Cherries Aid Marathon Recovery

Try cherries before and after your next long ride, run or grueling workout.

Here’s another weapon to add to your endurance training recovery arsenal: cherries. Marathon Runners Should Pick Cherries for a Speedy Recovery comes from Science Daily and it profiles a recent study out of Northumbria University in England. Marathoners who ran the London Marathon were split into two groups. Twenty marathon runners drank either a tart cherry blend juice or a placebo drink twice a day for five days before taking part in the London Marathon and for two days afterward. The story summarizes the research findings as follows:

“The findings indicated that the group who drank the cherry juice recovered their strength more rapidly than the control group over the 48-hour period following the marathon. Inflammation was also reduced in the cherry juice group, as was oxidative stress, a potentially damaging response that can be caused by strenuous physical activity, particularly long distance endurance exercise.”

It might be reasonable to conclude that cherries could aid cyclists, swimmers, cross-country skiers and maybe strength & power athletes as well. More research will be needed to confirm this guess. In any event, adding cherries to any or all of your recovery strategies may be a simple and tasty idea. (For more recovery methods, check out recovery nutrition, cold water immersion, and caffeine.)

Sounds like good news! However I can see it now… Sports nutrition stores will soon be stocking and promoting cherry juice extract–in a pill!! The stuff will cost more than cherries and probably won’t work. Warm weather is coming and cherries will soon be in the grocery stores. Buy ’em and eat ’em.

Achilles Tendon Issues: Help from Dr. Ivo at Summit Chiropractic

My wife and I just recently enjoyed a long weekend in the mountains full of skiing/snowboarding, sleeping in, and wishing we had a condo near the slopes. Part of that weekend included a visit with Dr. Ivo Waerlop at Summit Chiropractic in Dillon, CO. I went in hopes of 1) getting help with my sore left Achilles tendon that’s been bothering me for months, and 2) get some of his thoughts on barefoot running. The visit was very helpful and enlightening.

Dr. Waerlop was featured in a Denver Post article on barefoot running. My wife looked up his web site and it grabbed my interest. Dr. Waerlop is involved in the biomechanics of cycling, running and skiing (three things I love), and he’s involved in barefoot running. In fact, he’s a biomechanics advisor for Vibram. He’s also an accupunturist.

I won’t go into every detail but his asessment of my gait was very precise and his explanations very thorough. He assessed my feet, legs and trunk; observed my gait; and presecribed several exercises for me plus a sole lift for my shoe.

Most importantly we focused on attending to the causes of my problems (faulty biomechanics in the feet and toes) rather than the symptoms (pain in the Achilles–oh yeah, and my low back and my left shoulder).

He also advised me on barefoot running. I probably won’t ever be a full-on barefooter but I likely will be doing some barefoot running in the near future. (Gotta take it slow!)

There’s more. Dr. Waerlop is part of the Homonculus Group. (What is the homonculus? Excellent question. Click on the word to find out.) This is a group of physicians and sports performance/injury rehab professionals who are “committed and driven to better understand the problems of pain and movement impairment in this world (basically the aches and pains that ail individuals.)” The Homonculus site is rich with podcasts, articles and discussion threads (though it appears their discussion board has received a lot of spam which should be removed. Go to page 1 of the discussion board for legitimate information.) Finally, Dr. Waerlop is one of the Gait Guys whose lectures on gait assessment are found at Youtube.

I am very excited to dig into the articles and podcasts. If you’re a trainer, coach, or injury rehab professional–or if you’re just a fitness geek with some spare time, I highly recommend you investigate some of this material. I can’t get enough of this stuff!!!

Counterpoints to Barefoot Running

I think it’s important to analyze any trend or issue from several viewpoints. In the world of fitness and nutrition we see all sorts of fads come and go. Today barefoot running is gaining in popularity. I’ve posted recently on some of the research that suggests barefoot running may be healthier for the joints than shod running. So, I believe it’s worth considering doing some barefoot work whether it be gym work such as weight training or agility work; or perhaps very short runs on a soft surface such as grass. It may in fact be beneficial to work toward a full transition from shod running to barefoot running. That said, it’s vital to consider other views.

First, the Science of Sport gives us Barefoot running – new evidence, same debate. One notable point the writers make is this:

“I guarantee that the media are going to be all over this and they are going to tell you that you should be running barefoot or in Vibrams. You will hear how science has proven that being barefoot will prevent injuries, and that those of you who are injured should blame your shoes as you lob them into the garbage bin.

(This sort of observation can go for just about every new study that’s reported in the press.) I think it’s entirely likely that runners may latch on to barefoot running thinking that it’s an instant magic cure for whatever is bothering them and the results may be disastrous. (Then what will the press, physical therapists, and podiatrists say? “Barefoot running is the worst thing in the world! No one should do it ever! Then we’ll have discarded a potentially helpful tool from our toolbox.)

The article goes on to give an example of what happens when the pendulum swings too far and runners adopt something very new and very different into their training:

“And I will illustrate this with our own insight into footstrike and injury. When the Pose research was done in Cape Town, athletes basically had their footstrike patterns changed through 2 weeks of training in the new method. The biomechanical analysis found lower impact forces (sound familiar? Same as the Nature paper), and even less work on the knee joint. This was hailed as a breakthrough against running injuries, because lower impact plus lower work on the knee meant less chance of injury. Jump ahead 2 weeks, and 19 out of 20 runners had broken down injured. Why? Because their calves and ankles were murdered by the sudden change. And the science showed this – the work on the ANKLE was significantly INCREASED during the forefoot landing.”

Thus we get the very clear point that barefoot work must be added gradually into your routine. A rapid switch in running technique is probably a very bad idea. DO NOT move rapidly to replace all your shod miles with barefoot miles.

Over at the Running World According to Dean you can read Another Barefoot Running Story. He seems a bit skeptical on the issue of barefoot running. Owen Anderson at Educated Runner has presented two posts on barefoot running: Barefoot, Nearly Barefoot and Bearfoot Running; and Barefoot Running: What the Harvard Study Really Said. Both articles are again somewhat skeptical of barefoot running and running in Vibrams. Anderson’s second post is most valuable I believe in that he points out some of the limitations of the study “Foot Strike Patterns and Collision Forces in Habitually Barefoot versus Shod Runners” that appeared recently in the journal Nature.

Anderson makes this point: “The Nature investigation did disclose some interesting information about the effective mass of the foot and shank (which we won’t discuss here), but it offered no other information about the potential links between barefoot running and either injury or performance.”

He’s correct. This study was not a long term study. The study indeed showed lower impact forces at the ankle, knee and hip during barefoot running when compared to shod running, however the runners were not observed over the long term. Thus we only know what happened during the short duration of the study. This situation is indicative of most barefoot running studies. Nor did the study investigate which method–barefoot or shod–results in the fastest performances.

Further studies should be conduced looking at several points. First, long-term studies should look at injury rates of shod runners compared to barefoot or minimally shod runners. Second, we need to move beyond injury issues and look at racing performance. In other words can we run faster barefoot/minimally shod or in shoes? Third, it might be interesting to see how many people have tried to convert from running shoes to barefoot running but were unsucessful. What happened to these people?

From my point of view, none of these other posts or viewpoints have changed my thinking that some degree of barefoot work is very likely healthy for a fair number of people. It’s not necessary for anyone to permanently discard their running shoes for bare feet, but perhaps it would be valuable to consider taking the shoes off from time to time and letting the feet behave like feet.

News on Barefoot Running: Part III

To this point we’ve looked a couple of aspects of the human foot and running. In Part I we looked at research showing the unshod or minimally shod foot worked quite well at running for the vast majority of human history. In Part II we looked at the following: 1) research linking knee osteoarthritis to high loading forces on the knees, 2) higher loading forces were associated with stability shoes, and 3) lower loading forces were associated with shoes such as flip-flops that allow a more natural foot movement. Thus we can conclude that in order to avoid ailments such as knee osteoarthritis (and I might guess the same for hip, ankle, and low back arthritis) we should do whatever we can to allow our feet to move unencumbered.

[Researchers] concluded that running shoes exerted more stress on these joints compared to running barefoot or walking in high-heeled shoes.

So here are the lastest findings on this issue. Running Shoes May Cause Damage to Hips, Knees and Ankles, New Study Suggests details the findings of a study published in the December 2009 PM & R, the journal of the American Academy of Physical Medicine and Rehabilitation. (Here’s the abstract, and the full text.) Researchers studied 68 healthy adult runners as they ran on a treadmill both in modern running shoes and while barefoot. Significantly higher torque forces were observed in the subjects when they were in running shoes. The study reports “An average 54% increase in the hip internal rotation torque, a 36% increase in knee flexion torque, and a 38% increase in knee varus (inward) torque were measured when running in running shoes compared with barefoot.”

Those are significant forces! And why do most people wear running shoes? To protect the feet, provide stability, to be comfortable… Very interesting that these shoes actually increase the forces which we’re looking to minimize. In closing, the researchers say,

“Reducing joint torques with footwear completely to that of barefoot running, while providing meaningful footwear functions, especially compliance, should be the goal of new footwear designs.”

So with that statement in mind, I’ve recently purchased a pair of Vibram 5-Fingers model KSO. I’ve worn them the past couple of days at work and they’re quite interesting. I plan on wearing them exclusively when I weight train, and I plan on running in them fairly soon. (There’s a little too much snow on the ground here in Denver right now.) I’ll probably try some running on the grass first and then try short runs on pavement. We’ll see what happens…

News on Barefoot Running: Part II

Previously I discussed how wearing shoes alters the human running stride. For millennia, our feet functioned well enough to get us to the 1970s when we put them into running shoes. The result seems to be our adopting a running stride (heel strike) that may be more stressful and injurious than an unshod stride (forefoot strike). I want to continue the discussion by looking at a few more studies of our feet and the effect of shoes.

The original ATV...

I’ll go back to a Science Daily article from November of 2007 called Your Knees Want to Take you Shoe Shopping. The research was originally presented in 2007 at the American College of Rheumatology Annual Scientific Meeting. Researchers analyzed the effects of various footwear on patients with knee osteoarthritis. Specifically, they looked at loading of the knees.

The first point the researchers make is this:

“In knee osteoarthritis, there is abundant evidence that patients with abnormally high loading knees (high amounts of stress on part or all of the knee joint) are at increased risk of both injury and disease progression.”

Now, the important research findings were these:

“Researchers found that clogs and stability shoes were associated with significantly higher loading of the knees, while the walking shoes and flip-flops resulted in lower knee loads similar to those occurring when walking barefoot. Therefore, shoes that allowed natural foot motion and flexibility appeared to be more beneficial in terms of knee loading.”

That final statement goes to the point that a natural stride, unaffected by modern high-tech footwear seems to be more healthy for us. Here’s more supporting information. Footwear Alters Normal Form and Function of the Foot is a 2009 Science Daily article that profiles a study on barefoot walking. Specifically the researchers studied people who’d never worn shoes. The researchers wanted to observe the biologically normal function of the foot which had evolved for millions of years without the influence of shoes. They indeed saw habitually unshod feet moved performed differently from shod feet. The article notes:

“Barefooters have a relatively wide forefoot and manage at better distributing pressures over the entire surface of the foot sole, resulting in lower (and most likely favourable) peak pressures. As such, the fundamental scientific results are also important for clinicians and for the design of quality footwear, which should not hamper the foot’s biologically normal function.”

In Part III of this series I’ll discuss new research that demonstrates running shoes actually contribute to greater stress at the ankles, knees and hips.

The cutting edge of running technology!

First of all, a disclaimer: I am NOT telling everyone to throw out their running shoes/inserts/orthotics and go barefoot to run all the time forever. If you’re having success then keep doing what you’re doing. I do however suggest reconsidering what you think you know about the human foot and the shoes we put on them. If you’re in pain then you MIGHT consider changing from a highly structured foot environment to something less structured. Alright, on to the important stuff.

The case against running shoes (or maybe FOR going barefoot from time to time) seems to be mounting. What we’ve got here is more evidence that for running, the human foot all by itself is likely the most highly advanced instrument for the job.

I’ve posted previously on the issue of running and human evolution, and the issue of running shoes vs. barefoot running. Research continues on the issue. An article in Science Daily titled Barefoot Running: How Humans Ran Comfortably and Safely Before the Invention of Shoes tells us of research on three groups of people: those who had always run barefoot, those who had always worn shoes, and those who had converted to barefoot running from shod running. (This analysis of different types of runners is one strong point of the study.) Runners in Kenya and the U.S. were subjects. The project was a joint effort between Harvard, University of Glasgow, and Moi University. The full article can be accessed for a fee in the journal Nature.

The researchers observed very different patterns during barefoot running vs. shod running. Barefoot runners land on the mid-foot or the forefoot whereas running in shoes tends to promote a heel strike. Barefoot running results in a more spring-like step by utilizing the arch of the foot rather than driving the heel into the ground.

“Our feet were made in part for running,” Daniel Lieberman (researcher) says. But as he and his co-authors write in Nature: “Humans have engaged in endurance running for millions of years, but the modern running shoe was not invented until the 1970s. For most of human evolutionary history, runners were either barefoot or wore minimal footwear such as sandals or moccasins with smaller heels and little cushioning.“

The researchers suggest than in fact barefoot running may be less injurious than running in modern running shoes. They caution that running barefoot or in minimal footwear must be a gradual process if one has been running in shoes for a long time. Lieberman delves further into the biomechanics of barefoot running on his web page called (surprise!) Barefoot Running. I haven’t read this site yet but I’m planning on digging into it ASAP. Looks very interesting.

From what I’ve learned as a personal trainer I recognize the immense importance of properly functioning feet. If you take a look at your feet and how much movement is available to those things you may be surprised. There’s a lot of potential movement there! Proper foot movement brings on proper knee movement which brings on proper hip movement which makes the trunk and the shoulders move properly. Liberman observes that humans have been using their feet for far longer than the modern running shoe has been around. In our modern age we’ve decided that much like our food, we’re going to out think nature and “improve” on something that’s worked well for a very long time. But what happens when we put our feet in running shoes? We start to take away movement. We put a big piece of foam between us and the ground so that we desensitize our feet. (Compare this to going to a movie in sunglasses or listening to music with earplugs in.) In other words, we seriously alter something that’s been working pretty well for thousands of years. This alteration in function is made even more dramatic if we use orthotics. So it seems entirely likely to me that many cases of knee pain, hip pain, even shoulder and neck pain may well be rooted in what we’ve done to our feet. At the very least, I think it’s worth examining the issue. I’ll discuss more on the issues around barefoot vs. shod running in upcoming posts.

Z-Health for Toe Pain

This will be brief. I’m enormously excited over the results I’ve been getting from my Z-Health work. My back pain, Achilles pain and shoulder pain have all improved quite dramatically over the past few weeks. (I also added 70 lbs. to my deadlift in one fell swoop!) Yesterday it was my wife’s chance to be surprised by Z-Health.

My wife is a triathlete who’s had intermittent big toe pain in her left foot over the past several months. It comes and goes and it never had a clear-cut cause. Yesterday, after visiting with Jason Wood in Lakewood, CO I went home and had my wife go through some Z-Health R-Phase drills. One of the Z-Health concepts deals with opposing joints. That means since my wife’s toe pain was in her left foot, I had her go through drills with her right hand and thumb. The result? No toe pain whatsoever! As she gaped in bewilderment, she drove her foot into the ground and wiggled her foot all over and she could not replicate the pain. The toe pain returned this morning during a dog walk, she went through the drills again for a few moments and again the pain was gone. (As an aside, the toe pain comes on most notably in a pair of hiking boots. Perhaps the shoe is interfering with the natural function of her foot, as I’ve discussed here.) Pretty cool stuff this Z-Health.

I’ll be taking the R-Phase certification in March and April of this year and I’m extremely excited. I’ve just barely begun to scratch the surface with this exercise protocol and I expect to see more and more dramatic results. If you’re a fellow personal trainer, a chiropractor, physical therapist or anyone else involved in the health & fitness business, I highly suggest you look into Z-Health for everything from injury treatment to increasing sports performance. If you’re an athlete or just an everyday fitness fan who’s either in pain or not performing as well as you’d like, you would do well to seek out a Z-Health trainer for help and advice.

“We’ve shown that caffeine reduces pain reliably, consistently during cycling, across different intensities, across different people, different characteristics.”

To this point I’ve discussed nutritional strategies and cold water immersion as recovery methods for endurance athletes. Now, the quest to relieve sore muscles, malaise and fatigue continues with a look at caffeine. While caffeine could’ve been discussed as part of nutrition, its role is quite different from the role that food plays.

Science Daily does it for us again. Two articles profile caffeiene’s benefits. The first, Caffeine Cuts Post-Workout Pain by 50 Percent, Study Finds, discusses caffeine’s post-workout role.

The article profiles a study from the University of Georgia where caffeine’s effects were studied in nine female college students. The subjects engaged in a workout that induced mild post-workout soreness. One and two days later they performed one of two different thigh exercises with some subject having taken caffeine and others taking a placebo. One caffeine-consuming group reported a 48 % reduction in pain compared to the placebo group. The other group experienced a 26% reduction in pain compared to placebo.

The authors concede several weaknesses in the study. First, there was a small sample size. Second, the subjects were all female. Finally, they were not regular consumers of caffeine. So we don’t know if the effect will be seen in the public at large, among men and/or among people who regularly ingest caffeine. That said, the findings may be of interest to endurance athletes looking to recover from strenuous workouts.

Move over Gatorade...

The second article, Caffiene Reduces Pain During Exercise, Study Shows looks at caffeine as a pain reducer when taken pre-workout. This study was performed by former competitive cyclist and University of Illinois kinesiology and community health professor Robert Motl. He and his friends had long consumed caffeine prior to tough rides. He eventually decided to study the substance.

Motl wanted to examine the effects of caffeine on muscle pain during high-intensity exercise as a function of habitual caffeine use. He examined two groups: one made up of habitual caffeine users, the other made up of non-caffeine users. He found both groups had similar reductions in muscle pain during exercise after caffeine consumption.

Motl says, “We’ve shown that caffeine reduces pain reliably, consistently during cycling, across different intensities, across different people, different characteristics.”

So what are the practical implications? Motl explains that caffeine and its pain-reducing effects should help you push harder and thus go faster and/or longer during your workout or race. Or perhaps you could do your same workout but more comfortably.

Lots of Stuff to Read: Sports drinks with protein, Negative phys. ed teachers, Running shoes and knee damage, Why crunches don’t work, Science of weight loss

Wow! There’s a lot of good reading out there on the health & fitness front. I can’t comment on all of it but I’ll refer you to several articles that may pique your interest. I’ll get back to recovery strategies for endurance athletes later.

Protein Sports Drinks Proven to Give Best Performance: This is pertinent to the recent discussion on endurance training recovery. This article from Science Daily profiles an analysis of carbohydrate-only recovery drinks vs. carbohydrate-plus-protein recovery drinks. According to one of the study’s authors, “Liquid carbohydrate and protein supplements given early during a six hour post-exercise recovery period helped subjects better maintain subsequent time trial performance and power output, compared to supplements with carbohydrate alone”
Negative Phys Ed Teacher Can Cause a Lifetime of Inactivity: Science Daily again gives us a profile of an interesting study–one that may illuminate why so many of us in the Western World have an aversion to exercise.
Running Shoes May Cause Damage to Knees, Hips and Ankles, New Study Suggests: Once more we turn to Science Daily. The question of whether or not running shoes are actually healthy for us has yet to be answered. Here we have evidence that in fact barefoot running results in less stress to joints of the lower body.
Stop Doing Sit-ups: Why Crunches Don’t Work: Most of us in the fitness business gave up crunches and similar type movements long ago. If you’re still doing them you’re wasting your time. This article from Newsweek offers a decent explanation of why.
Exercise & Weight Loss: The remarkably well-informed and eloquent lads of the Science of Sport give us a four-part look at the most popular issue in health & fitness.

Time to relax!

Post-workout nutrition was the focus of the last post. Adequate intake of water, protein and simple carbohydrates is vital for repairing the body and preparing for subsequent endurance workouts. We can add to the recovery strategy the use of cold water immersion.

“Cold water immersion resulted in significantly lower muscle soreness ratings; reduced inflammatory response and consequent muscle damage; and better repeat sprint ability and leg strength,” Jeremy Ingram, physiotherapist, in the J Sci Med Sport. 2009 May;12(3):417-21.

Injury treatment has long featured the application of ice to strains, sprains, bruises and other injuries where swelling is present. Strenuous or long bouts of exercise can damage muscle cells thus resulting in conditions similar to injury such as low-grade swelling, pain, and nervous system disruption. Studies by the Journal of Science and Medicine in Sport, the European Journal of Applied Physiology, the Journal of Sports Sciences, show cold water bathing was well as hot/cold contrast bathing reduces these symptoms and helps speed recovery.

Protocols for cold water immersion and hot/cold contrast bathing are discussed here and here. (The idea behind the contrast method is to create a pumping action in the capillaries to speed blood flow and thus increase the recovery process) Peak Performance Online offers this free download titled How to ensure a speedy recovery from exercise. (Peak Performance Online features many free downloads on a wide variety of sporting topics. Definitely pay them a visit if you want to read a lot more.)

The basic protocols for cold water and hot/cold contrast recovery vary but are fairly similar. Here are two examples:

Cold Water Immersion
If you are going to try cool or cold water immersion after exercise, don’t overdo it. Ten minutes immersed in 50-60 degree Farenheit water should be enough time to get the benefit and avoid the risks. Because cold can make muscles tense and stiff, it’s a good idea to fully warm up about 30 to 60 minutes later with a warm shower or a hot drink.

Contrast Water Therapy (Hot-Cold Bath)
If you prefer alternating hot and cold baths, the most common method includes one minute in a cold tub (50-60 degrees Farenheit) and two minutes a hot tub (about 99-104 degrees Farenheit), repeated about three times.

My own cold-water recovery has employed two simple methods. First, when I lived in Virginia I had access to a swimming pool in the summer. Following a ride or run in the hot weather, I got in the pool, preferably in a shady area, and relaxed. This past summer in Colorado, I filled my bathtub with cold water so that my legs were covered and I dumped in a small amount of ice. It was cold but not painfully so. I sat and drank Recoverite and an energy drink with caffeine. I found the results very beneficial.

Speaking of caffeine, I’ll discuss that in Part III.

Denver Fitness Journal

All Things Health and Fitness by Kyle Norman, MS, CSCS, FMS, RRCA Running Coach

Endurance Training