You Won’t Believe This! How To Bounce Back From A Marathon-Training Injury
From 2014 to 2017, Irish marathon runner and big-data expert, Barry Smyth, had access to a massive amount of runner training data from Strava. This data, which included approximately 400,000 marathon runners training for 800,000 marathons, has allowed Smyth to do “real-life” analysis of important marathon training and racing questions.
Smyth’s most recent paper has gone where no one has been able to go previously. He asks and then answers a question every veteran marathon runner has faced. Here’s the question: “If I lose time to injury in my marathon training buildup, how should I return to training when healthy?”
There are many potential answers to that question. They range from “very conservatively, so you don’t get reinjured” to “very aggressively, so you can go for the gold on race day.”
Ask any coach, exercise scientist, or physical therapist for their answer, and almost 100 percent will select the conservative approach. In running, we just don’t believe in making up for lost time. We believe in patience, slow-steady progress, and staying healthy against future injuries.
Surprise! That’s not what Smyth’s data revealed. And he had a LOT of data--he found 103,000 runners in marathon training who missed 7+ consecutive days of training--presumably from injuries.
When these runners returned to training, some ran 20 to 25% less than they had been previously. They followed the conventional wisdom.
However, one-third “effectively doubled their training.” They apparently felt nervous about a rapidly-approaching marathon race, and opted for an all-in approach.
At this point, you’re thinking, “That’s a recipe for disaster.” But it wasn’t. The hard-trainers finished their marathon “slightly faster” than those who followed a conservative approach. They also missed fewer training days (from presumed injury) in the rest of their marathon prep than their more-cautious peers.
Before I could email Smyth a few hard questions, he responded with answers. “It would be unwise to conclude that it is safer to come back aggressively after an injury, notwithstanding what our data showed,” he wrote. “I think this effect was likely due to runners who were not badly injured, and were able to come back strongly.”
Still, the paper clearly showed that it’s possible to get over an injury, and jump back into training more aggressively than most have believed. Many running injuries are minor, heal quickly, and allow for continued hard training. Plus, the injury might have given you a good recovery period. Just remember that familiar cardinal rule: Listen to your body. More at Case Based Reasoning Research & Development.
Optimize Your Running Form With This ONE Change
Bas van Hooren is a great running researcher engaged in exploring many aspects of training and biomechanics. Tom Goom is a British physiotherapist who frequently uses infographics to explain the latest research. Both contribute here to this discussion of runner biomechanics and running economy.
A recent van Hooren paper in Scandinavian J of Medicine & Science in Sports used an “artificial neural network (ANN) approach” to analyze various aspects of good running form. He found, in particular, that a high heel-kickback was linked to inefficient running. That is, “More economical runners exhibited less knee flexion.” He also noted several other running-form factors related to running economy.
Goom presented the same information in an easy-to-grasp infographic here. He takes the technical data and presents it in a familiar fashion--as a runner’s body moving through space. This includes advice about heel kickback, forward lean, and ankle toe-off, and how they relate to running economy. This is a great and useful contribution.
For a brief review of a runner’s “stance phase” vs “swing phase,” here’s more visual guidance from Doctors of Running.
Run Better In The Heat With … ??? Frozen Water Balloons???
Not to beat a dead horse … but if it wasn’t hot enough already, the July 4 holiday reminded us of what’s coming this summer. So here’s a brief summary of recent (and important) articles about endurance performance in the heat.
The Gatorade Sports Science Institute has one of the best overviews on adaptation to the heat. It takes 1 to 2 weeks of “daily heat exposure” (about 90 minutes/day) for your body to become acclimatized to the heat. That doesn’t mean you can race as you would on a 50 degree day. But you can get better, and feel better.
The NY Times wondered how the Olympians are preparing for a sultry Paris summer. This piece has great insights and advice from Ed Eyestone, coach to Olympic marathon runners Conner Mantz and Clayton Young. Did you know about the frozen balloons trick? Me, neither.
The “Sweat Science” guy, Alex Hutchinson, visited the University of Oregon to try one of the techniques many Olympians are using: hot baths (or saunas). He turned red-faced and miserably unhappy from the heat, and wondered if too much heat adaptation could diminish one’s on-the-run training. Good question.
Two recent papers raised new red flags about running in the heat. One found that it increases your carbohydrate burn. Another that it could increase injury risk. Why? Because “the physiological response to heat stress is similar to but more severe than the physiological response to prolonged exercise.”
The greatest threat with hot/hard running in summer weather is heat stroke. Dr. Gabe Mirkin explains why this should never affect you … unless you’re running in the Olympics, as Gabriele Andersen was 40 years ago at the 1984 Games. Otherwise, just stop, seek shade, and douse yourself with cold water if possible. (By the way, Andersen was completely fine 15 minutes after finishing the marathon, and ran a road race without problem the following weekend.)
An article in Exercise, Sport & Movement assesses “critical environmental limits for human thermoregulation” in a time of climate change. Especially vulnerable are “young children, the elderly, pregnant women, and outdoor laborers.” The latter er could be extended to outdoor endurance athletes.
And the problem is double-edged. Temps are rising, and so is obesity, which makes the body more vulnerable to heat. Conclusion: These factors provide impetus to the “urgency for adaptive measures and climate change mitigation.”
How To Prevent Knee Arthritis With Broccoli & Bicycling
“Arthritis” is one of those words no runner ever wants to hear. Or, worse, to experience.
It immediately conjures images of knee and/or hip pain, and a possible need to take drastic action. Some give up running and switch to the bike or swimming pool. Others eventually agree to surgery and joint replacement.
Strong NSAIDs provide temporary relief from arthritis pain. However, long term use is not recommended, due to side effects and various risks. As a recent preprint paper notes: “New options are required to reduce pain and improve quality of life for people with OA.”
Okay, here’s one you didn’t expect: broccoli soup. A small but well designed and randomised controlled trial in the United Kingdom found that: “High glucosinolate broccoli soup is a novel approach to managing OA that is widely accessible and can be used on a large scale.”
Subjects had all been suffering from knee pain for a number of years. They ate one 300 ml bowl of a “high glucoraphanin” broccoli soup at least 4 times a week for 12 weeks. Glucoraphanin is a phytonutrient found in many cruciferous vegetables, and also in supplements. (The study was not funded by a commercial entity.)
After the BRIO soup intervention (BRoccoli in Osteoarthritis), subjects reported significantly lower arthritis pain scores and fewer bad-joint days. Broccoli and similar foods (sprouts, kale, cabbage) have been linked to many other healthy outcomes.
Conclusion: The researchers say they “observed clear patterns for improved pain across a range of pain measures.” More at MedRXiv with free full text.
Also a lifetime of bicycling is associated with lower risk of knee pain and arthritis. It appears that more is better, both in terms of years cycling and time/week. More at Medicine & Science in Sports & Exercise.
Here’s Your Ultimate Guide To Calf Muscle Injuries
Calf injuries aren’t the most frequently reported running injuries, but they aren’t far from the top either. They afflict many runners, and they come and go at irregular patterns. They often prove resistant to long-term prevention. This makes them extremely frustrating.
Here’s a long, deep article that offers a complete guide to rehabbing from calf injury, and preventing the next one. It’s based on 20 extensive interviews with “a select group of international experts.” Nobody’s wearing rose-colored glasses here; no one’s pretending that they’ve got a sure-fire program.
But they are cautiously optimistic, stating “There is hope for preventing calf muscle injuries.” However, “Don’t expect a single intervention to do the trick.”
If you suffer from calf-muscle injuries, you should read the complete guide in its full-text version at the free link below. Here are a handful of highlights.
After just a day or two of isometric exercises, most experts begin to prescribe single-calf raises. One expert said that he didn’t bother with double-leg raises, because patients “just cheat.”
Calf muscle strengthening is “a cornerstone of building muscle capacity and resilience.”
Don’t return to running by “plodding” for distance. You will get better results from running less but at a quicker pace.
“Don’t run a calf muscle like you would run a hamstring (or quad, or adductor).” That is, accept a slower, more-delayed return to running in order to reduce a re-injury.
When healthy, continue your calf-strengthening exercises. “The single-leg calf raise has a universal role for training.” You should be able to do 30 at a time.
More--much more--at Sports Medicine Open with free full text.
The Results Are In >> Low Cal Diets Threaten Your Immunity
Most coaches, nutritionists, and other exercise scientists understand the dangers of low energy intake (LEA, low energy availability) on endurance athletes, particularly young females. Yet there have been few randomized trials in this arena. It seems borderline unethical to conduct such a trial, so I was surprised to discover this one.
It included 12 endurance trained, healthy and menstruating women (average age, 27) with body mass of 18-23 (pretty low), and 6 hours a week of endurance exercise. They were each randomly assigned to a normal-eating group, or a low cal group (about 55% less than normal). Both groups spent 14 days of regular training on the assigned diet, then returned to 3 days of normal eating before completing an exhausting 20-minute bicycle time trial.
After an 11 day “wash out” period, all subjects were switched to the opposite eating group, and the process was repeated. All received a range of blood tests during each diet period, and after the 3 days of returned-to-normal eating.
Results: Subjects lost 1.5 pounds with normal eating, and 4.2 with low energy availability. On the exercise test, power output was significantly lower after LEA, and also lower when expressed as power/weight (despite the weight loss that might have increased this ratio).
The blood testing revealed “increased cortisol levels” and a pronounced negative effect on the immune system.
Conclusion: “Our study illustrates a substantial impact of short-term LEA on the immune system.” This could heighten runners’ susceptibility to infections and disease. “These findings underscore the critical importance of limiting LEA exposure for female athletes.” More at Redox Biology with free full text.
Male athletes also face risks. Among 13 hard-training Irish runners and triathletes, 77% were found to have low energy intake. The researchers noted that this could “lead to impairments in bone health” as well as “reduced oxygen-carrying capacity.” More at European J of Nutrition with free full text.
Beware Fake Science In Olympics Marketing
I anticipated much of what I read in Nick Tiller’s essay “From Gods to Gurus” about superstition and science at the Olympic Games. But I also learned more than I expected.
For example, I wasn’t surprised by Tiller’s skepticism over Michael Phelps’s use of cupping therapy, Mo Farah’s belief in cryotherapy, and many athletes’ use of kinesio tape. It turns out that a major k-tape company donated 50,000 rolls to athletes before the 2008 Beijing Olympic Games, and many of those athletes subsequently wore the tape “like performance art” during their televised Olympic appearances. Bingo! A huge, instantaneous marketing success.
I also expected that many athletes would have “lucky socks” or other lucky apparel that they believe essential to their success. But I didn’t know that one speed skater always touches both eyebrows and winks at the camera to guarantee a good race. Or that a swimmer follows a ritual involving a number sequence of 8-4-4.
Why such bizarre approaches? Because believing does in fact help you perform better. That’s the power of the placebo effect.
But there are steep downsides. When Phelps starts selling his own cupping device, and anyone else pushes their favorite (but unproven) device or supplement, people can get hurt. They get hurt in the pocketbook, of course, but also physically. One review site has documented nearly 400,000 deaths and $3 billion in economic damages due to “unregulated alternative therapies.”
Tiller tells another tale I hadn’t heard before. He says that something called the “Sagan Effect” discourages the most-knowledgeable scientists from engaging in discussion of controversial approaches. When they do, they are often stigmatized by their academic peers, who apparently think experts should stay ensconced in their ivory towers.
At the same time, good science writing is drying up along with other forms of solid journalism that previously aimed to inform the public. This double whammy is a great boon to non-experts, who find they can peddle their snake oil in a virtual vacuum--AKA, the Internet. Buyer, beware. More at The Skeptical Inquirer.
99 Year Old Finishes Peachtree 10K In Atlanta
It’s a little early for “Runner of the Year” nominations, but Betty Lindberg has almost clinched my vote. She just finished her 35th Peachtree Road Race 10K in Atlanta at the ripe young age of 99. And Peachtree’s hills and summer heat make it anything but an easy run. Lindberg will turn 100 in September. Let’s hope she’s got a fall 5K on her race calendar.
These days, Lindberg trains with “quick strolls” around the neighborhood where she lives. Quick or slow, what’s the difference, so long as you’re out there. At Peachtree, she almost cracked the 3-hour barrier. Maybe next year? She’s got a number of family members to accompany her and keep her motivated.
Lindberg is also a regular at several other Atlanta races, and has set some USATF national records in recent years. She holds the 90-95 road record for 5K, 55:48. Here’s a short article about her Peachtree race, and here’s a longer one with much more background--all the way to her birth in September, 1924. Check out the joy and energy on her face.
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