January 5, 2023

Cardiologist saves two lives in Monterey Bay Half Marathon with “Today Show” video

This has to be the best running story of 2022, and perhaps any other year. It’s the most inspirational, and also delivers one of the most important messages any runner can learn.

The inspiration: A doctor--a cardiologist no less, named Steven Lome--saved two lives at the Monterey Bay Half Marathon. In both cases, he came upon fallen runners who had stopped breathing, and he brought them back to life.

The message: Learn CPR, or review what you know. You don’t have to be an M.D. to save another runner’s life. And you don’t have to use mouth-to-mouth resuscitation, as the “hands only” guidelines no longer recommend it. You just have to know where to pump on a person’s chest, and how hard and fast to pump.

Here’s a short but intense video segment from The Today Show, which reunited the three participants for the first time since the half marathon. Lome finished in 2:30:32.

And here’s a top CPR video from the Boston Marathon, the American Red Cross, and the American Heart Association. It includes instruction from cardiologist Aaron Baggish, a many time Boston Marathon finisher himself and one of the world’s leading exercise cardiology experts. Please take four minutes to review this video. You never know when you might have a chance to use hands-free CPR. It could be during a race, or any day on any run. 

As Dr. Baggish says: “Each and every one of us has an opportunity and a responsibility to assist in the event of an emergency like a cardiac arrest. CPR is a life-saving action that can be performed by almost anyone, and recent studies have shown that bystander CPR, specifically by the person who first witnesses the cardiac arrest, is the most important determinant of whether a runner lives or dies.” More on You Tube.  

How to set smart goals and achieve “sustainable excellence”

I don’t want to pile on too much with “January Resolutions” material, because you’re probably already tired of it. That said, you’ll likely engage in some goal setting at some point this year, maybe 3 months before a big race. And no one does a better job providing evidence-based advice in that department than distance coach and all around performance expert Steve Magness. So you should consider his recent Twitter thread.

He points out that “process” and structure are key components. I also like several of the physicians he quotes, and the way they say that goal setting should include: “dosing, consideration of harmful side effects, and close supervision.” More at Twitter Steve Magness.

In a similar vein, Magness’s writing partner, Brad Stulberg, has put together a guide to reaching “sustainable excellence” in 2023. It’s a fantastic term, combining both personal aims and our connection to larger wholes like the environment. It’s a long list with 27 items, each worth your consideration. These two struck a chord with me: First, #10, “Become a master of showing up.” And, second, #21, “Take the work extremely seriously, but yourself not so much.”

Be sure to check out the full list. You’ll find others that resonate strongly. More at Twitter.com/BStulberg.

Alcohol causes inflammation, cancers, and has no heart benefits

No nagging here. And it’s easy to understand why many runners enjoy their beers and cocktails. We sweat a lot, we feel that we deserve a small reward for our regular aerobic outputs. This is just a reminder that some of your beliefs about healthful alcohol consumption might be mistaken.

Runner’s World has a long feature story in which the director of the National Institute on Alcohol Abuse and Alcoholism say, “The truth is, there’s no safe amount of alcohol, not even one drink a day.” More here.

Dr. Gabe Mirkin summarizes the research results, pointing out that earlier studies showing an alcohol = longer life connection were flawed by wrongly-selected control groups. In fact, “Alcohol causes inflammation and oxidative stress that damages cells and increases risk for disease.” More here.

Carbohydrates: We keep learning important new wrinkles 

It was more than 50 years ago that Scandinavian scientists and British marathon great Ron Hill popularized carbohydrate loading for improved endurance performance. You might think that 50 years is long enough to reach the finish-line in our understanding of carb loading. But, no, the opposite seems true. Driven by new tools and the growth of athletes attempting extreme events like Ironman and ultra-distance trail events, we keep learning more. 

In particular: More carb-consumption while running is better, but pay serious attention to your stomach-gut issues.

Here are two deep dives into new carbohydrate-loading approaches. Both come from commercial sources, but ones that are putting a lot of time and emphasis on scientific research. The first from First Endurance explains how Multiple Transportable Carbohydrates (carb mixtures that include fructose) increase the body’s ability to absorb and use more carbs quickly. 

Also, it takes only two weeks of “Gut Training” to improve your stomach’s tolerance for high-carb mixtures--up to 90 grams per hour, or about .6 grams/lb calibrated to your personal weight.

The second article explains why modern carb-loading protocols are much shorter than the week-long system used by runners in the 1970s. Now a couple of days is considered sufficient. Your body responds fast to what you consume, burning more fats or carbs according to recent intake.

One new research report found that the optimal marathon fueling might look like this: several days of carb loading, followed by a modest high-fat meal 4 hours before the race, followed by a carb gel on the start line. This approach seems to promote an optimal burning of both fats and carbs for top marathon performance. More at Supersapiens.

Should you wear super shoes in training?

First came the amazing performances that so many runners have recorded since the widespread adoption of super shoes (carbon fibers + lightweight, springy foams) in the last 5 years. Everyone could see the many fast times at various road-race finish lines.

Now comes the next question: Will super shoes also help you train farther and faster, perhaps with fewer injuries? This excellent article at Neo.Life digs into that debate. Most of the experts interviewed here seem dubious. Their outlook could be summarized as: “Running produces forces, and the forces have to go somewhere. They don’t just disappear in a shoe’s midsole.”

A few are also concerned about the tall stack height of super shoes. The height seems likely to increase instability problems--ankle sprains and the like. And still others note that training more and harder doesn’t seem a recipe to reduce injuries vs training more modestly

But a few are cautiously optimistic. And if you ask Maegan Krifchin how she ran 3 ever-faster marathons in a 4-week period last fall (culminating in a personal best of 2:29:21), she’ll point straight to her Adidas super shoes. “I definitely think they’re helpful,” Krifchin says. “One hundred percent. I think it allows us to bounce back from workouts and races and feel pretty fresh.” More at Outside Online.

Strides can build speed without injury risk

As the general trend in endurance training slides toward more miles of easy running vs too many miles of hard tempo runs and high intensity intervals, coaches and runners have to figure out how to incorporate some degree of speed work. After all, at almost any race distance, you need a certain amount of leg speed.

One possibility: More use of fast, short strides to keep you sharp. Such strides--say 20 seconds modestly fast, 40 seconds decelerating, and then the next stride acceleration-- will get you moving fast without having to hold the pace for too long. This should train the muscle fibers and oxygen delivery to the fibers without adding so much stress/force that you risk injury.

Strides aren’t sprints. Strides are smooth, fast, controlled running. Use the short rests as “a natural governor on pushing too hard,” as recommended by David Roche at Trail Runner.

Cold water immersion aids recovery, doesn’t hinder training adaptations

Post workout cold-water (ice) baths first gained notoriety about 20 years ago when Paula Radcliffe revealed that she was using them as a recovery system. This news spurred a big boost in the process, and we soon saw photos of Meb Keflezighi sitting in the freezing streams of Mammoth Lakes CA after his workouts.

Years later, an opposing position appeared. Some theorized that reducing inflammation with cold-water immersion could also reduce the natural training effect that occurs when muscle cells are damaged and must repair themselves. 

The recently published first meta-analysis and systematic review of cold water immersion (CWI) therapy found it “more effective than active recovery, contrast water therapy and warm-water immersion for most recovery outcomes.” It was significantly less effective, however, than “air cryotherapy,” which requires super-cooling in a chamber. 

Conclusion: “CWI is effective for promoting recovery from acute strenuous exercise in physically active populations compared with other common recovery methods.” More at Sports Medicine.

Two years ago, a similar research review, but more narrowly focused on the question of possible interference to exercise adaptations, also offered reassuring news for runners. CWI has “a deleterious effect on resistance training adaptations but does not appear to affect aerobic exercise performance.” More at Sports Medicine.

What are the big trends and best products for 2023?

With regard to new trends, I’m intrigued like Alex Hutchinson about how Artificial Intelligence will affect personal training. I’ve even asked ChatGPT for a 16-week marathon plan, but it cut out after 12 weeks--not very helpful. I think Michael Joyner made the most insightful comment when he observed that we’re tired of HIT training. “I think we are going to see people challenge themselves to be consistent without feeling like they need to go all-out. There will be more focus on low intensity: Just doing something and building physical activity into your day.” More at Outside Online.

Needless to say, we fitness fans will have a lot of new products to consider this year. My wife and I can’t stop talking about a mini home sauna, and I’m also intrigued by some of the vertical greens-growing devices I’ve seen. Here are 25 fitness product picks from Fortune.

Silly walks aren’t efficient walks, and that’s the point

It was inevitable that a study into “silly walks” as performed by the Monty Python comedy team would attract media attention. And it did. Here’s one example. 

I’m pretty sure the so-called “teabag walk” isn’t going to change anyone’s walking-for-exercise habit even though it increased calorie burn by 250%. The thing is, you could achieve more-or-less the same by walking backwards, or wearing a 50-lb vest, or marching about while pretending you’re in the North Korean Army. And no one’s doing any of those things.

As runners, we try to increase our efficiency--our running economy--by wasting as little energy as possible. Any extra, unnecessary movement increases our oxygen intake. When someone’s trying to lose weight, however, they might aim for the opposite, as inefficient movements burn more calories.

But this approach is almost always short-sighted. The only exercises we continue to do in life are those we find simple and pleasant--a stroll around the block, a run around a park. Monty Python can be both fun and instructive. But you won’t be doing silly walks for long. Original research paper here at the British Medical Journal (free full text).

Twin studies teach us new exercise truths

Studies of identical twins who are raised together but then lead separate adult lives often produce fascinating and impactful results. For example, they can help us understand the influence of epigenetic forces. The twins have the exact same genetic makeup, but they “evolve” in their own lifetimes due to their individual habits like exercise, diet, and so forth.

Here researchers investigated epigenetic differences between identical twins at age 50. They twins were divided according to who exercised 150 minutes per week, and who didn’t. Did the exercise make any difference in genetically-identical individuals? Yes. “An increase in physical activity is correlated with a decrease in metabolic measures such as BMI and waist circumference,” which are related to negative health outcomes. Walkable neighborhoods also made a difference. 

We are what we were born with. We also are what we choose to become. Choice and behavior can make a big difference. More at Nature (free full text).

SHORT STUFF you don’t want to miss

>>> Meta-analysis and systematic review of wearing a mask during exercise = higher perceived exertion, breathlessness, fatigue, and heat sensation “although the overall effect on exercise performance appeared to be small (free full text)

>>> Sometimes good, sometimes bad: In an RCT, Ibuprofen had some bad effects on the gut-intestines, but seemed “to suppress circulating markers of inflammation.”

>>> How many calories do you burn while strength training? About 6 per minute.

GREAT QUOTES make great training partners

“Always bear in mind that your own resolution to succeed is more important than any other.”

--Abraham Lincoln

That’s it for now. Thanks for reading. See you again next week. Amby

December 22, 2022

“Descending ladders” climb to top of workout ladder

The descending ladder interval workout has always made a lot of intuitive sense. You go really hard for a set distance and pace (let’s say 3 laps) that you probably couldn’t repeat a second time. So you cut down your second repeat to 2 laps while maintaining pace. Then you do a 1 lapper. Then half a lap. Always at the same pace.

The result is a strong piece of training at a hard pace. You manage to hold that pace through the entire workout, with each repeat remaining “do-able,” only because each is shorter than the preceding one. 

Now we have impressive physiology data to reinforce the benefits of descending ladders. At Outside Online, Alex Hutchinson describes a paper that compares several different workouts, and explains the power of descending ladders.

Several weeks ago I noted another report favoring long intervals over shorter ones for stimulating your vo2 max. It appears that High Intensity Decreasing Interval Training, or HIDIT, is even better. More at European J of Applied Physiology. 

Simple (but complete) guide to good running form

Several running experts who are also members of the American College of Sports Medicine have teamed up to produce a deeply-referenced review article they call “Healthy running habits for the distance runner.” It’s a running-form article, and not one about diet and sleep and the like. Their work includes a nifty free Infographic that actually looks the way most of us would like to look at mid-stride--relaxed, balanced, good posture, moving smooth.

The accompanying article includes many of the usual tips that are always worth reinforcing: Run with shortish, quickish strides, as quietly as you can, while squeezing your glutes, tightening the tummy, and being careful not to overdo a forward lean. Also, the authors are big fans of taking walk breaks when you feel overly fatigued, as during long runs. They believe that excessive fatigue causes bad running form, which leads to injuries.

I particularly like the simple instructions at the bottom of the Infographic. “When tired during a run: Take a break and walk a minute or two. Breathe and eliminate fatigue. Re-envision good running form, and then re-engage back to running.” Also, “Avoid injury: Do not outrun your endurance on long runs, as this is when form breaks down. Consider periodic breaks along the run, or try intervals.” More at Current Sports Medicine Reports.

The secret of Kenyan running success

It’s no secret that Kenyan runners have dominated world competition for the last 30 years. The “secret,” or at least the unknown, is a clear and compelling explanation. Maybe good genetics plays a role; no one is quite sure. Maybe it’s the altitude and clean air. Or the fact that most Kenyan runners don’t touch a drop of fluids during their weekly 30K long runs. “That’s okay,” says head coach Patrick Sang. “They don’t need it.”

In this wonderful story with fantastic photos, Sang posits that simplicity and community are the key building blocks to strong Kenyan running. At training camp, the athletes follow a routine of “Sleep, eat, train, repeat.” Everyone pitches in with the shopping, cooking, and cleaning--even superstar Eliud Kipchoge. He has just one special perk--a modest private bedroom.

“I think that when you stop leading a simple life, your mind-set loses contact with the outside world and you lose your focus on your actual goals,” says Kipchoge. “At this point, you run the risk of forgetting about the really important things in life.”

The article author adds: “The Rift Valley – Iten and Kaptagat in particular – is like nowhere else on earth. Everybody knows a champion who is friends with another champion, who is the neighbor of another champion.” Magic begets more magic. More at World Athletics.

Welcome to the “Recovery Decade:” Get more sleep

If you or I were to claim that we’re in the “Recovery Decade” of exercise training science, it would be hard for anyone to argue. Sleep is the new intervals. A few examples follow.

Here’s an Infographic that sums up a recent Sleep Loss systematic review and meta analysis. It found that every hour of lost sleep diminished performance by 0.4 percent.

The U.S. Navy considers itself a “ high-reliability organization that must maintain optimum performance under challenging conditions.” To see how things were going, the USN commissioned a major study of the sleep habits of 7617 personnel on 73 different ships. Result: Basically no one was getting more than 7 hours sleep. Worse, “Fatigue-induced occupational functional impairment was directly related to sleep deficiency.” More at Journal of Sleep Research.

Most interesting of all, recent Philadelphia Marathon winner Amber Zimmerman, PhD, is doing post-doc work in “sleep medicine.” Does that make her a believer? Yup, big time. Even though she’s often running long in the pre-dawn hours, Zimmerman aims for 8.5 to 9 hours of sleep a night. There’s another good reason she’s performing better now than ever before, having achieved a 5 minute improvement with her 2:31:35 at Philly. Zimmerman notes that she has slowed her easy-day runs from 7:00 pace to 8:30 pace. More at Fast Women.

“Train your brain” with pre-workout exercises

The effect of brain training and brain fatigue on endurance performance remains an area of great academic interest. Not to mention practical potential. Here, researchers put subjects through several rigorous mental routines before exercise training. Another group did the same training without the prior mental stress.

After five weeks, both groups were tested for endurance performance, which improved twice as much in the mental-routines group (24%) vs the exercise-only group (12%). Conclusion: “Mental training before physical training improves endurance performance greater than physical training alone.” More at European J of Sport Science.

The power of Relative Perceived Exertion

Relative Perceived Exertion (RPE) might be one of the most important concepts in training, coaching, and exercise physiology. But it’s under attack every day because you can’t measure it with a wristband or a pricey digital gizmo. There’s no multi-million dollar marketing campaign trying to convince you of RPE’s benefits because there’s nothing to sell. 

RPE is literally the way you feel--good or bad? energized or fatigued?--and some have become so high-tech that they dismiss anything without a bright, blinking display. They may also become dazed and confused by advice to train and recover according to “how you feel” just as they lack faith in the “drink when you’re thirsty” recommendation.

But what other device can factor in, as RPE does, changes in pace, terrain, distance, altitude, heat, humidity, dehydration, mental fatigue, muscle soreness, glycogen availability, and more? None. And it’s free. 

Using RPE, you can monitor your training so it’s “mostly easy, sometimes hard, and sometimes very hard.” You might also realize it’s smart to adjust any workout that doesn’t feel the way you expect it to feel.

RPE was developed by Swedish physiologist Gunnar Borg from the 1960s onward, and first appeared as a 6 to 20 scale roughly equivalent to low and high heart rates (from 60 to 200, divided by 10). The scale extended from minimal effort to max effort. Borg RPE ratings have also been transposed onto a 1 to 10 scale. 

If you pair your daily exercise with a Borg assessment of how each effort felt, you could move toward an enhanced notion of training intensity, recovery, and adaptation (ie, increased fitness.) The link here includes a free full text history with updated neurophysiology and practical applications. See Int J of Environmental Research & Public Health.

Consider these for your New Year’s resolutions

I’ve reread Steve Magness’s and Brad Stulberg’s “The Growth Equation Manifesto” many times this year, and it only rings more true each time. If you’re looking for a couple of solid resolutions for 2023, start here. I guarantee you’ll find one or more.

It’s hard not to smile over “Avoid foods wrapped in plastic.” The most important might be: “Don’t expect things to feel good all the time.”

You might want to print out the full Manifesto and refer to it often. That’s what I do. The advice is “Simple though not easy,” as Magness and Stulberg would phrase it. But any effort you put into these principles will almost surely be returned many times over. More at The Growth Eq.

Curcurmin gets positive review for exercise and recovery

There are a number of spices and herbs with supposed beneficial effects on running or at least on reducing muscle soreness and inflammation. Cinnamon is a favorite in my home. We enjoy putting it in coffee, on oatmeal and apples, and basically wherever we can.

Curcumin has probably attracted the most attention in sports medicine. It’s the yellow spice in turmeric, which is often used in Indian and Middle Eastern cooking. Here a long review article reaches positive results on curcumin, concluding “Due to the anti-oxidant and anti-inflammatory properties of curcumin, it can increase exercise performance and decrease exercise-induced muscle soreness and muscle damage.” 

Also: curcumin, via its antioxidant properties, may be effective in “reducing cellular oxidative stress, especially in mitochondria over the long term, as well as positively impacting exercise endurance, strength, and recovery to improve overall health.” More at Food Science & Nutrition (free full text).

How to use percussion therapy for muscle pains/injuries

Percussion massage “guns” (horrible name but quite descriptive) seem like the current and future leader for anyone suffering from muscle pains like the familiar DOMS that runners experience after hard workouts and races. These things are new and not extensively researched yet, but you have to admit that a machine can apply forces much faster and perhaps harder (if that’s what you want) than human hands. Also, while they can be expensive, you also have to compare them to the hourly fee of your favorite massage therapist.

Here’s a guide to their use. The author makes an important point--one that you’ve heard a million times about the way you train: Don’t go too fast, too soon. With massage guns, that means start gentle and build up as your muscles adapt to the percussion. More at Stack.

Here are two free “Consumer Reports” evaluations of massage guns from a year ago, but without the actual reviews (which would require a subscription). The first. The second.

Big data reveals that exercise protects against serious Covid

Doctors from the large Kaiser Permanente health insurance group took a retrospective look at more than 190,000 people in their system who had a positive Covid test. They asked these subjects: “How much did you exercise before getting Covid?”

The results showed a clear dose-response association between degree of inactivity vs regular exercise and severity of eventual Covid illness. “Those who were consistently inactive were 191% more likely to be hospitalized and 391% more likely to die than those who were consistently active.” This held true across ethnicities, ages, prior high blood pressure, and other variables. 

The researchers concluded: “The results of this study document substantially higher odds of hospitalization, deterioration events, and death, with lower amounts of self-reported physical activity in a stepwise fashion for adults infected with COVID-19.”

Therefore, “Public health leaders should add physical activity to pandemic control strategies.”

More at American J of Preventive Medicine.

SHORT STUFF you don’t want to miss

>>> Nasal breathing strips helpful to runners but certainty of evidence is “very low.”

>>> DIY myofascial release effective against ITB in cyclist group (free full text)

>>> “Hormonal and metabolic considerations” to guide women’s nutrition across the lifespan (free full text)

GREAT QUOTES make great training partners

“Eventually the hoopla will die down, and people will run the same way we brush our teeth--every day, without a fuss.”

--Jim Fixx

That’s it for now. Thanks for reading. See you in two weeks. Amby