The Author

Steve Gonser DPT

Steve Gonser graduated with his Doctorate in Physical Therapy from Daemen College, instantly applying his knowledge of human movement and functional anatomy to his passion for running. Steve is a 2x Ironman, including a 10:41 finish in Lake Placid and a Sub-3 hour marathoner.

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Injury Risk of Running on Tired Legs

Fatigue alters the way we run. Transition from mile one to mile 26 of a marathon and there’s no hiding the stark contrast in how our movement transforms. The presence of pain (injury or lactic acid) and fatigue causes us to limp, drag, and claw our way to the finish line. The clawing may not be the most economical movement from point A to B, but when systems begin to fail the body finds a way. Sure, that may be fine for race day, after all you’re throwing all your eggs into one race basket. But what about training? What happens when those of us grinding through our 9-5, fueled off coffee and will power, begin to log countless miles on legs that are simply fatigued?

Our muscles intend to control for the forces associated with running. Our neuromuscular system catches us as we enter the ground, store landing forces, and redistribute said forces back into the ground. No matter the level at which you compete, fatigue is always a limiting factor—it’s true for all sports.

Again, fatigue is inevitable during racing, but the chronic fatigue of training (or racing too often) is what I see all too often in the clinic. Missed PR’s result in desperate attempts for another shot. “I’ve always 60 mile weeks for 10+ years,” litters the mouths of master runners. Or simply, “I like to race, it’s social for me and I love it.” And although you may get away with it for a season or two, it all comes full circle. I’m not asking you to not run when you’re legs feel tired, but simply to become more aware.

A study in 2001 found that upon fatigue of the dorsiflexors (front of shin muscle), the rate of impact loading significantly decreased.1 You may see the word impact paired with decreased and think, “oh, good!” but don’t be fooled. The rate of loading decreased. Ideally, we want a longer loading rate as it gives our body time to shock absorb. Shorter loading rates mean the same force, but in a smaller amount of time. Similarly, a 1998 used an accelerometer to find increasing acceleration of the lower leg as fatigue began to increase.2 Increasing acceleration translates to decreased control, likely increasing your risk for injury. This pertains specifically to lower body injuries. A retrospective study found that 50% of stress fractures are found in the bottom third of the tibia3 (shin)—the same area where the study conducted in 1998 placed their accelerometer.

You don’t have to ask too many runners before you find one with injury woes below the knee. The leg is really left out to dry, and as we see, particularly in the presence of fatigue. It all comes full circle to a few key principles: strengthen what’s weak, stretch what’s tight, and watch your training. If the fatigue increases loading rates, then don’t chalk a few bad runs up to “being tired”—rest. In a perfect world, we could all run, improve, and stay healthy. Unfortunately, our planet is far from perfect (pointing at the inhabitants—not the planet).

Remember, your muscles control your landing forces. So what happens when the muscles are tired and weak? The force of landing doesn’t change–just your ability to control it. Loads are transferred from muscle to tendons, ligaments, cartilage, and bone. Sore joints chronic tendon injuries, and inflamed soft tissue injures are just the start. Recovering from these injuries can be a nightmare. These chronic fatigue injuries can accrue over years, while taking months to heal. Be smart and take a cross training day when needed. It’s completely impossible to avoid all running injuries, but you can certainly steer their frequency.

References

1. Christina K, White S, Gilchrist L. Effect of localized muscle fatigue on vertical ground reaction forces and ankle joint motion during running. Hum Movement Sci. 2001;20:257-276.

2. Verbitsky, O., Mizrahi, J., Voloshin, A., Treiger, U., & Isakov, E. Shock transmission and fatigue in human running. J APPL BIOMECH. 1998;14:300-311.

3. Monteleone, G. P. Stress fractures in the athlete. Sports Med. 1995;26:423–432.

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Recurring Single Sided Injuries: Part II

Recurring single sided running injuries are not typically a coincidence. Part I discussed a common clinical presentation that’s often overlooked: leg length discrepancy. And although leg length is not the only reason for recurring injury, it’s a great place to start. Early identification of a leg length discrepancy can result in rapidly improving symptoms. It’s simple enough to check, too. Leg length issues are not overly common in the running community, but if missed conservative treatment will surely fail. Sure, you can rest an injury and see your symptoms (pain) improve, but you’ll likely be fronted with frustration when the pain abruptly returns as within a run or two.

With our foot fixed on the ground the pelvis and hip socket become a moveable piece in the chain. Typically your hip and pelvis maintain stability through the surrounding musculature, including the pelvic floor, abdominals, and hip muscles. It should make sense that a loss in surrounding strength in said muscles could cause instability at the pelvis. An unstable pelvis has the ability to come ajar (and often stay ajar). You might be thinking, “Well I’m sure I would realize if one leg was longer than the other,” right? Unfortunately not. Your neuromuscular system is tricky and subconsciously adjusts. This prior patient had no idea…

recurring, single, sided, running, injuries

“You know your right (or left) leg is longer than the other, right?” I ask. “It is?” you respond. This happens nearly 99% of the time during evaluation. Finding a leg length discrepancy is only a third of battle. The second third is fixing the alignment and the final third belongs to maintaining alignment. Typically the first two are cake, while the final stage of maintaining alignment is often left unaddressed.

Re-Alignment

You may thinking, “if my pelvis can shift into the wrong position, it certainly can shift back, right?” Absolutely. Re-aligning the pelvis can be achieved by patient-generated or clinician-generated forces. Patient-generated forces, also known as Muscle Energy Techniques, utilize your own muscular contractions to pull your pelvis back into alignment, while clinician-generated forces are performed by a PT, chiro, or MD. Advancing to a patient-generated force is always ideal as you’ll be able to monitor your leg length and adjust as needed. Self-aligning are musts for completely managing and fixing pelvic malalignment. Skipping right to stabilization exercises are pointless if you’re stabilizing your pelvis in the wrong position.

Maintaining Alignment

Ah-hah, the tricky part. To maintain alignment you’ll need to regain strength through the spine, pelvis, and hips. For some, maintaining alignment is fairly easy while others fight a longer battle. Although I have no empirical evidence, clinical experience leads me to correlate a longer history of symptoms with increasing difficulty maintaining alignment. In fact, I’ve re-aligned patients in the past to only see them fall out of alignment by sitting up–a perfect example of instability. Without this final stage of stabilization you’re really missing the boat. The trick is to re-align, stabilize, and repeat.

Getting Started

It’s tough going at this alone, especially if you’re uncertain of the direction and magnitude of the pelvic shift. Knowing the right stabilization exercises is important, too. Instead of navigating a confusing landscape of anatomy and treatment, find a PT (physio for all our Canadian friends) who can help you identify your shift, correct it, and stabilize it. Your plan should include a program that trains you on self-correction (for home) and proper stabilization exercises to maintain alignment. Don’t make the mistake that I see all too often: correcting the the leg length but failing to stabilize it afterwards. You’ll find your self being becoming increasingly dependent on a clinician-generated force (adjustment).

Remember, leg length discrepancy aren’t the only cause for recurring single sided injuries, but it’s always a great place to start–particularly for those who are failing to see improvement from traditional treatment. If ruled out (by a clinician–not you) progress to evaluating strength deficity and form flaws that cause recurring breakdown and injury.

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Recurring Single Sided Running Injuries: Part I

“My right side is my bad side. If you could only replace my right side I wouldn’t be injured so often.”

The above statement is used interchangeably between right and left sides, but is heard far more often in the clinical setting that one would expect. Many runners talk about their “bad side” as a hot mess of recurring problems that have plagued both racing and training. For some, the injury is recurring and consistent: “Every time I ramp my mileage past XX/week, my Achilles flares up.” Substitute the Achilles for shin, knee, hip, plantar fascia, etc… you name it. In fact, the exact injury might not be interchangeable, but the side of your body is: “I’ve stress fractured my right shin, have suffered from right knee issues and my right hip gives me trouble during speed work.”

Recurring injury is often a biproduct of biomechanical error. Biomechanical injuries often respond to rest in the short term, but often boomerang themselves back into your life. You can always rest an injury (it’s probably the go-to move for most runners). With rest comes decreased inflammation and often symptom relief. You’re flying high; after all, you rested—your injury is now behind you. It’s not long before your hopes to return to training transform into frustration. Your rest, whether it be self-prescribed or dictated by that “just stop running” doctor, did nothing for your injury. Truth is, rest doesn’t restore strength or motion deficits. Injuries that result from poor biomechanics (strength, flexibility, etc.) are rarely, if ever, fixed through strict rest. An Achilles Tendon injury that results from poor glute strength will continue to suffer once your rest cycle is over. Without addressing the biomechanical issue (poor glute strength) the Achilles will continue to degrade and re-injure from increased load. The scenarios are endless, but they all end with you frustrated and angry.

Some runners are lucky enough to be one and done with an injuries. Training errors are often the case in this scenario. Injuries that result from training errors often respond well to rest, as the load of training has been removed and the tissue had time to heal; unfortunately, most training injuries are laced with biomechanical errors. What often appears to be a “one and done” injury can result in a single sided injury plague that may last weeks, months, or years.

Hang with a group of runners long enough and you’ll invariably hear, “such and such always gives me problems” or “all my injuries are on my right/left side.” Runners present me with laundry lists of single sided injuries. Stress fractures, on top of tendon injuries, blanketed with joint pain can be and often are single sided. Stop blaming age for a bad knee (note the singular: knee). Both knees are the same age. You’re the one with biomechanical errors causing one to wear down. Without having an hour of anatomical study or clinical experience it should be blatantly obvious to everyone that something anatomically is at fault. Runners joke about cutting off their right or left side because “it’s always a problem” or “doesn’t work right.” Whether it’s denial or failing to connect the dots, there’s no more excuses. Figure out your errors and address them.

The Single Sided Plague

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Although there are varying reasons for recurring single-sided injuries, the best place to start is leg length. Leg length issues are more common than one might suspect. In fact, I’ve had three runners this week with significant differences between their right and left leg lengths. The reasons for a long limb are above the reach of this article; however, identifying (and fixing) a leg length discrepancy can be the answer to persistent single sided injuries. Depending on the length of “unevenness,” these patients typically respond rather quickly to treatment.

Leg length discrepancies occur for multiple reasons. Our pelvis is mobile—some more than others. The pelvis can shift up and down, slide forward and back, and rotate forwards and backwards. These shifts, slides, and rotations can occur from an external force (stepping into a hole) or internal force (muscular imbalance or pelvic instability). For some, the answer is purely anatomic as one leg simply grew longer than the other. None the less, such a simple find can pay huge dividends in long term running health.

recurring, leg, length, running,injuries

Leg length discrepancies are the ninjas of the injury world. Due to our neuromuscular systems inept ability to subconsciously compensate, runners with a leg length discrepancy are typically oblivious to the difference; however, the unevenness is real. A short or long limb makes for an uneven gait, while drastically altering a finely calibrated muscular system that prefers a specific length-tension relationship. You may be thinking, “well both feed on the ground, so my leg length must be ok.” Sometimes the simple answer is the wrong answer. The best way to feel an uneven pelvis is to stand with one shoe on. Both feet can continue to touch the ground through compensation. With enough time you would acclimate to the acquired leg length difference and feel “symmetrical.” Crazy, huh?

Here’s an example of a runner with a significant leg length discrepancy due to muscular imbalance and pelvic instability:

Part II of this article will display how to test for a leg length discrepancy. Stay tuned to both email and our social media pages: Facebook and Twitter.

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Postpartum Moms Neglected in Recovery

“If men were responsible to carry and deliver a child it would be the end of mankind” –a statement that is often loosely thrown around by men. It’s usually a charming deflect for those carrying a y chromosome, but do guys really know what it takes? I didn’t. For certain, a man’s body is anatomically wrong for carrying and delivering a child, but shouldn’t we still understand what it takes? All of our articles have so far have pertained to running postpartum, but it’s important to put this in the perspective for life. So guys… pony up and learn what it takes to keep mankind afloat while logging those miles. It’s time to have a better appreciation for running moms… they’re fighting an uphill battle.

Part of the larger problem is the complete disregard for what pregnancy does anatomically. Generic “take it easy for a few weeks” prescriptions are offered verbally until an eventual clearance to “slowly resume normal activity.” Truthfully, it’s no wonder why postpartum moms are littered with injuries and trouble returning to the roads. It shouldn’t shock you to know that runners are fairly type-A. Type-A paired with the “want” for your old fitness and considerable time off is simply a recipe for self-destruction. There should be a return to running protocol, but there isn’t. What about a restoration of strength program? Nope. We’re about to change that.

My motivation for learning more about the anatomical changes during pregnancy came for good reason. My wife, Celia, and I are expecting our first child in January 2015 and as you can see, she’s now outnumbered 3:1! (Watch out high school rankings 2020 and beyond!) Aside from being overwhelmingly excited, I quickly embraced my inner nerd and began reading research. Yeah, while some dads are thumbing through “What to Expect” books I was scouring online journals to see what this meant for my wife. My first thought, “Holy $#17. I can’t believe women are not being referred to physical therapy following delivery.” The research isn’t hiding either. Studies blatantly display resulting postpartum weakness accrued through the abdominal wall (hello back pain), along with links between vaginal birth and urinary incontinence (Kegels may not be your answer). Don’t get me started on cesarean sections, either. Even though postpartum research pertaining to strength deficits has proved impossible to find, clinical judgment leads me to believe that resulting weakness is unavoidable in the short term (months) and quite possibly long term (years). Although C-sections rarely result in the cutting of muscle, it does disturb their common midline attachment—the linea alba. Even if C-section acquired weakness is proved to be a non-factor, research DOES support lumbar and pelvis instability as a result of pregnancy. It doesn’t matter whether the baby is delivered vaginally or via C-Section. The weakness results from the growth and development of the fetus prior to delivery. Read more about that here and here. A C-Section can only worsen or compound the problem. Nonetheless, the answer is the same: restore core strength.

postpartum, running, program, pregnancy
The above image shows the superficial anatomy of the abdominal wall, including the linea alba. It’s important to remember that a deep layer of abdominals, particularly the transverse abdominis, attaches to the linea alba. The lower dotted line references a typical C-Section cut called a “bikini cut.” The outward facing arrows show a common site to separate the linea alba for delivery.

Medical professionals aren’t the only ones. I was shocked to find very few resources for women looking to run postpartum. A hit or miss magazine article, maybe? Some online forums of mom are chatting about their experiences, but neither was solid nor held much value. The neglect is more apparent when I read the feedback for our upcoming Cradle to 5K program:

“I have always been an avid runner but after having my second child I have been experiencing a lot more back pain during and after running.”

“I’ve faced foot and Achilles injuries which I have never had in my 16 years of running.”

“My postpartum recovery this past year has been awful – despite returning to regular exercise (not just walking or chasing kids) about 8 weeks after delivery, I’m still struggling.”

“I have no clue what pregnancy has done to me, 4yrs on numerous orthotics and assessments later and I still can’t run injury free.”

These are moms who are all struggling and apparently looking for direction. We set out a few weeks ago to provide useful content to the apparent overwhelmingly common problem: returning to running postpartum. Based on our feedback we’ve addressed what I’ve deemed (without any statistically certainty) the most common issues: core strength and returning to running safely. Although, we only tell the “why” in these articles, our upcoming video series will address the “how.”

Other Articles for Mom

Running Postpartum: Getting Started
Whether you’ve had a child in the last year or 10 years ago, this article pertains to you. This isn’t article really isn’t meant to segregate new moms.
A Safe Return to Running Postpartum
“Do you have any kids?” A question I frequently ask my female patients during my past medical history. I’m not even looking for recently, either.
2 Home Tests to Check Stability
Low back, pelvic, and hip stability are so important. I’ll relate them back to a concept of “proximal stability.” I’ve touted the benefits of core strength before…
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Running Postpartum: Getting in Shape to Run

Whether you’ve had a child in the last year or 10 years ago, this article pertains to you. This isn’t article really isn’t meant to segregate new moms. It can influence any woman who has given birth. Ever.

Although I’m not a postpartum mother looking to run, I certainly understand the obstacles between the delivery room and the road. Truthfully, I see a fair share of moms in the clinic who attempted to return to running but found it more difficult than planned. There’s no lack of motivation, either. Who wouldn’t be chomping at the bit? Most running moms will trade their running shoes for other various forms of exercise leading up to the birth of their child, while some will forego most forms altogether. Let’s say you take the last two months off. Tack that onto what will likely be a minimum two months postpartum and we’re already looking at four months without impact. A cocktail of one part stir-crazy and three parts wanting to get back in “pre-baby” shape becomes a disastrous recipe for injury. A relative sedentary lifestyle is necessary as you accommodate a growing fetus, but nearly equally important to allow for ample time to recover postpartum. As we stated in our previous article on postpartum running, research has measured both thinning and weakening of the abdominal wall one full year postpartum.

Sciatica, SI dysfunction, and low back pain are large obstacles when looking to not only return to running, but life (and if you have to look any of those terms up it’s likely a good thing—meaning you haven’t dealt with them). Although what I’ll call ‘the big three’ (sciatica, SI dysfunction, and low back pain) represent a large percentage of postpartum impairment, moms looking to hit the pavement again will also likely flirt with an assortment of lower body injuries.

postpartum, post, partum, running, getting, started
Here’s a perfect example. This recent mom (delivery within six months of injury) suffered from nagging knee pain when she began her comeback. Treatment emphasized management of symptoms and swelling early and progressed to a variety of core stabilization and hip strengthening exercises. She returned to running within a few weeks. Other than managing the swelling (on the bone I might add), we did very little to address her knee. Treatment was focused on restoring spine and pelvic stability.

A common theme arises in my evaluation for moms looking to run: “I wanted to run to get back in shape. I wanted to run because it’s months since I last did.” If you’re reading this blog then there’s a fair chance that you run. Whether you’re a man or woman we all know the quickest way to burn calories: lace em’ up and start logging some miles. Sure. That may be true, but the changes that occur throughout pregnancy and delivery have something different in mind. You may, in fact, need to get back in shape to run.

I can’t recall how many times this has been written in my articles, but running is a highly loaded, repetitive activity. Without the stability and structural support to withstand impact your body breaks. With the literature being established that chronic weakness is overly prevalent in postpartum moms, it’s obvious that achieving prior strength and stability through the abdominals, hips, and pelvic floor is extremely important. It’s likely event required before beginning to run. Yeah. You may need to get back into ‘shape’ to run.

Our upcoming video series aims to teach you just that: restoring core strength while safely returning to running through a progressive, gradual return to running. As we continue to fine tune the video, literature, and program, we need your help. The feedback from article #1 was great and we are already incorporating your feedback. Through commenting below, on our Facebook wall, tweeting us, or filling out this form, we can continue to expand and perfect the program.

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Maximizing Push Off While Running

With growing evaluation of anatomy and function the more we can appreciate the designed (or adapted) system. From our head to our shoulders, knees, and toes (knees and toes) there’s an interesting progression that our body navigates from rigidity to flexibility and again back to rigidity. It should make sense at the most basic level, too. At the point of impact you’ll want a rigid system, designed to withstand the instantaneous forces of the foot meeting the ground. Almost immediately your entire body becomes flexible–from your foot pronating to your knee and hip flexing. This flexibility allows us to absorb high rates of loading and store energy for our preemptive explosion at push off.

Deviation from ‘the norm’, whether it’s due to weakness, tightness, sloppiness, or your bony structure, will affect the entire system. Of the previous reasons listed all but one (bony structure) is under your control. We all want to be faster, which usually equates to more miles, more speed workouts, more everything… more everything but refining the system. Yet, most of us slack on the items that can procreate speed without increasing run volume, frequency, etc. In fact, refining the system can not only improve speed, but also reduce your risk for injury–particularly for master runners. Think about it. You can move BETTER to waste less injury and maximize efficiency without having increase training stress. Win-win.

The goal of push off phase is simple: provide your body a rigid leg to transfer energy into the ground. Deviation between your spine and foot can all compromise the rigidity of your leg. Without a properly aligned leg at push off you’ll leak energy through unintended movements. A foot that fails to supinate or a knee / hip that fails to full extends are all deviations from ideal position. This all happens simultaneously, but let’s break it down into pieces.

Here’s a video explaining the push off phase:

maximizing, push, off, hip, running

The Hip

Starting proximally, the hip moves into extension at push off. Moving into full extension the hip moves closer to its “closed pack position” or most stable position. As our hips extend giant ligaments on the front draw taut. The tautness of the ligaments approximates the ball (femoral head) and socket (acetabulum) of the hip joint providing added stability. Limitations in hip flexor or anterior hip extensibility will limit your hip extension and your ability to achieve maximum stability. Tightness will draw range from your lumbar spine and further decrease stability proximally. A total mess!

Learn More About Hip Flexibility and Running

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The Knee

Your closed pack position at the knee is terminal extension, or when your knee is locked into extension. With your knee fully extended or straight, you great a very rigid lever for transmitting force down the leg and into the ground. A straight knee is terrible for shock absorption (ie heel striking), but is great at push off. Generally, the inability to achieve full extension is reserved for those with extreme tightness or prior surgery’s that didn’t result in fully recovery; however, we can still see runners failing to achieve full knee extension for another reason. Simply put—if you’re unable to achieve full hip extension it’s likely that your knee will follow suit. This is a general reminder that your whole body moves together and you’ll rely on your weakest link.

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The Foot and Ankle

Although your true ankle joint achieves maximum stability will full dorsiflexion (flexing the foot upwards), the intricacies of the 26 bones in your foot achieve maximum stability from supination, or when your foot turns inward, and when the big toe extends. The final piece of push off is ever reliant on what happens above at the knee and hip, but also the control through the front 2/3rds of the gait cycle. For example, achieving supination at push off will prove difficult if the muscles responsible for getting you there are unable. Collapsed arches and high, rigid arches can also play a larger role as your anatomy may limit your ability to achieve proper position.

Learn more about big toe extension here

In all, you’re dealing the cards your dealt. Luckily, most of us fall into a grey area that allows us to dictate our anatomy through selective stretching and strengthening. The take home message is simple. In a sport with extraordinarily high injury rates you’ll need to find a better means for improving speed and durability. Historically, runners seek speed through harder, longer, and more frequent workouts. And although you may reap benefits, you’re certainly opening the door for injury. Dedicate yourself to better movement and a weekly minimum of 60 minutes to improve upon deficiency’s.

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Prolonging Running Injuries with Strict Rest

You need to understand that you will be hurt. It’s nearly impossible to run, improve, and not develop an overuse injury. Your response to pending injury makes all the difference between spending two weeks out of commission or six plus. The response to injury for most runners is nearly the same. First, complete denial and one too many runs results in widespread tissue damage. It’s that one single run where in retrospect you knew you shouldn’t have stepped out the door. Once the widespread damage occurs the second major mistake occurs.

I can’t begin to emphasize the magnitude of the second mistake. This all too common mistake is a Hail Mary pass to recovery. Not only will it prolong your recovery, but it will completely zap will earned fitness. You’ll say, “I’ll just take a week or two off from running completely. That should do it.” Sound familiar? A week or two ticks by and you become infuriated with the realization that your symptoms are simply waiting for you to start running again. Too often runners use a physical therapist as a last resort. After all, you don’t want someone telling you to not run, right? All of sudden we’re the bad guy because we’ll tell you not to run, but you’ll do it yourself without any specific direction or program?

Extended rest without a progressive loading program is injury suicide. I’m not talking about the first few days post-injury, either. Sure, you may need rest in days 1-3, but I’m talking about the days that follow, the grey area where you can walk and negotiate steps without symptoms. You can literally do everything but run. Your body’s false advertisement of being “healed” is a huge problem–mainly for your psyche. I’m guessing you’ll bounce around the house, bound around up steps, and lunge onto your injured leg and brag how you dodged the injury bullet. The absence of symptoms leads you out the door smiling. With every minute (note: not mile) that ticks by your symptoms slowly emerge and within minutes you go from cloud nine to six feet under. I’ve seen this scenario play out countless times. It happens whether you’ve rested for a few days or even a few weeks. How can you rest for two weeks, feel nothing, and have your injury suddenly reemerge? The answer lies in tissue resilience to load and subsequent breakdown with time off.

Breakdown is inevitable without load. Think of an astronaut and how their bones significantly weaken while in space. Without the effect of gravity, which causes load and resistance with movement, your bones, muscles, and other tissues essentially atrophy and disappear. The same is said for those who are bedridden. Compared to non-runners, those who run have a built their tolerance to load through training. Injured tissue takes a hit to this tolerance.

prolonging, running, injuries, with, rest

It sounds self-explanatory when I say it, but injured tissue requires a progressive gradual load that slowly builds you back to running. The length of this loading program is usually related to how severe the injury and how long you wait after onset. Loading tissue (muscles, joints, ligaments) is always warranted. The feedback provided through a progressive loading program will relay the required info to determine when it’s safe to return to running. No more heading out the door “hoping it will hold up.” The program will help rebuild injured tissue while preventing breakdown of healthy tissue.

With frequent running you’re building your body’s tolerance to the associated impact. You’re building a base for both legs. Rest for say an injured Achilles will not only lower the tolerance for the Achilles, but for both legs that have adapted to the stresses of training. You’ll need to refocus following an injury. Come to terms with it and stop acting as if treating clinicians are the bad guys. Find yourself a gradual load program that doesn’t reproduce symptoms. An injury offers a few opportunities to rebuild overall strength, balance, and flexibility–areas that have likely taken a back seat during training. A gradual loading program is more than riding a bike, too. Find what you can do successfully and repeat it until the program needs to be adjusted. Plenty of research exists on the loads associated with certain activities (lunges, step ups, etc.). You just need someone to lay the blueprint. Suck it up and ask for help. PT’s are not the bad guys.

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4 Training Lessons for Marathoners

You’d be amazed how many times during the week I talk training plans: how to stay injury free, train through injury, and peak for race day. The whole conversation revolves around a few main points that are overlooked in nearly every training plan. These concepts are widely used by the great running coaches are touted in countless books by the legends. The concepts and ideas, paired with my individual research, have served me well. I’ve PR’d in my last four marathons (all under 3). Three of the four courses are by no means fast (Pittsburgh, NYC, and Boston). Instead of writing about my training, why not open the book altogether and give you a glimpse into my 2014 Boston Marathon Training Log?

For some, the rules I discuss below will leave you overflowing with self-doubt during your training, particularly for those who seemingly do the opposite. As you’ll see below, most of my time was spent running much slower than race pace (nearly 30-40 seconds slower than marathon pace). Track workouts didn’t evolve until I was deep into training. You’ll also see how I approach strength training and injury, which happened twice while training for Boston.

The majority of plan is based on heart rate. Heart rate is a great gauge for training, but not so much or racing. Think of heart rate as a governor, keeping your pace in check based on the demands of temperature, elevation, and fatigue. My heart rate is broken into five zones, 1 being easy recovery and five being “I hate myself this hurts.” I was tested by Doug Bush of Endurance Factor using a sub-threshold test. If you’re not local to Buffalo, NY ask around. You’ll want to get this done.

Without further ado, here are my lessons (with training log support) for marathoners.

Lesson 1: Slow Down

Training Log: 27 of 30 Runs were in Zone 2 at the Beginning of Training

Speed kills (your legs). Zone two heart rate is your golden zone. You’ll spend the majority of your time in Zone two, particularly early in training. I’m fairly certain that most coaches will agree that runners tend to run too hard too often. Most runners train a bit harder–at or around zone three. Think of zone three as the ‘just hard enough to feel like you’re working, but not hard enough to be uncomfortable.’ Zone three invites breakdown early and often docks training time later as you struggle with injury. Take a peek at my training log. You’ll notice roughly 95+ percent of runs for the first nine weeks (18-9) were in zone two or below. Nearly all those runs were 30+ seconds slower than marathon pace.

Lesson 2: Long Run Pacing

Training Log: Every 18 Mile Training Run was in Zone 2 Heart Rate and up to 40 Seconds Slower than Goal Marathon Pace

Does anyone really care how fast your performing on your training runs? I can’t tell you how many athletes walk through my doors and reveal that their long runs are performed at marathon pace. Are you crazy? Race pace will inevitably cause breakdown–even at marathon pace. Running your long runs at a pace at or faster than marathon pace is a sure fire way to become my patient. Don’t give me your excuses about “building confidence,” either. You don’t have to “see if you can do it.” The long run is an endurance builder and your primary focus is to avoid breakdown. If you’re outside zone two heart rate you’re running too hard. This is especially true early on. Take a peek at my training log. You’ll notice that all of my long runs were in zone two with the exception of one 18 miler that was performed in god awful conditions. Slow Down! Please?

Lesson 3: Speed Work

Training Log: Only Two Speed Workouts Performed in First 10 Weeks (To Get Ready for C-Race)

There’s not entirely too much research on the concept of speed development, peaking, and maintaining maximum fitness, but it should make sense that you can only stay maximally fit for so long before you either become injured or overtrain. We like to think there’s a shelf life on speed and since you’re likely not running for a paycheck, you’ll want that maximum peak performance for race day. You can’t expect to visit the track once a week throughout training. There’s a time and a place for the track. Take a peek at my training log. You’ll notice that I don’t start any ‘faster’ running until week eight. Weeks eight through four build on long tempo intervals of roughly two miles and are faster than race pace. Normally, the four week mark begins adding speed to all the long “slower” workouts performed in zone two. Frequent bouts at the track are deemed difficult, but not damaging. This training plan offered a long B Race at Around the Bay, which served as Boston walk through. Normally, you would see 1-2 track workouts a week focusing on intervals at 800m or less.

Lesson 4: Upkeep Training

“I don’t have time to strength train.” What you’re really telling me is that you don’t think it’s valuable. You need to find time. You’ll find more value in losing 10 minutes of three runs and adding a 30 minute strength workout than doing the opposite. You’ll notice a few things here.

1:

I didn’t do a RunSmart Strength Workout every week. Life does get in the way, but doing no work in this realm is out right crazy. You’re sending an invitation to an injury.

2:

When I was injured I spent an excessive amount of time fighting my way back with strength workouts. An injury signals breakdown. Your body is hurt. Instead of sulking, take the time to rebuild and fix deficits.

3:

Yes, I too get injured.

Be smart with your training. The four lessons above outline common cause for for not only injury, but blowing up on race day. The fact is–most of them are factors within your control. And listen, stuff happens. Running is a tough gig and can take its toll. Listen to your body and rest when it begs you to. In running, there are no medals for those who ran fastest in training. Leave your “should have” and “could have’s” at the door.

Posted in Performance, Personal, Prevention | 4 Comments

How Long Does it Take to Recover from A Marathon

There seems to be growing trend of under valuing recovery. Runners fear days spent not running equates to a fitness vacuum, sucking weeks of training gains. First, you need to come to terms that you can’t be at peak fitness year round. It’s impossible. You’ll break. Your fitness graph should roll upwards with ascents and descents. The forever present plague of under, or in some instances–non existent, recovery in the running population boggles me. As runners, we’re great at justifying more. “I already signed up to race,” “I’m not sore anymore,” and “I didn’t race that hard” are verbal diarrhea that litter my clinic. Justifying a quick recovery with a poor performance is dumb. A race that went less than ideal isn’t a valid excuse to slack on recovery. You’re not only recovering from race day, but all the time spent training.

“I’m not sore anymore.”

For whatever reason, runners correlate the absence of soreness with being recovered. I don’t have to cite the fact that muscle soreness peaks at 48 hours and dissipates thereafter. At this point it’s fact. Going down the stairs post-marathon normally isn’t an open invitation for a race the following weekend. Hell, it’s not even an invitation to start running again. Unless you’re running for a paycheck, pushing your recovery is simply a death sentence to sustaining a healthy running career. I’m not saying you can’t get away with it, but trust me… it will catch up with you. Justifying a quick return with “I feel pretty good,” feeling “recovered,” or “I won’t race hard” isn’t a green light to lace up. Chances are… there’s zero chance you can sign up and not go all competitive on a race.

Research conducted in 2007 by Petersen et. al. found significant muscle weakness both at two and five days post marathon. Using a counter-movement jump researchers found 18 and 12% decrease in performance two and five days post marathon. Maximum voluntary contraction, a measure of maximum muscle force, for both the knee extensors (quadriceps) and plantarflexors (calfs) found 22 and 17% respective dive in performance 2 and 5 days post marathon. The moral of this story? Running within the first week is really out of the question. That includes you–person attempting to justify a ‘shake-out run’. This study fails to account for the fatigue proximally. Fatigued and strained core muscles will likely cause excessive motion distally at the knee and ankle and invite injury into your life. Without a properly functioning set of butt and core muscles you can kiss healthy knees and ankles goodbye. Leetun et al found that hip external rotation and abduction (think glutes) weakness are significant predictors for injuries in basketball players and track athletes. The majority of injuries were found at the ankle (65%) and knee (23%) respectively.

Said weakness arises when muscular tearing occurs at a microscopic level. The ratcheting system responsible for generating force is destroyed. Luckily, your body responds by repairing the system to a stronger state, that is if you let it. Muscle breakdown is measurable. An enzyme called Creatine kinase (CK) is released post injury. It circulates through the blood and can be measured. Elevated CK measures were found up to one week post marathon in a study conducted by Kobayashi et. al., reflecting signals of damaged tissue leaking contents into the surrounding fluid.

Further extending the damage timeframe, a 1985 study by Warhol et. al. found structural repair at the cellular level to under electron microscopy to take three to four weeks. Continued tissue regeneration was also found at 12 weeks. Yes. That means that three months later structural repair is still occurring.

This article isn’t suggesting that you wait 12+ weeks prior to running, but to timeframe the accrued damage that occurs with long distance racing/running. At the very least you should wait a week before running again. You should also weigh the danger of racing or running too hard too soon. Easy running is one thing, racing or running hard is completely different. Personally, I follow the “one day of recovery for every mile raced” rule. Post-Boston Marathon I waited roughly seven days before running. Even then, I felt like garbage. I’ve been slowly reintroducing miles while shifting my focus to strength and balance.


Post race is time to rebuild and recovery. Shift back to regaining balance and strength that were neglected as training increased and time was pinched. Easily spending one hour a week with RunSmart Yoga and RunSmart BaseSix can effectively (and efficiently) assist you in regaining core and hip strength before your next round of training. Be smart. Don’t freak out. Let yourself decondition, recover, and rebuild. Remember, you can’t be at peak fitness year round.

References

Peterson K, Bugge Hansen C, Aagaard P, Madsen K. Muscle mechanical characteristics in fatigue and recovery from a marathon race in highly trained runners. Eur J Appl Physiol (2007) 101:385–396.

Leetun D, Ireland ML, Willson J, Ballantyne B, Davis IM. Core Stability Measures as Risk Factors for Lower Extremity Injury in Athletes. Med Sci Sports Exerc. 36(6):926-934, 2004.

Kobayashi Y1, Takeuchi T, Hosoi T, Yoshizaki H, Loeppky JA. Effect of a marathon run on serum lipoproteins, creatine kinase, and lactate dehydrogenase in recreational runners. Res Q Exerc Sport. 2005 Dec;76(4):450-5.

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2014 Boston Marathon Race Report

Truth be told, I wasn’t exactly sure of my capabilities before Sunday night. I was caught up writing plans for some different athletes and studied the course based on their capabilities. Sitting down Sunday night, a mere 14 hours before the gun set us off, I decided to write a best and probable case scenario.

I’m not one to get caught up in hype. It’s weird. I’m an anxious and often impatient person. It encompasses nearly 95% of my life, but racing seems to relinquish any and all uncertainty. I sit down and look at my data from all the training I accomplished and set up realistic expectations. I simply stick to my plan and trust in my training. It’s funny. I toe a starting line every year encompassed with uncertainty of my capability. I look at previous races and think, “wow, can I really run faster than that?” Regardless, I set a plan and gave it my best go.

Our weather report couldn’t have been better. Cooler temps paired with a tail wind called for a fast day. Working my way through athletes village, which resembled that of a refugee camp, I made my way to the start. One thing was clear: it was going to warmer than anticipated. I met up with a running friend, Matt Kellman, and we decided to run together (again). Overheating was my primary concern consider winter spent more time below freezing than above. None the less, I broke down the race into five segments and went to work.

Segment 1: Start to Mile 4

2014, boston, marathon, race, report,

Plan: 6:30/mile

Actual: 6:30/mile

Mile 1: 6:38 Mile 2: 6:25 Mile 3: 6:29 Mile 4: 6:31

The first four miles are a mess of bodies and rolling downhill. With zero wiggle room, you were pretty much held to the pace of the pack. Runners were being tripped left and right, while some were pushing through for position. It was comparable to jumping lanes in traffic only to be stopped in another lane. The plan here was to bank some time without blowing the quads up early. Overall, I knew I was paced within a few seconds of the plan, but I wasn’t feeling overly confident. A crowded, narrow road left you at mercy of the pack.

With my lack of internal “hype” I’ve been known to be a rather slow starter. Inadvertently, this allows me to often run fairly even across long races. My last three marathons: Boston, New York and Pittsburgh have nearly all been even split.

Segment 2: Mile 4 to Mile 15

2014, boston, marathon, race, report

Plan: 6:35/mile

Actual: 6:35/mile

Mile 5: 6:36 Mile 6: 6:34 Mile 7: 6:39 Mile 8: 6:34 Mile 9: 6:32 Mile 10: 6:41
Mile 11: 6:40 Mile 12: 6:41 Mile 13: 6:25 Mile 14: 6:35 Mile 15: 6:40  

After coming in hot from the downhill I knew it would be tough to dial in to a slower pace. I was still feeling sluggish coming through the 10K mark, but again, I think it helped me dial it in and prevented me from over reaching. The crowds began to grow as you ran through Ashland, Framingham, and Natick. A swell in crowds was coupled with growing adrenaline. Mile four to 15 were sandwiched between defining changes in terrain, it was easy to segment this nine miles. The entire segment was laced with rolling hills. A mile slow was followed by a mile fast, eventually averaging them to goal pace. Each passing town came out in full force and provided crazy noise. Fun fact: slapping outstretched hands of toddlers provides a significant boost in energy. I used it throughout my day at Boston. Shouts of ‘Thank You Runners’ and an outpouring of support from the crowd, volunteers, and law enforcement ticked these miles away faster than ever. The first twenty miles felt easily half of that. At the tail end of this segment came Wellesley. Wellesley is home to an all-female college who are notorious for offering up smooches and noise to fuel runners through mile 15. Signs of “Stamina Turns Me On” to a rolling tally of total kisses kept you smiling and running. The noise through Wellesley was unreal. Deafening is an understatement. I imagine it’s the closest you could feel to being a professional athlete. I ticked through miles and felt fantastic. After a quick self-assessment I thought about pushing. I can honestly say I felt zero fatigue moving through mile 15. I decided to hold back, which was the right decision.

Segment 3: Mile 15 to Mile 16

2014, boston, marathon, race, report

Plan: 6:30

Actual: 6:30

This short, fast downhill segment came before the notorious hills of Newton. The plan was to bank some time in anticipation. I did just that. Felt great and ready to tackle some hills!

Segment 4: Mile 16 to Mile 21

2014, boston, marathon, race, report

Plan: 6:41

Actual: 6:53

Mile 17: 6:54 Mile 18: 6:54

Mile 19: 6:39

Mile 20: 6:52 Mile 21: 7:07  

I hit the hills with a high cadence and the goal of being able to push over the top. Again, the crowd was fantastic. Fueled on spilled Gatorade, high fives, and adrenaline, I took my time on the climbs. The sun began to roast and I continued my plan that I instituted from mile five. Hit up the water station and just start dumping. I felt terrible for anyone in tow, but I know what I needed to do. I averaged 3-4 cups of water at every station: one for my mouth and the rest for my body. As I lapped each mile I knew I was off considerably and even saw a single 7:05 on Heartbreak Hill. Still feeling great I calmed my nerves coming through mile 21 and looked forward to the descent into Boston—ready for a strong finish.

Segment 5: Mile 21 to 26.2

2014, boston, marathon, race, report

Plan: Whatever I Have Left

Actual: 6:37/mile

Mile 22: 6:32 Mile 23: 6:41 Mile 24: 6:34
Mile 25: 6:44 Mile 26: 6:42 Finish: 5:49

The downhill into Boston was awesome. What a fast way to end the course, that is, unless you pounded the downhill early. I felt fantastic cresting Heartbreak Hill. The plan here was to go with whatever was left in the tank. Truthfully I felt great. I took in all Boston had to offer. I settled into a groove and kept it there. “MEB WON” was shout from the crowds and for the first time I saw an entire pack of exhausted runners began to cheer. It was amazing. The downhill into Boston began to wear on my quads and the last three miles easily compensated for how easy the first 20 felt. I hit aid station repeat button, a simple sip of Gatorade paired with 5+ cups of water over my head. I kept reflecting back to all the support I had for this race. That, paired with an awful winter, urged me to continue my push. There’s a lot of pressure when you know so many onlookers are tracking you!

Finish Time: 2:54:22 – 43 Second PR

Much like the previous 26 miles, rounding Boylston was amazing. This was by far the most amazing piece of running I’ve had to date. I dug deep and knew a PR was all but mine. It hurt and when I finished I looked down to see 2:54:22, a 43 second PR.

Throughout the course complete strangers acted as if you’re a rock star. Awestruck: the only way to describe this experience. As fatigue set in you would run up on an athlete with a prosthetic (or two). You would see a mother or father pushing their child through the run. How could you do anything but run harder? Every obstacle was greeted by the city. It didn’t matter if they knew you or not. “Let’s go, baby!” “You got this!” “Keep it up. Let’s go. Let’s Go.” launched me over these hills. Prior to running Boston I thought I would be a one and done, but honestly, I have no doubt I will be back.

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