Friday, February 28, 2014

One Last Farewell Swim

One last swim for charity
This was the pool where I learnt how to swim in the 1970's. I've been teaching my son how to swim there too this past few years. When my wife was pregnant, she did hydrotherapy there for her low back pain and to get some exercise as well.

When I started training seriously for triathlon, this was the pool that I started training at. When I broke my head and back last year (and my previous knee surgeries) this was the the very place I came to do my rehabilitation.

So definitely on this last day that Buona Vista Pool is opening its doors for the last time I had to come and bid a very fond farewell to the pool.

In fact, I went to the pool twice today. Brought patients there for hydrotherapy this morning and later in the afternoon went with my wife and son to take some pictures and for one last swim with my son. We went earlier in the afternoon before the crowd came, hence it look really empty.

Big splash coming up
Look mama, I can swim

We'll definitely miss you dear Buona Vista Pool.

Wednesday, February 26, 2014

Don't Always Believe What You Read

Below is an article from yesterday's Financial Times. John Connors, the quoted podiatrist suggests wearing "maximalist" running shoes like him "as we get older, we are the ones who need the most shock absorption underneath our shoes."

Well, my last patient yesterday started having knee pain after he started wearing Hokas. This patient of mine has done the grand daddy of triathlons, the Hawaii Ironman triathlon and has also run the Gobi March race, a 250 km desert race, before you think my patient is a rookie runner. He too was probably "fooled" by what he read from another article about the benefits of Hokas.
My patient's Hokas
My patient's knee is a lot better after yesterday's treatment, but I think he's not going to wear his Hokas for now. Don't get me wrong, the shoe may suit some runners, but not my patient or you for that matter.

Here's the article.

Fat-soled running shoes to protect middle-aged knees
25 February 2014
The Financial Times
As I huffed and puffed down the glorious Bowen Road jogging path during my last visit to Hong Kong, I was surprised to see a line of runners approaching, wearing what appeared to be black gloves on their feet instead of shoes. These, of course, were the now famous Vibram Fivefingers, which helped start the current fad for minimalist trainers.
The idea behind minimalist athletic shoes is simple enough: the closer to running with bare feet, the better. The theory is that raising the heel above the toes causes all sorts of bad things in your feet. Christopher McDougal’s exciting book Born To Run details how Mexico’s Tarahumara Indians run 100km mountain races in leather-thonged sandals without a whimper.
Back at home base I bought a pair of minimalist trainers and took them out for a spin. Eight hours later, it felt as if someone had poked needles into my calves. For an explanation, I turned to John Connors, a New York podiatrist who advises the world’s elite long-distance runners and was physician to the US team at the London Olympics.
Dr Connors laughed and said he had been seeing an increasing number of patients who had tried to adopt minimalist running shoes. “People say to me we weren’t designed to run with trainers,” Dr Connors says. “But we were also not designed to run on concrete and macadam.”
Dr Connors says that when you run, you are hitting the ground with four times your body weight, and hard surfaces such as concrete cannot absorb the shock. So the force goes right back up your leg. “Minimalist shoes are putting more stress and strain on the Achilles tendon, and more stress on the bones of the foot and leg,” he says. “I’ve been seeing a spike in Achilles injuries because of the eccentric load being placed on the tendon.”
He believes middle-aged runners need to take special care even if they are frequent exercisers because cartilage in their knees is beginning to wear down through normal use. His solution? “Lessen the load on the knee by getting something underneath you that reduces the load.”
As if by divine intervention, a new type of running shoe has started to appear in stores in the US, Europe and parts of Asia as an antidote to the minimalist trainer craze. It is called the Hoka One One and is the brainchild of Jean-Luc Diard and Nicolas Mermoud, former executives of French sporting goods company Salomon.
Mr Diard and Mr Mermoud are ultra-marathon mountain runners and wanted a shoe that would not destroy their legs when they ran downhill, which puts more stress on the lower legs. The Hoka idea they came up with, more by trial and error than scientific theory, has between 1.5 and 2.5 times the cushioning of normal trainers, depending on the model. But because the cushioning is evenly layered along the bottom of the shoe, the Hoka’s heel is actually much more like a minimalist shoe in terms of drop to the toe.
After studying the world’s elite runners, Dr Connors says that the best way to land when running is on the mid-foot, because the body then has the ability to absorb the shock and propel the body forward. The Hokas are ideal for this because of the way the cushioning is centred on the mid-foot.
Dr Connors says that while most elite runners use traditional trainers, he now runs in Hokas because he has a torn meniscus, the shock-absorbing cartilage of his knee: “As we get older, we are the ones who need the most shock absorption underneath our shoes.”

Friday, February 21, 2014

Running Injuries Linked To Your Footstrike

Photo by Jordan Shakeshaft from flickr
I wrote earlier that the minimalist/ barefoot inspired type running shoes sales were declining, however researchers seem to be very keen on finding how they affect running still. To put it simply, researchers are very interested to find out if barefoot running, minimalist shoes or how you land (forefoot, mid or rear) can reduce injuries.

A group of South African researchers specifically studied how barefoot running (or forefoot striking) affects five common running injuries.

Bear in mind that many researchers and runners alike tend to assume "barefoot running" and running with forefoot/ midfoot strike as similar although some studies have shown differences.

Well, here are the main points on the five common running injuries. Regarding shin splints/ tibial stress fractures injuries are decreased by barefoot running although runners have to be extra careful with transition time from their previous more cushioned shoes.

Increased incidences of metatarsal (or your foot) stress fractures with barefoot running. I've seen some of our patients with metatarsal fractures after switching to Vibram Five Fingers.

As I've written earlier before, good news if you have knee pain as it may be reduced by barefoot running, but not so good news if you have Achilles tendon injuries as it may be increased with barefoot running.

For those of you with plantar fasciitis, barefoot running can reduce this if you gradually and correctly transition from your cushioned running shoes.

Well, as you can see, nothing is foolproof yet with barefoot running. What the researchers were sure was that bad training practices like training too much too soon, running too fast and hard are the major causes of running injuries. And my favourite, they mentioned that good (i.e. correct) running technique may be more important than shoe selection.

Tam N, Wilson JLA, Noakes TD and Tucker R. (2013). Barefoot Running: An Evaluation Of Current Hypothesis, Future Research And Clinical Applications. BJSM. doi:10.1136/bjsports-2013-092404.

Saturday, February 15, 2014

Liverpool And Hamstring Strains

Strain your hamstrings again? Are you a Liverpool fan as well? How are the two related? 

Well, you can read all about it here.
*Picture by Kevin Mustong from flickr.

Thursday, February 13, 2014

Too Many Intervals Too Soon

Have you got an important race coming? And you're a little behind in your training, not quite in the shape you wished you hope to be and am tempted to really ramp up your training?

Well, the result from the following study will suggest you hold your horses.

A group of Norwegian researchers investigated the training response/ adaptations in 21 runners of completing 24 high intensity interval (HIIT) sessions over three or eight weeks. Both groups did no running after the last HIIT session.

In the first group, the runners did the hard 24 HIIT sessions over an eight week period. After doing 8 of the interval sessions, their VO2 max improved 2.3%. After 16 sessions, VO2 max improved 7.1%, At the end of eight weeks, their VO2 max improved a whopping 10.7% ( after resting 4 days).

For the 2nd group of runners, when the same 24 HIIT sessions were cramped into three weeks, their fitness actually declined during the three weeks and they only improved after almost two weeks (12 days to be exact) of no running. Even then, their improvement was 6.1% VO2 max, less than the first group.

Clearly, the results show that when training intensity  is too high, the runners cannot adapt to the training.

Just for those of you curious runners, their HIIT intervals were 4 x 4 min hard at 90-95 % VO2 max done running uphill on a treadmill with 3 min recovery.

Well, we live in an instantaneous society now where we want results at the snap of a finger. With running though, it pays to be dedicated, disciplined and patient.


Hatle H, Stobakk PK, Molmen HE et al (2014). Effect Of 24 Sessions Of High Intensity Aerobic Interval Training Carried Out At Either High Or Moderate Frequency, A Randomized Trial. PLoS ONE ((2): e88375. doi:10.1371/journal.pone.0088375.

*Picture of 2013 National Schools Track and Field meet 800m A Division Girls final  by richseow from flikr

Thursday, February 6, 2014

"Text Neck" On The Rise

Is that YOU using your phone?
If you have read the Straits Times article in page 4 under the Mind Your Body section today (ST 060214)you may read about why neck pain is on the rise here in sunny Singapore.

Well, it is mostly due to our love for our mobile devices - our heavy usage of our mobile devices. Before your neck pain becomes chronic, make sure you read one of our popular post on treating your chronic neck pain.

*Picture by my friend Chang Tzu Han during his visit to Singapore

The article in today's Mind Your Body