Articles

Running

Adapted to run

As humans we have several unique biomechanical and physiological adaptations that make us the long distance champions of the land mammals. When your friends and family tell you that running is bad for you, you can hit back with these incredible facts.

Humans started running about 2 million years ago.

We are not the fasted runners on land, however, Bramble and Lieberman say “it’s our combination of reasonable speed and exceptional endurance”, that worked for us in the past as hunters. A good hunter can outrun an antelope over long distances and this persistence hunting to exhaustion method is still used by the Bushman today. Bramble and Lieberman think that running may have driven our evolution to give us the anatomy and physiology we have today.

So, what were these adaptations and where can we see then in our bodies today?

· Long springy Achilles tendons that store and release energy with efficiency, making running easier. Along with this springy Achilles tendon we have a well formed arch in the foot with its own springy tendon. This combination is important for running and allows for shock absorption and energy release while running.

· Upright stance allows for less of the body area to be exposed to the heat of the day giving us the advantage over our four legged land companions.

· We sweat from every area of our body allowing for comprehensive cooling of the system through evaporation, enabling us to run for long hours in the heat if hydration is available along the way.

· Long legs allow for increased stride length that increases speed without the necessity of increasing the number of steps. This developed 1.8 million years ago, early in our running career.

· Broad shoulders, shorter arms and a narrow waist along with flattened facial features makes it easier to balance the head and upper body against the movement of the legs.

· Our large joint surfaces at the knees and hips allow for absorption of the increased stress of running compared to walking.

· Our large buttocks, which are absent in our primate relatives, help to stabilize us, and the researchers think they may have evolved specifically to counterbalance us in the act of running.

Can we ignore 2 million years of evolution and sit on the couch. Clearly not. Maybe its not even enjoyment that gets us out there but some primal instinct that lives in our very anatomy and physiology.

Reference sources:

Bramble. D and Lieberman. D, Endurance running and the evolution of Homo, Nature, Sepetmber 2004
Tim Noakes, Lore of Running, Oxford University Press, 2001
The Great Dance: A Hunters Story, 2000, Documentary DVD, Craig and Damon Foster

Common causes of gym and sports injuries and how to prevent them

The most common injuries in sport are muscle and ligament tears, bruises from falls and knocks, and overuse injuries from repetitive activities. Apart from unexpected trauma, most injuries are preventable to a degree through correct training and conditioning of the body.

The three most common preventable causes of gym and sports injuries are:

· Sudden increase in the duration of the activity

· Sudden increase in the intensity of the activity

· Sudden increase in the speed of the activity

This applies to all sports from weight lifting through to endurance sports such as running and ball sports such as tennis and squash.

What are the rules for safe exercise?

Listen to your body

The first rule of safe exercise is to listen to your body and adapt your day’s exercise to the current state of your energy and injury levels. For example if you have had a few nights of poor sleep your body will be fatigued, this means that a hard exercise session may tire you to the point of injury as your reserves are already depleted. Pain is a warning of potential or actual damage to your body structures, and is a clear indication that you need to address an injury or change your training behavior. Ignoring pain that is repetitive and on going through a training session could lead to long periods of recovery, so address it early if you want to maintain a steady training schedule.

Exercise progression

Small regular progressions of speed, distance or intensity (weight) are better than a sudden increase. Only change one variable at a time. For example in the gym if you increase the weight you use, keep the speed and the number of repetitions the same until you are adapted to the new weight. When increasing your distance in endurance sport, go a bit slower or keep the same speed until your joints are adapted to the new distance. Only increase a small amount each time, adding on 10% of the previous distance is a common suggestion.

Warm ups and cools downs

Warm up and cool down. Warms up and cool downs should reflect the needs of your sport. Warm up the muscles and joints you are going to use, for example in running warm up with a walk or a slow jog. For hockey warm up with a slow jog and some drills for co ordination.

Cool downs should include those same muscles groups, so a cool down for running should be slower jog or walking. Gentle stretching of the main muscles used during the sport should be part of your cool down. Never stretch into pain, it should feel pleasantly stretchy not agonizing. Stretching should be done after exercise or if done on a rest day, should be slowly with respect for the tight structures. Remember that unless your sport is gymnastics, ballet or climbing you don’t need extreme suppleness.

Warming up for a weights can include cardio vascular exercise like cycling but the first set of any muscle group should be slower and lighter to get that group warm.

Prevention is better than cure

If your sport involves high agility activities such as quick turns, sudden sprints and stops or balance with speed you need to train your joints and muscles to react fast. This training is called plyometric and proprioceptive training. Ask your physiotherapist, biokineticist or coach what exercises you need to.

Rest

Training too frequently without enough rest time is a common cause of injury. Your body needs time to heal and grow stronger after each training session. When you are younger it needs less time, as you get older it needs more time. Rest days in your week are as important as training days. Rest weeks in your training month are also important. A rest day may mean no exercise at all or a very relaxed session of a completely different exercise to your normal sport. A rest week involves halving your exercise intensity for the week or doing a different sport for the week that is of light intensity and uses different muscle groups.

Sports equipment

Incorrect equipment is the cause of different kinds of injuries from blisters (painful but short lived) to tennis elbow. Test your equipment before you buy if that is possible. Get advice from different trustworthy sources, as what works for one person may not work for you. Know your options within your sport for individualizing equipment if necessary.

At work

If you are desk bound at work make sure you get up frequently and stretch your arms and legs. Sitting for long periods fatigues some muscles and often results in poor postures that predispose to injuries in sport.


Recovery from Running

Recent research on Compression Garments and Cold Water Immersion

Compression Garments

Compression garments are advertised extensively now and many runners have asked whether they are worth using.

The British Journal of Sports Medicine recently published a systematic review and meta-analysis of the literature studying compression wear and its effects on recovery. Four variables were studied: delayed onset muscle soreness (DOMS), muscular power, muscular strength and creatine Kinase. 12 studies were included and the results were measured at baseline, 24h, 48h and 72h post exercise.

The analysis concluded that compression garments had positive effect on all the variables, showing that compression garments enhances recovery from muscle damage.

Another analysis suggested that compression garments provide ergogenic benefit (performance enhancing) during sport too, with initial studies suggesting increased jump height, faster lactate removal and faster warm up. Not all the studies showed benefit though, with some showing no change in performance for males engaged in high intensity running on a treadmill.

Two points of interest are that in order to promote venous return in the legs compression wear has to achieve a pressure of 18mmhg at the ankle and 8mmhg at the thigh. A garment that provides insufficient compression will not have the same benefits as one that does.

No adverse effects have been reported in the literature from wearing compression garments. It is sensible though to make sure they fit correctly enhance venous return and don’t cut off your blood supply!

Cold Water Immersion (CWI)

A 2012 Review from the British journal of sports medicine concluded that cold water immersion is an effective strategy for improving delayed onset muscle soreness (DOMS) post intensive exercise. Despite the research showing that it is an effective strategy the mechanism by which it works is unclear. No negative effects of CWI were found, however no long-term studies have been done.

In detail:

CWI improved the symptoms of DOMs at 24h, 48h, 72h and 96 h post intensive exercise. A note here is that DOMS can only be rated subjectively and it is impossible to blind the participants to CWI. This introduces some unavoidable bias.

CWI reduced the efflux of creatine Kinase after exercise

CWI improved the recovery of muscle power after intensive exercise.

CWI the practicalities: When? How long? How cold?

In the studies analyzed the intervention was applied within one hour of the exercise and could be repeated daily for five days post exercise.

The studies varied between ten and twenty minutes with the majority using 12 to15 minutes per session. At least half the studies performed the CWI twice to four times in a 24-hour period.

The temperatures chosen were 5 degrees (4 studies) 10 degrees (3 studies) 15 degrees (five studies) 12,5 and 9.3 degrees, one study each.

As you can see the protocols are varied, leaving you with a wide range of possibilities in temperature and time. It was suggested in the discussion that a faster rate of muscle cooling would be achieved with less adipose athletes and so the protocol can be adjusted for personal body composition.

No analysis was done as to how hydrostatic pressure effects CWI, so we don’t know whether lying in an ice bath is as good as standing in a tall ice bucket.

The last pertinent point the study makes is, are the practicalities of performing CWI worth the benefits? How many of us after a long run want to spend time preparing, then standing in a large bucket of ice water?

References

Hill Jessica, Howatson Glyn, van Someren Ken, Leeder Jonothan, Pedlar Charles: Compression garments and recovery from exercise induced muscle damage: a meta-analysis Br J Sports Med 2014 48:18

Leeder Jonothan, Gissane Conor, van Someren Ken, Gregson Warren, Howatson Glyn: Cold water immersion and recovery from strenuous exercise: a meta-analysis Br J Sports Med 2012; 46:233-240

Wallace Lee, Slattery Katie, Coutts Aaron: Compression garments: Do they influence athletic performance and recovery? Sports Coach 2006 Vol 28, No 4


Training

All runners have a training programme. Some runners are highly disciplined and never miss a day on their schedule. Others are so erratic they have a hard time calling it a training programme, more of a “run whenever time allows”. Both these styles have potential pitfalls related to over training. The disciplined runner can over train due to lack of proper rest and packing in more training than the body can withstand. The run whenever you can type may overdo it when they have the time, enjoying it so much on the day they forget that their body is untrained for the distance they are running on the day, and so pay for it afterwards.

I’m not suggesting changing your running programme or non programme, rather applying a few thought processes, and internal body checks, to planning the run you are doing today.

1) How are you feeling today? Have you had sufficient sleep? Did you run hard yesterday? If you are feeling well rested and strong run according to your fitness level and your programme. Feeling well and strong is not an indicator to suddenly run double the distance or double the intensity of your current fitness level. If you are feeling tired, plan a shorter route and a slower pace. You may warm up to a faster pace and feel energised by the run which is great, but don’t push hard. Bear in mind the previous days run or the lack of sleep or whatever it was that made you plan a slow run in the first place.

2) How many quality sessions are you planning in a week? Your training should include one tempo run, one hill repeat or sprint session if you have a good base behind you, and one long slow run. The duration and distance for each will depend on the race you are training for and your current fitness level. If you are not racing it will depend solely on your current fitness level. Overdoing any one of these inevitably leads to fatigue or injury.

3) When do you want your fitness to peak? Is it a race or a holiday? Either way your training needs to be graded up to the event. If the event is a few months away schedule in 4 weekly rest weeks where your training is less strenuous. You can decrease the distance, speed or frequency of training in that week or do different things like cycling or swimming. These rest weeks help your body to cope with the demands of training and help to keep your mind fresh and full of enthusiasm. The week before your rest week can be slightly more demanding than usual as you know you will be resting out your tendons and joints in the week to come.

4) How do you care for your joints and muscles outside of running? All joints need compression and release for nutrition. If they are constantly compressed it is difficult for the cartilage to get nutrients from the joint fluid. If they are never compressed joints fluid is not moved into the cartilage at all. Not only do joints need compression and release they need it across all the cartilage, not just in one position. This means that all your joints will benefit from full range of motion mobility exercises. You can either simply go systematically through your body and move each joint in every way possible, or, if you prefer not to think about it, do pilates, yoga etc. This is a valuable adjunct to training and helps you to know your body, and so hopefully know early if you need to rest or adjust your training.

Happy training.

References:

Prof Tim Noakes: Lore of Running, Chapter on training

Biology of tendon injury: healing, modelling and remodelling: P. Sharma and N. Maffulli,

J Musculoskelet Neuronal Interact 2006; 6(2):181-190

Rehabilitation Following Surgical Procedures to Address Articular Cartilage Lesions in the Knee

James J. Irrgang, MS, PT, ATC 1 David Pezzullo, MS, PT, SCS, ATC 2 >

Journal of Orthopaedic & Sports Physical Therapy >

Volume 28, Issue 4