Friday, October 2, 2015

Don't Try Anything New On Race Day

Elid Kipchorge and his shoes
I was away on holiday this past week after teaching the Kinesio Taping Level 1-2 course over the week end and did not have regular internet access at where I was.

Having just returned, am catching up on all my mail and news and I came across the results from the recently concluded 2015 Berlin marathon.

Eliud Kipchorge ran and won in a personal best time of 2:04:01 hours in a pair of prototype shoes that malfunctioned!!

According to reports, Kipchorge started having problems with his prototype Nike Air Streak 6 barely just a kilometre into the race. He bravely ran on even after the insoles popped out at the 20 kilometre mark forcing him to run the remaining 22 kilometres with flapping insoles.

Look in your own running shoes and you will find a insole (or sock liner) which is usually easily removed and can be replaced by your own custom orthotic if needed.  They are normally fairly secure and I've never seen them come off during a run (or a race for that matter). Racing flats usually have flatter and thinner inserts that are often glued down and not easily removed.

He ended up with blisters on his left foot and a cut on his big toe with lots of blood.

Remembering he was a sponsored athlete, he added with good PR skills "We have talked with technicians and even the highest authority of the (Nike) company. They are resourceful people. Remember, in life, challenges must be present and I urge my fans to run to Nike stores and grab this version immediately when it's out".

Ethiopian running legend Haile Gebrselassie joked tongue-in-cheek that Nike shoes would never be better than his preferred brand of Adidas. Maybe that's why Gabrselassie joked about it, as Kipchorge was previously sponsored by Adidas.

As you've often heard from me, don't try anything new on race day. I've learnt the hard way before too. Now that's a different post.

Talking about the Nike Air Streaks, I owned a pair of the first version way back in 1997. You can see it below.
The original Air Streak

Sunday, September 27, 2015

Day 2 Of Kinesio Taping Level 1-2 (270915)

Day 2 of the Kinesio Taping Level 1-2 course starts with some questions on how tape left overnight felt on the participants. The participants discussed why there were good or adverse reactions.

After clearing doubts on KT 1, we moved on to Day 2's program on the six Corrective techniques and also on EDF (epidermis, dermis fascia) taping.

The EDF taping concepts and techniques were not taught in many earlier courses so the participants were all ears.

Here are some pictures from Day 2.

Feet together now
Ram's head ? Looks like seagull to me 
Class picture 

Saturday, September 26, 2015

Treating Bertrand's Hip Made His Shoulder Better

Other than treating patients, I like teaching too (sometimes). To make sure I can answer all the questions I get, I need to put in extra effort to keep myself updated and it keeps me on my toes. I always like to keep improving myself.

Now that I probably cannot become a better athlete, I try to make my patients better quicker. And teach better too. And I get to meet other people too.

Spending time explaining biotensegrity
And we do have foreign participants as well from Indonesia (Sports doctor) and from Malaysia of course. Even Elaine from Tunku Abdul Rahman University College who previously attended my Introduction to Kinesio Taping course in Malaysia came for this course.

Elaine in her Cleopatra pose today
Check this out, I found a picture of Elaine from nearly two years ago when I taught the Introduction to Kinesio Taping course in Malaysia.

Here's Elaine in the same pose in KL in November 2013
Here's the practical that threw everyone off. After explaining "biotensegrity" and the "onion tree" model, I demonstrated how treating Betrand's hip made his shoulder better????

Taping Bertrand's hip
And making his shoulder better
Stay tuned for tomorrow's KT 2.

Sunday, September 20, 2015

Probiotics Improve Running Performance?

What my son eats
My wife came down with a bad bug three weeks ago. Then my seven month old infant caught it. I was next. I had a pretty sore throat and was running a temperature. My schedule was fully booked with patients, so I reckon I still had to go to work. I had to take Arcoxia twice to bring my fever down.

I'm actually allergic to Panadol and NSAID's (non steroidal anti inflammatories), but for some strange reason, I can take Arcoxia for my fever with no allergic reactions. I woke up a few mornings later feeling strange in my stomach ........ NSAID's can really mess with the healthy bacteria in my stomach.

Eating your meals too quickly, sports drinks and popping pain medication (or NSAIDs) and life stresses can also decrease the amount of healthy bacteria in your gut as you've found out from my story above.

For those of you who also train hard, the heavy training wears down your immune system and increases your chance of falling ill or picking up an infection. Especially when recovering from a hard workout.

So can improved gut health make you a better runner?

A study on a small group of runners in the European Journal of Applied Physiology showed that their run time to exhaustion in the heat improved by 14 percent after taking probiotics for four weeks. Now that's really relevant to us in hot and sunny Singapore.

Another study showed a 50 percent reduction in the incidence of upper respiratory and gastrointestinal symptoms in elite rugby union players.

Most studies recommend their subjects taking probiotics twice a day. The off season is a good time to experiment with different food and brands of pills you may wanna try. It usually takes about 14 days for probiotics to start working.

You can find them in yogurt, kefir, sauerkraut or in Yakult (for those in Singapore, although it also has lots of sugar).

So don't look at probiotics as a performance enhancer. What it can do is to keep you healthier so you can train better.

Prebiotics help too. Prebiotics are nondigestable fibre compounds that help beneficial bacteria thrive in your intestine. Bananas, asparagus and garlic are good sources of prebiotics.

It is also found in breast milk, Hmmmm, my wife is still breast feeding my seven month old son......


Shing CM, Peake JM et al (2014). Effects Of Probiotics Supplementation On Gastrointestinal Permeability, Inflammation And Exercise Performance In The Heat. Eur J Appl Physiol. 11491): 93-103. DPO: 10.10.1007/s00421-013-2748-y.

Haywood BA, Black KE et al (2014). Probiotic Supplementation Reduces The Duration And Incidence Of Infections But Not Severity In Elite Rugby Union Players. J Sci Med Sport. 17(4) 356-360. DOI:

If you like popping pills

Sunday, September 13, 2015

Carbs With Your Paleolithic Diet?

Picture by Lord Jim from Flickr
I've previously written on the Paleolithic or caveman diet before, which typically consists of hunted meats and fish and food that can be gathered like eggs, insects, fruits, seeds plants and herbs etc.

As a result you're supposed to get healthier, low fat protein, healthier fats and much less dairy and grain (or carbohydrates) than what we normally eat today.

A recent published article however suggests that the Paleo diet did in fact consist of lots of starchy carbohydrates.

The researchers put together information from genetics, archaeology, physiology and nutrition to come up with a theory that our Paleolithic ancestors did actually eat starchy plants like potatoes and possibly even cooking them over fires.

They also suggested that eating carbs help made our brains larger. Without carbs, we may be very different today. We may also not be runners like we can be now.

The authors wrote that carbohydrates are essential for long distance running which is how our ancestors chased down and captured prey. We get energy from glycogen stored n our bodies during vigorous exercise. Our glycogen stores normally lasts about 20 miles (or 32 km) and if you don't eat or drink, you'll hit the wall.

Even evolutionary biologist Daniel Liberman, who has written so much about humans and barefoot running said "The idea that people shouldn't eat carbohydrates is just silly, we've been eating carbohydrates for a long time."

Lieberman however isn't convinced that carbs helped Paleo hunters run better. His research suggested that Paleo hunters who chased down their prey didn't have to run that fast as they actually walked and ran. At those speeds (to keep up with a wounded prey usually) they may not need a lot of carbohydrates. Their bodies probably used more fat instead.

I've written before that relying on fat may help running performance. This is especially true if you have trained your body to use fat as fuel (which our bodies have plenty). It allows us to run further without hitting the wall.

Some have proposed that this may be better for ultra marathon distances (since you tend to run slower). However as speed increases, carbohydrates tend to be vital, especially if you want to run long and fast, suggested Lieberman.

Do take note that the carbs our Paleo ancestors ate were complex carbohydrates and not the overly processed and refined carbohydrates we get on supermarket shelves today.

The authors suggested that we need to be careful when trying to replicate ancestral diets as we still do not know exactly what Paleo man ate.

Looks like you can and should eat complex carbs, especially if you wanna race long and fast.


Hardy K, Brand-Miller J et al (2015). The Importance Of Dietary Carbohydrate In Human Evolution. The Quarterly Review Of Biology. 90(3): 251-268. DOI. 10.1086/682587.

Cavemen and dinosaurs? by Orln Zebest from Flickr

Sunday, September 6, 2015

Men Do Get It

Picture by German Tenorlo from Flickr
Mention osteoporosis and usually what comes to mind is that someone has fragile or brittle bones and that someone is usually female. If I'm a guy I don't have to worry about it.

It will probably shock you then that estimates in America show that almost two million men have osteoporosis and 16 million men have osteopenia (bone density that is lower than normal but not low enough to be considered osteoporotic). The contributing factors are not doing correct exercises and ageing.

Medication can help improve bone health but recent studies show that strength training and jumping exercises are s a healthy alternative.

Researchers studied a group of osteopenic men for a year comparing the effects of weight training and jumping exercises. Both groups of participants completed 60-120 minutes of targeted exercises each week.

The jumping exercises included jump squats, forward hops, split squats, box jumps and depth jumps. The weight training group did squats, modified dead lifts, lunges and calf raises with weights.

Both groups also took calcium and a vitamin D supplement during the study period.

Six months into the research, both groups of men had a significant increase in whole body bone mass, including the lumbar spine (low back) and they maintained the increases for 12 months.

The weight lifting group also had a significant increase in hip bone density. At the end of the study, all the participants had sufficient vitamin D.

The participants also reported low pain and fatigue suggesting that the exercises have good compliance rates and can be easily adapted in a real life setting.

The researchers concluded that targeted exercise with the correct supplements are an effective way to improve bone density rates to reduce risk of developing osteoporosis in men.


Hinton PS, Nigh P et al (2015). Effectiveness Of Resistance Training Or Jumping-exercise To Increase Bone Mineral Density in Men With Low Bone Mass: A 12-month Randomized, Clinical Trial. Bone. 79: 203-212. DOI: 10.1016/j.bone.2015.06.008.

Monday, August 31, 2015

Latest Research On The ITB (Iliotibial Band)

Picture taken from my Canon Ixus 
Mention the ITB (or iliotibial band) and images of pain quickly crop up. IT band syndrome is a painful overuse injury usually at the lateral (or outer) portion of the knee in many runners and cyclists.

Latest research on the IT band from Daniel Lieberman's Harvard lab by his former student Carolyn Eng shows that the IT band may not function as what was formerly believed.

Another view
The ITB runs along the outer part of the thigh, originating from your Tensor Fascia Lata and Gluteus Maximus muscles just above your hip to attach just below the knee. It is made up of fascia, an elastic connective tissue found throughout our body. Fascia is a sheath of connective tissue that wraps our muscle, nerves and blood vessels. It also connects our muscles to bones.

The researchers used human cadavers to investigate how the IT band moves and stretches during walking and running. A computer model was then built to calculate the forces and strains involved and then compared to the equivalent structure in chimpanzees (published in another journal).

Previously, the IT band's primary function was believed to stabilize the hip during walking. Carolyn Eng's research suggested that the IT band actually acts like a spring, storing energy when you swing your leg back and releasing it as the leg swings forward.

This energy storage capacity is highly developed in humans, enabling it to store 15 to 20 times more energy than a comparable structure in chimpanzees.

Lieberman suggested that if we consider evolution and how humans are adapted not just for walking but running as well, then the IT band is looked at at a totally different perspective. The IT band looked like another elastic structure, similar to the Achilles tendon, and this may be important for saving energy during walking and especially running.

The researchers estimate the IT band stores about seven joules of energy during fast running compared to about the standard estimate of about 50 joules in the Achilles tendon.

The researchers hope that with this improved standing of how the IT band works, they can compare how much forces the IT band transmits in runners with and without IT band pain. This will then establish a scientific basis for treating IT band injuries.


Eng CM, Arnold AS, Liberman DE et al (2015). The Capacity Of The Human Iliotibal Band To Store Elastic Energy During Running. J Biomech. pii: S0021-9290 (15) 00354-1. DOI:10.1016/j.jbiomech.2015.06.017.

Eng CM, Arnold AS et al (2015). The Human Iliotibila Band Is Specialized For Elastic Energy Storage Compared With The Chimp Fascia Lata. J Exp Biol. 218(15): 2382-2393. DOI: 10.1242/jeb.117952.

Here's Carolyn Eng's (Harvard University) computer simulation of a human leg running from here.