Thoughts on Posture: Part I

Mom often told us to “stand up straight.” (Did she ever explain how to do it though?)Look around you and you’ll see some spectacularly “bad” posture. Slumped spines are all around us.

How important is posture with regard to pain? For a long time, various schools of thought have insisted that poor posture causes back pain, neck pain, shoulder pain and all sorts of other ailments. The fact is though posture and pain don’t really correlate all that well. Research by pain scientists have observed the following:

people in pain showing poor posture
people in pain showing good posture
people without pain in good posture
people without pain in bad posture

So we see that posture really isn’t strongly linked directly to pain. Further, we can’t really tell the chickens from the eggs: Did poor posture bring pain or did pain bring on poor posture. Or maybe we see both poor posture and pain in someone yet they really don’t have anything to do with each other. Sort of like hair and headaches. We often see them both in the same person yet we know they don’t really have anything to do with the other.

Todd Hargrove at BetterMovement.com wrote a great post on all of this called Back Pain Myths: Posture, Core Strength, Bulging Discs. He writes the following:

“In one study, researchers looked at the posture of teenagers and then tracked who developed back pain in adulthood. Teenagers with postural asymmetry, thoracic kyphosis (chest slumping) and lumbar lordosis (overly arched low lack) were no more likely to develop back pain than others with “better” posture.

Another study looked at increases in low back curve and pelvic angle due to pregnancy. The women with more postural distortion were no more likely to have back pain during the pregnancy. A systematic review of more than fifty four studies found no good evidence of a correlation between posture and pain. Leg length inequality seems to have no effect on back pain unless it is more than 20 mm (the average leg length difference is 5.2 mm). Hamstring and psoas tightness do not predict back pain.

These results are particularly striking given that many studies have quite easily found other factors that correlate well with low back pain, such as exercise, job satisfaction, educational level, stress, and smoking. Although some studies have found a correlation between back pain and posture, it is important to remember that correlation does not equal causation. It may be pain is causing the bad posture and not the other way around. This is a very likely possibility. People will spontaneously adopt different postural strategies when injected with a painful solution. Big surprise!”

What am I trying to say here? That posture doesn’t matter and that we should ignore it? Nope. I’ll give you some reasons to pay attention to posture:

Proper posture while lifting makes you stronger.
Proper lifting posture keeps you safe.
Tall, erect posture makes you look better.
This same tall posture makes you feel better and more confident. (Yes, the brain and posture are strongly linked!)

I’ll get into these topics in the next post.

“The new findings are part of a growing body of research that has challenged the accepted wisdom that saturated fat is inherently bad for you and will continue the debate about what foods are best to eat.”
– New York Times

The New York Times Well Blog posted an article recently called Study Questions Fat and Heart Disease Link. The article reports on a study in the Annals of Internal Medicine. This is a literature review of 75 different studies that examined the relationship between saturated fat and coronary disease. The study’s conclusion:

“Current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats.”

Beyond the saturated fat factor, the discussion on cholesterol and the different types of low-density lipoproteins (LDLs) is pertinent and echos the information in this post. Note also the comments on carbs and sugar from Dr. Rajiv Chowdhury, lead author of the new study and a cardiovascular epidemiologist in the department of public health and primary care at Cambridge University:

“The primary reason saturated fat has historically had a bad reputation is that it increases low-density lipoprotein cholesterol, or LDL, the kind that raises the risk for heart attacks. But the relationship between saturated fat and LDL is complex, said Dr. Chowdhury. In addition to raising LDL cholesterol, saturated fat also increases high-density lipoprotein, or HDL, the so-called good cholesterol. And the LDL that it raises is a subtype of big, fluffy particles that are generally benign. Doctors refer to a preponderance of these particles as LDL pattern A.

The smallest and densest form of LDL is more dangerous. These particles are easily oxidized and are more likely to set off inflammation and contribute to the buildup of artery-narrowing plaque. An LDL profile that consists mostly of these particles, known as pattern B, usually coincides with high triglycerides and low levels of HDL, both risk factors for heart attacks and stroke.

The smaller, more artery-clogging particles are increased not by saturated fat, but by sugary foods and an excess of carbohydrates, Dr. Chowdhury said. ‘It’s the high carbohydrate or sugary diet that should be the focus of dietary guidelines,’ he said. ‘If anything is driving your low-density lipoproteins in a more adverse way, it’s carbohydrates.’”

NPR also reported on this research in Don’t Fear the Fat: Experts Question the Saturated Fat Guidelines. This article offers a timeline leading up to the current research:

“So, let’s walk through this shift in thinking: The concern over fat gathered steam in the 1960s when studies showed that saturated fat increases LDL cholesterol — the bad cholesterol — the artery-clogging stuff. The assumption was that this increased the risk of heart disease.

But after all this time, it just hasn’t panned out, at least not convincingly. When researchers have tracked people’s saturated fat intake over time and then followed up to see whether higher intake increases the risk of heart attacks and strokes, they haven’t found a clear, consistent link.

In fact, the new study finds ‘null associations’ (to quote the authors) between total saturated fat intake and coronary risk. And a prior analysis that included more than 300,000 participants came to a similar conclusion.”

Both articles include caveats and reservations by other researchers. Read the articles to see those. I’m not sure they’re anything but what’s been said in the past, and this new research seems like a strong basis to refute the old advice.

A Life Long Fight Against Trans Fats

Dr. Fred Kummerow is a researcher who has no reservations about consuming saturated fat. He was one of the first researchers to lead the charge against trans fats. The New York Times profiled Dr. Kummerow in A Lifelong Fight Against Trans Fats. He observed in the 1950s a link between the man-made trans fats and coronary disease. It took decades for the rest of the food science world to accept his findings. He’s 99 years-old and still working. Some of his findings on vegetable oil and cholesterol are worth considering:

“In the past two years, he has published four papers in peer-reviewed scientific journals, two of them devoted to another major culprit he has singled out as responsible for atherosclerosis, or the hardening of the arteries: an excess of polyunsaturated vegetable oils like soybean, corn and sunflower — exactly the types of fats Americans have been urged to consume for the past several decades.

The problem, he says, is not LDL, the ‘bad cholesterol’ widely considered to be the major cause of heart disease. What matters is whether the cholesterol and fat residing in those LDL particles have been oxidized. (Technically, LDL is not cholesterol, but particles containing cholesterol, along with fatty acids and protein.)

‘Cholesterol has nothing to do with heart disease, except if it’s oxidized,’ Dr. Kummerow said. Oxidation is a chemical process that happens widely in the body, contributing to aging and the development of degenerative and chronic diseases. Dr. Kummerow contends that the high temperatures used in commercial frying cause inherently unstable polyunsaturated oils to oxidize, and that these oxidized fatty acids become a destructive part of LDL particles. Even when not oxidized by frying, soybean and corn oils can oxidize inside the body.

LDL’s and Kummerow’s own eating habits are discussed:

If true, the hypothesis might explain why studies have found that half of all heart disease patients have normal or low levels of LDL.

“You can have fine levels of LDL and still be in trouble if a lot of that LDL is oxidized,” Dr. Kummerow said.

This leads him to a controversial conclusion: that the saturated fat in butter, cheese and meats does not contribute to the clogging of arteries — and in fact is beneficial in moderate amounts in the context of a healthy diet (lots of fruits, vegetables, whole grains and other fresh, unprocessed foods).

His own diet attests to that. Along with fruits, vegetables and whole grains, he eats red meat several times a week and drinks whole milk daily.

He cannot remember the last time he ate anything deep-fried. He has never used margarine, and instead scrambles eggs in butter every morning. He calls eggs one of nature’s most perfect foods, something he has been preaching since the 1970s, when the consumption of cholesterol-laden eggs was thought to be a one-way ticket to heart disease.

“Eggs have all of the nine amino acids you need to build cells, plus important vitamins and minerals,” he said. “It’s crazy to just eat egg whites. Not a good practice at all.”

(Contrast that statement with the recent news of a poorly designed study that suggested eating eggs were as bad as smoking.)

I’m glad to see this type of information getting out. I think the giant lumbering battleship that is our nutritional advice is slowly turning another direction. Real food trumps processed food every time it seems, even if it’s loaded with fat and cholesterol.

Got food? Nope.

Back in May I discussed Michael Mosley and his PBS special called Eat, Fast, and Live Longer. It motivated me to try out fasting. This is an update.

Fasting can take on various different forms. We often think of fasts in terms of total abstinence of food and drink but that’s not the only way to fast. Fasts may be undertaken for several days at a time, for 24

hrs, or during part of a day. Reasons to fast include medical instruction, weight loss and other health benefits, or religious devotion. I’ve employed two types of fasting for weight loss and the various other health benefits discussed in the previous post and below.

Types of fasts

– Intermittent Fasting: Intermittent fasting has days of fasting alternated with days of non-fasting. I’m not doing a full-on fast but rather I’m extending my nighttime fast and reducing my calories on these days. This pattern has been popularized by Michael Mosley’s FastDiet aka the 5:2 Diet. (As I’ve said, I find Mosley’s work compelling, but to be fair, the Wiki entry on the 5:2 diet mentions a lack of evidence for its efficacy. Make your own decision.) I typically take two rest days throughout the week on Wednesday and either Monday or Friday. These have been my fasting days.

The strict version of intermittent fasting has men consuming about 600 calories on the fast days, women about 500 calories. That ain’t much! I’m training for some athletic events so this isn’t necessarily the ideal time to fast as I need all sorts of nutrients, fuel, and protein in order to engage in and recover from workouts. My modification simply has me waiting to eat (more on that right below) and generally trying to consume fewer calories. I actually sort of look forward to trying this very low-calorie fast though. When I’m ready…

– Restricted Feeding Window: This process is the other component of my fasting project. Essentially, this has you restricting the time during which you eat. Typical suggestions are to eat only during an 8-hr. time period of the day and to fast the other 16 hrs. Eating programs such as the Perfect Health Diet and the Warrior Diet advocate the restricted eating window.

Research in mice has indicated favorable benefits of the restricted-feeding window. The Salk Institute for Biological Studies released a study last year in which a researcher said:

“It’s a dogma that a high-fat diet leads to obesity and that we should eat frequently when we are awake,” says Satchidananda Panda, an associate professor in the Regulatory Biology Laboratory and senior author of the paper. “Our findings, however, suggest that regular eating times and fasting for a significant number of hours a day might be beneficial to our health.”

Further, an article by Brownen in Ageing Research Reviews discusses evidence that both caloric restriction and intermittent fasting may have potential to combat age related illnesses such as Parkinson’s and Alzheimer’s. This type of information supports my efforts.

My early experience

I’ve combined intermittent fasting with the restricted feeding window for about a month now. I reduce my calories two days per week and I take in very few calories (about 230) in the morning. This comes from the coconut oil and grass-fed butter in my version of Bulletproof coffee. The idea is to prolong the overnight fast. Then sometime around noon or later I start eating. I typically do this on Wednesday and Friday which are my rest days. I’ve fasted on Mondays as well.

Besides the likely health benefits of fasting, I’d also like to lose some weight and get down to 195 lbs. I’m training for both the Triple Bypass bike ride and the Continental Divide Trail Run and both of those efforts would be a little easier if I were a little lighter. Therefore I’m tracking my caloric intake and expenditure with My Fitness Pal (Myfitnesspal.com). It’s a fantastic tool for anyone wanting to lose weight. (If you want to lose weight then you must track your food intake. If you’re not willing to track your food then you’re not serious about losing weight–and that’s OK. It’s just not going to happen unless you decide to do it.) I started using it in conjunction with fasting. It seems to be a very good combination. I’ve consistently weighed anywhere from 202 lbs. to about 207. Now, I’m consistently weighing anywhere from 195 lbs. to 198 lbs. My body composition has improved as well from about 18% to about 15%. These changes came about very quickly

My Fitness Pal has you filling out a profile that includes such data as age, sex and activity level. You then enter in how much weight you’d like to lose and how quickly you’d like to lose it–1 lb. per week for example. I started off using My Fitness Pal by only tracking my calories and not tracking my exercise expenditure. At times it was really tough to keep my calories within the prescribed range. Once I started entering my exercise data My Fitness Pal adjusted my caloric intake and allowed me to consume quite a bit more which was very helpful. It looks like my rapid weight loss was probably due to my adhering to the recommended caloric intake of a sedentary person. This while I was exercising quite vigorously and staying below the recommended calories on my fasting days. Quick weight loss indeed.

More information

If you’re interested in learning more about fasting, I’ve listed some resources below. I’m new to this and there’s a lot more you can learn.

Depriving yourself: The real benefits of fasting – This comes from the Chicago Tribune. The evidence of the benefits of fasting are discussed:

“When it comes to treating cancer, Valter (cq) Longo, director of the Longevity Institute at the University of Southern California, thinks that short-term complete fasts maximize the benefits. He’s found that a 48-hour total fast slowed the growth of five of eight types of cancer in mice, the effect tending to be more pronounced the more fasts the animals undertook (Science Translational Medicine).

Fasting is harder on cancer cells than on normal cells, he says. That’s because the mutations that cause cancer lead to rapid growth under the physiological conditions in which they arose, but they can be at a disadvantage when conditions changes. This could also explain why fasting combined with conventional cancer treatment provides a double whammy.

Clinical trials assessing the impact of fasting in people with cancer are ongoing. Early results are promising, says Longo, and patients in the advanced stages of cancer, who cannot wait for the results, might find it worth discussing fasting with their oncologist.

Could fasting prevent cancers developing in the first place? Evidence is scant but there are ‘very good reasons’ why it should, says Longo. He points out that high levels of IGF-1 and glucose in the blood, and being overweight are all risk factors for cancer, and they can all be improved by fasting. Another risk factor is insulin, says Michelle Harvie at the University of Manchester, UK.

Studying women whose family history puts them at high risk of developing breast cancer, she put half of them on a diet that involved cutting calories by about 25 percent, and half on a 5:2 fast. After six months, both groups showed a reduction in blood insulin levels, but this was greater in the fasting group. Harvie’s team is now analyzing breast biopsies to see whether this translates to fewer of the genetic changes associated with increased cancer risk.

High insulin is also associated with type 2 diabetes, so perhaps it is no surprise that fasting shows promise here, too.”

Ready, Set, Fast: How Strategic Meal-Skipping Can Help You Lose Fat, Gain Muscle and Get Healthier – Dr. John Berardi of Precision Nutrition wrote this for The Art of Manliness. It’s his account of his own fasting experiment. He gives a good rundown of fasting basics, different types of fasts, links to fasting research, and his take on how to get started.

The UK’s Hot New 5:2 Diet Craze Hits The U.S. – Weight Loss Miracle? – We haven’t discussed the drawbacks of fasting. This article from Forbes discusses several aspects of fasting including intermittent fasting which the 5:2 Diet is based on. Some of the downsides of fasting are mentioned here too.

“The main drawback of intermittent fasting that has drawn many vocal critics is that it’s really, really hard to do. There’s no question, you’re going to be pretty hungry – and pretty grumpy – on your fasting days. And when dieting is miserable, people tend not to stick to it. And when they don’t stick to it, they get discouraged, often eating even more once they give up. Other than that, experts cite side effects including dehydration, irritability, anxiety, sleep problems, and bad breath.

Like many fad diets, intermittent fasting is likely to work really well for some people, discourage many more. But you won’t know which group you fall into until you try. So get ready to start coordinating your fast days with family and friends; the 5:2 FastDiet is going to be around for awhile.”

The writer makes a good point. Fasting isn’t all that easy or fun. But neither is cancer, diabetes or being overweight. What’s your health worth to you?

Lower Trap/Scapula Mobility & Strength Process

I’ve had some on and off right shoulder pain for a while. Along with it has been some wrist and elbow pain. I’ve worked wrist mobility, elbow mobility and I’ve worked shoulder internal rotation as well as elevation and retraction of the scapula. Like I said, the pain comes and goes so I figure I’ve been knocking on the door of the issue, but I haven’t yet nailed it. I’ve employed the following process to very good effect. I’ve used the same process with several clients and seen some very nice changes in shoulder pain and mobility, and neck pain and mobility.

An elevated shoulder

Recently, I asked my wife to look at my shoulders from the back and see if there were any discrepancies or anything that seemed out of place. She quickly said my right shoulder was higher than my left. I took a wild guess and figured I had an elevated scapula and that perhaps my lower fibers of my trapezius muscle weren’t doing their job.

The trapezius

The trapezius (or “trap”) is an interesting muscle. As the name implies, it is a trapezoid. From the picture you

The multi-talented trapezius

can see the superior fibers originate from the base of the skull and attaches at the lateral clavicle, acromion process, and the spine of the scapula. The middle fibers originate from C7 and T1-3 and attach at the acromion and scapular spine. The inferior fibers originate from T4-T12 and run upwards to attach to the lower scapular spine.

The traps do several things. Largely, they shrug your shoulders up (elevation), shrug them back (retraction) or shrug them down (depression). The traps also play a role in rotation, lateral flexion, and extension of the neck. The traps work closely with lots of other muscles including the lats, the levator scapula, deltoids, rhomboids, the muscles of the rotator cuff and a host of neck muscles. Consequently, if some part of the traps are too tight, too long or offline in some way, the result may be shoulder pain, neck pain or other issues down the line such as elbow, wrist or possibly jaw pain.

Mobilize & strengthen

To get things feeling and moving correctly, I like to start with soft tissue work via a lacrosse ball, the Stick, a foam roller, or whatever tool you like to use to soften tight tissue. I’ve found the stick rolled along the upper trap to be quite effective. An example is below. Also, I like to pin a lacrosse ball against my shoulder blade and the wall to get at the external rotators, mid traps, rhomboids, etc. I like to use the lacrosse ball in a similar fashion to work the pecs, but facing the wall instead of backing into the wall. Then, I’ve been using the following combination of stretches and strength work to put things in working order.

First are a couple of stretches I stole from Kelly Starrett at MobilityWOD.com. Both are useful ways to work on internal rotation and tie in some neck mobility. We often see poor shoulder movement that includes poor internal rotation and tight neck muscles–whether the lower trap is messed up or not. Working some internal rotation, moving the neck and loosening the tissue in that neighborhood seems to help facilitate good shoulder movement.

Second, I use the prone-Y simply to get a feel for what it feels like to use the lower traps. It’s nearly impossible to do this one wrong. Make sure to keep the glutes engaged so the low back doesn’t arch too much. Put a cushion under the forehead so as not to mash your face into the ground, bench, or table. I like to go to mild exertion. This isn’t something to make you grimace. It’s simply to get you connected to your lower traps.

The face-pull comes next. Take a staggered stance so as not to lean back. Keep the upper arms parallel to the ground. Keep the shoulders down–but don’t let the elbows drop. This may be a challenging skill for some. You may find your brain gets a tougher workout than any of the muscles involved. Again, no need to go to use a lot of weight or go to high exertion. Technique is #1 here!

Then I go to something I call a shrug-down. You can do this with a lat pull-down or cables or tubing of any sort positioned overhead. It can also be done with an assisted pull-up machine or unassisted hanging from a bar. The important thing is not to go too heavy. Just like the other exercises, this should feel too easy to start with. Many people find it quite difficult to shrug the shoulders down without bending the elbows. This is a skill and it may take some time, some steam coming out of your ears, and sticking out your tongue to master it.

Finally, I like going to a full cable pull-down or pull-/chin-up. Just like the other exercises, I suggest you go light. Try to separate the scapular depression (the shrug down) from the elbow flexion. See if you can make it sort of a two-part exercise: shrug down, pull up, lower yourself back down, un-shrug. Let me know if this helps your shoulder and/or neck issues.

Even if calorie restriction does not help anyone live longer, a large portion of the data supports the idea that limiting food intake reduces the risks of diseases common in old age and lengthens the period of life spent in good health.
– Scientific American

The second of Michael Mosley’s PBS series on health is titled Eat, Fast and Live Longer. A significant portion of the program is devoted to the health effects of fasting or caloric restriction. (He does not suggest that you actually consume your food at a rapid pace.) I’ve read and heard about some of the benefits of fasting and I’ve played around with it a little bit. After understanding the results of Mosley’s self-experiment with fasting, my wife and I both were very motivated to enact some form of fasting in our lives.

Michael Mosley PBS

Watch Eat, Fast and Live Longer with Michael Mosley on PBS. See more from Michael Mosley.

Benefits of caloric restriction

There seem to be several noteworthy benefits to fasting (aka caloric restriction.) I’ve written before that hunger actually seems to stimulate movement and alertness. The idea being that a hungry animal must go look for food.

Also, caloric restriction seems to extend the lifespan of various organisms and reduce incidence of various diseases. (Many studies have been done on animals, others in humans.) Caloric restriction seems to improve insulin sensitivity, heart function, and seems to improve memory in the elderly and may help in epilepsy treatment. Fasting seems to make brain tumors more vulnerable to radiation treatment, and calorie restriction–particularly carbohydrate/sugar restriction–appears to be an effective treatment for other cancers. (To be fair, there are other studies finding few benefits to calorie restriction. A recent study in monkeys suggests that the type of calorie matters more to lifespan than the amount of calories consumed.)

In this episode of Mosley’s show, he discusses Insulin-like growth factor or IGF. I won’t go into all the details of this compound, but it seems that it plays a key role in the development of several cancers and diabetes. In a study from the Journal of the National Cancer Institute, subjects with breast cancer, prostate cancer, colon cancer and ovarian cancer had higher levels of various types of IGF compared with controls. The study says:

“Evidence suggests that lifestyles characterized by a high-energy diet may affect the IGF system, which may, in turn, connect such lifestyles to high rates of cell proliferation and predispose cells to risk of malignant transformation.”

An article in the Harvard Gazette discusses studies with similar findings.

Why is this important?

Fasting decreases levels of IGF. Beyond just cutting calories, protein needs to be reduced as well. Watch Mosley’s special or read his BBC article The Power of Intermittent Fasting for more discussion on fasting and IGF.

I’m not a true academic researcher and I don’t claim to have found all the definitive evidence of this whole IGF/disease relationship, but from what I’ve read and heard it sounds like too much food may push us towards some types of diseases including various cancers. Periodic caloric restriction seems generally like a good, healthy idea.

If you look at the Wikipedia entry for fasting, you’ll see that the practice has been around all over the world for thousands of years, often for religious purposes. I tend to think though that if a practice hangs on for that long, our organism must on some level see something beneficial in it. Further, as noted in the Scientific American article How Intermittent Fasting Might Help You Live a Longer, Healthier Life, ancient humans were often forced to fast due to availability of food. A reliable supply of three (or more) square meals a day is a very recent addition to humanity. It’s possible that this pressure in evolution helped select for healthier genes that survive today.

In the next entry, I’ll discuss various types of fasts and my early experience in toying with caloric restriction.

“I have a section called, ‘Stop doing crunches,'” said Westfahl. “If your core routine mainly consists of crunches, you are training for bad posture.”
– Alison Westfall personal trainer, Boulder

Briefly, if you’re an athlete (particularly a cyclist), a fitness enthusiast and/or interested in addressing back pain, you should check out a recent article from the Denver Post titled, Tom Danielson, Tour de France cyclist from Boulder, focuses on core strength, writes book to address back pain. The article covers former pro cyclist Tom Danielson and his trainer Alison Westfall and their approach to addressing Danielson’s back pain. The two teamed to write a book called Core Advantage: Core Strength for Cycling’s Winning Edge.

Five clients mentioned this article to me and it definitely has some useful information in it. The admonition to quit doing crunches is the first good piece of advice. The second is the inclusion of the glutes as part of the core:

“Pain in Danielson’s spine compelled him to see Westfahl, who found his problem wasn’t rooted in his back, but in his glutes. She had him stop doing crunches — his primary core workout — and switch to other exercises, ones that, among other things, would persuade his glutes to start working properly when he rode.”

There’s more good information in the article including descriptions of three core exercises. Have a look. The book sounds interesting to me as well. Probably need to put it on my wish list.

Running Awareness: Cadence, Foot Placement, Lean

I just started the new year with a run in the cold with my dog. It was a good run and I can report that I’ve tuned into something(s) important. I was aware of several gait-related details that I adjusted and played with, those being cadence, foot placement and the degree to which I lean while running. Why was any of this on my mind?

Cadence

First, upon reading the excellent Anatomy for Runners I’ve become more aware of my running cadence aka how often my feet hit the ground. The author Jay Dicharry discusses a popular notion that the ideal cadence is about 170-180 RPM. I’ve run with a metronome a few times to investigate this idea and compare this range to my normal cadence. Turns out my cadence was quite a bit slower. The problem I found when running at this higher cadence is that my cardiovascular system felt overwhelmed! Maintaining even the low end of that cadence was very challenging. Seems that I may have found a simple solution. Before I get to that, let’s discuss why a quick cadence may be beneficial.

Changing cadence to prevent overstriding

I mentioned in my last post that where your foot lands is very important in running. You want the foot to land as near to your center of mass as possible, not way out in front of you, a situation also known as overstriding. Several elite-level running coaches have discussed cadence and foot strike position. I’ll let their words do my talking. First, Steve Magness at Science of Running says:

“Then why is everyone in a rage over increasing stride rate? Because as I’ve pointed out before, most recreational runners simply overstride, which artificially creates a very low stride rate. Why? Because the foot lands so far out in front of the Center of Mass that it takes a while for your body to be over it and ready to push off. So, when some running form coach says to increase stride rate to X, what ends up happening is the runner is trying so hard to increase stride rate, he chops his stride a bunch by putting his foot down earlier and landing closer to his center of mass, thus decreasing the overstriding. Nothing particularly wrong with that.

Where we go wrong is in the logic that the stride rate increase is the key. No, it’s not. It’s the elimination of the overstriding. Using the cue to increase stride rate is a way for coaches/runners to reduce the heel striking overstride.”

The key concept here is that it’s not cadence in and of itself that’s so important, but rather by manipulating cadence we can improve the location of where the foot lands. Pete Larson at Runblogger puts it well when he says:

“In other words, reaching with the leg is bad, and increasing cadence can help us avoid doing that. Let me repeat – overstriding is what we are trying to prevent by manipulating cadence. If you don’t overstride, manipulating cadence might not be wise or necessary.”

Now, you may be asking why is overstriding an issue? Essentially overstriding is harder on the body. In contrast, keeping the foot closer to you won’t beat you up so much. I won’t go into the details but if you’re interested, then please check out Jay Dicharry’s posts on Loading Rate Part 1: What Does it Mean for You and Part 2. (Part 2 is a very interesting discussion as to why a forefoot, midfoot or heel strike may not matter at all.)

Leaning forward

I’m obviously on the lookout for gait and running mechanics information. I recently discovered a very good site called Kinetic Revolution. There’s all sorts of very useful science-based information there for runners and triathletes. Among all this wealth of good stuff, I came across the post titled Essentials of Running Mechanics. That post features a video from a South African running coach named Bobby McGee. (Insert whatever obvious Janis Joplin joke you’d like.) Leaning forward is the first thing McGee discusses. Through leaning we can go faster or slower: more forward = faster, more upright = slower.

Remember earlier I mentioned that this faster cadence was overwhelming my heart and lungs? At the 1:34 minute of the video McGee discusses this issue. He says to simply get a bit more upright (don’t lean so far forward) to slow down and control the cardiovascular exertion. I tried it today and it worked perfectly! I was able to a) maintain proper foot placement under my center of mass by b) speeding up my cadence and c) adjusting my lean so that I was more upright. The overall result is that I maintained a quick pace and felt good doing it. I felt my glutes working well. Foot placement felt ideal. All-and-all I was very pleased with what this small adjustment did for me.

Awareness

When it comes to either pain or performance issues, we’re often told that we need to get stronger. We need to strengthen our core to help back pain. We need to strengthen our legs to pedal or run faster. We need stronger arms to swim better. Strength is important for sure. There’s no substitute for it. It’s money in the bank.

Awareness and pain

Here’s something slightly different to consider: Awareness. A lot of pain and poor performance issues aren’t so much strength-related as they are awareness-related. By this I mean we need to know how to use our muscles to control our limbs and a lot of us don’t have the awareness we need to accomplish the task. Here’s a common example:

A client complains of knee pain. I watch them squat, walk up and down stairs, and maybe do some one-leg mini-squats.

The glutes aren't doing their job and the knees suffer for it.

I observe a valgus collapse–the knee or knees cave in as he or she moves.

What are the consequences?

This type of movement pattern sets us up for knee ligament damage, meniscus damage, IT band pain, patella pain, and possibly back pain. Even if the person isn’t in pain, this is a very inefficient movement pattern. Whether running or walking, this valgus pattern makes for poor shock absorption and energy transfer into the ground. We’re slow and weak when our knees collapse like this.

Why is it happening?

Back to the “A” word, awareness. Very commonly we can’t use our glutes correctly–and we’re not aware that we’re not using them. We have what Thomas Hanna calls “sensory motor amnesia.” We’ve forgotten how to move. (Modern living is a killer. We sit too much!!)

Why do glutes matter to knees?

The glutes (glute maximus, medius and minimus) along with the tensor fasciae latae start up in the pelvis and feed into the IT band. The IT band then attaches to the top of the tibia right below the knee. In this arrangement, if we tighten or squeeze the glutes the knee will rotate outwards. If we release tension from the glutes then the knee will tend to collapse in. Control of the knee largely resides at the hip with the glutes. (By the way, we could discuss awareness of the foot as it pertains to a valgus knee too. If the big toe isn’t firm to the ground and we don’t have competent arches then the knee may collapse in.)

The keys to the knees.

What’s the solution?

Often someone with knee pain has been told they need to strengthen muscles around the knees namely the quadriceps. This was the thinking for years. So people did knee extensions. The muscles near the knee definitely got stronger but that didn’t improve the walking, running, or stepping pattern that was causing the pain. Now we understand that the glutes have more influence over the knee than the muscles surrounding the knee. The pattern of movement is the key factor. It’s how we use our muscles! We must become aware of how we move, and aware of how we employ our muscles during movement. If we gain awareness of the glutes then we can start to control the knee. Strength isn’t the main issue. (The same can be said for the deep core muscles and back pain.)

We need awareness before we can get strong, fast or powerful. In fact, if we’re not moving well–if we’re not aware of how we’re moving–and we add weight or speed to the scenario then we’re marching headlong into dysfunction, pain, and poor performance. It’s analogous to hammering a bent nail. The harder we pound the more it bends and we’re headed for trouble.

Awareness for performance: the bench press

I spoke with a friend and former client of mine who’s learning to bench press. (My ego demands that I tell you he lives in another state which is why he’s working with a different trainer.) He told me he learned to use his lats for the bench press. (Think of trying to bend the bar into a horseshoe.) Now, with the lats engaged he’s got a stronger foundation from which to press. He’s called in more muscles to help disperse the work. His shoulders are more stable. Now he can get stronger and likely avoid injury. Awareness should come first. (I wish I were aware of all this stuff when I was training him!)

Beyond this example, Louie Simmons in the Westside Barbell Squat and Deadlift Manual directs lifters to identify their weakness–become aware of them in other words–and work to shore them up. He says don’t necessarily do the exercises you like. Do the exercises that work for you.

Awareness for performance: running

First, all the stuff above about glutes and knees pertains very much to running. Remember that. What else should we be aware of while running? Think about where your foot lands. Does it land way out in front? It shouldn’t. If it does you’ll likely have problems. Rather, the foot should land just barely out in front of your center of mass and the foot should land right below the knee, not out in front. If you watch recreational runners you’ll often see the foot land out in front. Watch elite runners and that foot lands very close to right underneath. Think of your leg as a swinging pendulum. If the pendulum swings wide then a) your foot lands out in front, b) your cadence is slower and c) it’ll take more energy to run. In a better situation you’ll swing your pendulum/leg in a shorter arc. The foot will land closer to you which will result in a faster cadence and you’ll be more efficient. You’ll be faster and you’ll be in a better position to avoid injury. For more on this and further awareness of how you should run, check out this very informative article by Jay Dicharry, author of Anatomy for Runners.

Awareness for weight loss

So we’ve discussed awareness as it pertains to pain and performance. Where else does it matter? Do you want to get leaner and generally healthier? Then you better be aware of your eating habits. Very similar to poor movement patterns, poor eating habits will over the course of time do great damage to our physique and overall health. The problem is a habit is an unconscious thing. We’re not aware of our habits! We eat mindlessly in front of the TV. We’re caught without healthy food to eat so we resort to fast food or packaged frozen dinners. We take nibbles of junk snacks thinking that we’re not eating that much garbage, but by the end of the week we’ve consumed a lot of crapola. The result? We look and feel like a sick, sluggish mess. What can we do?

Keeping a food journal is by far one of the most effective and cheapest things you can do to help become aware of your eating habits. You can use any notebook. Or you can use an online program such as MyFitnessPal.com.

Does this sound inconvenient? Writing out 1/2 cups, tablespoons, grams, etc. can be a hassle. Guess what. You don’t have to employ painstaking detail to get the benefits of keeping a food journal. You don’t even have to track every meal every day. If you eat some M&Ms, write “M&Ms.” If you eat a salad write “salad.” If you can only manage to track breakfast three days a week then that’s better than tracking nothing at all. The point is to start to become aware of your eating habits. Any progress at all is progress. Awareness must come before you can expect to see change.

Awareness elsewhere in life

How are you handling stress? What time do you go to bed? If you’re trying to get in shape or you’re training to compete, you better know these things. If you’re aware of your workouts but your not aware of how you’re resting then you’re compromising your ability to lose weight and compete.

Hard exercise is stress. So is work. So are some of our interpersonal relationships. Alcohol and sugary foods cause stress. The winter holidays are full of stressors. If stress goes up in one or more areas then it must come down in others. Otherwise you’re courting illness, injury or at the very least extreme fatigue. If you’re feeling pulled in 100 directions then it may be a good idea to scale back your workouts a little. Don’t give up though! Recognize that more/harder exercise won’t help you if you’re highly stressed. Finding some way to decrease some of your stress is critical to good mental and physical health. Take stock of these things. Be aware of what’s going on in your life. Then you can take measures to manage things.

The research showed that those who sat for long periods of time have a higher chance in their risk of diabetes, heart-disease and death.
–Diabetes Research Group, University of Leicester

It’s been suggested that you sit too much. New research from the University of Leicester backs up this claim. (By the way, there are several other studies showing the same thing. Look here, here, here.) The study combines the results of 18 different studies and includes nearly 800,000 participants. Here are the important details. Emphasis is mine:

“The research showed that those who sat for long periods of time have a higher chance in their risk of diabetes, heart-disease and death. Interestingly, the results were independent of any individual physical exercise undertaken, suggesting that even if an individual meets the physical activity guidelines, their health may still be at risk if they sit for long periods of time during the day.”

I find this fascinating. You’re putting yourself at risk of death if you sit too much–even if you’re highly physically active. So in this way, sitting is like smoking. We can’t seem to out-exercise our sitting habit. So what do we do? We need to move a little. Researchers suggest we take frequent breaks from sitting and go move around.

It’s often easy to sit at your desk for hours on end and not even know it. We need to be reminded to move. So here’s an idea: Set a recurring meeting on your computer’s calendar. Make it every half-hour or hour. Label it “Get up and move around.” Otherwise, try this series of spine mobility drills. (Because it’s not just sitting per se that’s so bad, but lack of movement that’s the problem. You can still move while sitting at your desk.)

Good Reads: Rethinking Sleep, A Look At “Hardcore” Workouts

Two recent articles have caught my attention. One comes from the New York Times; the other is a two-part piece from a blog called Fit For Real Life. The Times article presents some new concepts on our sleep patterns. The blog post gives a good insight on workout intensity and why more doesn’t always equal better.

Sleep

“It seemed that, given a chance to be free of modern life, the body would naturally settle into a split sleep schedule. “

I’m a big fan of sleep. I’ve mentioned here and here that lack of sleep is tied to various ailments such as obesity and obesity-related issues like diabetes. As I’ve always understood it, most adults need 8-9 hours of sleep a night. (I also understand it that a small part of the adult population actually thrives on five or fewer hours of sleep per night. I wish that were me.) The NY Times article Rethinking Sleep has me… rethinking sleep.

The article describes the American view of bedtime and sleep and contrasts that with other cultures’ take on the same thing::

“Typically, mention of our ever increasing sleeplessness is followed by calls for earlier bedtimes and a longer night’s sleep. But this directive may be part of the problem. Rather than helping us to get more rest, the tyranny of the eight-hour block reinforces a narrow conception of sleep and how we should approach it. Some of the time we spend tossing and turning may even result from misconceptions about sleep and our bodily needs: in fact neither our bodies nor our brains are built for the roughly one-third of our lives that we spend in bed.

The idea that we should sleep in eight-hour chunks is relatively recent. The world’s population sleeps in various and surprising ways. Millions of Chinese workers continue to put their heads on their desks for a nap of an hour or so after lunch, for example, and daytime napping is common from India to Spain.”

The article goes on to cite historical variations on sleep including a mention in the Canterbury Tales of going back to sleep after her “firste sleepe.” Further, physicians from the 16th century mention “first sleep” and “second sleep.” Research from the NIH supports the concept that divided sleep patterns may naturally occur during the night.

Deep sleep or REM (rapid eye movement) sleep is discussed. This is the most valuable sleep time during which our brains are highly active. REM sleep aids cognitive function, helping us solve problems and perform at a mentally high level. The benefits of REM sleep can be derived from any type of sleeping pattern, not just from eight straight hours of sleep. Research suggests that brief naps can be quite useful.

The article concludes with a discussion of workplace napping. Though napping at work isn’t allowed for most of us, the concept may be gaining traction at some places such as Google. The Army is also experimenting with the concept for soldiers who need to be ready to fight around the clocks. Strategic naps may be essential to keep them ready for war. The Texas Rangers baseball team has also prioritized sleep and napping for its players.

I can say from my own experience that napping during the day is way more than a luxury. Since I’m a personal trainer I tend to be able to nap on most days of the week. I believe it’s absolutely essential for my mental state and my overall health. I couldn’t imagine taking another job that didn’t allow for it. The pay would have to be MUCH higher, and I imagine I’d hate life a little for it.

“Hardcore” Workouts

“There is a finite amount of quality movement before the movement pattern breaks down, eventually degrading enough that your body is at risk for a variety of issues, including injury, if it continues.”

I found this two-parter on Twitter and I really like what the writer has to say. Her words echo my observations of many a gym member’s exercise routines and many a personal trainer’s training strategies–namely “more/harder is better.” Any idiot can exercise–or push someone else to exercise–until he or she vomits, passes out, or collapses. Easy! Swing a 24 kg kettlebell 800 times in an hour then do 100 pushups. Run 20 x 400 m all-out sprints with one minute rest between sprints. Add more weight. Go faster. There is a better way to work out.

The articles do a very good job of explaining what happens as we fatigue, namely we don’t move as well. We collapse at the feet, knees, hips, spine… We set ourselves up for needless wear, tear, and injury. It’s a very good read and here are the links:

“It’s a dangerous thing to think that harder/more is better. It’s not. In fact, it’s likely what limits the long-term fitness success of many. And, when used incorrectly (as I see far too often)- it’s the fast-track to injury.” The Poison Is In the Dose: A Look At “Hard-core” Workouts”

“So what if your movement patterns are dysfunctional? Fix them. Practice does not make perfect. Practice makes permanent. If something isn’t working don’t continue doing it: that only teaches dysfunction & permanent faulty movement patterns.” Where There’s Smoke, Don’t Fan the Fire: Continuing Our Look at “Hard-Core Workouts”

Denver Fitness Journal

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

Fitness Tips

Thoughts on Posture: Part I

More Nails In the Saturated-Fat-Is-Bad Coffin

The Fasting Experiment: Part II

Lower Trap/Scapula Mobility & Strength Process

The Fasting Experiment: Part I

Good Core Strength Artice

Running Awareness: Cadence, Foot Placement, Lean

Awareness

Sitting is Hazardous to Your Health

Good Reads: Rethinking Sleep, A Look At “Hardcore” Workouts