The Big Running Plan Begins

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There’s a big event that I’ve had on my mind for years.  It’s the Gore-Tex Transrockies Run. This year’s gig is six days, 120 miles with 20,000 feet of elevation gain. I’m looking at running the 2015 race so I figure the mileage and such should be about the same. Go here for maps and descriptions of this year’s stages.

Preparation for the Transrockies run means a whole lotta running this year.  I need to do more trail races and another marathon, most likely a trail marathon. I’m running a lot (for me) right now. I’m up to about 30 miles per week. I’ve got a 5k this weekend and more races planned (more on that in a moment.) The very good news is that everything is feeling solid and strong, including my stubborn, chronic Achilles/heel trouble.

I’ve also consulted with Denver-area running coach Jay Johnson. I saw him speak at the NSCA Endurance Clinic a few months ago and I became very interested in picking his brain a bit. I’ll be communicating with him every month or so to fine tune my workouts and run plan. Speaking of which…

My first and only marathon (two years ago) was based on the FIRST Run Less, Run Faster plan.  This plan has only three run days per week: a track workout, tempo run, and a distance run.  Two days a week were devoted to a cross-training workout on a bike or rower.  I also ran the Ft. Collins Half-Marathon and Park-to-Park 10-Miler based on this plan. It’s a minimalist running plan. It’s very useful if there’s limited training time available. This plan got me through several races but I want to know if a different type of plan will increase my performance. I’m curious if more running will make me a better runner.

The Transrockies run is a lot of running for several days in a row, thus with the SAID Principle in mind, it makes sense to me that I should train in as close a fashion to the race as possible. This time around, I’m going the maximalist route with the Hansons Marathon Method.  (I also need to get the Hansons Half-Marathon Method.)

Something to consider with this high-volume plan is the opportunity to practice running. That is, with all the miles and the recovery runs, I get the chance to refine my running skills. Running is a skill just like playing a horn or driving a golf ball. Running improvements don’t come just from the obvious increases in fitness that come from speed work, tempo runs and tough long runs. Matt Fitzgerald discusses this idea in a Running Times article called Rethinking Junk Miles:

You see, running is a bit like juggling. It is a motor skill that requires communication between your brain and your muscles. A great juggler has developed highly refined communication between his brain and muscles during the act of juggling, which enables him to juggle three plates with one hand while blindfolded. A well-trained runner has developed super-efficient communication between her brain and muscles during the act of running, allowing her to run at a high, sustained speed with a remarkably low rate of energy expenditure. Sure, the improvements that a runner makes in neuromuscular coordination are less visible than those made by a juggler, but they are no less real.

For both the juggler and the runner, it is time spent simply practicing the relevant action that improves communication between the brain and the muscles. It’s not a matter of testing physiological limits, but of developing a skill through repetition. Thus, the juggler who juggles an hour a day will improve faster than the juggler who juggles five minutes a day, even if the former practices in a dozen separate five-minute sessions and therefore never gets tired. And the same is true for the runner.

 (BTW, Russian kettlebell and strength expert Pavel Tsatsouline discusses the exact same principle but with regard to strength training.)

The Hansons Plan has me running often in a fatigued state. The longest run I do though is 16 miles. Most marathon plans feature a 20 mile run. So why only 16 as a longest run? This 16-miler will take place after several days of running. I’ll have a tempo run then an 8 or 6 mile run the day before the 16-miler. The idea as they say in the Hansons book is that I’ll be training to run the last 16 miles of the marathon. Sounds interesting and plausible to me. That goes along with something Coach Johnson suggested. He said that at some point, in preparation for the Transrockies Run, that every other week I should run back-to-back long trail runs. Again, this goes to the idea of training specificity. I imagine I’ll do that next year.

Here’s a list of races and potential races I plan to run this year:

  • 3/2/14 – That Dam 5k – Denver: I need to run a 5k so I can derive my training paces for the marathon plan.
  • 4/6/14 – XTERRA Cheyenne Mt. Trail Run 12km – CO Springs: Don’t know anything about this race but I’m looking fwd to it.
  • 5/4/14 – Ft. Collins Marathon 13.1: Ran this one last year and had a great time.  Went out a tiny bit too fast though.  Hope to better my time of 1:47.
  • 6/7/14(maybe) – Boulder Sunrise Duathlon 3.1 mile run / 17.3 mile bike / 3.1 mile run – Boulder: My wife is doing this triathlon. I don’t swim well enough to do a tri but I’ve done some duathlons and this might be fun and a change of pace.
  • Summer – 5k: Coach Jay Johnson suggested I train for and race a 5k. He said putting in that speed work would be useful for a Fall marathon.
  • 8/23/14 (maybe) – Continental Divide Trail Race 15.5 mi. – Steamboat: Ran this one a couple of years ago and it was brutal but beautiful and a very laid-back kinda thing.  Wouldn’t mind taking it on again in a better pair of shoes. Not sure if this one fits into the overall race plan.
  • 9/20/14 – Aspen Golden Leaf Trail Half-Marathon – Aspen: This race got a great write-up in some running magazine (Runner’s World?  Competitor?) recently. We’ve never been to Aspen. Sounds interesting. Should be good preparation for the marathon.
  • 11/8/14 – Moab Trail Marathon: This is my main race. We’ve never been to Moab and this is a great reason to go.

That’s my plan right now. I’m very excited about this! I’m feeling great right now. I really love the process of getting to these races. I love the anticipation and the training. We’ll see what happens.

NSCA Endurance Clinic Summary: Day 3

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David Barr: Nutritional Supplements & Ergogenic Aids

  • NSCA CSCS, USA Track & Field, Precision Nutrition Certified, participated in research with NASA
  • High Return On Investment Supplements
    • Caffeine
      • blocks adenosine which results in
      • less fatigue and
      • lower feeling of exertion during activity
      • concerns include GI distress and diuresis (exessive urination)
    • Carbs
      • type: glucose, fructose, maltodextrin
      • timing: during exercise
      • beneficial in events lasting >2.5 hrs
      • dosing by duration: 60g/hr for 2-3 hrs, 30g/hr if <2 hrs
    • Fish oil
      • effects
        • increased muscle anabolism
        • may enhance recovery
      • Don’t look at total Omega 3s
        • You want EPA = 180 and
        • DHA = 120
      • If eating a high-fat diet (me) then up the Omega 3s.
      • potential synergy with Vitamin E
    • Protein (He seems to be a big protein guy.)
      • Don’t use during exercise (but what about Accelerade?  No good?  Didn’t get a chance to ask.)
      • Consume up to 2 g per kg of body weight or 1 g per lb.
      • Whey post workout: 20-25 g is the limit
    • Nutrient timing:
      • Protein pulse feeding
        • multiple protein feedings per day of 20-30 g
        • ups protein storage
        • Seems the effect of this is separate from the training effects from the workout.
      • Take about 40 g of casein before sleep to help blunt catabolism
      • Carb timing:
      • If you need rapid glycogen replenishment then consume carbs soon.
      • If you have 24 hrs before the next workout then it’s not an issue.
      • Protein and the workout
        • If you’ve eaten soon before a workout then don’t worry.
        • If you haven’t eaten in a while then eat protein pre-workout.
    • Keys to hydration
      • specific prescription better than ad libitum or drinking at will.
      • (Dr. Tim Noakes disagrees and I side with Noakes.)
      • flavor enhances consumption
      • cold increases palatability
      • drink early/often
    • Building the optimal endurance drink
      • 200 ml water/15 minutes
      • sodium: 450 mg/L
      • Carbs: 8-10%, 90 g/hr: glucose and fructose
      • Protein (potentially): 7%
      • You must “train the gut” or use this stuff while training in order to condition the digestive system to put up with it.
    • Antioxidants
      • mitigate free radical damage and aid recovery
      • Don’t take directly after workouts.
      • May be a case for taking antioxidants during activity
    • Lactate
      • Lactate is used as energy.
      • Doesn’t cause burn/fatigue
      • Cytomax makes some sort of drink w/lactate in it.
    • Buffers
      • bicarbonate
        • 300 mg/kg
        • potential GI trouble
      • Beta alanine
      • Theoretically: use both for a systemic effect
    • Nitrates
      • may help power output
      • may mitigate effects of altitude
      • Improved time trial performance in cyclists
    • Immunity
      • CHO
      • Vit C
      • Vit D
      • Zinc
    • Common deficiencies
      • Vit D
        • No toxicity
        • 6000-10,000 IU/day
      • Iron: Test for it.
      • Magnesium
    • Experimental considerations
      • hyperhydration
      • “train low” (carbs): unclear if this benefits performance
      • echinacea: increases EPO
      • ketones: novel energy source
    • Future prospects
      • cobalt chloride
      • guanidinopropionic acid
    • Other resources

Tim CrowleyProgram Design: Strength Training for Endurance Athletes

  • CSCS, NASM-PES, USA Cycling Elite Level Coach, 2008 US Olympic Triathlon Coaching Staff, USAT Elite Coach of the Year and Development Coach of the Year, Owner TC2 Coaching, Head Strength Coach at Montverde Academy
  • Huge need for endurance strength & conditioning coach
  • “Great swimmers are great athletes that swim fast and great athletes are strong.” – Richard Shoulberg, Germantown Academy
  • STRENGTH MUST BE THERE FOR SPEED!
  • Program Goals
    • Reduce injury incidence
    • Reduce injury severity
    • Increase athletic performance
    • Improve athleticism
  • If you can read/learn 1 hr per day then you’re way ahead of the crowd.
  • Try stuff out before we give it to athletes: workouts, tools, food
  • Book: Endurance Training Science & Practice, Mujika
  • He covered various research evidence showing that strength training aids runners, cyclists and other endurance athletes
    • Reasons strength training works for endurance athletes:
      • conversion of type IIX fibers into fatigue resistant type IIA fibers
      • improves strength (like money in the bank)
      • rapid force production
      • improved neuromuscular function
      • tendon stiffness (essential for running)
      • improved max speed for fast starts or finishes
    • Common myths
      • Heavy weights make you big
      • Weight training hurts young athletes
      • Endurance athletes need light weight/high reps
      • Heavy weight training reduces ROM
      • Lifting equals bodybuilding
      • Squats hurt knees
      • Only for use in off-season
      • Endurance training will build strength
    • Important considerations
      • Strength work often isn’t to improve the engines of endurance (legs for running for example) but rather to address weaknesses, increase overall athleticism, and avoid injury
      • As pressure mounts on an athlete, find ways to coach less and simply get them to perform at their ability.
      • Time:
        • an obstacle for endurance athletes
        • goal is 30-40 min 2x per week
        • Try high-intensity/low-volume workout to increase muscle activation prior to a track workout
      • Energy
        • finite amount of energy for training
        • can’t interrupt endurance sport training
        • DOMS can be a problem
        • physical effects of high-vs low-volume
        • psychological effects
      • Reciprocal Inhibition
        • Reduced neural drive to opposing muscles
        • Areas of concern
          • scapula/thoracic spine
          • hip flexors/glutes
          • hip adductors/glute medius
          • anterior core/low back
      • Pattern Overload
        • Endurance sports are cyclical
        • high incidence of overuse injury
        • lots of “itises”
      • Force Couplings
        • Key body regions for multisport athletes
          • internal vs. external shoulder rotators
          • hips in saggital plane (flexors vs. extensors)
          • hips in frontal plane (glute medius and quadratus lumborum)
        • Eliminate power leaks
        • Improve movement economy = free speed
      • Masters athletes
        • strength development/maintenance is vital to success
        • loss of power declines faster than strength
        • mobility is crucial
        • compensation patterns
        • slower recovery from injuries
      • Program design
        • foam rolling/movement prep
        • mobility
        • corrective exercise
        • strength
        • keep it simple
        • less is more
        • quality over quantity
        • develop power
      • Self-myofacial release (SMR)
        • foam rollers
        • tennis/LAX balls
        • golf balls
        • the Stick
      • Mobility
        • May be the most important component in the beginning
        • a must for masters athletes
        • Vital concerns:
          • hip mobility
          • thoracic spine
          • ankles
          • 1-leg squat
          • split squat every workout
          • His ACL injury rate is almost 0.
      • Overuse injuries
        • Be proactive
        • shoulders
        • low back
        • glutes/glute medius
        • lower leg/ankle
      • His go-to exercises
        • inverted/TRX rowing
        • anterior core
        • core dynamic stabilization
        • single-leg squatting (priority goes to 1-leg over 2-leg work)
        • glute/hamstring and glutes
        • trap bar deadlifts
        • ankle band walking
        • eccentric calf raises
      • Mobility and Stability
        • Mobility is the combination of muscle flexibility, joint ROM, and the body segment’s freedom of movement
        • 2 types of stability
          • static 1-leg stance
          • dynamic core stabilization during athletic movement
        • Example: Hips are stiff so lumbar spine becomes too mobile/unstable and injury is incurred.
      • 10 exercises to include
        • Cook hip lift

      • Hip flexor stretch
        •  X Lat pull (couldn’t find a video)
        • Reverse cable fly

        • single-leg squat

        • single-leg deadlift

        • stability ball pushup or TRX pushup (unstable surface)

        • lawnmower row

        • cable and tubing lifts and chops (and other similar exercises)

      • single-leg heel raise
  • Resources

Nick Clayton, Power Training for Endurance Athletes

  • Objectives
    • Explain how training with explosive movements benefits endurance performance
    • Correctly perform variations of the Olympic lifts and plyometrics specific to performance in endurance activities
    • Lecture
    • Practical
      • dynamic warm-up
      • Olympic lift variations
      • Plyometrics
    • Why train for power?
      • Rate of force development
      • eccentric strength
    • Non-barbell Olympic lifting
      • Clean, snatch, jerk variations
        • kettlebells
        • dumbbells
        • medicine balls
      • Plyometrics: various 1 and 2 leg jumps, hops, skips
      • Nick said he would create videos of all the exercises and post them.  When/if they’re available I plan to post them here.
      • This was a fantastic session from warm-up to all exercises.
      • It was very much in line with the idea of creating athleticism.
      • These drills exposed a lot of weaknesses and lack of athleticism in a lot of the participants.
      • Exposing these weaknesses could be a huge opportunity to improve athletic performance.

Conclusion:

This clinic was just excellent!  It far surpassed my high expectations and that’s a rare thing.  The combination of theoretical/academic/”sciencey-type” stuff, practical application of the science, and physical participation kept the whole thing extremely interesting.  I came away with my mind overflowing with ideas.

Several things are prominent in my mind right now:

  1. I was re-introduced to some of Gary Gray’s concepts.  I’ve returned to doing the 3D lunge matrix with much greater understanding of hip, spine and knee position, plus how to tweak the lunge matrix in all sorts of ways.  I’m doing it again and all my clients are doing it now.
  2. The concept of athleticism as a necessary foundation is a HUGE concept to me.  We tend to specialize too much.  We devote ourselves to endurance sports which go one direction (saggital plane) and we neglect 3D movement.  We avoid crawling, climbing, rolling, hopping, jumping and engaging in unpredictable movement situations.  Check out the people going into and out of Spinning classes and you’ll see a lot of broke-down people who can barely hobble.  They aren’t athletic.  And I have been one of those people–but not anymore! Every one of my workouts now has a dedicated 3D movement component, power component and I try to do something that I don’t typically do.  Athleticism deserves a blog post of its own.
  3. I’m going to contact Jay Johnson for some coaching.  He did such a fantastic job of distilling academic information into practical application.  I can only coach myself so far.  I need someone who’s been through the process both as a runner and a running coach.

NSCA Endurance Clinic Summary: Day 2 (I forgot to summarize the final presentation.)

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Maybe I was in a rush to post the Day 2 summary, I’m not sure.  I forgot to summarize the final presentation of the day.

Dr. Jeff Matthews: Running Injuries – The Big Picture

  •  DC, CCSP, CCEP, 1996 USAT National Team, high school track coach
  • Primary shock absorber of the body: FOOT PRONATION
    • Pronation isn’t a bad thing–it’s supposed to happen.
    • Posterior tibialis controls pronation via eccentric contraction
  • Secondary shock absorber: knee flexion
  • Aches & pains of the leg, foot and toes
    • Metatarsalgia
      • Pain at the metatarsal phalangeal joint as the heel leaves the ground too early.
        • Causes
        • limited ankle dorsiflexion
        • tight gastrocnemius
        • weak digital plantar flexors
      • Treatment
        • stretch gastroc with straight leg
        • increase distal plantar flexor strength
        • rigid forefoot in shoes
        • decrease stride length & employ heel strike
      • I have off and on metatarsalgia.  I’m going to work the toe flexors, particularly the flexor hallucis brevis.  I’ll use a band.
    • Hallux limitus and rigidus (aka Turf Toe)
      • Dancers and defensive backs get this as a result of doing a lot of stuff on their toes.
      • Loaded dorsiflexion of the big toe should be 42 degrees at toe off.
      • To check: Sit with knees bent at 90 degrees.  Lift toe with finger while foot is flat on the ground.  If it’s less than 30 degrees then you’ve got a problem.
      • Stretch toe flexors: Pull toe back 20-30x/day.
      • Restore joint motion to big toe.  I’ve been playing with this stuff quite a bit lately.  I’ve got a constantly tight left calf.  I’m wondering if restricted toe dorsiflexion is part of the problem.
      • I’m not only working to stretch the FHB, but also to strengthen it so my big toe can grip the ground.
      • Here’s a good big-toe mobility video:

    • Insertional Achilles tendonitis
      • occurs near the base of the AI
      • common in high-arched, stiff feet
      • common with Haglund’s Deformity.
      • Seems I have a bit of this; more along the lines of a bursitis from what I cant tell.
      • Strengthen with eccentrics.
      • He says “Work on the front of the tendon,” as that’s where the blood flow comes from.
    • Achilles Paratendonitis
      • He describes this as occurring with an audible squeak or creak–I’ve had that!
      • An inflammation of the sheath around the tendon
      • Work on the front of the tendon to increase blood flow.
    • Achilles non-insertional tendonosis
      • degenerative non-inflammatory condition from repeated trauma
      • treatment
        • rest
        • muscle work to stimulate fibrolasts to remodel
        • when appropriate, strengthen posterior tibialis and flexor digitorum longus
        • How do we strengthen the FDL?  Here’s one way:

    • Patellofemoral Pain Syndrome aka runner’s knee
      • comes from abnormal femoral movement
      • hip muscle weakness is the cause; increases with fatigue
      • Testing for PFS: 1-leg squat & check for 3 things:
        • leaning toward stance leg to maintain balance
        • knee caving in
        • falling
      • Treatment
        • retro patellar pain: recruit/strengthen the vastus medialis oblique (VMO)
        • stretch hips, foam roll quads, increase hip flexor strength
    • IT Band Syndrome (ITBS)
      • strengthen hip abductors
      • decrease tension on the tendon with soft tissue therapies
      • stretch glute max and TFL
      • may take 6 weeks (Didn’t take me that long to overcome mine.)
      • Check out my post on IT Band issues for more help.
    • Popliteus tendonitis
      • The popliteous unlocks the knee from the extended position.
      • inserts under the IT band and can cause lateral knee pain
      • if weak then knee may stay locked and send shock to the back
    • Treatment
      • Strengthen the popliteous
      • soft tissue therapy
      • control pronation (probably with foot strengthening drills and more importantly, HIP ABDUCTOR exercises)
      • Here’s a video on recruiting and strengthening the popliteous

  • Hamstrings
    • Hamstring strains have the highest recurrence rate and can take 4 months to resolve
    • Semimembranosus protects the medial meniscus during knee flexion
    • long head of biceps femoris helps stabilize SI joint and is most frequently injured in runners because of the long lever arm decelerates knee extension
    • more proximal the injury the harder to treat
    • Treatment
      • increase length, strength and flexibility
      • evaluate pelvis
      • strengthening abs/stabilizing pelvis can position pelvis correctly thus putting hamstrings at proper length
  • Low back pain
    • Pain causes weakness/looseness
    • Internal or external femoral rotation may become problematic.
    • Treat hips
    • A TFL problem = a glute medius problem.  This is huuuuge to me!
    • Seems to me that sitting too much is maybe the main problem here.

 

 

Making Stuff Faster

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Here’s a very interesting video from PBS by way of Scientific American.  It’s part of the 4-part Nova series Making Stuff…  This discussion is on making stuff faster. Here, the host explores how to make faster runners.

The big takeaways here are:

  • 1) Hit the ground harder and
  • 2) Keep the torso stiff.

I haven’t seen the actual episode yet but I love the analysis and advice.  A lot of runners think that simply running more will yield better running.  But if you run the same way more and more then you should expect more of the same.  In this video, the host is given a few instructions on how to run.  The result?  He gets about 2 seconds faster on a 100m sprint.  That’s a great result!

Strength isn’t discussed in this video but I think we can very safely assume that a stronger runner can strike the ground harder than a weak runner.  So squats, deadlifts, 1-leg squats and jumping should aid in this endeavor.  Also, the advice to keep the core rigid falls right in with the research and teaching of experts like Stuart McGill.

Really, though in the end, it’s the brain that’s the target here.  The runner is able to recognize faults in his running technique and alter how he runs.  Thinking and awareness are vital!

IT Band Syndrome: We Have A Weak Link

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“The single most important factor in predicting and possibly treating IT band problems is hip abductor strength.” John Davis, Running Writings

A weak link is found

My last post discussed finding and fixing our weak links. Well, during a trail run I found a weak link and the quest is on to bring it up to a respectable level. At this point I’ve boiled it down to poorly functioning glutes–the glute medius to be specific. Glute dysfunction is fairly common and I’m realizing more and more that I’ve had a good dose of it for quite some time. It’s gotten better but I’ve got to make it better yet. Right now this weak point is causing me some knee pain.

Inside IT band syndrome

Lateral epicondyle; where IT Band pain is typically felt

Lateral epicondyle; where IT Band pain is typically felt

Recently, while finishing a long trail run, I began to feel the dreaded symptoms of IT band syndrome (ITBS). Chances are, if you’re a runner then you either have or you will experience this issue too. If you look at the Wikipedia entry on ITBS you realize this is a mysterious ailment that might be caused by a myriad of issues from the feet to the hips, from the muscles to the bones, from too much running or cycling or rowing or dancing or whatever else you might do on one or two legs. Conventional treatment ranges from ice to ultrasound to stretching to orthotics and various pain drugs like ibuprofen.  (Do we really think that ITBS was caused by a lack of ibuprofen or an absence ice sitting on our knee?) I want to fix this issue and clarify what’s at work here. Let’s see if I can make some sense.

IT Band insertion

IT Band insertion

ITBS symptoms

The most typical symptom of ITBS is lateral knee pain, somewhere in the neighborhood of what you see on these two pictures. That’s where the IT or iliotibial band inserts. As is typical, I felt a sudden onset of pain at this site while running downhill. It’s a fairly sharp pain. Knee flexion while stepping down off a step often brings it on. Apparently, ITBS can be felt elsewhere along the IT band.

  The research: It’s all about the hip abductors.

I found some superb articles with some very valuable information regarding the root cause(s) of ITBS and how to address the issue. Biomechanical solutions for iliotibial band (IT band) syndrome / ITBS comes from RunningWritings.com.  Glutes rehab – recent research and Gluteus medius – evidence based rehab come from Running-physio.com. There is some overlap between these articles and they all refer to quite a bit of important research.  If you’re a trainer who’s working with someone who has ITBS or if you’re suffering from ITBS, I strongly suggest you read these articles. I’ve summarized some things but definitely go to the sources for a thorough rundown.

Both sources cite a study from Stanford, and here’s what you need to know:

“Long-distance runners with ITBS have weaker hip abduction strength in the affected leg compared with their unaffected leg and unaffected long-distance runners. Additionally, symptom improvement with a successful return to the pre-injury training program parallels improvement in hip abductor strength.”

Some sources suggest that foot/ankle dysfunction–specifically over-pronation–is at the cause of ITBS rather than hip dysfunction. Irene Davis and others of the University of Delaware studied both the hips and feet/ankles. They stated:

“However, aside from this variable [an increase in rearfoot inversion moment], these results begin to suggest that lower extremity gait mechanics [i.e. foot and ankle] do not change as a result of ITBS. Moreover, the similar results of the current study […] suggest that the aetiology of ITBS is more related to atypical hip and knee mechanics as compared to foot mechanics. Therefore, the current retrospective study provides further evidence linking atypical lower extremity kinematics and ITBS. (Ferber et al.)”

The Running Writings article discusses several other studies that had similar findings to the Stanford study. The writer reached this conclusion:

“At this point, the evidence overwhelmingly points to a biomechanical fault in the abductor muscles of the hip as the root cause for IT band syndrome.  Weak or misfiring gluteus medius, gluteus minimus, or tensor fasciae latae muscles are unable to control the adduction of the hip and internal rotation of the knee, leading to abnormal stress and compression on the IT band.  This muscular dysfunction manifests as excessive hip adduction and knee internal rotation, both of which increase strain on the iliotibial band and compress it against the fatty tissue between the lateral femoral epicondyle and the IT band proper, causing abnormal stress and damage. But although the pain is coming from the lateral knee, the root of the problem is coming from the hip muscles.”

(By the way, the hip abductors of which I speak consist of the gluteus maximus, gluteus medius, gluteus minimus and the tensor fascia latae or TFL.  See below.

Here’s something important: Very often the glute medius doesn’t do its share of the work and the TFL does too much work. Therefore it becomes important to condition the glute medius while de-emphasizing TFL activity. The side-lying hip abduction exercise (described below) works particularly well for activating the glute med while minimizing TFL activation.)

Hip abductors. If they're weak, your knees will probably hurt.

Hip abductors. If they’re weak, your knees will probably hurt.

The Running Writings piece also says, “a doctoral thesis by Alison Brown at Temple University also investigated (hip abductor) muscle strength in runners with and without ITBS; interestingly, she found no difference in maximal strength, but a significant difference in endurance.”

On a slightly different note, a recent study in Medicine and Science in Sports and Exercise indicates excessive hip adduction (adduction is the opposite of abduction; If you adduct too much then you’re not abducting enough.) is a precursor to patellofemoral pain or PFP. So again, we see abnormal hip mechanics playing a role in knee pain in runners.

Finally, the Running Writings article does a nice job of dispelling some myths about ITBS, among them the idea of foam rolling and/or stretching the IT Band. I won’t go into all of it but the bottom line is: Don’t bother. The IT band isn’t the problem–it’s the hip abductors! Work on them.

Tredelenburg gait

What happens when those hip abductors fail to do their job? We get what’s called Trendelenburg gait. Here’s a picture of it.  Notice the right

Trendelenburg gait

Trendelenburg gait

hip drops. When that happens the hip muscles on the left are stretched which puts prolonged tension on the IT band. That excess tension may cause pain at the IT band insertion located on the knee. There’s your pain.

Testing the abuductors

Heeding the observation that hip abductor endurance is key to ITBS, I tested that endurance using the old-fashioned, Jane Fonda-style side-lying hip abduction. (I elected to forgo leg warmers.) I got to almost 30 reps on my right leg (the affected side) and the hip was dying. I got to 30 reps on the left leg and with only moderate fatigue. I’ve seen similar performances in several other clients and my wife who also has some ITBS. This all fits in line with what this research found.

The exercises

The two articles from RunningPhysio do a great job of discussing a wide variety of exercises that engage the glutes. In Glutes rehab: recent research we see research on the exercises that elicit the most contraction from both glute medius and glute max. Look at the tables below to see which exercises get the most out of these muscles. (I’m not sure exactly how all of these exercises were performed.)

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Here’s RuningPhysio’s take on how to apply this information:

Practical application

From the research findings a good programme for runners wanting to target GMed would be starting with single leg mini-squat, side-lying abduction and pelvic drops and progressing to single leg dead lift, single leg squat and side-lying bridge to neutral. For advanced work you could add leg weight to side-lying abduction or combine side plank with upper leg abduction. This set of exercises would start with at least moderate GMed activation and progress to in excess of 70% MVIC. It would contain both functional weight-bearing exercises that are a closer fit to the activity of running, and non-weight bearing activities like side-lying abduction which has been shown to activate GMed without increasing unwanted activity in TFL and anterior hip flexors (McBeth et al. 2012) and has been used successfully to rehab runners with ITBS (Fredericson et al. 2000).

Runners wanting to improve GMax could start with single leg bridge, lunge with neutral trunk and single leg mini-squat and progress to single leg squat, single leg dead lift and forward step up. All of these exercises are ‘closed chain’ single leg activities where the GMax provides power to extend the hip but also works to help stabilise the hip and pelvis. As a result they are fairly functional for runners as GMax has a similar role during running.

In Gluteus Medius: Evidence-based rehab, the writer very wisely discusses differences in what we might call “functional” vs “non-functional” exercises. (This article also describes most of the exercises you’ll want to employ.) Generally, we might say a functional exercise would look like something we do in real life. A 1-leg squat or 1-leg deadlift is an example. These exercises have us standing (weight bearing) and using the whole body in concert. We don’t isolate a muscle in a functional exercise but rather we train a movement pattern and integrate lots of muscles together. In contrast, a non-functional exercise tends to isolate a muscle. The side-lying abduction or side plank are examples of non-functional exercises. These exercises don’t much resemble anything we do during most of our daily activities or sports. That doesn’t mean they don’t have value though, and the article does a nice job of discussing this issue.  The article states:

“Closing thought, from the research I’ve read and patients I’ve seen, a combination of both functional weight bearing and less functional (sidelying) exercises is most likely to be effective in glutes rehab.”

My process

Like I said, my right glute med is indeed easier to exhaust than my left. I figure though that I should work both sides with a little extra work on the right. I’ve been doing lots of the side leg raises and side planks.  I can’t yet do a good side plank while abducting the top leg. That’s a tough one. It’s one to shoot for in the future. I’m also doing a lot of band walks.  I don’t loop the band around my ankles though, I loop it around my feet. This study determined that placing the band around the feet recruits more glutes and less TFL. These are sort of the non-functional exercises that I do pre-workout or first thing in the morning.  

Pre-workout or throughout the day:

  • side-lying hip abduction: 2-3 sets x 10-20 reps.  I go to exertion.
  • side planks: 2-3 sets x 10-20 seconds
  • band walks: I side shuffle as well as walk forwards and backwards. I go to exertion.
  • Hip hikes: Easy to do. This movement has you lifting the pelvis away from the Trendelenburg gait pattern.

Functional/main exercises:

  • 1-leg squat: 3 x 8-15 reps. I recently used a kettlebell in the arm opposite my stance leg.  I focus on keeping my pelvis level, knees somewhat apart and I don’t let my non-stance side hip drop which is very important. I also throw several reps in randomly throughout the day.

  • 1-leg deadlift 3 x 8-15 reps: I often hold one or two kettlebells, dumbbells or a barbell.

  • Off-set step up: 3 x 6-12 reps use a knee-high plyo box for this. I hold a dumbbell on the side opposite my stance leg. I drive up powerfully with the stance leg then do my best to control my descent back down. I don’t plummet back down uncontrolled.

  • ice skaters: 3 x 12-20 reps. This is a power exercise in which I drive side to side in an explosive manner. There’s no way to do this without using the glute medius.

  • 1-arm carries/farmer walks: I carry a kettlebell in one hand and walk. Very functional and simple to do.

These exercises do a great job of conditioning our movement sling system. Read here and here to learn more about these systems of muscles that work together as we move.

Interesting and Informative Information: Fat Isn’t So Bad, Skimpy Research on Injury Prevention in Runners

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Read this!  Learn things!

What if bad fat isn’t so bad?

“Ronald Krauss, M.D., won’t say saturated fats are good for you. ‘But,’ he concedes, ‘we don’t have convincing evidence that they’re bad, either.'”

I’ve written here that I’ve been persuaded that not only is fat good for us, that “bad” saturated fat is also at the very least not as bad for us as we’ve been led to believe.  I found another article to further support my thoughts.  What if fat isn’t so bad? is a 2007 article from NBC News.  In it, we get a good dissection of the various flawed studies by which we’ve arrived at the idea that fat–particularly saturated fat–is pure evil.

The article discusses among other things Ancel Keys’s landmark Seven-Countries Study from 1970. This study did more to advance the fat/cholesterol/heart disease link than anything else around. This study went on to frame our current low-fat guidelines. Seems the conclusions that were drawn were quite inaccurate.  From the article (emphasis is mine):

“The first scientific indictment of saturated fat came in 1953. That’s the year a physiologist named Ancel Keys, Ph.D., published a highly influential paper titled “Atherosclerosis, a Problem in Newer Public Health.” Keys wrote that while the total death rate in the United States was declining, the number of deaths due to heart disease was steadily climbing. And to explain why, he presented a comparison of fat intake and heart disease mortality in six countries: the United States, Canada, Australia, England, Italy, and Japan.

The Americans ate the most fat and had the greatest number of deaths from heart disease; the Japanese ate the least fat and had the fewest deaths from heart disease. The other countries fell neatly in between. The higher the fat intake, according to national diet surveys, the higher the rate of heart disease. And vice versa. Keys called this correlation a “remarkable relationship” and began to publicly hypothesize that consumption of fat causes heart disease. This became known as the diet-heart hypothesis.

At the time, plenty of scientists were skeptical of Keys’s assertions. One such critic was Jacob Yerushalmy, Ph.D., founder of the biostatistics graduate program at the University of California at Berkeley. In a 1957 paper, Yerushalmy pointed out that while data from the six countries Keys examined seemed to support the diet-heart hypothesis, statistics were actually available for 22 countries. And when all 22 were analyzed, the apparent link between fat consumption and heart disease disappeared. For example, the death rate from heart disease in Finland was 24 times that of Mexico, even though fat-consumption rates in the two nations were similar.”

The large-scale Women’s Health Initiative is discussed:

“We’ve spent billions of our tax dollars trying to prove the diet-heart hypothesis. Yet study after study has failed to provide definitive evidence that saturated-fat intake leads to heart disease. The most recent example is the Women’s Health Initiative, the government’s largest and most expensive ($725 million) diet study yet. The results, published last year, show that a diet low in total fat and saturated fat had no impact in reducing heart-disease and stroke rates in some 20,000 women who had adhered to the regimen for an average of 8 years.”

Several other studies are discussed.  The comment from the article on these studies is this:

“These four studies, even though they have serious flaws and are tiny compared with the Women’s Health Initiative, are often cited as definitive proof that saturated fats cause heart disease. Many other more recent trials cast doubt on the diet-heart hypothesis. These studies should be considered in the context of all the other research.”

The article goes on to discuss the subtle differences between the types of LDL or “bad” cholesterol.  Seems that all LDLs aren’t created equally:

“But there’s more to this story: In 1980, Dr. Krauss and his colleagues discovered that LDL cholesterol is far from the simple “bad” particle it’s commonly thought to be. It actually comes in a series of different sizes, known as subfractions. Some LDL subfractions are large and fluffy. Others are small and dense. This distinction is important.

A decade ago, Canadian researchers reported that men with the highest number of small, dense LDL subfractions had four times the risk of developing clogged arteries than those with the fewest. Yet they found no such association for the large, fluffy particles. These findings were confirmed in subsequent studies.

Link to heart disease
Now here’s the saturated-fat connection: Dr. Krauss found that when people replace the carbohydrates in their diet with fat — saturated or unsaturated — the number of small, dense LDL particles decreases. This leads to the highly counterintuitive notion that replacing your breakfast cereal with eggs and bacon could actually reduce your risk of heart disease.”

In much of the medical community, this talk of fat being healthy (or at least not un-healthy) is heresy. There seems to be a strong bias against openly discussing evidence to the contrary.:

“Take, for example, a 2004 Harvard University study of older women with heart disease. Researchers found that the more saturated fat these women consumed, the less likely it was their condition would worsen. Lead study author Dariush Mozaffarian, Ph.D., an assistant professor at Harvard’s school of public health, recalls that before the paper was published in the American Journal of Clinical Nutrition, he encountered formidable politics from other journals.

“‘In the nutrition field, it’s very difficult to get something published that goes against  established dogma,’ says Mozaffarian. ‘The dogma says that saturated fat is harmful, but that is not based, to me, on unequivocal evidence.’ Mozaffarian says he believes it’s critical that scientists remain open minded. ‘Our finding was surprising to us. And when there’s a discovery that goes against what’s established, it shouldn’t be suppressed but rather disseminated and explored as much as possible.'”

Go here to read the full article.

Injury prevention in runners – “skimpy research”

The smart people at Running-Physio have done a good job of summarizing a research review of studies looking into injury prevention in runners. In all, 32 studies involving 24,066 participants were examined. The relationship between injury and running frequency, volume, intensity and duration were examined. The results? I’ll let the writers tell you;

“Regular followers of RunningPhysio will know of the ongoing debate we have with those staunch supporters of research who insist we must be evidence based. Surely this shows us just how unhelpful research can be in reality – over 30 studies, involving 24,000 runners and no firm conclusions on injury prevention! No wonder Verhangen (2012) described it as “skimpy published research” and went on to conclude,

‘Specifically for novice runners knowledge on the prevention of running injuries is practically non-existent.’

Nielsen et al. isn’t the first review of its kind in this field – a Cochrane Review in 2001 reached a very similar outcome and was updated in 2011 with equally negative conclusions; Yeung, Yeung and Gillepsie (2011) completed a review of 25 studies, including over 30,000 particpants and concluded,

‘Overall, the evidence base for the effectiveness of interventions to reduce soft-tissue injury after intensive running is very weak.’

They go on to make the very wise observation that, “More attention should be paid to changes in training charactisitcs rather than the characteristics themselves.”  Based on their reading of the research review, Running-Physio makes the following suggestions:

Novice runners should be especially cautious with increasing volume or intensity of training.

Increase in weekly mileage should be done gradually. The higher the weekly mileage the more caution needs to be applied in increasing this distance. Running expert Hal Higdon talks about runners having a ‘breaking point’ – a weekly mileage above which they start to develop injuries. For every runner this is different but with experience you can find your breaking point and aim to work below it. A gradual increase in mileage helps avoid crossing this point and picking up an injury.

Changes in intensity of training should be added in isolation, rather than combined with increase in distance. Be cautious when adding interval training or hill work and use each training session for its specific goal (i.e.long slow runs at an appropriately slow pace).

Be aware of signs of injury – look out for persistent or severe pain, swelling, restricted movement or sensations of giving way.

Use rest sensibly – don’t be afraid to rest or replace running with cross training when your body needs it.

Seek help – the right GP, Physio or health care professional can make a real difference!

Something I observe here is that we’re often looking for the  (training variable) that causes the one thing (an injury).  In reality, it’s typically many variables (some of them unseen) that bring on an injury. Also, nowhere in the article or the research is the discussion of running technique. I would think that how someone runs probably has a big effect on whether or not he or she becomes injured. I’ve mentioned previously that where the foot lands in relation to one’s center of mass is quite important as it pertains to impact and running efficiency.  I’d be interested in an analysis of the foot placement (and stride length and cadence) in the role of injury.

 

One Week Until the Colorado (Half-)Marathon

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I like this plan. You might too.

The Colorado Marathon and Half-Marathon are coming up on May 5.  It’s in Ft. Collins, north of Denver.  I’m running the half-.  It’s actually my first half-marathon.  I’ve run several 10-milers, a 15-mile trail race, 10k’s, 5k’s, and one marathon, so this shouldn’t be any radical departure.  This is a very popular race that fills up early.  The course is supposed to be scenic and this time of year is spectacular in Colorado.  It’s also slightly downhill which should make for a fast race.

My goal time is just under 1:38 about 1:47.  That’s based on a 23:10 5k I ran last year.  That it’s downhill makes me think I might get a little bit better time.  I’ve been following the 3-run per week Runner’s World Run Less, Run Faster plan developed by the Furman Institute of Running and Scientific Training (FIRST).  I enjoy the plan for several reasons.  First, it covers the whole spectrum of speed: fast track workouts, tempo runs, and long runs. Everything is paced.  Times are based on a 5k race time.  The plan pushes me to run harder than I probably would on my own.  That’s good.  Second, with only three runs per week it’s time-efficient.  The idea is for you to do only what you need to do and nothing more. That’s another good idea.

I’ve been lifting several times per week with two of those workouts being hard workouts.  The workouts are loosely based on the Wendler 5/3/1 scheme. (Week 1: 3×5 reps.  Week 2: 3×3 sets.  Week 3: 5 reps, 3 reps, 1 rep.  Week 4: reduce the work load and take it easy.  Then start the process over with more weight.)  They’ve looked like this:

Workout 1

  • barbell, kettlebell, or dumbbell clean & press
  • box back squats
  • core work, one or more of the following: ab wheel roll-outs, hanging knee-ups, cable chops, cable lifts, side bends, Turkish get-ups, 1-arm farmer walks

Workout 2

  • 1-leg work: pistols alternated each week with 1-leg RDLs.  I mix pistols off a box with TRX pistols.  Two weeks from the race I’ve done some single leg jumping on and off a plyo box.
  • weighted pull-ups or chin ups
  • bench press
  • core work: similar to workout 1

Other workouts

  • Mobility work: I’ve been religious about using the rumble roller, lacrosse ball (big-time favorite of mine), and the Stick to address my soft tissue.  I’ve also been smashing my quads with a barbell ala Kelly Starrett’s Becoming a Supple Leopard pg 326.  (That one’s great for nausea.  That is, if you’re not currently nauseous and you’d like to be, the barbell quad smash will get you there.  Seriously, it’s really improved my hip flexor ROM and helped reduce soreness.)  I’ve worked a lot on ankle mobility; foot/big toe mobility; hip flexors, extensors, adductors and rotators; quadratus lumborum (HUGELY for me lately), and thoracic mobility.  I’ll often combine this work with a trip to the hot tub either before or after.
  • If I missed an exercise one day due to time or fatigue, I fit it in on another day.
  • There are lots of core exercises to pick from.  I don’t do them all in one workout, therefore I often get one or more in on another day.

I think single-leg work is very important.  Running is a one-legged gig.  Mobility, stability and strength on one leg is an essential ability.  Further, it seems that getting strong on one leg makes me stronger on two legs (squat or deadlift), but getting stronger on two legs doesn’t necessarily seem to make me stronger on one leg.  The last week before the race I might do some single-leg jumping only–and nothing else.  It’s time to rest.  More work at this point won’t improve my race performance.

The core work has been a big part of this scheme.  I’ve spent more time on specific core work than I have in the past.  I understand it better.  I perceive its importance more thoroughly than I used to.

I’m hoping for good weather.  Spring in Colorado can be sunny and gorgeous or it can be frigid, snowy/rainy, and rough.  Sunny and gorgeous is my preference.

Check out Kinetic Revolution

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If you’re a runner, or triathlete or if you’re a therapist or trainer who works with runners and or triathletes, then you should have a look at Kinetic Revolution. It’s an English site run Neil Scholes and James Dunne. Between them they have fairly impressive credentials as both athletes, coaches and rehab specialists.

For a fee, Kinetic Revolution offers coaching on running technique, flexibility, strength and other topics. Online courses on running technique and strength are also available.

I’ve been digging through the blog recently and I’ve found a lot of thoughtful, informative stuff.  Most recently I read through ITB or Not ITB… That is the Question.  As you might guess it’s about IT band syndrome. I like the discussion on why the foam roller probably won’t help you get over IT band troubles.  To that point the article discusses that in fact your IT band pain probably isn’t an IT band problem, but rather is a problem with some of the muscles that attach to or near the IT band.  For more good information, check out the lively comments following the article.

The big picture here is that if you’re a runner/triathlete and/or you’re geekily into reading about this stuff like me, you’ll find a lot of great information at Kinetic Revolution.

Running Awareness: Cadence, Foot Placement, Lean

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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.

 

Book Review: Anatomy for Runners

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Are you a runner?  Do you know a runner?  If yes, then I HIGHLY recommend Anatomy for Runners by Jay Dicharry. MPT, CSCS.  It’s simply a fantastic book on the hows and whys of overcoming running injuries and increasing your performance.

Dicharry hits numerous nails very solidly on the head.  He doesn’t just talk about treating the symptoms of our injuries. Rather, he gets at the true causes of our injuries–namely we don’t know how to stabilize our spine, hips, knees, ankles and feet appropriately.  We’ve forgotten how to move!  The book covers anatomy, gait mechanics, soft tissue maintenance, corrective exercises, footwear, orthotics, stretching, strength. Chapter 9 is a self-assessment process to help you figure out if you’re both mobile and stable enough to run.  If you’re lacking in those departments, he presents strategies and exercises to shore up your weak areas.  Impressively, he presents all this fairly technical information in a very easy-to-read kind of way.  This isn’t a dry, boring textbook.

Dicharry is a physical therapist, strength coach, running coach and a cycling coach; so he knows his science.  But, I think one of the most important aspects of Anatomy for Runners is that Dicharry writes from the perspective of a formerly often-injured runner.  This point-of-view is one with which I and probably a lot of other people will identify.  He cites numerous conversations with doctors that told him to rest and he’d get better.  He’d rest, run again, then he’d be injured again.  (Guess what, resting doesn’t fix anything!  If you’ve got a flat tire and you quit driving the car, the flat won’t fix itself.)  Other docs told him him he should probably quit running.  If you’ve heard that then you know how maddening and disheartening that advice is!  He didn’t quit.  He did the good work of figuring out how to run properly. I think his words will give hope to people who may have arthritis, worn cartilage, worn menisci (that’s plural for miniscus) and other “injuries” that may have lead physicians to tell you to quit running.

So it’s almost Christmas.  People are asking you what you want and you’re wondering what to buy for them.  Click the link below and get this book!