare our minds for the inevitable end-of-race push we’ll need to reach the finish line.

Association/Disassociation

Elite runners tend to use the attentional strategy of ‘association’ to deal with pain, which involves focusing their attention internally on the body’s sensations, such as muscular strain, breathing, etc. They literally embrace the pain and see it as a necessary part of their eventual success.

Non-elite runners, on the other hand, are more likely to direct their attention away from the body’s physiological signs of distress by distracting themselves and concentrating on other things, or ‘disassociation’.

Although research findings seem to be mixed, association is generally related to faster running times than dissociation, although runners of all levels are more likely to associate during competition and disassociate during training runs.

It is the state of association that holds a greater risk of injury by continuing the effort despite the body’s warning signals. When used properly, however, association can allow runners to successfully ride the thin line between pushing hard and overdoing it.

The Carbo Load

Carbohydrate loading is the technique of gradually increasing carbohydrate and fluid intake each day, beginning anywhere from a week to 24 hours before competition, while exercise is tapered downward, to maximize glycogen storage.  Some strategies also called for depleting carbs by exercising intensely and lowering carb intake. This approach has proven dangerous and did not necessarily optimize glycogen stores (Reference: Advanced Sports Nutrition by Dan Benardot).

Each subsequent study seems to tweak the original carbo-loading approach ever so slightly, which is why I’m going to stick with my favorite advice on this one: do what works best for you. However, there’s some interesting information out there in regards to pre-race nutrition and refueling options during the race:

  • Maybe it’s the taper, not the carbo-loading: a 1992 study at McMaster University reported that a seven-day taper increased glycogen stores in middle-distance runners significantly and also resulted in a 22 percent increase in running time to exhaustion. Diet was not manipulated in this study.

By sharply reducing mileage, as with the pre-marathon taper, the amount of carbohydrate the muscles burn daily also sharply decreases, causing glycogen stores to increase without any change in the diet.

  • A study of 257 male and female runners in the 2009 London Marathon revealed that carbohydrates eaten at breakfast on race day, during the race itself, or on days earlier in the week were relatively unimportant. It was primarily what people ate on the day before the race that mattered. The runners who consumed more carbohydrates the day before the race maintained their pace past the 18-mile mark where the others did not.
  • It’s worth repeating that glycogen stores are used up faster if your pace fluctuates above and below a certain average than if your pace holds steady at that average.
  • On the other hand, if you feel your glycogen stores won’t last, a walking break will help preserve glycogen. You might also try Jeff Galloway’s run-walk-run approach.
  • Instead of increasing food volume or calories the day before a race, replace some fats or proteins with carbohydrates.
  • A 2016 study found that carbo-loading may be harmful to the heart by reducing the production of atrial natriuretic peptide (ANP), a hormone that helps the body get rid of excess salt and reduces blood pressure. The principal driver for this acute reduction in ANP appears to be the increase in glucose. A word of caution for Clydesdale runners or runners with pre-existing health issues.
  • Immediately following an intense workout is an ideal time to consume simple carbohydrates (some say this window of time is within the first hour while others say within 2 hours). There’s a great post by Rob Sulaver on Arnold Schwarzenegger’s website explaining the science behind this (Exercise & Carbs: A Game-Changer). This science shows that consuming carbs during this window of time feeds the muscles without getting stored as fat.

The Carbo RE-Load

Refueling during the race is a science of its own, and the options seem limitless when you consider energy drinks, energy gels, caffeinated options, and homemade varieties. Studies continue to find carbohydrate refueling an important component of maintaining exercise durations longer than 90 minutes.

A Human Kinetics post, Carbohydrate Intake During Exercise, included an excerpt from a study (as documented in the book, Sport Nutrition) that showed glucose concentrations dropping during exercise (at 70% of V.02max) after 1 hour, and reaching extremely low concentrations at exhaustion after 3 hours. With carbohydrate feeding, glucose concentrations were maintained and the test subjects continued to exercise for 4 hours at the same intensity.

The very best article I’ve found on the subject of refueling is at fellrnr.com. This article, “A comparison of the best energy gels”, explains which gels work best, for what reason, a definition of gel’s ingredients, as well as a comparison of the ingredients between major brands of gels, and when to use them. There’s also dozens of links to additional resources from the original article. What follows is an excerpt of this article copied directly from the fellrnr.com site.

 

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View a larger version of this chart that’s easier to read here: fellrnr.com

1. Energy gels are easy to digest, but they can spike your blood sugar, so ideally take one within 5 minutes or so of starting the run. I think the Peanut Butter Gu is a good option as it has a little bit of fat and isn’t too sweet, but other gels will work well. If you need something more substantial, consider a meal replacement drink like Ensure.

2. An Accel Gel is a good option as far as gels go, but you’re better off with something more substantial like a meal replacement drink (Ensure, etc.) or a chocolate milk. I’d only use Accel Gel if I needed something post run that I had to carry on the run itself.
The time and distances here are broad guidelines. Generally you shouldn’t need carbohydrate support for shorter runs, but if you’re Glycogen depleted from a long run, then a Gel might be useful. On ultra-distances, carbs and gels become less important and you start needing more “real food”.

3. Caffeine can improve performance at all distances, but for shorter distances, it’s probably best to take it before the run. Consider a Red Bull or other caffeinated beverage, or even caffeine tablets. I’d avoid coffee as there is evidence that you don’t get the same benefit from caffeine when it’s in coffee.

4. A little protein can help offset muscle damage, and so swapping your carbohydrate based gel for an Accel Gel might be good on ultras. However, you should be looking at other fuel sources in an ultra for most of your calories.

5. Caffeine can improve performance at all distances, and a gel can be a convenient way of taking it. Note that Caffeine can trigger some digestive problems in some people, and other forms of Caffeine might be easier pre-run. Consider a Red Bull or other caffeinated beverage, or even caffeine tablets.

6. You can sweat out a lot of sodium when sweating heavily, with estimates as high as 5,000mg/hour in some cases. In those situations, even the 200mg of PowerBar gel is not much, but it may help. The sodium in a PowerBar gel could help augment the limited sodium you would get in most sports drinks. (See The Science Of Hydration for details.)

7. There is some evidence that pickle juice can help with Cramps, and that it is the taste rather than the absorption of the pickle juice that helps. Therefore it is possible that the sour, tart flavor of eGels might help deal with cramps.

8. Reactive hypoglycemia is where consuming carbohydrate causes your blood sugar to rise, and then the resulting insulin release causes a blood sugar crash. This is believed to be quite rare and even rarer during exercise. If you think you suffer from this problem, I would advise you to verify this by checking your Blood Glucose. The meters are cheap and easy to use.

9. As well as Hammer gel, consider Carb BOOM or SIS Isotonic gels.

10. See How to eat a Gel for details.

 

 

Featured Image: Statue of the “Tired Man” (Megfáradt ember in Hungarian), referring to the poem of Attila József. The statue is the work of József Somogyi.

Read more:

Exercise-in-a-pill’ boosts athletic endurance by 70 percent (Science Daily)

“Exercise-in-a-pill” boosts athletic endurance by 70 percent (Salk.edu)

The physchology of sports injury: is ‘no-pain no-gain’ the path to sports injury? Sports Injury Bulletin

A Winner Runs Through It  RunnersWorld

The Evolving Art of Carbo-Loading, Active.com

How and when to carbohydrate load (AKA carbo loading), Fellrnr.com

When to eat Energy Gels in the Marathon, Fellrnr.com

 

This post is meant for informational purposes only. It is not intended to provide medical advice. Please consult a physician to discuss your specific pain/injury, the treatment options most appropriate for you, and to ensure there are no contraindications in the treatment options you may adopt.