Wednesday, March 25, 2009

Don't Set Off Too Fast

Here's a personal experience from one of our patients at a race recently. Standing at the start line, training all gone to plan. Well rested and taper went well. When the horn sounded for the start, the runners at the front burst off and my patient follows. Legs feel fresh, the first few kilometres past quickly, a check of the watch says a PB (personal best) on the cards.

Upon reaching the halfway mark about 8 minutes ahead of schedule, doubt crept in slowly "Have I started too fast". By the finish line, target time was missed by 5mins (let alone a PB) and my patient was left swearing at the unintentional over ambitious start.

How many of you actually heard about the runner (or any runner) who started their race too slowly and finished wishing they'd started off faster? Probably not huh? It doesn't happen very often. But starting too fast is a mistake that even the most experienced runners make. Getting the pace right for a training run is hard, doing it in a race even more so.

Yours truly made the mistake before as well. In my first serious 800m race, I bolted into the lead at the start and led the race til the last 100 metres when I begin to struggle big time. Two of my competitors came around me and I ended up 3rd. I could have placed better or even won had I paced myself better (I proved that point when I won the same event the following two years in a row against the same runners).

That's why you see rabbits (pace makers) in all the big races - Boston, Berlin, London marathon etc. These runners are paid to run at a certain pace for the big guns racing. Those who run track and watch the Golden League Grand Prix meets can testify to that as well. Most of the world records are set this way, with their (pace makers) help. Like most things in running and racing, there is no short cut, you'll have to practice running a certain distance at 3,4, 5 minutes per kilometer to learn how to pace yourself.

You have to be aware of your stride rate, length, breathing pattern, arm swing etc and then observe how they change as you get tired whilst running. As you get stronger, probably all these will get easier and you can step your training up a notch. Using a GPS or heart rate monitor can help, but as you know, all electronic devices are fallible. If you can learn how to pace yourself you won't make be left at the mercy of a flat battery or failing signal. Plus, except for very long races, it is always better to leave the gadgets at home during the races (my personal opinion).

Before your race you would have know from your training what sort of time you can expect to maintain over the distance raced. Find out about the course, know which part of the course has terrain or slopes/ hills that may slow you down. Allow time to get across the start line in races which has large fields and accept that your pacing and finishing time may be affected.
Don't try to make up for lost time in the first few kilometers, try to claw it back a few seconds at a time . And when you can see the finishing or at least hear the race announcer at the end and a race marshal tells you last few hundred metres then you can muster up a decent sprint for the line.

The scientific rationale for this is simply that slower, steadier pace at the earlier stages (of any endurance race) will spare some of your carbohydrate stores since at slower speeds the body is more inclined to burn fat. This means that there will be some carbohydrate available at the later stages of the race so that fatigue and "hitting the wall" can be avoided.

Sometimes wearing a "pace band" around your wrist to clearly show your optimum split times will be most useful. I've seen runners write it on the back of the hands with permanent markers as well.

Tuesday, March 17, 2009

Pain Free Running

Do you want to run pain free? please read on if you do.

As you have read from the previous post, the thick heels from your high tech running shoes will encourage you to land with a heavier heel strike. Landing on your heels causes you to pronate (or roll your foot inwards) which then puts stress on your shins (leading to shin splints), knees, hips and your back. This "unnatural" heel strike is partly to blame for causing all sorts of running injuries. The evidence is now considerable and definitely stacking up in the article from the previous post.

Is landing our our heels unnatural you will definitely ask. Well, I'm going to say yes. Next time you happen to be in the company of little children look at how they walk or better still, see how they run. Parents who have kids and are reading this will tell you their little ones are always "falling forwards" as if they are tipping over slightly whether walking or running. And believe me they have a nice smooth style and they are fast. They also have no foot pain (or knee, hip and back pain for that matter) even though they love running around barefooted. Somehow as we grow older, we all stand up taller and walk with our stride out longer and landing on our heels.

We've had patients who have been told never to run again but are able to run pain free and even take part in races after seeing us at Physio and Sports Solutions. How do we do it? We do it by teaching you how to run with good technique so you can run pain free. Similar to how little kids run. Come and join us at our running club (please see or for details) or come see us in the clinic.

Saturday, March 14, 2009

Do High Tech Running Shoes Work?

All you readers out there be ready for some shocking news from a study published in the latest issue of the British Journal Of Sports Medicine. I think all the shoe companies out there will not be too impressed with this paper with regards to their technical running shoes.

The researchers reviewed results since 1950 from controlled clinical trials and systematic reviews (the two highest levels in terms of quality with regards to research papers).

Their aim - to investigate if running shoes with highly cushioned heels or pronation controlled systems depending on the wearers foot type had any effect on running injury rates, risk of osteoarthritis, overall well being and of course running performance.

First let's review some background information.
American Frank Shorter won the marathon Olympic gold medal on September 10, 1972. It is believed that his victory ushered the start of the American running boom where millions of Americans took up running leading to a huge surge in running shoes being sold. This of course led to an explosion of a vast shoe industry.

Since the 1980's, the heels of running shoes are heavily cushioned and/or have features to control subtalar joint (also known as talocalcaneal joint; where the talus meet the calcaneus) motion. Prescribing such shoes along with orthotics are considered the gold standard for injury prevention. Depending on your foot type, overpronators, mild pronators and supinators are prescribed motion control, stability and cushioned shoes respectively.

The use of cushioning in running shoes are based on the following assumptions (1) impact forces while running is a significant cause of injury. (2) running on hard surfaces causes high impact forces. (3) a cushioned shoe reduces impact forces. (4) cushioning itself to cause injury is minimal.

Evidenced based facts (1) weak evidence to show that running on hard surfaces increases impact forces or injury rates. (2) weak or poor evidence to show that cushioning reduces impact forces or injury rates. (3) diminished proprioception (joint position sense) is a significant side effect of heavily cushioned shoes. (4) reduced ability to monitor impact and foot position carries a significant risk of harm.

Assumptions based on the use of pronation control systems (or motion control shoes) (1) helps to normalize subtalar joint
motion in the foot. (2) overpronation linked to overuse injuries. (3) limiting pronation will minimize this risk of overuse injuries. (4) montion control shoes are effective in reducing injuries via this approach.

The evidenced based facts (1) subtalar joint motion or foot types are not consistently associated with runners' injury rates. (2) both motion control and cushioning shoes are relatively ineffective and unreliable in changing subtalar joint motion. (3) b
oth motion control and cushioning shoes causes both small and inconsistent changes in subtalar joint alignment.

In addition it is suggested by shoe companies that raising the heel of a running shoe can minimize Achilles tendon strain and thus reduce Achilles tendon injuries. However the researchers found mixed results with this. In fact since the introduction of shoes with cushioned heels and pronation controlled systems, there has been in increase in Achilles tendon injuries rather a reduction.

Evidence also shows that foot placement on ground with the heel elevated causes the foot to be in a position of poor proprioception (or joint position sense). Read increase in injury as a result. Current levels of heel height in running shoes also been noted to increase pronation.

The researchers found no proof that high-tech running shoes reduce running injury rates, risk of osteoarthritis and overall well being. What about improving running performance? None as well!

The researchers mentioned that sports medicine professionals and not advertising was to blame for this myth regarding high tech running shoes. Why you may wonder? Sports Medicine Australia (SMA), the New Zealand Society of Podiatrists (PNZ) and the International Federation of Sports Medicine (FIMS) all have been endorsing shoes by ASICS despite no credible evidence was the reason given by the researchers. Also mentioned, these footwear recommendations made by SMA, PNZ and FIMS are as part of sponsorship arrangements with ASICS.

Well, here you go, not quite what you expected I'm sure. In my next post, I will discuss what we at Physio Solutions have been doing with regards to running for the past two years. Yes, we have actually not done what others have been doing with regards to running and running shoe selection. Now we have the evidence to back us up as well. Stay tuned.

Please email me if you want this article.

CE Richards, PJ Magnin and R Callister. (2009). Is Your Prescription Of Distance Running Shoe Evidenced Based. British Journal Of Sports Medicine. 43(3) pg 159-162.

Sunday, March 8, 2009

Find More Time To Train

Back when I was still training, it always seems like some days are not long enough. While I always managed to make time to train, I never ever seem to find enough time to rest. I used to attend swim training sessions that start at 5.30am. Yes you read it correctly, that's 5.30am.

I'll wake before 4.30am, try to eat a little and try to leave my place by 4.50am. I'll ride my bike to the pool and then swim from 5.30 am til 7.15am or thereabouts. Sometimes I'll even find time to do some treatment for my fellow swimmers. After which I'll ride to the clinic where I used to work and if early, run some laps on the track (to practice running off the bike) before showering and getting ready to see patients. Yup, I would have swam up to 5km, bike and ran a little on days like this before 8.30am. My patients used to asked me "what time do you go to bed?" I'll always tell them "not early enough", before telling them I have to catch up on sleep on the weekend. They always ask me how I do it.

Well, here's how you plan the work and work the plan. I always look at all the other things I have to do and then plan how to fit it in. Remember this, there is no written rule that long runs must happen on Sunday mornings and track interval sessions must be on a Tuesday or Wednesday. What is most important is that once you decide when your running or training time is, you have to make it happen. That may mean you need to see your training as a priority. Of course you will have to be realistic about the other demands in your life. Read wife, kids, jobs, family significant other etc. Sometimes a narrow window of of opportunity may open itself, and you can squeeze a workout in (lunch time?). You'll feel good about yourself and even re energized. Trust me on this one.

There are some of us that have schedules that makes running in the morning difficult. I personally used to find training in the mornings difficult, I was always more fond of training in the afternoon or evenings until I started work. I found it tough to train at the end of a long work day, I was always tired. Worse still for those of us who don't get out of the office before 9pm. That's why I decided to build training into my work day. That's when I started training in the mornings. Gradually I got used to it and was even able to start swim sessions at 5.30am. A major plus point for me since most races at held in the mornings. Get up early on race day, no problemo, since I'm used to it already.

Don't expect to be able to do it straight away. Be patient and you will be able to find more time to train.

Monday, March 2, 2009

Training Accumulates

As my first running coach used to say "training accumulates". It's like putting aside your all your coins or loose change at the end each day into a piggy bank or money jar. At the end of the week it may not seem like much. After a few months, the amount will be fairly significant.

Similarly for your training. If you build up your endurance now, it will definitely help you later on in the year.