Showing posts with label injury prevention. Show all posts
Showing posts with label injury prevention. Show all posts

Friday, April 20, 2012

New Shoes! A (sort of) Book Review

Last week I decided it was time for a new pair of kicks. My GelExcel33's were well past their prime with 550+ miles on them - I was through the soles and actually wearing into that white stuff in areas - yeah, not so great to run in when you're in the throws of marathon training. I'd been tossing around the idea of going minimal.  If you're not familiar with the term, minimalist running is supposed to mimic running barefoot; minimalist shoes contain no arch support, no cushioning, and no large chunk of material under the heel. This, supposedly, promotes a good mid-foot strike instead of a heel-to-toe rolling landing/push-off; also, apparently all of the muscles in your feet and calves will become balanced as they will now all need to work in synch to keep you moving. So it sounds pretty good, right? Run better, stronger, and with less injury.

I walked into a new local running store excited to try out some minimalist shoes.  The gentleman working that afternoon, who turned out to be the owner, asked me what I was looking for, and when I said I wanted to try something more minimal that what I was currently wearing, he asked me why. Having not expected this question (and therefore not prepared a carefully crafted response) and feeling a bit defensive, I offered, "Well, I just read Born to Run." This was apparently not the answer he was hoping for, a look of complete annoyance crossed his face. Great...this shopping experience was off to a fantastic start.

I was surprised, really, at this comment from the owner. My impression of Born to Run, written by Christopher McDougall, was that it was incredibly interesting and inspiring; a very well written account of the author's personal experiences with tons of factual information blended in.

The book describes a tribe living in the canyons of Mexico, separately almost completely from modern civilization. This tribe, the Tarahumara Indians, run.  All the time. At all ages. For crazy long distances. Without shoes. This last bit is the key to their beautiful, injury-free running form - no shoes.There are accounts of the Tarahumara coming to the US to compete in famous ultra-marathons, sponsored by shoe companies. They would start the race in their flashy new shoes, and after several miles, remove them and finish barefoot! 

While McDougall describes his experience traveling to Mexico with several US elite runners for a race with the Tarahumara, he also looks into the history of the running shoe, how and why it evolved as it did, and goes further, into the history of human beings, and how we may have evolved the way we did just so that we could be distance running machines.

Born to Run is fascinating. It's a must-read for every runner, offering a prospective on the sport that will get you thinking about your running style and keep you motivated for a long time.

So back to my shoe-buying...

Willing to oblige me, the owner brought out several pairs of shoes, each with a varying degree of minimalism, and our discussion started as he helped me into the first pair:

Point: "There are more running-related injuries today than 30 years ago."
Counter-point: "There are more runners today, the percentage of injuries is the same." I had to concede here because I couldn't remember the actual statistics - darn, I'm usually really good with numbers.

Point: "Wearing a shoe with tons of support stunts the development of muscles in your feet and legs and causes imbalance."
Counter-point: "People cannot move from a highly stabilized shoe to one without any stabilization - this will lead to injury."

And so it went on for a while and, I have to admit, I was completely impressed with the owner's knowledge, not only on subject of minimalism, but also on each shoe that he had in his shop. In the end, we agreed that minimalist running is all about progression. Moving from a highly stabilized shoe to a minimalist shoe may take years, with many intermediate steps down in stabilization. Minimalist running is about understanding your body, knowing when you are strong enough to make the next step without risk of injury. For me, I started with a pretty chunky shoe in August 2010. By Spring 2011 I wanted something lighter, and then I got rid of my arch suppport in Winter 2011.

In talking with the owner, I hadn't realized that I was running in basically the lightest version of Asics out there. I tried a very minimal Inov-8 shoe, but decided instead on the adidas Boston 3's. Making a drastic change to complete minimalism in the middle of marathon training, maybe not such a good idea; changing from cushiony Asics to the adidas with more feel is good enough for now!

Friday, April 6, 2012

IT Band Recovery

The key to happy running is healthy running, to stay healthy you need to prevent injuries.  The best prevention is to follow the rule of Gradual Progress be sure to get rest and don't overdo your training.

However, if you are like me and thousands of other runners, you will have the unfortunate experience of an injury sometime during your training. The causes and types of injuries are numerous from bone fractures, to foot injuries, to iliotibial band syndrome (ITBS).  ITBS is one of the more common running injuries that typically appears after a quick increase in the amount of training or miles you put in.

You can minimize the impact of an injury by continuously sensing your body and if something begins to not feel right, you should stop what you are doing immediately before it worsens.  In numerous cases, people with the start of an injury make it much worse by forcing themselves to push through the pain.  That is not the correct thing to do, and you will regret it later during the weeks or months spent recovering.

The iliotibial band is a length of fibrous tissue (not muscle) that runs along the outside of the femur between the hip and knee.  It's purpose is to stabilize your knee and hip.  Iliotibial band syndrome (ITBS) is the name given to the pain resulting from inflammation caused by rubbing of the iliotibial band against the outside of the knee and hip.

My ITBS started as a dull but painful sensation on the outside of my right knee.  I knew it was bad when the pain began to get worse during my run.  Note: If the pain is getting worse, you are making it worse and you need to stop immediately.  After I had stopped, there was a sudden sharp pain.  If you experience any injury, it is best to diagnose it properly by going to your doctor to ensure that you don't think it is something different like runner's knee.  However, runner's knee is typically associated with pain around the cap of the knee, and ITBS is associated with pain on the outside of the knee (right side of right knee, or left side of left knee) and possibly pain or popping on the outside of your hip.

I took a day or two off, and tried to go out and run again.  The pain came right back after a mile or two.  After doing some online reading, I discovered that recovery can take at least a week or longer for the pain to go away.  I also discovered that ITBS can be caused by supination or over-pronation, running on banked roads, running up or down steep hills, or muscle imbalance (hip abductors, gluteus medius).

I took a full week off, no running.  I did a few basic strength training exercises targeted towards my hip abductors and gluteus medius.  A popular exercises is 'clamshells'.  To do a clamshell, lay flat on your side with your knees out in front of you, bent at 90 degrees.  You rotate the top knee up/out, and then back.  Repeat for 10-12 times on each side.  You can increase the resistance of this stretch by using a latex resistance bandtied into a loop wrapped around your thigh near the knees.  I also did some basic lunges, and walking.  A new pair of running shoesto replace the previous pair with 500-600+ miles seemed to also help.  A product that was recommended to me by my local running shop was a simple high-density foam roller (shown below).  The roller is used to apply firm pressure to the IT band to allow it to safely stretch out to remove tightness which causes friction on the outside of the knee and/or hip.  I began to do this daily before each run to reduce tightness.

A foam roller can help safely stretch out a tight IT band before and after a workout.
After a couple of weeks, my running was back to normal and I was happy to have that ITBS problem behind me.

Running Injuries

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Thursday, April 5, 2012

Gradual Progress

The rule of gradual progress for distance running is a valuable tip I picked up from the book Chi Running. The author, Danny Dreyer, explains that everything that is a great accomplishment comes through a gradual development sequence or progression.  If you are building a house, you would start with excavating and pouring a foundation, then building the walls, then putting on the roof before you start to finish the inside and move your things in.  If you didn't follow that sequence, it would be a disaster.
He applies this principle to distance running. It is important to set reasonable expectations as you start running, and allow your body to make the necessary changes to help you through the stages of development as a distance runner. Injury prevention is often overlooked by most individuals new to running, but a sudden injury will quickly put a stop to your progress as a runner.  Injuries are irreversible, so the only way to not have them is to prevent them before they happen, otherwise you are faced with weeks, maybe months or years of recovery.

There are many other great tips in the book Chi Running.  It's an easy read with great pictures to help you improve your running on a mental and physical level.