Tag Archives: UVA Running Medicine

The Traveling Runner: how to maintain benefits from weights when you don’t have a gym

Does anyone else live in a bubble where time-zones tick by as fast as minutes? Last night I got back home from one trip, unpacked, repacked, and flew off again this morning….traveling can be tough on our routines, and unfortunately, wreak havoc on our athletic efforts. Let’s face it, on some trips we have hours on end to utilize the high end gym (that is likely nicer than the one you have at home!). But for most of the time, it’s a pulley machine, a swiss ball, and a treadmill stuck in a standard sized hotel room masquerading as a “gym”. Not really an ideal environment to push the limits. And on top of limited equipment, you likely only have about 30 min between answering emails from your “regular work” on top of everything else demanding time on your trip. So how do you maintain your benefits of your weight work while facing the demands of traveling?

 

Its easy to say – OK – no weights, I’ll just go for an easy run. No harm in this at all. But for those of you really dedicated to making gains while on the road, there is a will, and a way. Take a look again at the previous post on ways to improve your neuromuscular recruitment. If the weight room isn’t set up to help you kickstart those fast twitch fibers, hitting some local hills, or even doing sprints in the parking lot go a long way.

 

But remember, the goal of these is to go HARD. Really hard. As hard as you are working on the last few reps in the weight room. And to go that hard, it means you have to rest between intervals. For those of you who think that rest is only for the weak, let’s look at what sprinters do. People who run hard for a living (sprinters) take approximately 1 full minute easy for each 10 meters they run. So yes, a 30 meter sprint means 3 minutes rest before the next one. And keep the durations short. Intervals over 40 meters aren’t helpful. And while sprinting hills is really tough, the effort should still be quite high and be limited to less than 20 seconds of effort. Throw your shoes on, hit a short easy run, some dynamic warm-up moves, and then hit some intense hills or sprints. Jump in the shower, and get back to travel life……knowing you did something for yourself before the day even started.

Neuromuscular control: why is it important for runners, and 3 easy ways to improve it

Efficient movement is one that allows you to activate your muscles as fast as possible. Why? Because running demands some pretty quick contact times (between .08 – .3 seconds every stride). If you can generate a forceful contraction rapidly during the stance phase, you’ll tap into some amazing efficiency. And tapping into those forceful contractions requires good “neuromuscular control”. This term gets throw around a LOT with abandon. A quick explanation here: Strength is nothing unless your body can control it. Our nervous system needs to “learn” to control our newfound strength and power. Said simply: better neuromuscular control, better economy.

 

To get more of your nervous system in the game, we need to recruit more muscle fibers to contract. And there are three ways that we can increase muscle fiber recruitment.

 

  1. Sprint all the time. If you are in a drag race, you aren’t going to pull up in a Prius. You are going to borrow your neighbor’s Porsche. Who cares about economy, you want to win the checkered flag! Running as fast as you can isn’t really that efficient. It costs way more energy per distance than running slow. This increased energy cost comes from recruiting a LOT of muscle fibers at once. Sprinting is actually one of the best running- specific forms of strength training out there. Its not just for track-stars. I have my 800 meter, 5K, 10K, 13.1, 26.2 and even ultra runners doing sprints at various cycles during the year. But its hard, and that why we don’t do it every day!
  2. Run Hills. No secret here. Running up hill requires we raise our body up against gravity more than running on flats. And the extra force per step it takes to conquer that hill comes from….you guessed it…..more muscles fibers being recruited each and every step. Hills are tried and true for years to improve running-specific strength. But again, these place a big training load on our body, and we can’t do them every day.
  3. Lift weights. The cool thing about weights is that we can get a huge increase in the number of muscle fibers activated (there’s that catchy term again…..more neuromuscular recruitment!) without a big cardiovascular and connective tissue training stress. Lifting quite heavy and quite powerfully has been directly coorelated to running economy. And here again, you can’t do these daily either.

 

So the secret to improving your ability to activate more muscle fibers comes from, well, activating more muscle fibers. Take a look at your training plan and see how you can include 1 or 2 of these techniques into your own strategy each week. A little goes a long way here. Have fun, and watch as you achieve those running milestones.

 

Does barefoot running really impact injury or performance? Evidence for the peanut gallery

Screen Shot 2014-05-16 at 2.34.30 AMOK…..most of you are going to have a field day with this blog post, so let’s just get it out there. Barefoot running came in a BIG way. And like most BIG things that come quickly, its fading at a rapid rate. A lot of people think barefoot runners are nuts, and begging for injury. And others think that the injury risk is the same as those who wear shoes, but the location of injury in the body will just move from one to another. Well, I’m not really a fan of speculation.

Some years ago, I put out a survey to barefoot runners with some simple questions. How much to you run barefoot? Why did you go down this path? Did barefoot running impact your injury risk or performance? Over 500  runners responded. Thank you interweb.

To be 100% forthcoming, the study is biased towards runners who have actually tried barefoot running (not minimal footwear, but true barefoot). Duh, you had to have experience running barefoot to answer the questions! Barefoot runners are a passionate bunch, but we made the default assumption that people tell the truth. And yes, its just a survey. But it provides an interesting slant. Instead of wondering if barefoot running works, why not just ask people who do it?

This study, “Barefoot Running: Evidence from the Field” was just published in the Journal of Sport and Health Science, and you can get a full download right here. And for those of you who just want the simple version, the abstract is below.

Now I’m not saying that all of you should ditch your shoes for 100% of your mileage. But this idea of barefoot running supports a very critical concept. Feet are capable of some pretty good work. Barefoot running, when done in the right volume and circumstances, can be a great training tool to help you build a better body. And no matter what side of the barefoot debate you stand on, putting better bodies into running is a concept we can all get behind.

Abstract

Background

Running is becoming an increasingly popular activity among Americans with over 50 million participants. Running shoe research and technology has continued to advance with no decrease in overall running injury rates. A growing group of runners are making the choice to try the minimal or barefoot running styles of the pre-modern running shoe era. There is some evidence of decreased forces and torques on the lower extremities with barefoot running, but no clear data regarding how this corresponds with injuries. The purpose of this survey study was to examine factors related to performance and injury in runners who have tried barefoot running.

Methods

The University of Virginia Center for Endurance Sport created a 10-question survey regarding barefoot running that was posted on a variety of running blogs and FaceBook pages. Percentages were calculated for each question across all surveys. Five hundred and nine participants responded with over 93% of them incorporating some type of barefoot running into their weekly mileage.

Results

A majority of the participants (53%) viewed barefoot running as a training tool to improve specific aspects of their running. However, close to half (46%) viewed barefoot training as a viable alternative to shoes for logging their miles. A large portion of runners initially tried barefoot running due to the promise of improved efficiency (60%), an attempt to get past injury (53%) and/or the recent media hype around the practice (52%).

A large majority (68%) of runners participating in the study experienced no new injuries after starting barefoot running. In fact, most respondents (69%) actually had their previous injuries go away after starting barefoot running. Runners responded that their previous knee (46%), foot (19%), ankle (17%), hip (14%), and low back (14%) injuries all proceeded to improve after starting barefoot running.

Conclusion

Prior studies have found that barefoot running often changes biomechanics compared to shod running with a hypothesized relationship of decreased injuries. This paper reports the result of a survey of 509 runners. The results suggest that a large percentage of this sample of runners experienced benefits or no serious harm from transitioning to barefoot or minimal shoe running.

Win. Or Don’t. Life lessons learned from losing at individual sports.

Screen Shot 2014-04-21 at 11.37.03 PMMy kids are the best. They are awesome. They are perfect! Let me tell them how wonderful they are 24/7!

If you are a parent, there is no doubt how you FEEL.

But, now we are hearing different messages from psychologists that all this praise isn’t really best for our kids. We are hearing a new message: praise the work, not the kid.

Experts tell how this plays out. When you tell your kid “you are an awesome bagpipe player!” twenty times a day, your child begins to believe it. They begin to link “awesome” with themselves. But they don’t build a framework of why they are awesome, or what it takes to achieve awesome. Anyone ever heard of Justin Bieber? My 2-yr old makes better life decisions than this guy. While he’s been swooned by millions of adolescent girls, he’s completely lost the ability to discriminate feedback between from fans, and who he really is.  Perhaps this is an extreme example, or maybe its not. Experts tell us too much praise breeds a sense of false sense of security. Kids begin to believe what they are told, but they don’t associate the praise with the action required to achieve this praise.

Apparently, what we should be saying is “I’m so proud of all the hard work you put into playing bagpipes.” While some people may view this as trivial, kids appear to get a different message. They hear that you are proud of the WORK they put each day. They associate hard work with  success. And since everyone likes praise, they focus their efforts on the work to earn more praise.

The world of sport is pretty cool: we can learn complex life lessons while doing fun things that we actually enjoy. But team sports and individual sports give us uniquely different experiences.

Think about it. Its the finals. Your team scores the winning touchdown, 3-pointer, or homerun. The crowd rallies. Fans on on their feet. Cheers. Coach gets doused with the water cooler. In fact a lot of people confuse the vibe that these Norman Rockwell images convey with the actual   achievement of winning.

I love team sports (if you are an LSU fan and have seen a home game at Tiger Stadium, its a whole different state of mind) but they can be confusing for young minds. If you win, great. Why did your team win? Did every player on the team carry out each play perfectly? Did you win because 3 starting players are so incredible they made up for deficiencies on the rest of the team?  Or did you win because the other team made error after error, or had 2 of their best players hurt?

Because each of the three scenarios would convey a completely different sense of accomplishment. If YOU or your kid nailed the game – awesome! “I’m so proud of that key penalty kick you blocked” you may say. But maybe your kid didn’t play their best. In fact, maybe they screwed up big time, but the team still won. What kind of lesson does that convey to an 8 yr old? Is everyone on the team still a winner even if some of the kids blew their position that day? Or maybe the opposing team just couldn’t get their act together. does that make your kid a winner? Does being a “winner” really breed positive feedback for individual skill and inner drive?

I’m a firm believer that team sports can teach you a major lesson: sometimes things happen that are beyond your control (other players, other teams, bad calls from the ref). Team sports offer an immersive environment to build relationships and develop trust with others to help work around unique problems you encounter.

But kids can be overwhelmed with the desire to WIN, and lose focus of the process it takes to have a great performance. Individual sports offer the ability to look uniquely at yourself.  And from a developmental standpoint, this is big. The legendary coach Joe Vigil often says “there are few sports more nobel than track and field. Its you a fixed course and a watch. And there is no hiding.”

Let’s think about this. I’m twelve, swimming the 100 meter butterfly at the state meet. I’ve put in tons of work, and show up prepared. The gun fires, and I’m soaring off the block, stroking as hard as I can, only to show up at the finish one tenth of a second out of first. Next up is the 200 fly. Again, I showed up a few hundredths, or maybe a few tenths of a second off the big win. I have no idea how many times I didn’t win, but it was a LOT!

And in these individual events, the hard truth was obvious. The only reason I didn’t win was because I didn’t perform. Maybe I blew my start. Maybe I blew my race strategy. Maybe I showed up less fit than I needed to be. I was 12, and certainly didn’t have a lot of life experience to make sense of all this. But my coaches over the years were beyond incredible. Each and everytime I didn’t win, they helped me reflect on my limits, which motivated me to overcome these limits, and praised me for what I had done to perform. I learned specific lessons – and won – through losing. But each time, they were things I had control over. And when you have control over the situation, you can improve.

The take home from all this? All these “life lessons” obviously didn’t turn me into Michael Phelps. But they helped me grow as a person. I begin to understand what I was good at, and what areas of my training / life I need to work on. As a 12-yr old, I needed direction, and individual sports gave this to me. I learned to look at myself objectively. Oddly, things still happen to me now, that I can compare to experiences and challenges I learned from competing as a young athlete. And guess what? I still screw up in life, and I’m still trying to be a better person.

We all love our kids unconditionally, and win, lose, or tie, they need to know that. But as for lessons learned from the world of sport, Its up to us to help channel these wins and losses within our kids to help them grow.

Because there was another time I dove into the pool. And that time, things clicked. And a state record fell. And so did a spot on the national rankings. And I understood all the work I put in to make that moment come true. I was pretty pumped. Not only did I win, I grew. And I want my kids to know this feeling too.

The Dynasty of Running Medicine Continues

photo 1-11The University of Virginia Running Medicine Conference continues to be the premier source of training and applied knowledge for clinicians across the country. I’ve been lucky enough to co-direct this course with my colleagues Dr. Robert Wilder and Eric Magrum for the past twelve years. We assembled an entourage of experts to bring us up to speed on the latest research, and how this applies to our patients.  And this year, we had requests to expand into talks on performance planning and progression, and we delivered.

From the clinical side:
Dr. Fran O’Connor described findings of “Exertional Rhabdomyolysis”. Its great that the endurance community is embracing strength training. However, going to big too soon can lead to some serious health implications. Dr. O’Connor described how to identify these signs and symptoms when people go a little too aggressively in CrossFit and other competitive environments, and how to ensure that you are progressing training appropriately.

Dr. Wilder described “The Runner With Heel Pain.” Sure your plantar fascia can be the driver of your nagging pain, but there are other structures in this area that drive symptoms, and other areas that can refer to the heal. He reviewed what these are, and how to manage them for success. And on Saturday, Dr. Wilder led a water running lab to discuss tips to ensure high physiologic training stress to maintain fitness while placing the body in a reduced training load.

“The Great Toe” was presented by Eric Magrum. Conservative clinical management of the big toe is essential to proper foot stability. We reviewed normal foot function, problematic scenarios, and how to address each. The one-two punch was saturday’s lab session with hands on evaluation and treatment.

But sometimes, the great toe isn’t so great. Dr Joe Park presented “The Not-So-Great Toe” and discussed the skilled surgical management of the foot and lower leg when conservative care hasn’t worked. Dr Park presented the current state of care for foot management, how this impacts the entire lower quarter, presented some case studies to offer real world application, and innovative, outside the box solutions for correction of serious disorders.

Dr. Siobhan Statuta wasn’t stressed out when she presented “You’re Stressing Me Out! – a review of foot stress fractures.” We reviewed the identification, management, and return to play criteria to ensure successful care.

Dr. John McKnight had some great content (and great pictures) of “common skin conditions of the foot” – we discussed everything from blisters to foot fungus to serious infections, and how to treat these from a clinical as well as a practical approach. Yes, make that one more use for duct tape.

Have you ever wondered what happens “inside” the muscle, and why some tissues sustain strain injuries (tears) more than others? Dr. Silvia Blemker presented the engineering side of the equation. She showed her innovative work with real-time MRI and how the shape of the aponeurosis affects the stress and strain of muscular forces, and how we can learn more in the future in our efforts to prevent injury. In short, muscle architecture matters.

Now, we’ve discussed how to get runner’s healthy, let’s look beyond into the world of performance.

Have you ever wondered what type of cutting edge training principles are employed by Olympic athletes? and why this works? Our keynote speaker Dr. Brad DeWesse identified what constitutes successful athletic performance, and how to cycle your training to achieve it. Sure there’s an “art” to coaching, but is’t it nice when you can make things objective? Brad was able to present data points on values they assess on all their athletes, how they implement training for targeted improvements in the lab, and what kind of outcome this has in the real world. Impact? The US has won more medals in the sports Brad is working with. Its the stuff of genius.

With a formula for successful training in front of us, yours truly provided an overview talk called “Run Better: Clinical, Strength, and Power Prep for Strength and Endurance Athletes.” We identified how to put a better body into your overall plan: how to screen for muscle imbalances that restrict optimal physical development, how to fix them, and most importantly, how to integrate these skills into running mechanics. Following this, I presented real world case scenarios (with data) to show how this impacts both quantitive lab values and race times. Result? Pain free runners that are setting good numbers in the lab and PR’s on the course.

I’d like to thank over 230 physicians and therapists who attended, and about 100 of you who return each and every year. This course almost seems like a small family at this point, and we greatly appreciate your support, enthusiasm, ad feedback each year. Dr Wilder, Eric, and myself wish you success in implementing these concepts with your patients and athletes!

 

a new way to train for running. Lava magazine and Linsey Corbin lead the way

Its not all blood, sweat, and grinding to the same ‘ol tune.

Lava magazine spoke to Linsey Corbin to discuss the innovative things we did together to rehab her injury and get her ready to run Kona. Yup, a 9 mile long run, plus some outside the box thinking = a 3:04 marathon at IM world championships.Check out the full article for the story by Lava. 

Training the old way is boring. Training the new way is faster (and fun!)

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Anatomy for Runners: Top 9 Thought Provoking Books of 2013

Its always nice to get a shout out. Steve Magness is one of the “better thinkers” in the world of running, coaching, and athlete performance, and I respect his opinion highly. Apparently, Steve is nice enough to respect mine as well, and named Anatomy for Runners as one if his “Top 9 Though Provoking Books of 2013″ – thanks Steve. If you live under a rock, and haven’t come across his amazing blog, I highly recommend checking it out: the Science of Running.

And while I’m at it, I’d like to say thanks to all of you who have purchased the book. I teach all over the country, and the number of clinicians and coaches who already have the book, and actually USE it daily on their teams and patients is, well, quite humbling. I know the little niche I operate in will never reach the status of the Harry Potter, but there are over 11,000 of you around the world reading this book over the past year. I hope its making you rethink the way you approach your training, and your patients, your teams, and ultimately producing better results. If you’d like to pick up a copy, click on the link on the right side of the page!

The work of a decade of my career, bound into the "take home version" for you.

The work of a decade of my career, bound into the “take home version” for you.