RUNSAFE: "Too Much, Too Soon"

In the British Journal of Sports Medicine March 2020, we discuss the “too much, too soon” theory. 

In running, it is widely accepted that athletes sustain sports injury if they train ‘too much, too soon’. However, not all runners are built the same; some can tolerate more running than others. It is for this reason that prescribing the same training program to all runners to reduce injury risk is not optimal from a coaching perspective. Rather, runners require individualized training plans. 

In acknowledgement of athlete diversity, it is therefore essential that researchers, assisted by runners, coaches and others, ask the right causal research question in studies examining sports injury etiology. In the article, we conclude “In the light of the limitations of population-based prevention that intends to provide all athletes with the same advice, we argue that a stronger emphasis on research questions targeting subgroups of athletes is needed. In doing so, researchers may assist athletes, clinicians and coaches to understand what training advice/program works best, for whom and under what circumstances”. 

In this light, participants in the Garmin-RUNSAFE Running Health Study, are a part of one of the first research studies that, based on a priori defined criteria, seeks to understand what running advice works for certain runners.

Read more about causal questions and the “too much, too soon” theory here:
https://bjsm.bmj.com/content/early/2020/03/05/bjsports-2018-100245 
Note that the publisher owns the copyright for these publications so only the abstracts are available for free.

RUNSAFE: The "Wrong" Shoe?

A new publication from the RUNSAFE group that has surfaced March 2020 in the journal Footwear Science. Here, we highlight that the cause underpinning running-related injury occurrence is the relation between exposure to training load, internal tissue loads, and tissue capacity - with tissue load exceeding its capacity being the key biological mechanism in the development of injury.

On this basis, we examined the beliefs of running shoe salespersons and physiotherapy students regarding the influence of running shoes and foot pronation on running injury occurrence. Unfortunately, both populations hold beliefs that do not align well with current understanding of causes underpinning running injury occurrence. 

In the article, it reads “…the use of the terms “wrong shoes” or “adequate shoes” is likely inaccurate terminology. Viewed from a causal perspective, “wrong shoes” effectively do not exist as you are able to run a shorter or greater distance depending on the choice of running shoe… Despite this evidence, it remains common practice to recommend running shoes based on foot morphology and foot pronation”. If you find the topic appealing, you are able to read the abstract of the article here:

https://www.tandfonline.com/doi/full/10.1080/19424280.2020.1734869

CTS: If It (Or You, For That Matter) Ain't Broke Don't Fix It

(Uninjured) Heel-Strikers, Rejoice! Change to Forefoot Striking Not Necessary, Research Shows
Jason Koop, Head Coach of CTS Ultrarunning/December 17 2019

For far too long, heel strikers have been ridiculed, mocked and laughed at in running communities around the globe. It’s time for that to stop. We’ve heard it all before. The rationales for a forefoot strike go something like this:

“Our Paleolithic ancestors inevitably ran on their forefoot because they didn’t have shoes. They couldn’t heel strike because it’s too painful.”

They also lived to the ripe age of 40 and usually died because they were simply left behind by their hunter and gather pack. So, there’s that.

“We were ‘Born to Run’ on our forefoot, just look at the Tarahumara.”

The Tarahumara are awesome, but do you really want to run with old tires attached with leather straps on your feet...?

(Link to article)

Outside: On Your Left?

Runners, Stick to This Side of the Road
Martin Fritz Huber/Outside, Mar 30 2015

If you keep tabs on aging rockers and their brushes with the law, chances are you read about a recent incident involving David Crosby and an ill-fated roadside runner in California. Crosby was driving about 50 miles per hour in a black Tesla when he slammed the runner from behind. The runner suffered several fractures and lacerations after impact, and needed to be airlifted to a Santa Barbara hospital. Crosby, 73, who was driving the speed limit at the time, maintained that he was blinded by the sun and didn’t see the runner, who is expected to make a full recovery.

It all seems like an unfortunate accident, but there’s a catch: The runner, it appears, was running with traffic, not against it. Though not illegal on a national level, that move goes against common sense...

(Link to article)

Runners' World: These Boots Were Made For...?

Why Runners Might Want to Try Walking in Minimalist Shoes
Alison Goldstein/Runners' World, 21 Dec 2018

As runners, we are encouraged to do a whole load of “prehab” activities: core work, strength sessions, stretching, and foam rolling, among others.

Sometimes, though, life gets in the way. Our other commitments—jobs, family, friends, even other hobbies—can encroach on that time, and we inevitably end up taking the gamble: We skip some of those injury prevention tasks, cross our fingers, and hope for the best as we set out for our runs.

So wouldn’t it be nice if something we already do as part of our daily lives—say, for example, simply walking—could double as an injury prevention tactic?

(Link to Article)

MapMyRun: Core Work For Runners

The Five-Move Core Workout for Runners
Molly Hurford/MapMyRun, March 22, 2017


A stable core can greatly benefit your running. Building stability in your core helps to improve your running posture so you can navigate trails more easily and build muscle along the way — plus, core stability is a huge factor in injury prevention for runners. One review showed core weakness led to “less efficient movements, compensatory movement patterns, strain, overuse and injury."


Core work doesn’t have to mean long hours in the gym, either: the best core work tends to be done with bodyweight, and you can get a full workout in just a few minutes wherever you are. The key to this training is that, unlike crunches, you’ll target your entire body by actively engaging the muscles. You need to focus on strengthening your core from the inside out. In a recent study on muscular balance, core stability and injury prevention for mid-to-long-distance runners, noted that internal work can help keep your core stable.


Check out these simple, easy-to-master moves and add them to your routine...


(Link to Article)

Two-To-Three of Six, Huh?

The Five Worst Habits of Runners
Mackenzie Lobby/MapMyRun blog, July 25 2017


Research suggests that 37–56% of runners end up with an injury each year. If you’re a runner, this statistic probably doesn’t surprise you because you’ve probably been hurt before.
But running and injury don’t have to go hand in hand.
Many sport-specific ailments are avoidable with a careful and calculated training routine. The first rule of thumb: The plan you follow should be tailored to your individual needs as a runner. What works for your running buddy may not work for you.
But beyond picking the right race-prep plan, you can increase your risk for injury if you neglect certain preventative measures. Here are the top-five worst habits the majority of runners are guilty of, and the research-backed reasons you should stop doing these things if you want to run injury-free for months and years to come...
(Link to Article)

Three Is The (Un-)Magic Number

The Three Most Common Running Injuries
Adam Elder/Outside, July 12 2017




Every year, as many as 80 percent of runners get injured. Most suffer from a handful of common injuries. These are not good odds.


But here’s the good news: You can avoid them. In fact, these injuries are often easier to prevent than to cure. For advice, we turned to Dr. Jordan Metzl, a sports medicine physician in New York City who’s run 35 marathons and finished 14 Ironman triathlons.


Here are the three most common running injuries, according to Metzl, and his advice on how to prevent them...


(Link to Article)

Outside: Being Injured...

How to Mentally Recover from an Injury
Brad Stulberg/Outside, May 17, 2017
For an athlete, being injured is often harder psychologically than it is physically. But the elites have developed a few key tools to help stay happy and sane while healing...
(Link to Article)

Outside: How to Comeback

Getting Back into Running, According to the Pros 
Four of the sport's best on what they've learned from taking time off and coming back

Martin Fritz Huber/Outside Online, May 11, 2017

Every athlete knows that comebacks aren’t easy....Regardless of whether you’re returning from an injury or a voluntary hiatus, regaining your previous form can pose a challenge that’s as much mental as it is physical. Your body may be slow to relearn movements that once came with fluid ease, just as your mind wonders why the hell it’s taking so long...

(Link to Article)

Outside: And I Get Grouchy

The Five Things That Happen to Your Body When You Quit Working Out
The good news? They're all pretty simple to reverse—or prevent entirely.
Dan Roe/Outside May 1, 2017

When a planned rest day turns into a rest week or a nagging injury keeps you out of the game for longer than anticipated, you expect a little guilt over dropping your exercise habit. But we consulted the experts to break down what happens when workouts grind to a halt and what they have to say may surprise you. It's okay to take time off, but there are physiological changes that you should be aware of. The good news: while some gains do vanish overnight, most are reversible or don't take much effort to maintain...

(Link to Article)

Training Peaks: Functional Training

Functional Training For The Run
Allie Burdick/Training Peaks, April 28 2017

Running was once thought to only be performed in the sagittal plane (forward motion). However, we now know there is a frontal plane movement due to weight shifting from one side to the other, as well as transverse movement through the torso when your shoulder and opposite hip link up. Since strength and stability through all three planes of motion are clearly present, it makes sense to train them equally. This will help your body endure the stress of weekly workouts, create efficient and strong movement patterns, and lessen any imbalances that may lead to injury...

(Link to Article)

MapMyRun.com: Bum Glutes?

5 Must-Do Glute Exercises for Runners and Cyclists
Shane Barnard/MapMyRun.com/January 15, 2016

Glutes (aka butt, bottom, backside, booty or tush) hold a lot of power, and strengthening them can help you become a better runner, cyclist, walker, jogger, skater, swimmer, dancer, squatter…you get the idea, right? Strong glutes are a win-win for your body because they help take pressure off of your knees and back. When your glutes don’t work properly, other muscles have to compensate to do the work. This can result in discomfort and injuries...

(Link to Article)

MapMyRun: No, Not That Happy

Running Strong Starts With Happy Feet
Molly Hurford/MapMyRun.com 13 Feb 2017

Running is tough on our feet. We train through blackened toenails, blisters and even the dreaded plantar fasciitis. The American Podiatric Medical Association says that each footstrike is between three and four times our bodyweight striking a hard surface. One study looking at competitive collegiate runners showed that each year, 74% of them complained of chronic foot pain or suffered an injury. In the general population, another study found that 50% of the runners surveyed had running-specific injuries annually...

(Link to Article)

Outside Online: Work Hurts Badly Enough

The 5-Minute Warm-Up for Any Sport
Just a few quick moves will set up your body to perform at its best in any sport and keep you injury-free while you work
By: Michael Easter//Mar 20, 2017

We can’t blame you for wanting to skip the fitness foreplay and go straight into your sport, especially when time is limited. But the hurried approach does more than just slow your first few miles or stiffen your reps. When you drop the hammer before your body is ready, at best you’re limiting your performance potential; at worst, you’re putting yourself at much greater risk for injury, according to researchers at the University of Alabama.

Many people skip the warm-up because they assume an effective routine must also be a long one. But science tells us that’s just not the case. The right set of moves can prep and prime your body in just five minutes, says Doug Kechijian, co-founder of Resilient Performance Physical Therapy, in New York City. “An ideal warm-up elevates your heart rate and body temperature, allows you to move better during your activity, and gets your system ready to fire,” he explains.

Kechijian has worked with every type of athlete in the book, from Special Forces soldiers and NBA stars to professional outdoorspeople and amateur gym-goers. He says the majority of people dream up and then abandon complicated warm-ups. In reality, he says, most of us have the same tight areas and benefit from the same drills, so a one-size-fits-all routine is more feasible than you might think. Kechijian pulled the six most-powerful moves from his arsenal and bundled them into your new no-excuses warm-up routine. Move through the set continuously before jumping into your workout.

(Link to Article)

Newswise via Outside Online: Can They Tell Me Where My Training Plan Failed?

Combating Wear and Tear
University of Utah bioengineers detect early signs of damage in connective tissues such as ligaments, tendons and cartilage
22-Mar-2017//University of Utah

By the time someone realizes they damaged a ligament, tendon or cartilage from too much exercise or other types of physical activity, it’s too late. The tissue is stretched and torn and the person is writhing in pain.

But a team of researchers led by University of Utah bioengineering professors Jeffrey Weiss and Michael Yu has discovered that damage to collagen, the main building block of all human tissue, can occur much earlier at a molecular level from too much physical stress, alerting doctors and scientists that a patient is on the path to major tissue damage and pain.

This could be especially helpful for some who want to know earlier if they are developing diseases such as arthritis or for athletes who want to know if repeated stress on their bodies is taking a toll.

“The scientific value of this is high because collagen is everywhere,” Yu says. “When we are talking about this mechanical damage, we’re talking about cartilage and tendons and even heart valves that move all the time. There are so many tissues which involve collagen that can go bad mechanically. This issue is important for understanding many injuries and diseases.”

The team’s research, funded by the National Institutes of Health, was published this week in the latest issue of Nature Communications.

(Link to Full Article)

Active.com:Only Eight Of 'Em, Huh?

8 Ways to Piss Off a Runner
Caitlin Chock/Active.com

Although many runners are high on endorphins thanks to all those miles logged on the roads, trails and tracks, there are a few situations that can turn that happy mood into a sour one. Here are eight sure-fire ways to piss off a runner (details in link...)

Tripping a Runner

Hogging Lane One

Delaying Their Run

Pointing Out When They Can't Run

Delaying Post-Run Food

Provoking the Injured Runner

Calling a Runner The "J" Word

Inflicting the Jeans Debacle

Washington Post:Tightness Can Help Runners!

They say runners need flexibility, but you may be surprised at the latest thinking

BLUF: Dynamic warm-ups, range-of-motion work and strength training may keep you running better and for longer than static yoga poses.

Amanda Loudin, Washington Post, February 25

For years, runners have believed that their sport makes them too tight and that they should turn to yoga to lengthen their muscles, become more flexible and thereby develop into better runners. It turns out, though, that the opposite may be true: Coaches and physical therapists now say that bending like Gumby may, in fact, cause problems.

“When it comes to running, flexibility is overrated,” says Steve Magness, author of “The Science of Running” and cross country coach at the University of Houston. “Research shows that if you are too flexible, you are a less efficient runner.”

As Magness explains it, our muscles and tendons are designed like springs. As our feet hit the ground during a run, those springs release stored energy and propel us forward. If the springs aren’t tight enough, they can’t do their jobs properly.

Some research has touched on this in the past, but the idea that tightness can help runners is getting a new look in this era of yoga popularity. A 2010 study of eight distance runners looked at their overall running economy relative to flexibility.

The participants performed the classic “sit and reach” test before running, and their oxygen uptake was assessed. “We saw that those who were most flexible were the least efficient,” says Tamra Llewellyn, an assistant professor of health and human performance at Nebraska Wesleyan University and a co-author of the study. “Those with lower flexibility had greater elastic energy storage in their muscles and didn’t use as much oxygen.” In other words, their muscles could do more with less, allowing them to get more out of each stride at a lower level of exertion.

Yet the perception persists that more flexibility — even as much as that of a yogi — is better for runners. “It’s a myth we’ll probably fight forever,” Magness says. “We’re all taught from a young age to stretch to improve flexibility and performance.”

Running coach Jason Fitzgerald of Strength Running, a Denver-based coaching service, says he sees this notion everywhere: “People get the idea that runners need the flexibility of gymnasts, and it’s just not true. You do need the right amount of flexibility to go through the range of motion for your sport. But you don’t need advanced yoga moves to get it.” As Fitzgerald explains, running requires only a limited range of motion, all in one plane. Stretching and yoga aim to increase that end range, which is more than necessary for running.

Instead of seeking extreme flexibility, says Gene Shirokobrod, a physical therapist in Maryland, runners should focus on exercises that target abilities that need improvement, such as strength and range of motion. Those attributes are different from flexibility, and they’re more important for runners.

Shirokobrod says “there are broad concepts in running that help ward off injury and improve running efficiency, such as ideal hip extension, glute strength and sufficient ankle mobility,” he explains, “and for some reason, runners often skip this work.”

Range of motion is the ability of joints and muscles to move well and far in a given direction. Runners, for instance, benefit from good hip extension because this is the origin of most of a runner’s power, allowing them to push into and off the ground, Magness says. Hip flexibility, however, is simply how far a muscle can be stretched in a mostly static state. If runners stay injury-free, odds are their range of motion is just fine. “You should be striving for the range of motion that your event requires of you,” Magness says. “As long as you have that, there’s nothing to worry about.”

He encourages runners to swap out more-static yoga-type moves intended to improve flexibility with dynamic movement. A 2015 study showed that a dynamic warm-up enhanced performance in a small group of well-trained middle- and long-distance runners. Dynamic exercises performed in the 10 minutes just before running prime the body to go through the required range of motion.

A dynamic warm-up routine, Fitzgerald says, can include such movements as lunges, high-knee skips, squats and sideways leg swings.

This is how 58-year old Mike Fronsoe, a retired pharmaceutical sales rep from Florida, helps ensure he has the right range of motion. “I use a dynamic routine” of about 20 different exercises, he says. On days when he’s strength training, he adds weights to some of those moves.

Since starting the routine about a year ago, Fronsoe says, he has had his first solid year of injury-free running, which has also helped him increase his mileage.

A small 2006 study of soccer players by Alain Aguilar, a lecturer at the Department of Exercise and Sport Science at the University of North Carolina at Chapel Hill, compared the value of dynamic warm-ups with traditional stretching and with no warm-up at all. The results showed that the group who performed the dynamic warm-up had better range of motion and muscle strength than the other two.

A dynamic warm-up might include a wide variety of movement, but it should always start with something familiar to the body, says Aguilar, whose 2006 study was done for his master’s degree. “It should be low-level movement similar to [what you use in] your specific sport,” he explains. “It could be things like walking lunges, inchworms or leg swings, and progress from there to some short, progressively faster run intervals.”

This dynamic work can be especially important for runners who spend much of their days sitting at desks, where hip flexors, which help hips achieve full range of motion, can become shortened and where glute muscles can grow weaker due to inactivity. “Many rehab exercises like donkey kicks, lunges and fire hydrants work well here,” Fitzgerald says, “because they wake up the muscles by putting them under some tension.”

He says he guides his running clients toward a “sandwich” approach to training. “I encourage them to spend 10 to 15 minutes with a dynamic warm-up, followed by their run and then some sort of cool-down routine. The cool-down post-run is where some light yoga movement can be a nice way to end an easy run.” Here yoga can bridge the gap between fast-paced movement and a return to a sedentary state by providing a light cool-down.

For those still intent on stretching before running, Matthew Sedgley, a primary-care sports medicine physician with MedStar Health, sums it up like this: “Dynamic as your warm-up, static as your cool-down and never ballistic — bouncing — stretching.”

None of this is to say that yoga isn’t good for you, especially for overall health. Its benefits can include lowered stress levels, improved balance and better sleep, in addition to greater flexibility for those who need it. But for a runner, the dynamic warm-up, range-of-motion work and strength training may keep you running better and for longer.