Greenbrier River Trail Marathon Race Recap

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The Greenbrier River Trail is a rail trail, mostly double track, that extends about 77 miles from Cass, WV to North Caldwell, WV along, you guessed it, the Greenbrier River. Much of its length is contained in the Monongahela National Forest. The Greenbrier River Trail Marathon is a USATF-certified race on the River Trail that starts in Cass, WV. The funds raised by this race benefit the maintenance of this lengthy recreational throughway via the non-profit Greenbrier River Trail Association. West Virginia only has a handful of marathons and this one will certainly put many marathons, even national events, to shame when it comes to beautiful surroundings. The course layout should produce times similar to a road race but those ugly and annoying buildings, cars, and streets are replaced with crushed limestone gravel, trees, fly fisherman, and a meandering river.  

But dang, I’m sore. Quaking quads. Cantankerous calves. Hurtin’ hammies. My severe soreness shall, in no way, bias this race recap. See, flat running is a significant departure from my typical racing and training. I love vertical change. Up, down, up, down, wash, rinse, repeat. This marathon has about as little up and down variation as you will find in this region. It drops approximately 300 feet across its entire length. So yes, it’s averaging a downhill grade but there are definitely short sections where it’s flat or will have just a very slight uptick in grade. But I’m accustomed to climbing and descending 300 foot changes in as little as a half mile!

Years of triathlon training and racing have taught me that you can’t underestimate the toll that flat and downhill courses take on your legs. The movement pattern doesn’t vary much the entire time, making it a unique demand compared to rolling or mountainous courses. Floridians would do well here.

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If you have the chance to ride the Cass Scenic Railroad, it’s a great family outing. On the day prior to the race, we rode the train from Cass to Whittaker Station. The leaves weren’t quite at the peak of their color change yet, but it was still very much worth the trip. The lack of running during the taper week made me want to race the train up the mountain as it held a steady distance-run-esque pace.

 Bet your marathon doesn’t have a steam locomotive

Bet your marathon doesn’t have a steam locomotive

After the train ride, I was able to get a preview shakeout run on the Greenbrier River Trail, pick up my packet, and enjoy the pre-race pasta dinner. Cass is a small town so everything is within walking distance.

Race morning it’s still nearly dark when we arrive. The fog, forest, and terrain keep this valley darker a few minutes longer than expected. An off-pitch Cass Railroad whistle echoed through the otherwise silent mountains during my warm up as I climbed Back Mountain Road, giving an almost eerie sense to the foggy surroundings. Cue the banjo.

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Our weather was almost ideal at the 8:00 AM start. A touch of humidity hung in the air and it would likely have been warmer than the mid-60s already if not for the heavy fog blanketing the hills and hollers. We could tell it would eventually become hotter as the day progressed, much as the day prior had done. And it did.

Though I didn’t warm up as much as I wanted, it wasn’t much of an issue since I like to start easy and build on long races. I don’t need a reminder that a marathon will take hours to complete and I have no issue with delaying the onset of suffering a bit.

At the starting line one of the other racers mentioned going for the 2:40s. I was hoping for 2:50s but all of that prediction stuff is guesswork when no one has raced the course before. We line up at the Cass Community Center,and the train whistle signals the start (a nice touch). We make a quick loop through a gravel street in Cass, and then we are onto the Greenbrier River Trail. I trotted along in 4th place as the first three pulled away. Would be a nice day to get top three though.

I wanted to take in my surroundings but tried not to lose focus. It’s difficult to ride the line of observing nature, working hard, and not falling on your face. The Monongahela National Forest is one of my favorite places, so I hate not to admire the views.

Despite the current beautiful weather, it had unfortunately and abnormally rained much of the prior week. The River Trail generally drains well, but being in a winding, tree covered valley, there were places along the path that were just a smidge wet. There was never any nasty, heavy, sticky, tacky mud but there was definitely squishiness in a few places where the trail becomes more grass and dirt than the primarily crushed limestone surface. A couple of the wooden bridge crossings were slick but not dangerous.

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The aid station folks were super supportive. It helps when volunteers give time splits and say things like “you’re looking strong.” I stayed within sight of the second and third runners for several miles but had lost sight of the first runner by mile 5 or 6 because of the curviness of the course. I think it was somewhere around mile 6 when I caught the two guys in front of me in relatively rapid succession. I felt decent and the splits were consistently where I wanted them. The aid station volunteers at mile 10 informed me the time gap to first place was two minutes. Really? After taking off that quickly? That’s not much at that point, depending on how things shake out, but I wondered if that wasn’t a rough estimate and more like four minutes.

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At some point, there was a very long straightaway in the trail that allowed me to see the lead cyclist and the first place runner. Perhaps I’ve made up time? Perhaps the gap really is just a couple minutes? Though they were just little specks on the horizon, it was enough information to keep me excited for the possibility of a better finish.

Many of the miles at this point were flying by, which is good for racing but bad for taking in scenery. My legs would actually do what I wanted. Speed up, slow down, square dance, hokey pokey, it didn’t matter. I occasionally had this feeling that my head was just mounted on a set of legs that were not my own. I’M INSIDE A ROBOT!!!! GUYS, I’M INSIDE OF A ROBOT!!!

As I rounded a sharp rightward curve around mile 15 I suspect my blood glucose was dropping and I broke my brain for a second as I glanced upward to the entrance of a giant space portal that was about to transport me into another dimension. Oh crap, that’s Sharp’s Tunnel. Doofus. Entering the portal, I quickly learned the tunnel is curved so you can’t see the other end and it is amazingly dark. It took a few seconds for my eyes to adjust. Don’t trip, space boy. It was actually very smooth soil. Pretty darn cool feature and certainly the first time I’ve raced through such a long tunnel.

An aid station awaits at the end of the tunnel. A volunteer yelled for me to get a banana and told me something like “you’ve got to catch the next guy.” Fantastic idea. I...chomp...will... chomp...win... chomp...this...chomp...eating...chomp...contest!

 Falling apart at mile 26.15

Falling apart at mile 26.15

More running ensued. (Bet you wouldn’t have guessed that.) By mile 19 I could consistently see first place and could tell I was gaining rapidly. Maybe gradually ease up to him and hit the pace hard? By mile 20 I had drifted up behind Andrew. He knew I was there, probably from my periodic grunting, said he had blown up but was very encouraging to me pushing onward past him. Thank goodness I didn’t have to do a hard surge because those hurt.

Taking the lead becomes a different beast because you are now the chased instead of doing the highly distracting and motivating chasing. I had no idea if there would be someone capable of hitting negative splits in the closing miles. A couple of miles clicked off where I was happy just to see splits under 7:00/mile. I had briefly listened to music for a few miles but now it was just irritating. I gained a new friend in lead cyclist Ray Adams who probably grew tired of my heaving and groaning.

 Race director Kellyn Cassell berating me for not running faster

Race director Kellyn Cassell berating me for not running faster

The final couple miles through Marlinton transitioned to pavement. My legs were reminding me with each step that they were indeed my own painful masses of contractile proteins instead of the Terminator’s as they seemed to want to piston more up and down than swinging forward and backward. I couldn’t get up onto my forefoot for any additional robot power because I could sense both calf muscles were one aberrant neuromuscular synapse away from cramping. Going to need an oil change and 15-point inspection after this.

The street crossings in Marlinton were staffed with more great volunteers. They rhythmically chanted “ROBOT SPACE BOY! ROBOT SPACE BOY!” with astonishing volume. (Not true). I spied with my two tired eyes an iron bridge that I recognized from a video of the finishing section. Must...aggggghhh….be...uggggghhhh...close. And then I see my favorite volunteers ever dancing while dressed in neon orange Japanese kimonos (or simply just waving orange flags) indicating a right turn into Stillwell Park. A glance at my watch tells me all I need to know...start kicking. Inflatable finish line arch, I love you. Wow, I’m glad that’s over.

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Seltzer, post-race snacks, pizza, sandwiches, finisher medals, pint glass age group awards, and custom pottery overall awards occupy our minds afterward. Great event Kellyn! Now, who wants to run back the other direction?

Results:

https://aptiming.com/race/results/624


The local paper wrote a nice article about the race:

https://pocahontastimes.com/first-ever-grt-marathon-a-big-hit/

Lyme disease: It got me and it's coming for you next!

As of 2017, Lyme disease prevalence is on the rise. And in the summer of 2017, thanks to being bitten by a tick infected with the Lyme bacteria (Borrelia burgdorferi), the disease was prevailing in my bloodstream. And organs. And muscles. And a bunch of other places that you don’t want bacteria hanging out. This article reviews the infectious process, diagnosis, and recovery that I experienced just a few short months ago.

First, here’s a couple not-so-fun facts: According to the Centers for Disease Control, Lyme is the most common vectorborne illness in the United States. In 2016, about 300,000 people were diagnosed with Lyme disease in the US and that number is expected to rise.

If you want to be frightened, watch the rapid progression of the reported Lyme cases move westward from the east coast as you click through the annual maps on the CDC website (https://www.cdc.gov/Lyme/stats/). When I wandered the woods for hours as a child, my parents and I didn’t have to worry about Lyme. We rarely even saw ticks. In the early 2000s, there weren’t many reported cases of Lyme disease in this (western PA and northern WV) region. But by 2015, the same region of the map is heavily covered in cases. I always wanted to be a dot on a CDC map!

My clouded confusion begins

I find ticks on myself every year - after mowing, after weed trimming, after running. I’ve always made it a point to pluck them off ASAP. One must have gone under the radar. If my recollection of the earliest symptoms is accurate, there was initially a period of at least 2-3 weeks in late May to early June where my blood pressure wouldn’t regulate very well, especially if I was feeling the least bit stressed. (Perfect timing for having recently started a business!) This was always worse in the morning. Hopefully few of my patients noticed me awkwardly grabbing the furniture and equipment, but I began to feel a need to cling to nearby objects just in case I would start to crash. My blood pressure would fluctuate noticeably even while simply standing still, which means I was becoming lightheaded several times a day (though I never had true syncope (loss of consciousness)). Being a longtime endurance athlete, my heart rate and blood pressure are low anyhow, so I’m accustomed to occasional positional blood pressure fluctuations. But this seemed more annoying because it was multiple times a day and sometimes took longer to return to baseline. This symptom was sometimes intense but sometimes just a hint. It also had less to do with my hydration level like it normally would after a hotter or harder workout. Overall, it was minor compared to the other symptoms that would follow...

 So tiny. So evil. 

So tiny. So evil. 

More infectious

I began to demonstrate significant symptoms of Lyme disease in the middle of June. But, of course, I didn’t know it was Lyme at the time and did not make a connection. That’s because these symptoms, like fatigue, are still not specific to the disease, just consistent with many viral or bacterial infections.

With a new baby around, I was sleeping less. He had a runny nose and recently started daycare so it would be reasonable to expect that I had just picked up an ordinary bug. Plus, I had just come off a harder run training block to prepare for an ultramarathon, so I thought initially that my body was just a tad more susceptible. This is one reason why some athletes will mistake Lyme symptoms for overtraining.

One Sunday evening, I developed a fever. This was accompanied with the worst night sweats I’ve ever experienced. The fever and sweats continued for the next three days, gradually worsening toward evening, which is common to any ongoing infection. The level of fatigue and demotivation was impressive, beyond typical flu levels in intensity and duration. With my 40-mile race looming, my wife gently (forcefully!) nudged me into an ER visit despite gradual daily improvement in the fever because I was also having a new and simultaneous lower abdominal pain (which I eventually realized was a referred pain from my thigh adductor tendons, but that’s another story). No surprise that they told me I had an infection. And elevated creatine kinase levels in my blood tests. Drink lots of water!

I thought I recovered through this initial phase by the following weekend because the fever seemed to have mostly resolved and the night sweats had slacked off. That was the weekend I ran the gorgeous Highlands Sky ultramarathon, albeit at a much slower pace than I would normally because it was obvious I wasn’t at 100% health yet. It seemed strange that I became very sore partway through the run even though I was running easier than I ever normally compete and I had rested much of the week. Then my quadriceps stayed sore at points deeper in the muscles for many more days after running than they typically would. This is unfortunately still very similar to overtraining symptoms.

 running slower in the race let me take a couple of nice photos

running slower in the race let me take a couple of nice photos

Recovery?

After resting for a week, as I always do after a long race, I tried to return to my typical training with some easy running. That went well enough and the muscle soreness had resolved. Then I had a bright idea to take back a couple of Strava KOMs/course records on a local trail (because I hadn’t actually raced hard in the ultra) and I expected that it should be safe to push a little effort.

I really was finally feeling good. Good enough to push. I ran the two hill climb intervals very hard that day and took the Strava segment crowns back. Great. Whoopee. No one cares except for the guy who lost the KOM. But it became apparent after that hard effort that my heart rate was not dropping back to typical levels as rapidly as it typically would.

Cardiovascular consequences

As July began, I noticed my heart rate was still not coming back down to my normal resting levels immediately after running or when waking up in the morning. And I would sometimes feel my heart beating with ridiculous force at rest and while exercising. So I made it a point to avoid pushing the effort, thinking I just wasn’t yet recovered from the combined race, baby stress, business stress, and illness. That was partly correct. Again, I had the same fever and night sweats and fatigue. I stopped running and just started slowly hiking every couple days for only brief periods because I would feel my blood pressure swing wildly with effort.

The heart rate issues would appear to resolve with a day of rest, so I was able to resume running slowly again by the end of the week though it was still abnormally tiring. I’m sure a small part of that was related to our high July heat and humidity, but a 12-minute mile had never felt that hard before.

As each run passed, I caught onto the trend that my normal cardiac function was off drastically enough that my Garmin Fenix 3 repeatedly detected that my “performance condition” was constantly in negative figures. It’s crazy that the watch could detect such a difference with great consistency. This might normally happen for a day or two after a hard effort but not for every run over multiple weeks consecutively.

Another not-so-fun fact: there’s a little something called Lyme pericarditis, which is an inflammation of the pericardial sac that surrounds the heart. And the Lyme bacteria can invade the nerves that supply the heart, leading to issues like atrioventricular block. Suffice it to say, the nerves don’t function normally after that and can contribute to those blood pressure swings.

Respiratory weirdness

It was a strange and alarming experience when I realized that I couldn’t quite take a full deep inspiration or achieve full expiration at rest or with exercise. It felt like my stomach was constantly trying to occupy the space where my lungs must normally reside. A “belly breath” wasn’t happening, which stinks because that’s always been a reliable technique to help me relax or to flush out the sensation of going anaerobic while running. I first noticed this inability to breathe into my stomach during the ultramarathon and was glad to be going easier then because I don’t think I could have eaten and absorbed food in a normal manner otherwise.

Neurologic, muscular, and joint happenings

For weeks I had this ongoing sense of muscle tightness along my thoracic spine and it took very little effort to strain my low back one day with yard work. Much like the earlier run soreness, that strain caused a deep, sore muscle pain that lingered for a couple days longer than I would typically experience.

It was also odd that I would feel a little uncoordinated during my runs. Not-so-fun fact #1358: Along with the nerves of the heart, it’s not unusual that the bacteria invade other parts of the peripheral nervous system and can eventually make their way into the central nervous system, neither of which are going to help coordination. You can even lose your vision.

I felt weak. My attempt at returning to basic strength training in mid-July was rewarded with both wrist joints hurting and even more spine region tightness and pain. On other days my ankle joints took turns aching and at another point one of my knees became painful. It was strange that the various joint pains would come only for part of a single day and then quickly decide to move onto some other place to piss off. They were nothing like an acute pain I might traditionally feel for a day or two after overdoing any form of exercise. That makes me wonder if it wasn’t more of an infectious arthritis, which is also common to Lyme disease. Oh cool. What a not-so-fun fact.

By the middle of July sleep was not counteracting the fatigue. I was taking a nap nearly every day and I usually consider naps a giant waste of time. I don’t even nap with the flu.

Okay, I’ll get it checked out

With my wife’s encouragement, I went to an appointment with a general physician who began to do blood work like checking for low testosterone or thyroid dysfunction. Oh yeah, and they thought it would be good to check for a multitude of sexually transmitted diseases though there weren’t any questions asked on that front. Unfortunately, despite asking about the possibility of Lyme disease, no Lyme tests were performed. The physician didn’t feel it necessary because I had no recollection of a tick being attached to me for a lengthy period or having the classic bullseye rash. (So much for making a potential diagnosis based upon the patient’s subjective reports.)

Now that doesn’t mean I didn’t have a tick attach to me at any point recently, because I most certainly do recall having one attached to me at the end of a recent long run. I promptly removed it. I’m a little skeptical of the CDC reported 36-hour time frames necessary to transmit the bacteria from a tick into the host but perhaps I had an immature tick on my scalp and had no idea it was there. Or perhaps the attached tick regurgitated when I went to remove it.

It was around this time that I noticed the back of my head itching and having a rash for over a week, but maybe that was some kind of psychosomatic thing. Who knows. I don’t care because it stopped.

 How many ticks can you count in this photo waiting to jump onto the passing warm blooded mammal?

How many ticks can you count in this photo waiting to jump onto the passing warm blooded mammal?

It just keeps getting better

To add to the symptom list, I developed a new problem: anxiety. Like take-your-breath away-because-your-chest-is-being-smashed-and-throat-squished anxiety. This was also worse in the morning. It lasted several days with varying intensities. Super favorite not-so-fun fact: It’s apparently not uncommon for people with Lyme disease to develop anxiety. I resisted the physician’s offer for medication because I’m too much of an arrogant “tough guy” and was hopeful we would be treating the real cause soon.

So while waiting on blood test results I began experimenting with a powerful drug. No, not the illicit kind, nothing prescribed, and not the over the counter kind either. I’m talking about the endogenously manufactured endorphin: adrenaline. You gotta try that stuff. This was really more of an experiment of exercise intensity but what I realized is that running hard into zone 5 could mimic the sensation of chest tightness and labored breathing that I might have in a competition but also what anxiety could produce. So I could actually make a run feel sorta “normal,” even though it clearly wasn’t. And the longer I would sustain a hard interval, the longer I would feel the weird blood pressure swings when the run ended. It did seem to reduce the anxiety intensity afterward though. I’m just smart enough to know I couldn’t and shouldn’t do this to myself during every run but it was an interesting observation. Perhaps one that I wouldn’t recommend if you suspect overtraining or Lyme disease. But it’s science!

My reward for seeking care

The physician calls me to let me know one of the blood tests came back with a positive finding. Apparently they think I have syphilis, because of a positive RPR test. The RPR (rapid plasma reagin) test is a non-specific test that looks for antibodies in the blood. This leads to a cascade of events. First off, now I’m a public health hazard so the medical clinic is required to report me to the Pennsylvania Health Department, without contacting me first, mind you. Kind of annoying. Then a health department nurse calls to counsel me on how avoid transmission of my STD. Fortunately, the nurse had time to chat. She understood, with some encouragement, that there’s a handful of other microscopic creatures, besides syphilis, that cause a positive RPR test, one of which is Lyme bacteria. She contacted the medical clinic and suggested that they test me for Lyme. By the way, I had no other syphilis signs or symptoms and my wife just gave birth to a perfectly healthy child less than three months ago. Congenital syphilis causes a huge number of birth defects and death in newborns. And I guess we’ll ignore our simultaneously healthy four year old because I’ve been playing the field for years now?

Increasingly irritated, I went back to the clinic that day, gave more blood and, wouldn’t you know it, the Lyme tests turned up positive a few days later. The CDC encourages testing for Lyme be done in two tiers. If the first tier tests (EIA or ELISA) are positive then a Western blot test should be confirmatory. The first tier tests could also be positive with syphilis.

Die Borrelia burgdorferi, die!

I spoke with the physician on the phone and (being a smartass) told her I’ve had more ticks on me so far this year than total sexual partners in my lifetime so statistically the Lyme disease wins. She prescribed doxycycline two times per day. As much as I hated to take an antibiotic, within a couple days the chronic fatigue began lifting and I felt noticeably better. Having been ill for so long, it was at this point that I realized how I had really been functioning almost as another person inside the same shell. Weird. Then I grew wings and flew away to Mars.

A few weeks later

I had finished up the antibiotic and fortunately none of the Lyme symptoms returned. For a couple weeks I did still have remnants of burns on my hands and fingers from taking doxycyline. For a person that tries to be outside nearly everyday of their life, increased sensitivity to sun exposure is an unfortunate side effect of this antibiotic. Did you catch that not-so-fun fact? Although, it was usually the sun exposure from mowing my yard during a two to three hour span that would lead to the burns. Is that a good reason to skip mowing? I could go run in the shade of the woods and not have issues.

An additional side effect of the medication was that part of my hands and fingers had a very frequent paresthesia (abnormal sensation). This occurred on both hands at all of the dorsal index and middle finger joints as well as the muscular part between the index finger and thumb. Those areas were extremely sensitive to hot water and were frequently reddened, almost as if I had a chemical burn. All of these side effects appeared around two weeks after starting the antibiotic and gradually worsened.

Noooooooo

Soon after I was feeling normal again, I encountered one of the smallest ticks I’ve ever seen. It had attached to my son’s back and I noticed it within an hour of him simply helping his mother in the garden for a few minutes. Even scarier when you know you have Lyme disease and you see your kid being bitten. It’s during this juvenile or nymph stage when ticks start to carry the Lyme bacteria. At about one-third adult size, they are much harder to spot and therefore more capable of infecting us. It’s amazing how quickly a tick can attach, too. In late summer I went for an hour run and by the time I made it back home there was an adult tick already attached to my lower leg.

Here’s a fun fact: Chickens and possums eat ticks. Now I just need an army of chickens and possums to trail run with me.

 There's gotta be a tick in here Somewhere. 

There's gotta be a tick in here Somewhere. 

Remember kids

Lyme disease is a major disruptor of athletic performance and healthy living. It can make you quite miserable and can be mistaken for overtraining and other illnesses. You need to be aware of Lyme’s increasing occurrence and recognize that it may manifest in a number of the body’s structures and cause many different symptoms. It took much perseverance on my part to have the problem appropriately addressed medically. I’m sure the diagnostics have improved, and for that I am thankful because I had a relatively quick diagnosis compared to some people who might go for years feeling awful and ultimately have less chance of proper treatment.

Stay safe out there!

Disclaimer: Several ticks have been harmed since the original writing of this article.

Here’s a nice running-related article on protecting yourself from Lyme disease: http://trailrunnermag.com/training/injuries-and-treatment/dont-get-ticked.html

 

University of Virginia Running Medicine Conference 2018 Takeaways

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Despite the best attempts of March’s winter weather to block travel, I made my way to Charlottesville, VA a few days ago for the Running Medicine conference they have every spring. UVA consistently does a great job of recruiting well known, excellent speakers for this event.

Here was this year’s agenda for the Friday lectures:

  • Knee Osteoarthritis: A Case Approach - Robert Wilder, MD, FACSM and Eric Magrum, DPT, OCS, FAAOMPT

  • Clinical Decision Making for Footwear - Jay Dicharry, MPT, SCS

  • An Update on Hydration Guidelines - David Hryvniak, MD

  • Post-Operative Guidelines: Return to Running after Knee Surgery - Bryan Heiderscheidt, PhD, PT (Keynote)

  • Gait Retraining: Finding the Right Balance - Bryan Heiderscheidt, PhD, PT (Keynote)

  • Regenerative Therapies for Osteoarthritis of the Knee & Hip - Fran O’Connor MD, MPH, FACSM

  • Nutrition: Controversies and Guidelines - Patti Deuster , PhD, MPH, FACSM

And the Saturday labs:

  • Systematic Video Gait Analysis - Bryan Heiderscheidt, PhD, PT

  • Rebuilding the Foot - Jay Dicharry, MPT, SCS

  • Dynamic Pre- and Post-Run Exercise - Anne Dunn, MS, CPT & Jason Dunn, MEd

  • Running Shoes 2018: Where are we now? - Mark Lorenzoni

 Nobody messes with yoda

Nobody messes with yoda

 CPR for foot muscles with Jay Dicharry

CPR for foot muscles with Jay Dicharry

There was so much great information presented, I could write for hours, but let’s just go with a few highlights.

  1. Runners with known symptomatic knee osteoarthritis may benefit from a 3-4 month trial of one of the following: glucosamine/chondroitin, omega-3 fatty acids, fish oil, krill oil, or avocado/soybean unsaponifiables (ASU). There is a not an abundance of research to support each of these interventions but they do appear useful in some cases and have a low risk. It is not advised to start taking all of them simultaneously.

  2. Once again, running does not cause osteoarthritis when performed at reasonable low to moderate mileage and intensity. There may be a potential relationship of higher mileage (>65 miles/week) and high intensities to developing knee OA. Overall though, runners tend to maintain a higher quality of life for more years without limiting knee pain than their non-running counterparts. That’s why running is actually believed to lead to protective cartilage changes, if anything. Let’s crush this myth.

  3. Those darn medially posted motion control and stability running shoes (the ones with the harder inner sole material) can contribute to extra load at the medial (inner) knee joint, which is the side where most people with knee osteoarthritis acquire their degenerative issues. In other words, they probably aren’t going to help existing inner knee pain and may even exacerbate it.

  4. Speaking of medially posted shoes, the location of the post continues to make no sense. The midfoot (navicular bone) drops maximally into pronation after the heel has lifted from the ground. How is the harder material that is no longer touching the ground going to stop this movement? It can’t. It won’t. Time to move on from your poor science, shoe industry. Let me take a moment to remind everyone that pronation is not necessarily an evil problem that even needs corrected with a shoe in the first place. But that’s not what sells shoes now is it? And one more thing, just because the inner foot arch appears to collapse while standing doesn’t mean that it does that same thing while running. Nor does it move any significantly extra amount beyond the amount every other foot type moves.

  5. There are a couple new things coming along in shoe design. You will see a new trend of placing greater densities of foam across the forefoot region of a running shoe while the heel will have a slightly lower density. We need a stable surface to push off. Also, there are now straight lasted cushioned shoe models. The general shape of the shoe is based on the last and can be curved, semi-curved, or straight. Straight lasts were previously found only in the motion control and stability shoes, which, as I just mentioned, tend to further overload the the medial compartment of the knee. That overload is less likely in a cushioned model that doesn’t have the ridiculously hard inner heel material.

  6. Following ACL reconstruction, runners and other athletes are returning to running before they have best function of their quadriceps muscle. These deficits, which are neurological in nature, are lingering for huge amounts of time, easily one year and even two years after surgery. While an athlete may demonstrate full strength of the quadriceps in a muscle test, and even good jumping technique, their ability to rapidly activate the quad muscle remains at a deficit, which leads to running gait changes, abnormal loading of knee joint, and potentially ongoing pain. Typical ACL protocols bring running back at 12 to 16 weeks post-surgery. Is that too early or are we just not appropriately getting the quad back online?

  7. Though they are far from perfected and minimally researched, regenerative medicine methods such as platelet rich plasma injections and stem cell therapies are showing promise in helping athletes recover from long-standing tendon and joint injury. They aren’t going to create a brand new tissue for you but are probably a worthy treatment option to try prior to surgeries like joint replacement. Research will tell us more in the next few years.

  8. Carbohydrate periodization may be beneficial in some runners to enhance fat oxidation and decrease carbohydrate dependence. With this method, which is actually how I personally train, you perform slower runs without any carbohydrate supplementation and maybe even do some of your shorter easy runs in a fasted state. That works great for early morning runs before breakfast. Your faster or harder runs would still have more carbohydrate intake prior and/or during.

  9. There are three running gait factors that consistently show the best relationships to injury in the research: overstriding forward of the body’s center of mass, excessive bounce (vertical oscillation), and excessive compliance (body instability) at mid-stance of the running stride.

  10. The gluteus medius muscle actually generates more force to stabilize the pelvis during mid-stance than the gluteus maximus when running on a flat surface at endurance speeds. Which is why it’s so important to get it functioning appropriately in endurance runners. The gluteus medius is notoriously weak and underactive in endurance athletes and that is reinforced by the repetition of moving in a single direction. You need to learn what it feels like to keep the pelvis level and stable while running and if you can’t do that, please come see me. I always prefer to teach people how to use their hip muscles in standing because the Jane Fonda leg raises lying on your side are typically performed incorrectly, and the leg raises don’t transfer into the actual way we use these muscles.

  11. Any coach or clinician that thinks they are accurately measuring joint angles on a two dimensional video or image is doing their client or patient a disservice. The angle values they are measuring are likely incorrect, especially if they aren’t using body markers.

 group run

group run

16 surefire ways to get and stay injured from running

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Nobody wants to be injured. Let’s review a few ways in the coming days that runners typically hurt themselves and maybe you won’t have to join that club.

  1. Chasing after specific mileages. Yes, for performance gains, you should have objective and defined goals. Certainly those can be related to mileage. But there’s more to healthy and successful running than miles per week. When a runner focuses too heavily on a certain mileage each week it doesn’t take into account many factors: the intensity of those miles, the terrain, the weather, the lack of sleep because you stayed up later than usual on a couple nights, the extra shift you picked up at work, your nutrition, and so on. You must account for all of the various types of stresses you have in order to stay healthy. Don’t be blinded by the numbers. Don’t get greedy. Improvement is a long and gradual process, and there is no equation or sum total of miles that leads to running nirvana. You can’t level up like it’s a video game after collecting mileage coins.

  2. Being unwilling to diverge from your cookie-cutter workout plan. How many times have you heard “listen to your body?” If you are sick or noticing the start of a slight niggle of an injury, don’t try to stubborn your way through while hoping the luck gods take pity on you. Weigh your options. Do you have more to gain or lose by completing three more of the Runner’s World website-prescribed 400 meter repeats on an aching calf? How much fitness would you really gain from that day of junk miles? When you are thrown a curveball it doesn’t mean you can’t get in a workout. It doesn’t mean your race in two weeks is now an impossibility. If you remain willing and ready to modify your plan at any time, it isn’t so traumatic to do so. You can become an exercise ninja, ready and able to adapt at any instant. That might mean cross training. It might mean rescheduling a hard day for a couple days later. It might mean taking a full rest day. It might mean completely ditching the plan you found doing a Google search.

  3. Doing the same thing over and over. Doing the same thing over and over. Doing the same thing over and over. Doing the same thing over and over. Isn’t that annoying? Guess what? Your body thinks it’s pretty annoying when you run the same pace and distances all the time on the same roads and same sidewalks. Is it that uncomfortable to do something different? Unlikely. But that protective part of your brain will tell you it is a problem to deviate. I don’t personally understand this - I hate running the exact same routes and intensities all the time - but I’m a weird trail runner and road runners don’t associate with us weirdos. The pavement pounders seem more reluctant to purposely and drastically switch things up. Yes, there is some good that comes from a consistent training stimulus because the frequent loads actually helps prevent injury. But that’s better off being an AEROBIC effort in most amateur runners, which means you have to run slowly. No, slower than that. (Thank you not-so-accurate online pace calculator for messing this up.) EVEN slower. More like trotting at times. Especially since we have these things called hills. What most runners do is train a bit too hard, too often, so it becomes a different stimulus. They sit just on the edge of discomfort, drifting past a high aerobic effort and into tempo pace, which is ANAEROBIC metabolism. That’s not something you should do for several runs in a week. You’ll get faster doing that, for a little while, but it’s not sustainable and eventually leads to every runner’s fear: a performance plateau. I’m giving you permission to not make every run hurt.

  4. Ignoring overall athleticism and strengthening. I’m going to keep harping on this one until at least the year 2025. If you have no variability in your movement, you are asking for trouble to occur at some point. If you aren’t strength training and doing something to improve and explore the way your body moves as an overall athlete, running itself will not keep you healthy for very long. It might take a few years, but the problems will come. The muscles and nervous system demand frequent challenge, or they gradually begin to lose optimal function. You won’t detect it at first, but it’s no great mystery of physiology that we start to lose strength beyond the age of 30. Running doesn’t keep anyone strong or powerful. (Though it’s certainly better than doing nothing.) Performing strength work even once per week is a potent stimulus if you work hard.

  5. Discounting the role of your routine posture and activities. I bet you thought about sitting up taller when you read the word POSTURE. Our daily lifestyle has more to do with getting injured than most people realize. One of the most common and detrimental issues I see in the clinic is that frequent sitting tightens the hip flexors on the front of the body. This keeps you from using the big gluteus maximus muscles that should produce a ton of force to propel a runner forward. So people begin to use the quads and hip flexors even more, the pendulum of the running stride shifts forward from its ideal location, and the cycle continues. It’s not as simple of a fix as just doing a couple hip strengthening items twice a week. The low back, neck, and thoracic regions are also areas that adapt negatively, thus shifting your body into an overall poor alignment. Mobility is lost. Strength is lost. Overall movement changes and there are eventual consequences.

  6. Using the workout plan of a runner who is of a higher ability level. You know, because if they got better with this plan then surely you will get better and run just like them in a couple months. Nevermind that they have different genetics, better running technique, and 13 more years of running experience. Plus, they have full hip and ankle joint movement and muscle control that you lost 8 years ago thanks to your desk job. Yes, clearly all of the details are all the same. I always wonder how many people try to mimic the workouts of elite endurance athletes when they end up on a website somewhere. Just because the pro marathoner does back-to-back long runs doesn’t mean you should for your first marathon.

  7. Listening to people who have no actual expertise but are ready to use you as their own personal guinea pig and offer plenty of untested advice for your training or injury recovery. I know this is often done in innocence, but that doesn’t make it any less concerning. Perhaps a more advanced athlete invites you to run with them and you decide to follow their workout or are too embarrassed to put forth any effort less than they are performing. The other athlete can mean no harm but may not really analyze the many possible scenarios that will impact your individual health. Them: “This is what my coach had me do.” You: “Oh my god, you have a coach, you must know what you are talking about.” People often do the same thing when they are injured. Them: “When I had plantar fasciitis the personal trainer told me to just do this stretch to my foot every day and not run and then it seemed like it got better in a couple months.” You: “I guess I should do that stretch everyday and not run.” Wait, you are taking secondhand advice about treating an injury from a personal trainer? I hope they have additional credentials!

  8. Not having fun. If it’s not fun, you’ll eventually burn out, which is the ultimate injury. Training variation can keep things fresh and interesting. Strength and plyometric training will help your running, so don’t shy away from it if you enjoy that type of exercise. If you are the competitive road racing type, maybe you need to train for an adventure race, triathlon, mountain bike race, or trail running race. Try Crossfit (but don’t get hurt) or play rec league soccer. Or even leave running altogether for a few months, not that I ever would encourage someone to do such a thing. Sometimes people do appreciate their running more and can actually improve performance and decrease injuries when they have been away from running for awhile. If you aren’t having fun, what is the point? To make yourself routinely miserable? Find something you actually enjoy and keeps you healthy. 

  9. Thinking an injury is gone just because an initial pain has subsided. Your nervous system is super smart. It can decrease the amount certain muscles work when moving and use an alternative strategy if doing so leads to less pain. It can shift the demand to other muscles to still get the movement done with the same total force output. Most people won’t have any awareness of this change in muscle activity. The initial area of injury may never flare up again, but many times when another pain arrives, the real problem isn’t where the newest pain is occurring. For example, low back or gluteus maximus pain leading to an Achilles tendon pain months to years later. This inhibition of muscle activity is clearly not ideal if those muscles were working just fine prior to the initial injury. Traditionally people (clinicians included) mistakenly try to rehab the area of current pain when they ought to be emphasizing something else. Prior injury matters.

  10. Not taking any easy days. Running is supposed to be hard! Running is supposed to hurt! I’m going to do high intensity intervals every time I run! And that’s four days every week right now but I’m going to work my way up to five days! What...the...heck? Why? Can we talk about how much I’m not impressed by Instagram photos of people “crushing it” multiple times each week? I get that there’s a satisfaction in showing off your hard work. But no one with any real longevity in endurance sport trains this way (because it’s unsustainable). Anaerobic efforts, like intervals and tempo work, are super helpful to improve fitness, technique, and speed - but are not necessary for every workout. Easy, slow distance miles just don’t give the sexy social impression that interval work creates. If you want to run for only five, maybe ten years, then go ahead, do crazy intervals for every run. To summarize a phrase from fellow PT Christopher Johnson: runners run at 80% effort 80% of the time which leads to an injury occurrence of up to 80%. Strive to stay in the 20%! Use a heart rate monitor, power meter, or monitor your breathing to truly keep tabs on your intensity. Pace is a poor measure of intensity for many runners but that’s what people rely on because it’s simple.

  11. Not recognizing the importance of recovery time and being proactive in your recovery techniques. Yes, I know you are busy. But do you want to run a handful of years or do you want to run for decades? Each day you should have a goal, and that goal doesn’t always have to be increasing speed, fitness, or strength. Recovery time can be broken into active and passive methods. Easy running days should be active recovery days, meaning they aren’t intended to gain you fitness but they are intended to make you feel loosened up and healthy. It’s still exercise. You should be able to finish an easy aerobic run and say “I could easily do that again.” On the passive side, learn a couple techniques to directly work on your muscle, tendon, and fascial tissues. Get yourself a lacrosse ball and a massage stick and use them at least three times a week on your major leg muscle groups to break up those funky tender and hard spots you have inevitably created in your legs. If you aren’t familiar with any muscle self-treatment techniques, check out “The Roll Model” by Jill Miller or “Becoming a Supple Leopard” by Kelly Starrett for ideas. Recovery time requires planning, just like the workouts. We create the muscle fiber adaptations to training gradually, while you aren’t training, so if you don’t allow enough time for that, when are the adaptations supposed to happen?

  12. Not being proactive about your recovery from an injury. Instead of actually completing what’s required to recover from an injury, some athletes prefer to do nothing. It’s the wait-and-see approach. Our bodies want to heal, so rest typically decreases pain in the short-term. But it doesn’t address the root of the problem for recurring and long-lasting overuse injuries. Unfortunately, this is a common practice among injured athletes, who routinely take a couple days of rest before trying to resume their typical training without any modification. If the pain just started a couple days prior and is getting better quickly because you did your due diligence, that’s one thing. But it’s an entirely different scenario when you’ve had persistent pain for a couple weeks, a month, maybe longer. Clearly rest isn’t the solution at that point. Some people avoid proper treatment because they are afraid of getting worse or delaying what little progress they’ve made if they attempt something new (like seeing a PT, massage therapist, or chiro). Or maybe a negative experience treating a prior injury leads to reluctance in discovering the best ways to treat a current injury. Some are fearful that nothing can be done to help their injury and they would be wasting their time to try other tactics. More often than not, doing nothing doesn’t get you very far. While adequate rest is oftentimes an integral part of the recovery process, it should never be considered the sole means to addressing an injury.

  13. Relying on medications to control symptoms. Medications, whether it be pills or injections, are not a viable long-term solution to a mechanical overuse injury problem. As athletes, when we get injured, we naturally look for the quickest solution that would allow us to return to training without pain. And because you are working hard in training, there’s little energy or time left to devote to active injury recovery techniques. While NSAIDs and corticosteroid injections have their place in orthopedic medicine, they rarely, if ever, provide a long-term relief of symptoms or resolution of an overuse injury. And let’s not forget the well documented side effects that these medications have when used with frequency.

  14. Trying to conform too rigidly to a supposedly ideal running technique. We all move differently. There are certainly some good components to things like Chi Running and the Pose Method but on some level you gotta do you to accomplish the task at hand. We were built for movement variation, so why not take advantage of that? You improve and become efficient at the things you work on most, meaning you will get faster if you work on speed specifically. Or you will gain endurance from emphasizing more long aerobic efforts. But there are also running form changes that come with mixing up your speed. Mindless running at the same pace, in a straight line, and on flat terrain doesn’t exactly encourage you to learn what is efficient for a given demand. Good runners are efficient at a variety of running paces. They know exactly how much effort to put into their movement to achieve a specific result. You don’t want the same muscles producing the same force in the same range of mobility with every practice run. Your nervous system, which is ultimately responsible for how your muscles work, will become efficient at running that one pace only. And if your most efficient form can only be performed at one pace, don’t expect that you will have the movement skills to stay uninjured and efficient if there is as need to run at other speeds (faster or slower). This problem becomes obvious in those who say, “I can run 10:00/mile pace but as soon as I go faster I start having pain at my _________.” Performing 5-10 second long strides/striders during or after a run can be helpful in teaching you how to propel your body forward quickly and efficiently but without the fatigue or technique breakdown that occurs with long intervals. They are especially helpful if you have little to no speedwork experience. And it’s okay to sustain a slower, trotting pace at times too. Also, don’t obsess over how your foot is contacting the ground (heel vs. midfoot vs. forefoot). Current research indicates that the location of where your foot contacts the ground relative to your center of mass matters more. We should be able to use any of those types of foot contacts depending on the situation (uphill, downhill, flat, loose rocks, etc.) The more varied your overall training, the more capable you will be of tolerating technique changes and running with your own best stride.

15. Believing you can rely solely on rest once you have signs of injury. Yes, there are times for rest, but they should be kept brief for tendon and muscle overuse injuries.

Runner: I’ll just rest for a week and that will take care of it.

Me: No, it won’t.

Runner: But rest took care of it when I had this injury a couple years ago.

Me: Did it? Apparently it didn’t or it wouldn’t have happened AGAIN. The real problem was never addressed. This thing has just been biding its time, always remaining a weak link, probably in conjunction with other problems of strength and mobility outside the area where you actually have the pain. The moment you have a training error, like running faster or further, it’s the first thing to break.

Runner: Oh. Well, I’ll just rest until the end of the week and then do my long run on Saturday.

Me: Did you hear anything I just said? *Pounds head on table.*

Our bodies adapt most favorably post-injury with controlled, specific stresses on the injured tissue. The best stress to place on a healing tissue isn’t more running either. If running was the cure then it wouldn’t continue to provoke long-term pain. Running places very high loads, thousands of times on the legs, hips, and torso. This requires a certain amount of muscle strength be in place to perform running safely. Strength that many runners don’t actually have when they start a running program. People too often try to gain fitness running but they don’t have the basic strength-based fitness necessary to run safely in the first place. So while you are resting the pain away, the strength isn’t increasing, is it?

 

16. Not trusting in the process of proper training by becoming impatient. We want it now, at broadband speeds, not dial up! So many runners do all their runs at a high intensity, assuming that strategy is the fastest way to improve. And many newer runners of all ages do find quick success as they make rapid cardiorespiratory gains. But three years into their careers, they start breaking down because the muscles, tendons, joints, and bones just can’t adapt with the rate of improvement the way cardiorespiratory fitness can. People that are hurt frequently aren’t able to train consistently so they stay injured and don’t reach a very high performance level, at least not for very long.

Instead, you should trust the training process and limit high intensity workouts to once or twice a week. You should work hard enough on the hard days to promote gains and then let recovery do its job. The performance gains you should expect from a single hard workout will be very small, if not imperceptible. In reality, much of succeeding is slowly and methodically putting in your time and simply remaining consistent at lower intensities. You have to think long-term. Like at least six months. There are no shortcuts to success.

If you like to run fast, you can do it frequently if you keep the durations VERY short with striders, which are great to perfect and maintain your form as often as every run. Most amateurs could improve their running technique anyway, so this will be time well spent. Then transition that better technique into your longer but less frequent (1-2x/week) intervals and tempo runs.

Some questions to think about:

  • Are your intensities and volumes during hard days and longest runs sustainable across a several month span of time?

  • Can you feel just  about fully recovered from any workout in two days or less?

  • Can you add an extra easy run or cross training day during the week and not feel destroyed after it?

  • Could you have done one more hard interval at that same pace?

  • Could you repeat that entire easy run all over again as soon as you completed it and still feel good?

If you are answering no, you might want to back off your need for crushing it a smidge. You can only go to the well so often in a short period of time. If you want to improve while staying uninjured, over the long haul your goals should be consistently good technique, sustainable and repeatable hard efforts, frequent but brief exposure to fast running, and frequently being active at lower aerobic levels.

 

Calf pain in runners: 9 causes and considerations From footwear to form

One of the most common complaints runners have is calf pain, particularly while running. It might initially come in bouts during just a couple runs, but sometimes it will stick around for weeks and months if left unaddressed. Rest usually improves this discomfort at first, but isn’t typically sufficient for long-term, consistent relief if the person continues to run and doesn’t make any other changes. They’ll complain that their calf muscles feel “tight.” And it’s common for both calf muscle groups to start to feel this way around the same time.

Some runners take the “I give up” approach and assume it’s a necessary part of getting older or running too many miles, so they begin to modify their training around it by planning an additional rest day or cross training instead. They take the “a little running is better than no running” approach, which I think is very reasonable for a true injury, but when something can be improved, why not address it the right way?

For the sake of this article let’s assume we are covering muscle-specific pain in the calf that isn’t too bothersome much outside of running. These are more likely to be muscle overuse syndromes or biomechanical overload syndromes. This cause of pain can be treated while you continue to run, if done correctly.

But there are plenty of other things that can cause calf pain and you will need a medical professional, not an internet article, to rule those out.

Possible (and Potentially Serious) Medical Issues to Rule Out

  • Blood clots/deep vein thrombosis
  • Nerve mobility deficits or irritability of the lumbar, sciatic, and tibial nerves
  • Calf muscle tear/rupture
  • Popliteal artery entrapment

What can you do?

Seek professional medical guidance if you have had a traumatic injury (often accompanied by a sudden “pop” or a feeling of being kicked in the calf). We are also very concerned if there is a more persistent or severe onset of pain, or additional symptoms like sensation changes (pins, needles, tingling, burning), fever, swelling, and redness of the calf. It’s important to consider your overall history because factors such as being older, having a history of a particular problem, recent immobilization, comorbidities, and certain medications can all have a role. These issues are very different than a mild discomfort, tightness, or fatigue that occurs only while running. It isn’t to say that some of these problems can’t be treated conservatively but you will have the best chance at success with proper diagnosis. We need to keep in mind too, if you have attempted treatment that doesn’t seem to be helping.

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Other considerations:

Calf Strength and Endurance Deficits

Logic would tell you that running demands a ton of work from the leg muscles. At some routine level of activity, the muscles adapt to that work and you keep on going from week to week without issues, just as happily as ever. Now what happens if you chronically demand so much from those muscles that they can’t adapt to what you are trying to have them do? They slowly start to...change…like your best friend from junior high school. At first it was cute but two months later you were just annoyed. The muscles don’t have to be painful, at first. Maybe they just feel more tired and tight. But when you keep running on them and don’t make any other changes they become more consistently problematic.

The muscle and fascial connective tissue isn’t able to adapt to your demands in a positive manner when demand outpaces normal repair over a long period of time. Why couldn’t the muscles withstand the demand? Most likely there wasn’t enough strength or endurance (or both) in the muscle group. Given enough time of chronic repetitive stress on under-prepared tissue, the quality of the soft tissue changes.

Running really requires something called “strength endurance” from muscles like the calf. You might even better call it “strength and power endurance,” but I don’t want the top of your head to blow off right now so forget I said that. The point is that the muscles of the calf have to withstand high forces (strength), very rapidly (power), and with high frequency (endurance).

The calf-strength variations that will show up when tested during a single leg calf/heel raise are often interesting. A runner might have tons of gastrocnemius strength during a straight-knee calf raise, but when the calf raise is re-tested while the knee is flexed, they can’t reach the top end of the calf raise anymore. Often this means they have decreased soleus strength, which is a real problem since, while running, we spend a large portion of the running stride with the knee slightly bent. Or maybe they can’t perform the same amount of reps on one side when compared to the other in either position.

Even worse is when the person can’t perform any type of single leg calf raises without relying on their long toe flexing muscles that come from deep in the calf region. My heart hurts when I see this. These people tend to grip with their toes during calf raises and just can’t get their brain to shut those muscles off while completing the raise because the bigger, outer calf muscles are just that weak. It’s not a surprise that people will run with those toe muscles engaged heavily too.

What can you do?

Build the strength of the calf muscles using calf raises, with the knee slightly bent and straight, without gripping with the toes, and with just a single leg at a time. Full ankle range of motion is key. Causing calf muscle fatigue is the goal. That might take five reps or 20. Don’t hammer it to death because you’ll probably become sore for two days. Early strengthening with bodyweight is good but after 2-3 weeks of 3-4x/week, runners should be able to add extra resistance, even beginning with something like 10 pounds. The calf needs to be strong, but...

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Other Strength Deficits

I am stating the obvious here, but it takes more than the calf muscles to propel a runner. Lacking hip or thigh strength could lead to a trickle-down of abnormal demand into the calf muscles. The calf could actually be super strong but just have to endure too much stress every time you go running because something else stinks at its job. End result: too much work being done by the calf muscles that leads to stress-induced discomfort.

What can you do?

Ensure you have full strength of the hip and thigh muscles (eg. gluteus maximus, gluteus medius, hamstrings, quadriceps). Strengthening exercises for these areas is beyond the scope of this article, but the point is you need to look outside the area of symptoms if you want to actually fix the problem. Remember to emphasize single-leg strengthening to ensure symmetry. If you can only do eight single leg bridges on one side and 20 on the other then you’ve got some extra work to do on the weaker side.

Neuromuscular control

Your awareness of and ability to modify the way your body moves at any given instant is a good indicator of overall athleticism. Remember, our muscles only know how to function based on what they are told by the nervous system, particularly the spinal cord. If your nervous system can’t figure out how much force to generate from the various muscles at any one moment then your movement isn’t refined. Picture a gymnast on a balance beam. It doesn’t take much error to result in falling off the beam. They really have to own their movements with precision and certainty. Kinda, sorta knowing where their feet are isn’t going to cut it. Or imagine an infant learning to crawl. They are constantly on the edge of failure until their nervous system figures out the best way to coordinate muscle contractions to keep their body stable. Your calf muscles must contract with correct amounts of other muscle contractions in that leg with every footstrike.

What can you do?

Working on drills to improve your balance and proprioception is key. As previously mentioned, single-leg work is a necessity. And I don’t mean sit on a machine to do knee extensions, calf raises or leg presses one leg at a time. When you use machines, there’s no real demand that requires the nervous system to learn how to stabilize your body. Single leg balance that progresses into single leg deadlifts, single leg squats, single leg hops, single leg box jumps, single leg calf raises, the options are many. The point is to emphasize standing on one leg while you move the rest of your body.

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Foot, Ankle Structure

An individual with a more flexible foot or ankle type that allows an inward collapse of the heel bone or inner foot arch could be placing more demand on their calf. These people are generically labeled as “flat-footed.” Though the more superficial calf muscles are mainly producing force for the forward/backward sagittal plane, there are additional forces that this outer calf and much deeper calf must withstand in the side-to-side or frontal plane. And then we must consider that the deeper calf muscles, like the posterior tibialis, that help to control the side-to-side ankle and foot motion, are also notorious for being part of the cause of pain.

What can you do?

Build the strength of the muscles that assist in stabilizing the ankle and foot that also come from the lower leg, like the peroneus longus, peroneus brevis, anterior tibialis, and posterior tibialis. One way of doing this is with resistance bands. This is also why I love single leg strengthening exercises like single leg Russian deadlifts that also require a person to balance and stabilize like a circus elephant on top a ball. As discussed below, you should perform routine soft-tissue maintenance on all of the calf muscles, superficial and deep.

Maintenance Habits

Here’s a big one. So you run for hours at a time or try to run really fast, essentially beating down the calf muscle fibers and their surrounding fascia and tendons, but then you don’t do anything good for those tissues? Resting is supposed to fix it all? It probably would if you weren’t trying to run most days of the week.

What can you do?

Buy and use a massage stick, foam roller, or lacrosse ball to routinely massage the muscles of the legs. Be sure to emphasize routine soft tissue maintenance for every major muscle group. The technique doesn’t matter as much as just doing something positive regularly for the muscles to keep them more supple and loose. Before the pain rules your life. Once the pain is consistently present, I can use techniques to get it to go away quickly and then you need to take over with a maintenance program.

Calf Muscle Length

In many instances, you can think of calf muscle length as an indicator of something besides true structural muscle fiber, fascia, or tendon length. The chronic abuse of running very often leads your nervous system into thinking a higher level of nerve-dependent activity is needed in the calf when it really isn’t. That keeps the fibers holding a greater tension at all times, which makes the calf muscle appear shorter than it really is structurally. So there’s a big difference between your nervous system telling a muscle to behave as if it is tight and a muscle that truly, structurally is short and tight. Weird, I know.

What can you do?

Calf stretching with the runner’s stretch or dropping your heel off a step is typically what runners choose to do if their calves feel tight. But if you want a change in actual muscle structure and length, be prepared for it to take multiple weeks of frequent and prolonged stretching. Like three 60-second stretches at least three days per week. A deep full squat will more likely max out the ankle joint motion and soleus muscle length while a straight leg heel drop on a step is meant to be a gastrocnemius stretch. But I would rather rely on the other soft tissue techniques mentioned above as maintenance, like self-massage, myofascial release, or dry needling to make the muscles relax, which automatically improves their length in many people. Remember, the goal probably doesn’t need to be improving the muscle fiber lengths, it’s convincing your nervous system to let the darn muscle relax.

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Running Technique

Certain techniques tend to stress certain tissues more over time - that is neither bad nor good. If there were ever a predictable running method to stress the calf muscles, it would be a forefoot initial contact style, particularly if the runner doesn’t allow the heel to reach the ground after making contact. With about 2.5x to 3x your bodyweight coming through the limb while running, there are huge lengthening or eccentric forces coming through the calf tissue when the forefoot touches the ground before any other part of the foot. This could be the case with midfoot striking too. Depending on the runner’s individual style though, midfoot contact can decrease calf stress. Heel striking itself doesn’t necessarily tend to load the calf the same way a forefoot contact might, but rest assured those people have their own set of problems at the knees, thighs, and hips. Overstriding, which commonly accompanies heel striking, can be more stressful though.

What can you do?

By choosing to use a forefoot contact you should know the calf area is at risk for injury and perform your due diligence with the maintenance just mentioned to keep the calf muscles loose, relaxed, and happy! You may not immediately need to modify your technique to a heel or midfoot strike but could do so temporarily to maintain running fitness until the calf muscle status has been improved. Overstriding needs addressed in any instance. This is where we often need to address hip strength and control, hip flexor length, and other possible issues throughout the entire leg.

Paces, Distances, Training Program Design

What type of running have you been doing lately? Fast, slow, mixed speed, uphill, downhill, shorter distance, longer distance? Are these methods what you have always done or has your training changed recently to incorporate more speedwork, racing, or hills?

What can you do?

If you changed your distance, terrain, or speeds, and the changes contributed to the symptoms, temporarily remove or decrease those stressors for a week or two. Uphills and running faster are the most potent instigators of calf pain. Know the threshold of when the pain would begin while running and then try to stay just beneath that point for a couple weeks while the strengthening and other soft tissue treatment take hold. Be sure to have a full recovery day without sports or running that doesn’t stress the calf muscles.

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Footwear

So you thought the zero drop or minimal shoes were great choice? Well, they are, but not if all this other stuff is off and you suddenly change the shoes too. They cause at least a 10% increase in calf load compared to a traditional shoe. Add that onto your already lackluster muscle tissue quality and we have a recipe for trouble. This is also an issue for runners when they switch suddenly from their base training shoes into their racing flats or spikes for competition.

What can you do?

Work your way into minimal or zero drop shoes gradually if you haven’t used them before. Two or three runs per week of 5-10 minutes is plenty in the first month. Run your warm up with them and then switch into your old training shoes. Gradually add faster workouts with spikes and flats into your training instead of just competing in those shoes. Spend more time barefoot at home and be sure to do the maintenance piece mentioned above to get the muscle tone to decrease. Here’s a nice article on transitioning to minimal footwear.


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7 Takeaways from the Healthy Running WV Conference

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Recently, I had the opportunity to attend the Healthy Running WV Conference held in Ranson, WV on November 3rd and 4th. There were about 50 attendees from a variety of backgrounds: running coach, MD, PT, DPM, and general runners. I doubt many of them left without having their preconceptions of training, nutrition, or health challenged. And that’s because the two primary presenters, Drs. Mark Cucuzzella and Phil Maffetone, are well known for challenging the status quo. Although both have a long history in exercise performance, lately they are more interested in public health. And for good reason. I wanted to share just a little taste of the information presented.

  1. Attempting to peak for endurance events can be unnecessary, injury causing, and downright unhealthy. Dr. Maffetone suggested that we may really only need 2-4 weeks of speedwork in the final preparation for a competition, and we can perform quite well with no speedwork at all if the aerobic metabolism has been well trained over time. This is quite a bit shorter than the 6-8 weeks recommended by coaches like Arthur Lydiard.

  2. Runners unnecessarily run too fast most of the time. I tell runners this all the time (some believe me, some don’t), but let’s revisit it. Exercise does not have to be uncomfortable to result in health and fitness gains. Dr. Maffetone recounted working with multiple elite and Olympic level athletes that had measurably deficient levels of aerobic fitness who continued to make significant performance gains when he took away their anaerobic training and ultimately trained them at slower speeds.

  3. Food quality is more important to overall health than a specific caloric intake. For everyone, athlete or not, poor quality carbohydrates do an extremely bad job of creating satiety. So guess what? You eat more of them. I’ve hammered my fair share of Oreos and still didn’t feel satisfied. The carbs lead to a dramatic insulin response that can change in magnitude over time. High-quality proteins and fats do a great job of making us feel full sooner and longer after a meal without the dramatic insulin spike. Unprocessed vegetables can even provide a worthy source of carbohydrate. This is not new information to me or many others, but it’s worth repeating for those that are unaware of how prepackaged food, which emphasizes carbs, have made so many things easier to prepare but far less nutritionally valuable.

  4. There are performance and health benefits to emphasizing greater protein and fat macronutrient intake over carbohydrate. Commonly accepted information encourages 60-70% daily carbohydrate intake for endurance athletes. We could get away with 30-40% or even less. Routinely de-emphasizing carbohydrate reliance in training forces the body to rely more on stored fat, which is pretty awesome if you want to run in a marathon or ultramarathon. Then you won’t require as much additional fueling during these longer events, delaying or ultimately preventing the dreaded bonk. Dr. Cucuzzella, who recently maintains a low carb intake, but has run for decades, has the physiology lab data to prove his increase of peak fat burning efficiency from 1.18 grams/minute to 1.9 grams/minute in just a year. These same kinds of beneficial metabolic changes were suspected many years ago by Dr. Tim Noakes in his famous text “Lore of Running.” I’m anxious to see where the research is on this in another 5-10 years.

  5. Sprinting hard at the end of a long event, like a marathon, is more likely to trigger a cardiac event (heart attack) in someone predisposed to having such a cardiac issue. Don’t know if you are at risk? Talk to your physician about finding out your coronary artery calcium score.

  6. A simple glucometer can be an excellent, affordable self-monitoring tool for detecting carbohydrate intolerance and the early onset of insulin resistance that leads to type 2 diabetes. Cucuzzella and Maffetone suggest that people don’t just wake up one day with type 2 diabetes. The changes occur over time because of poor nutritional quality. By the way, a few years back we called type 2 diabetes “adult onset” to differentiate it from the type 1 diabetes that people can have at birth. Unfortunately, that has become a misnomer because young children have begun to acquire type 2 diabetes as the American diet has emphasized low-quality processed carbohydrates since the 1980s.

  7. Insulin resistance is a common factor to a variety of diseases. There is growing evidence that issues such as cardiovascular disease follow long term metabolic changes associated with a high carbohydrate diet. Older research focused on cholesterol but the tide is shifting.

If you are interested in attending a future Healthy Running Conference, check out www.healthyrunning.org for more information. 

You can read more about each of this particular conference's primary presenters at the following sites:

  • Mark: https://www.drmarksdesk.com
  • Phil: https://www.philmaffetone.com

Rock 'N The Knob 20 Miler Race Report

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It’s fall, my absolute favorite time to run and compete, particularly in trail running events. And much like the road marathon season, there are far more events to choose from this time of year. I can’t seem to stop myself from signing up for runs even when I am initially planning for a non-competitive weekend.

The challenge and scenery drew me back to Claysburg, PA since I initially had the pleasure of attending Rock ‘N The Knob in 2015. Central PA has developed a large and involved trail running community, partly due to their fantastic selection of trails. As a result, great events like this have continued to grow. And a bonus: this is PA’s highest elevation trail running race.

Directed by Allegheny Trailrunners, the event has had a shorter race of 5-6 miles and a longer 20-22 mile event since 2012. The 10K was clearly quite popular this year with nearly 150 finishers. This may be the 2018 site of the USA Track and Field 10K Trail National Championships next year, which would make it even larger. The longer course was my preference this weekend and it ended up with 66 finishers.

The race typically starts a little later in the morning because the top of Blue Knob Ski Resort tends to be enveloped in thick fog during the cool September mornings. This year was an exception - we had a clear, sunny sky. I didn’t even realize how truly awesome the views were until this year. I had even raced the Lost Turkey Trail Marathon here a few weeks prior but that course didn’t go to the absolute top of the mountain like this one. The drive in certainly had fog and cooler temps but by the start of the race, temperatures were already above 70 degrees.

 Photo by Connie Stappello

Photo by Connie Stappello

The long course starts with a short gravel lot section followed by about 1.5 miles of rocky, technical trail. It’s so rocky that I managed to roll my left ankle before even running one mile. Frustrating. It must have been obvious since the runner behind me even asked if I was okay. I needed to be more careful or I was going to have the shortest trail race ever.

 Photo by Connie Strappello

Photo by Connie Strappello

The trail does eventually become less technical, on average, which is great because we really started descending. This portion visited the Lost Turkey Trail and the Crist Ridge Trail. I couldn’t believe how much the trail was covered with leaves in the valleys already. A group of four of us formed at the front, the lead occasionally changing between each runner in the first five or so miles. I eventually made it to the front to eat my fair share of low calorie spiderwebs. Three of us arrived closely smooshed together at the Pavia aid station, around mile 7.

Hitting the first major climb here, the legs were feeling good and reliable. That can be a deceptive thing when you have been going downhill for a couple miles, though. I recalled this area as part of a loop from 2015 where I somehow sprinted past a subterranean bee’s nest without being stung while the midpack runners heading up the hill were clearly not so happy. This year I’m carrying an Epi-Pen and Benadryl in case I’m not as fortunate.

Most of this first big climb was runnable, and Lee Strappello and I remained close as we neared the top and were forced to hike on increasingly loose and steep rockiness. Lee had been great to talk to for a few miles but after one hour of running together, I guess the time had come to split up. (AKA, I started feeling anxious.) His mother was taking tons of photos of us, a couple of which I’ve posted here.

 Photo by Connie Strappello

Photo by Connie Strappello

The trails become a little more overgrown and technical in the next section, around 10-11 miles. Unfortunately, I started to feel my calf muscles tighten during the steeper hiking of the 500-foot long Chappell climb. I knew I was taking a chance by racing for the third weekend in a row, especially since my calf muscles were more sore than normal after last weekend. Ultimately I wasn’t expecting to have full recovery and a peak performance but the trails here are so challenging, fun, and unique that I took the chance to race anyway.

Upper Ridge Trail was a quick reprieve from the technical parts and heavy climbing. The next tough, yet fun, area occurred around mile 12 at Deep Hallow Notch. Here the trail suddenly climbs the steep mountainside to the left, often using mossy, sandstone rock steps. It’s a climb of about 0.3 miles, far shorter than the upcoming Beaverdam Hollow climb so the threat level is lower. Knowing my calves were already tiring out, I kept trying to make it a point to take a slightly longer hiking step to make the quads take a bigger share of the load. Better in theory than practice.

Arriving at the Raven’s Rest aid station around mile 13 I downed half a water bottle, a few small cups of pickle juice, a gel, gummy worms, and a cookie. Let’s hope all that stays down. I recognized this station from 2015 so I knew there was about to be a really cool, technical section of singletrack up Mountain View Trail but then one of the tougher climbs I’ve ever encountered would begin. But that’s really why I came in the first place.

The Beaverdam Canyon climb crushed me in 2015 because I knew nothing about its difficulty. Even though two years had passed, I knew this time that it was painfully long and basically unrunnable. Over one mile of 99% power hiking at 14:00/mile. This is the part of the course that nearly every long-course runner won’t forget and I’ve not raced anything else comparable around this region.

And so the Battle at Beaverdam begins with repetitious crisscrossing of a half dry stream, switchbacks, and dozens of mossy rock steps. Midway up I see a soldier groundhog climb a few feet up a tree in front of me. I wondered if groundhogs and beavers were genetically similar. It leaps back down into the trail, surely plotting its line of best attack. But then it decides to climb back onto the tree and maneuver to the backside of it, much as a sneaky squirrel would. Clearly a confusion tactic, rodent. As I finally step beside the tree, the groundhog is clinging right at my head level, a couple feet away, staring with its beady eyes, blood dripping from its mouth. Okay, so there was no blood but I had visions of it leaping onto my face in a rabid fit of rage. Thankfully it stayed put.

More light becomes apparent through the trees and soon enough I can kinda, sorta run, here and there, at least. Even though the major climbing is done, the course rolls through the woods on the Lookout Loop to the next aid station around mile 18 where they tell me I had a six-minute lead at the prior aid station. I lean on the table and prophylactically down more pickle juice. So close to the finish yet still so far when my muscles are not agreeing with my brain about their assigned task.

I’m greeted with a bit more climbing up a brushy power line and then a huge descent begins down the ski slopes. That was a nice change until I came to the part that had a sign that said something like, “Are you an expert?” Here the slope really narrows amongst the trees and becomes ridiculously steep. This would be sketchy to walk on fresh legs. I seriously can’t comprehend people safely skiing that stuff. Despite having my shoes pretty snug at the start, my big toes and forefeet are noticeably unhappy hotspots while trying to limit speed.

 Photo by connie strappello

Photo by connie strappello

Cutting on into the woods again, it wasn’t long before I arrive at the next gut punch: a scramble climb known as “I Need A Sherpa.” A tow rope would have been sufficient. Because I had been descending for a handful of minutes, the moment I started to climb this entirely unrunnable section, both calf muscles and my left inner thigh locked into a cramp. Oh no. No. No.

There was a moment of doubt as to whether I could actually get my legs to work well enough to get up that hill. I began to move as if I was wearing downhill skis and trying to go uphill, rocking side-to-side. Maybe more like a gingerbread man would walk. The loose, flat rocks slip and slide underfoot, making traction unpredictable. Fortunately, the hill was covered in enough small birch saplings that I could use my upper body for assistance. There was a single random glove stuck in one of the saplings. Yes, please, give me a hand.

Cresting onto a service road, I started seeing folks from the 10K just down the hill. They were a nice distraction. Then up another less intense climb and then there’s another where two spectators at the top asked, “What do you want to hear? Pop? Rock?” My initial thought was that they must have a boombox or instruments. I yell, “Rock!” They immediately begin serenading me with their accapella version of Crazy Train. It was unfortunate for them that I had no money to leave a tip. Thanks fellas.

The course flattens and both calf muscles retaliate once more, making my ankles useless. For some reason I’m now running like a cowboy that just jumped off a horse. Dory from Finding Nemo enters my mind. “Just keep swimming, just keep swimming.” Because the calf cramps were from fatigue-related muscle failure, no amount of pickle juice was going to stop them but I’m certainly glad it didn’t start any sooner. The cramping gradually eased again with each step and I’m sure my grunting helped bring it under control. The 10K folks were encouraging me onward.

The course nears its finish as I pop out onto a road with spectators claiming the finish is just up the paved road. I guessed it shouldn’t be more than a mile with this many people around. And it wasn’t too many more steps before I saw that lovely timing clock and kicked a tiny bit.

Good enough for first place in 3:12:44 and an REI folding camp chair. Race director Ben Mazur greeted me with a cool medal/bottle opener. The local beer distributor was stationed a mere 12 feet from the finish line, making that Goose Island IPA a very reasonable distance away.

Being an odd distance under an ultramarathon or a marathon, I wasn’t quite sure of whether I should wear my hydration vest, carry a bottle, or just take water at the aid stations. In 2015, I didn’t carry anything but gels. But it was a heckofalot cooler then. By the end of this day, I drained a 50-ounce hydration bladder and was glad I went with that choice. And I still drank more water at several of the aid stations. It was hot and humid.

I was impressed by the number of 10K finishers hanging out at the finish line to cheer on the long course finishers. And maybe it was the beer but they were super nice and encouraging too. Fun day out there!

Nutrition:

  • 3 Gu gels
  • 4 Gu chews
  • 2 bananas
  • 10 oz. or more pickle juice
  • 1 cookie
  • 2 gummy worms

Strava: https://www.strava.com/activities/1187257503/overview

Results: http://ultrasignup.com/results_event.aspx?did=47941

 

Iron Mountain 50 Miler Race Report

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Absolutely the best race that $25 can buy. 

Damascus, a small town in southwestern Virginia, has been the host of the Iron Mountain 50 Miler for several years now. As trail running has become more popular, the event grows, and the level of racing becomes progressively more competitive. The event’s popularity isn’t likely to stop anytime soon.

The 50 mile start is at 7:00 AM so you can actually sleep in compared to many ultramarathons that would start at 5:00 or 6:00. We stayed just 15 minutes away in Abingdon, VA and arrived just after 6:00. Damascus itself is filled with a ton of bed and breakfast establishments, which might be more appealing if you were staying more than one night. For me, the $89 Quality Inn was sufficient for 10 hours of use.

 A Unique setup for the toilet paper dispenser

A Unique setup for the toilet paper dispenser

Parking was stress free right at the start/finish area for the 50 milers arriving early but I’m not sure if the 30 and 16 mile racers feel quite the same ease when that reaches max capacity. There is nearby overflow parking for entrants to use, regardless. Packet pickup goes off without a hitch. The shirts looked pretty cool though I didn’t buy one (because I’ve been informed via an unnamed source that I have about 30 too many).

With hurricane Harvey pushing moisture up the interior of the US, the chance of precipitation heading into Labor Day weekend was going to be high. So it wasn’t a surprise that it rained at the start of the race, then intermittently rained throughout the first half, and then progressed into a persistent heavy rain by the final two hours. Very reminiscent of the trail marathon I did a few weeks ago. I’m getting really good at ignoring rain. Historically, the race is more hot and humid.

 Prepare for launch

Prepare for launch

We start the race exactly on time - a testament to the consistent management of the event for several years now. The cloud cover makes it darker than typical for this time. The start for all distances is a five-mile stretch of crushed gravel rail trail known as the Virginia Creeper Trail. Damascus is a unique intersection of the Iron Mountain Trail, Creeper Trail, and Appalachian Trail. The Iron Mountain Trail was a part of the AT until the AT was relocated in the 1970’s.

Pretty quickly I felt like I was running too fast, my heart rate already in zone 5. Ummm….just 49 miles to go people. Can we at least keep it over 8:00/mile? I’d seen the prior results of my fellow competitors and had no intentions of vying for a win on this day as I watched three guys gradually drift away.

A couple more runners passed me as I tried to slow slightly and get my heart rate into zone 4. I struck up a conversation with a runner from NC who told me she was moving fast while she could. Long climbs and technical sections apparently weren’t her strong suit. If I recall correctly, she said she had competed there a total of seven times among the various distances. The conversation helped those early miles pass more quickly, but that section will still occupy your mind with its rhododendron and numerous bridge crossings over Laurel Creek or Whitetop Laurel Creek.

Leaving the rail trail and entering the real trails, I started the first climb in 7th place overall. I couldn’t believe how dark it seemed. The trees and undergrowth were so thick that a headlamp would have been useful for a couple hundred yards. That climb is particularly steep, but often wide, and occasionally rocky singletrack in its first mile. The course continues to ascend on more packed and smooth singletrack trails until close to mile 7. Then there’s still plenty of climbing to be had all the way to mile 20.

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My left foot had been nagging me a little during the past week, so I broke down and dry needled it the day prior. I felt it kick in a couple times from mile 9-13, while traversing the ridgeline along the Iron Mountain Trail. The pain just intense enough and lengthy enough to scare me. Fortunately, it ended up stopping. I’m not sure it would have stopped had I not sucked it up and done the dry needling.

After the 16 mile aid station, the 50-mile course crosses Whitetop Road and becomes gravel road that eventually gives way to grassy forest service road. Good. I particularly love running gravel road. Despite another four miles of climbing, this six-mile section goes by fast, partly because it also contains a quick, mountainous descent surrounded by a bit of fog as it tops our second highest point. I caught one runner on the descent, almost too easily, which makes me think I need to slow down. I was actually having more fun following him because it made me feel like I was moving faster.

A long gravel descent on Hurricane Road follows the aid station at mile 22 but I am finally met again with true trails a couple miles later that force a little more climbing out of my legs. Around mile 25 you should return to gravel road but I mistakenly crossed that road and followed a trail that was not on the course for just a couple hundred yards. I suspected that it was incorrect whenever the trail narrowed and I acquired several spider webs on my face. I would not have been the first person to come through if this was the course.

After coming back up the hill to the intersection where I lost the course, I am greeted by a long descent with tons of switchbacks. There are a few rollers but it finally arrives to an aid station at mile 29 where they tell me the climbing begins. Three miles to the next aid station, the volunteers say as they are refilling my hydration pack. By this point I’m annoyed with both gravel roads and descending and say, “Good, I’m tired of going downhill” in between mouthfuls of pizza. They confirm that I’m in fourth place. Not bad. Maybe number three will crack a bit?

Well, after 2.5 miles of that climb to the next aid station, I was the one starting to crack, struggling on the upper half-mile because it’s stinking steep. Everything looks and feels steeper when you are tired at mile 31. Additionally, that section of trail is used by horses and has more mud, ruts, and poo than the rest of the course.

Eventually, painfully, stubbornly I reach that next aid station at Hurricane Gap. This is the same aid station as mile 22 and completes this lollipop loop of the course for mile 32. Beef jerky looks to be the most appealing item. The climb had left me pretty drained. Leaving there I thought that I’d completed the main climb. Boy, that was COMPLETELY wrong. I guess the previous volunteers said three miles to the aid, not to the top of the climb.

I pop out onto a gravel road that seemed to climb for the next half hour. I was beyond halfway up but couldn’t seem to regain the running legs. Unfortunately, I’m not sure of the exact time spent continuing the climb because my GPS data was all jacked up after the fact, but I do know there were a whole heck of a lot of switchback turns up the rest of that mountainside, each one resembling the one prior. My love of gravel roads left a few miles ago. It was the mental low point of the day. I had to count steps or pick targets in order to run even brief periods.

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Finally! I summit the highest point of the course around 4200 feet and drop back onto the Iron Mountain Trail from the gravel. At this point the rain is heavier and I’m becoming cold but at least I can run at a decent clip on the singletrack. I start to put on my jacket but just as I’m ready to slip into the sleeve, the jacket is mysteriously ripped from my hands and disappears behind me as it’s grabbed by the surrounding thorny brush. My coordination is apparently declining.

I’ve never been so happy to get back onto singletrack, which tends to be the emphasis until you get back to Damascus. The major climbing was over. Just 15 miles or so to go. Now, the wet weather was adding a whole extra element of challenge as parts of the trail gradually became a streambed. But it was awesome. The ridge was already surrounded by fog and most areas remained very runnable. It is at this point that I seem to become robotic and is the point of running that I find to be a little addictive. I’ve entered “the zone.” Sure, the legs are a little uncomfortable but the descending on a rhododendron covered, tunnel-like trail feels like that warp speed they use in Star Wars as the periphery becomes a blur.

The next aid station is mile 37, Skulls Gap. I never did get to ask anyone about that peculiar and creepy name. In my haze I asked the volunteers if this was mile 38. A volunteer says “No, 37.” I said, “It’s okay if you just lie to me at this point.” The volunteer says something like, “In that case, you have 7 miles to the next aid.” Hey.... wait a minute! That’s not fair. My brain doesn’t work.

My wife surprised me at the mile 43 aid station, which was also mile 9. The volunteers tell her after I leave that they were worried about me because I apparently looked a little disoriented. What is orientation, really? There’s up, down, left, right. Good enough. But really I just wanted to be running again. It’s not weather I like to stand around in and I just wanted to finish up. At that point you’ve already proven to yourself that the major task could be done so let’s just hammer it home.

Around mile 46 the course splits back apart, so it was “new to me” trail once more. Here, I am running on motivation more than calories. My ignorance led me to believe it’s pure descending to the finish but actually I’ve encountered a challenging climb of maybe two-thirds of a mile. I surprised myself and ran nearly all of it. This is not the time to lose a placing because it would be a huge ego killer. It’s not looking good for seeing third place but I am catching a lot more 30-miler folks who were always encouraging me onward.

The final descent begins. It’s rumored to be unliked and technical. It actually wasn’t as technical as I was picturing but I did manage to briefly roll my left ankle once on those loose rocks. That portion went on forever, became quite dark, and then suddenly spit me out onto a paved street in Damascus. Gotta be close now though I don’t know where I specifically have to go.

This last section is the only real paved road running in the entire circuit. Arriving at the next main road intersection I had to stop to wait on vehicle traffic. My legs were so weird and wobbly at that point that I began to lose my balance, having to take a big step to the right in order to not fall down. Whoopsie. Good thing I don’t need need to pass a sobriety test.

Back onto the Creeper Trail, over a final bridge, and there’s the finish line at Damascus Town Park. I actually had enough energy to kick hard and felt good. Though I had wanted to come in under eight hours, I’ll take the 8:05:58 without complaint. I know where I lost the time and perhaps I’ll get another jab at this race one day.

 I literally became a mountain goat on the climb

I literally became a mountain goat on the climb

I’m positive there were burgers and hotdogs and other snacks awaiting my arrival but my memory was a smidge fuzzy right then. I do know I ate something. And my wife was kind enough to find my favorite recovery drink at the local grocery: chocolate milk. Every finisher received a nice package of freshly baked cookies.

Such a great, adventurous course and memorable day! Thanks to everyone volunteering many hours of their time to help us challenge ourselves!

Results: https://sites.google.com/site/ironmountaintrailrun/results-race/2017-results

Big ol’ nutrition list:

  • 4 Gu gels
  • 1 Carb-Boom gel
  • 3 bananas
  • 2 Oreo cookies
  • 3 vanilla wafer cookies
  • 1 mini Snickers bar
  • 6 Clif Shot Bloks chews
  • 8 oz. Coca-Cola
  • 16 oz. ginger ale
  • 2 small handfuls gummy bears
  • 2 small handfuls M & M’s
  • 2 small handfuls beef jerky
  • 2 oz. pickle juice
  • 4 dill pickle spears
  • 2 small cooked potatoes
  • ½ peanut butter and jelly sandwich
  • 1½ large handfuls of grapes
  • ½ slice of cheese pizza

New River Gorgeous Trail Half Marathon Race Report

If you wanted to run perfect trail conditions, the ACE Adventure Center outside Oak Hill, WV was the place to be this weekend. It was plenty sunny, hot, and humid, so there was no shortage of sweat dripping from the brim of my hat and a higher than average forecast for nipple chaffage, but that’s what you expect for August, isn't it?

When I had last attended this event two years ago, packet pickup took a very long time and as a result, the race start was delayed. Things were much improved this year. My packet pick up was completed in about 10% of the time it took me in 2015, which was a ton less stressful.

Despite driving nearly 3 hours, it was easy to make the trip to Oak Hill on race morning because the race didn’t start until 10:00. I know this bothers some runners, but I think it’s favorable if you like the additional challenge of running in the heat or maybe have an upcoming event approaching that will be in the heat. As we started, the temperature was around 70 degrees. Most of the course is tree shaded so the temperature in the woods likely stayed under 80 degrees for another hour or two.

 How many people are touching their watches and why is everyone afraid of the timing mat? Photo by Appalachian Timing Group

How many people are touching their watches and why is everyone afraid of the timing mat? Photo by Appalachian Timing Group

Charleston runner Clay Evans started out hard from the gun. And then I realized I hadn’t started my music. Fortunately we started on a short stretch of gravel road before entering singletrack so there was a moment to get those favorite jams going. I train with music about 25% of the time but in short competitive events such as this, I thrive on incremental doses of upbeat and occasionally vulgar rap and alternative rock. Music is a legal ergogenic aid. Just use only one headphone so you can hear folks coming, okay?

Clay and I separated from the other runners quickly, switching the lead back and forth from time to time. Then he told me he was running the other simultaneous event - the 8.5-mile run. I briefly considered letting him drift away from me as we headed uphill but figured any amount of hanging at the quicker pace could help me get closer to my goal of breaking 1:30:00 in the half marathon. As we neared mile 2, still climbing, he began pulling away from me at a pace I wasn’t willing to attempt, regardless of event. I wasn’t expecting to be just a couple beats away from my maximum heart rate. Sure hope he wasn’t kidding about being in the other race. Seemed like a good time to take in a glimpse of this view:

 photo by Anne Foreman

photo by Anne Foreman

After hitting the high point of that first and longest climb, I started recovering a bit and gradually came back up to Clay and coasted on by him. I could tell it was going to be a good day by the brief amount of time it took to recover from that hard effort and by the impressive number of birds cheering for me.

The best course description here would be “rolling.” It was actually really fun to hit some of the rollers out there, which reminded me of a rollercoaster on several occasions. Gain enough speed on the downhills and you can coast part of the way up the next climb before it feels too effortful.

 Photo by Anne Foreman

Photo by Anne Foreman

Most of the course is double track the width of an ATV (or four-wheeler, if you prefer). Some of it is wider forest road double track. There’s probably just a couple total miles of singletrack. For the most part it is non-technical as there aren’t many roots or rocks. Some sections are wide mown grassy paths. Overall this makes it a road runner’s trail race. Many of the trails would be a good introduction to trail running.

Much of the time I was paranoid of rolling my left ankle to the point of spraining as I had done in 2015. With the trails typically maintaining a clockwise direction around the mountain, there is a frequent camber to the trail that keeps your left side on the lower side of the hill. I remembered the exact point where I rolled it previously so I did what any sane person would do at that section: I slowed down.

The footing on the trail was typically firm and predictable as it hadn’t rained recently. The course circumnavigates the mountain top, never descending or climbing for long periods, so I’m sure that helps keep them dry as well. Trail maintenance had cleared out a couple of recently fallen trees. But somehow they didn’t clear out the snakes. I’m not asking much, am I?

 Much of the course is wider trail

Much of the course is wider trail

After topping the highest point on the course, and passing heavy equipment that you don't normally see on a trail run, there’s a fast grassy forest road descent. Nearly to the bottom, I caught a glimpse of a shiny black tubular creature in the grass and reflexively jumped away like an Appalachian kangaroo. I heard the snake jerk, probably because I scared it as much as it scared me but I didn’t bother stopping to ask it. I doubt it would have suddenly struck at a kangaroo because they can't eat kangaroos. I told the next aid station worker about it but I don’t think she was impressed.

The left hip flexors tightened a bit by mile 8, the climbs hurt more, and my general form deteriorated as the thigh muscles became heavier. I thought the course was a little short based on my old GPS data so I tried to remind myself that it was really only 20 more minutes of pushing. Rounding is always a useful tactic for time and distance mid-competition. It’s a great way to lie to yourself about the distance remaining because you’ll forget about it in 30 seconds anyway. And there is a ton of descending in the final 1/3 of the race so I just needed to quit whining. Although you don’t want to underestimate the final climb to the finish.

Bombing the final grassy section of double track descent I spied yet another shiny black tubular creature less than a squirrel’s length from my feet. Is there a reptile convention here this weekend? Where can I get my tickets? This one was stretched across the major width of Erskine Trail. There was no option to change direction at that very moment because: 1.) there was a giant drop off to the left, 2.) a steep embankment to the right, and 3.) my pace was roughly 6:30/mile. Good thing the kangaroo legs were warmed up by the earlier snake. Definitely the first time I knowingly jumped over a fully outstretched snake! It’s really okay if I make it another 23 years of running before that happens again.

I became a little panicked near the finish as I popped out onto the final road climb because I thought the next course marking I was to follow pointed toward some newly built trails on the opposite side of the road. I lost time wandering around in the woods there for over a minute while trying to find the next marking only to realize the course really did just climb up the road, just as it did in 2015. Wah wah wah. No race ever goes perfectly but I was bummed to not achieve my goal of breaking 1:30, coming in at 1:31:11.

Apologies to the young woman finishing her 8.5 miler that didn’t see me sprinting to the finish line and probably had her life flash before her eyes as I grabbed her to keep us both from going down in a burning heap of human shrapnel.

IMG_7475.JPG

Course summary: Minimal climbing (average 100 feet/mile, 1300 feet total), generally non-technical with occasional loose rocky sections but no rooty sections, slight but frequent off-camber, minimal singletrack at approximately 1.5 miles total, no more than a couple hundred yards of pavement, minimal muddy sections and no crazy swampy sections, primarily wide and maintained ATV width trail, about 0.5 mile of gravel road, no drop-offs, 100% runnable, generally well marked, fun course overall

Results: https://www.aptiming.com/race/results/543

 

Lost Turkey Trail Marathon Race Report: Lunging to Victory

Somehow I managed to enter an event before the largest rain soaking of Summer 2017. There’s crazy flooding all over this region and I thought it was a great idea to drive 140 miles in the pouring rain and sleep in my truck in the pouring rain and then do a long trail running race in the pouring rain. Needless to say, the drive that should have taken 2.5 hours was almost 3.5 hours. I slept in my truck bed but my camper top leaked so that was kinda damp and I woke up about every hour. Poor me. I’d do it all again.

It’s interesting that the entry price for the marathon and 50 miler were the same, but due to the timing of an upcoming 50 miler that I am training for, the marathon worked better in my training plan because it could replace a long run and push my effort. After being sick for the past several weeks with lyme disease, I wanted to race again now that I had begun the lovely antibiotics last week and was actually feeling a ton better. I hate ticks.

When I awoke for the fourth time at 3:00ish I considered that I could have just run the 50 miler because they were going to start at 4:00. The marathon went off at 8:00. The marathoners had to be shuttled from the Blue Knob State Park to the start of the Lost Turkey Trail whereas the 50 milers do an out-and-back on the same trails.

The bus was a little late picking us up, which I expect was from the insane fog on top of that mountain. And it was still raining. At first I could not even find the tent to pick up my packet at 5:30 even though I was only a hundred yards from it. The roads were barely visible and several us missed the turn into the parking area. It was the craziest, thickest fog I had ever seen.

I had raced from Blue Knob State Park before at an event called Rock n’ the Knob. The climbs were a little more epic than western PA and northern WV offer so I wanted to come back to have that extra challenge. The last time it was super foggy and a little drizzly but nothing like the drenching of the prior 24 hours.

 6:00 AM, fog's actually thinning out

6:00 AM, fog's actually thinning out

 1:00 PM, what a difference

1:00 PM, what a difference

Exiting the shuttle bus we had about 30 minutes until race start time. The rain slowed and seemingly stopped. I removed my Gore-Tex jacket, stuffed it in my pack, and put on a lighter shell. Normally I don’t carry two jackets but I don’t normally run in a hurricane either. But with just a moment to go before starting, the sky decided to begin another downpour. The race director fired a starting pistol. Only it didn’t fire, it… clicked. Fitting for the past few hours.

The first couple miles of the course were full of standing water. Being on a plateau, the water just sits and doesn’t drain anywhere. Plus it was still raining pretty heavily. My inner ankle began aching a little from the increased demand on my tibialis posterior tendon that comes with rock hopping and trying to run a little more gingerly on the slick or unpredictable deeper grass. I actually started to welcome the deep puddles as they would briefly override the ache.

I had three runners in front of me through this several miles of new squishy swampland. Even though the initial mile section is rocky and more technical, many of the early miles are wide, nontechnical grassy paths. There are a ton of intersections with other trails and roads throughout this course, so you really have to pay attention to avoid missing the turns. Finally, after much hoping, the trails started to feel a little more technical and that helped me pick off a runner.

I began passing the suffering runners from the 50 miler who were running the opposite direction. They were actually a really nice indicator from afar on whether I was still on the right trails. It looked like only about half of them even started and I know several people bailed from the marathon too.

At the first manned aid station, Buffalo Road, mile 9, the race director tells me the next runners are two and five minutes up. Being of the opinion that the first guy went out way too hard and the second guy probably did too, I figure there’s a good chance of closing that gap down. I was counting on the later steeper inclines I saw on the elevation profile to work in my favor.

 Not my pic

Not my pic

Eventually we get to a really long section of old pea gravel covered access road. I suppose it is still part of the Lost Turkey Trail but it is not technical at all and lasted nearly two miles. It felt like a road race because it was ever so slightly downhill and I felt like I could really open up. Being so flattened, it reminded me of running across an old coal strip mine, only without the acid mine drainage.

As I approach the next aid station, I see the runner who was previously two minutes ahead of me. Fantastic. I felt decent and spent just a few seconds in the King’s Field aid station so I could monitor his position. I tried to use the descent to my advantage but I couldn’t seem to see or catch that runner. Strange. Well that’s because he took a brief wrong turn just past the aid and I just didn’t know it until the next aid station.

I told those aid station volunteers that was the longest descent I had ever run and they thought it was funny, apparently because the race is known for crushing people. Beef jerky in hand I started up the really steep section of trail from Burnt House around mile 17. Lunge. Lunge. Lunge. Work it. Work it. Feel the burn in that booty. Uh huh. Uh huh. These are all things I say to myself on these climbs and are clearly one of my biggest and best performance enhancing secrets. Actually, I was thinking “who the hell puts a trail straight up the side of these steep ass hills without switchbacks.”

I notice my low back aching a little more than usual. I blame my inability to strength train for the past several weeks because the stinking lyme disease did something to my muscles that made them really easy to strain and become sore for days, which I had to learn the hard way multiple times. I hate ticks.

Perhaps it is somewhere in here where I recall running a ¼ mile section of the softest moss covered trail ever. I felt like I was committing a crime but I’m guessing it must be pretty resilient or it wouldn’t have been there in the first place.

Then, if I remember correctly, after getting to the top, a section of trail begins that seemed a little like someone just hung some ribbons along the hillside and figured running a group of people over it would eventually make a trail. It was super narrow and sometimes not benched at all so the mud on the off camber would just make you slide sideways down the hill toward what would surely be instant death. On one of steepest sections I had to climb through the limbs of this downed tree. I fell down there a little thanks to those pesky 50 mile runners who had come through and torn up the wet trail and smeared the tree in mud.

You won’t believe what happened next! Through some miracle of the human spirit, I kept on running. Because this is a running race, dammit. There’s no time to lie on the ground and bemoan the existence of mud. I realized this course becomes increasingly technical as it progresses.

Around mile 21, I approached Bob’s Creek, which I had seen in photos because of it’s unique overhanging cable “bridge.” It looked serious in the picture. But in real life I looked at the water and thought “that doesn’t look very deep.” Yeah, the muddy liquid was moving a little quick but I just stepped down into it and walked across, the water never going any deeper than my mid-thigh. I suddenly felt a little cheated, because I was imagining on the bus ride that this thing would have to be deep and fast today. I would surely have to cling to the cables above raging rapids. And if I fell in I would have to swim while being swept downstream for at least 50 yards. Other runners on the bus were even talking it up. If only I could have texted some frowny faces to someone who cared.  

 also not my pic and clearly from winter but there's disappointment creek

also not my pic and clearly from winter but there's disappointment creek

Just after I crossed “Disappointment Creek,” another serious climb begins. Real serious. Welcome to the final part of the event: the uphill lunging contest. About ¼ mile up the climb I spotted the runner in first place. Time for the arm warmers to come off (because I wasn’t wearing boxing gloves - this is a running race). And they were just going to slow me down anyway because of their poor aerodynamics. Past experience has taught me that uphill lunging contests are all about aerodynamics.

He caught a glimpse of me and I could tell he was probably more interested in just finishing at that point. Mostly because he said, “I’m just going to move at a snail’s pace” and immediately started screaming “Why me! Why me!” Well you can never really trust these trail runner folk because many of them are actors so I lit the afterburners and lunged my way up that climb at record lunge pace.

My lateral calves began cramping a smidge on the next descent and my left big toe was not happy but lucky for me there was soon an aid station known as “Lost Children” at mile 24 where I guzzled a bottle of miracle pickle juice. Here the race director provided her encouragement because she knew I had worked my way up to the front. Despite less than ideal conditions she was doing a really thoughtful thing by bouncing from one station to the next to encourage us. The volunteers were super encouraging too.

 "stairs"

"stairs"

At this point the sun is coming out and it’s suddenly a beautiful day. Too little, too late Mother Nature. Don’t even try to talk to me right now, I have a race to finish. Here begins the final uphill lunging contest challenge of going from 1800 feet to 3100 feet of elevation just so that you end up back at the Blue Knob Ski Lodge to eat a hamburger. Nearer to the top, the trail has a long section of rock stairs placed for your enjoyment. No longer can you define your step length because the steps do it for you. One less thing to worry about. For some reason I began grunting and snarling more than usual during this final piece, perhaps to demonstrate my manly dominance over the puny and weak mountain.

The race director cheated and drove her car up the much shorter and smoothly paved road to the top of the climb but she did greet me at the finish line after 4:15 of running with a sweet custom turkey call so that I can find that darned lost turkey.

 Loads of swag

Loads of swag

 I'm getting out of here

I'm getting out of here

Results are here.

Nutrition:

  • 4 Gu gels
  • 4 bananas
  • 1 bottle pickle juice
  • 4 Gu chews
  • 2 pieces beef jerky
  • 1 Rice Krispies Treat
  • 2 electrolyte tablets

Highlands Sky 40 Mile Trail Race Report

A couple days have passed and my quads still haven’t let me forget about this race. My quads aren’t normally this sore, but then again I don’t normally have such unusual circumstances leading up to a race.

I started feeling a tad funky on June 11, and I developed a 101-degree fever by the end of the next day. An accumulation of infant-induced sleep loss, disease carrying children, general life stress, recently increased training load, and a lovable personality made me the perfect host for Virus 349XY.

The fever persisted, fluctuating in intensity throughout each day - my intracellular fluids apparently being too tasty and nutritious for Virus 349XY to throw up a white flag. Every time I thought I had won the battle, I’d start to become super fatigued and fevered again.

Did I mention I went to the ER? Because apparently I had also strained a deep abdominal muscle in the weeks prior and just in case there was an off chance I had actually formed a strangulated hernia, I wanted to know prior to an ultramarathon. But there was no hernia and they thought I was crazy. Not sad about that lack of findings.

But it wasn’t good enough to just be sick. That little punk, Virus 349XY, also sucked out my motivation, threw it on the floor, and stepped on it repeatedly with its tiny little virus boots. All 47 of them. Jerk. So I’d stress about all the stuff I should have been getting done while lying on the floor with my squashed motivation.

I certainly wasn’t eating or drinking like I normally would leading up to an event. The one good thing is I would have been tapering and resting anyway. With this increased rest, as each day passed, I could feel myself growing stronger, like the stench on a pair of sweaty socks in the laundry basket, but the week is only so long and the laundry is eventually all washed up.

 sunrise at the race start

sunrise at the race start

After reluctantly making the trip south on Friday, we ended up getting to the pre-race dinner a little late. We joined the other racers to help ourselves to a good meal at the Canaan Valley Resort. I still didn’t have a huge appetite. Perhaps it was the (low) altitude. Probably not. I began to prophylactically guzzle Pedialyte and juice. Carbs and electrolytes, you mean everything to me. Please don’t let me bonk.

Off to bed before 9:00 PM under some decent fatigue. Mr. Virus gave his one last war cry by awakening me with a low grade fever again at midnight. We spoke briefly and I told him to get the hell out, I’d had enough of his misguided ways.

Race morning I awoke at 4:15 feeling pretty normal. But I knew there was no point in trying to hammer. Mostly because my wife coach told me so. My goal had to be modified from racing hard to simply completing the event. I’d come to terms with that possibility a couple days prior. Mostly because wife coach told me. Not ideal for something I had been building up to for 6 months but slow running is better than no running, right?

Wife coach wanted to see the start (and to ensure I wasn’t faking “normal”) so I skipped the shuttle bus and we drove down to the starting line at Red Creek. I was less excitable than usual but still just wanted to get moving. One of the race directors remained unwilling to allow me to race under a pseudonym in order to protect my fragile ego. I don’t want to mention any names but thanks Adam. My ultrasignup.com ranking has plummeted and my sponsors won’t return my calls. My lawyer will be in touch.

 nobody seems to go slowly the first 2 miles of pavement

nobody seems to go slowly the first 2 miles of pavement

Anyway, I hiked so much more of the first half of the course this year than last. I went way too fast on that section last year. That definitely helped me to feel pretty decent at the mile 20 aid station. Wife coach met me there, I think mostly to grab the ripcord from my pack and provide a de-motivational speech if I would happen to look the least bit like a dying squirrel left by the side of the road. Boy was she surprised. And yet so proud. So proud.

It hadn’t rained much lately so the course was drier overall than last year. I was surprised to be in the top 10 at that point because I was really trying to hold back and many people were passing me.

 switchback hidden amongst Stinging nettles

switchback hidden amongst Stinging nettles

 more stinging nettles

more stinging nettles

 traded nettles and slight climb for ferns and steeper climbing

traded nettles and slight climb for ferns and steeper climbing

 trading up to pine trees

trading up to pine trees

 topped out and we can see the sky again

topped out and we can see the sky again

Then as I began to run the “Road Across the Sky” there was no doubt that I just didn’t have any of my usual oomph to give. The legs were heavy, the strides were short, and the quads were already sore. Not good that early. But it didn’t come as a surprise, so I didn’t stress too much about it. I just tried to be consistent and enjoyed the sights and sounds of the birds, flowers, trees, and elusive wild pugs that have roamed this region for centuries. I stopped multiple times, which is atypical for me in a race, to take pictures and to listen for the faint snort of a wild pug.

 wild pugs should be appreciated from a distance. The WV DNR denied their existence for decades but frequent sightings led to their ultimate acceptance into the local animal identification texts by 1974. The WV DNR suggests that you do not attempt to make contact with a wild pug as they are typically disease carrying scoundrels. 

wild pugs should be appreciated from a distance. The WV DNR denied their existence for decades but frequent sightings led to their ultimate acceptance into the local animal identification texts by 1974. The WV DNR suggests that you do not attempt to make contact with a wild pug as they are typically disease carrying scoundrels. 

 pretty high up here

pretty high up here

 Road across the sky is about to end

Road across the sky is about to end

Compared to last year, there were better conditions this year while coming across the wide open Bear Rocks segment of the course as the temperature was only in the 70’s and it was partly cloudy. I found Travis Simpson at the next aid station. He wasn’t having a great race either. Claimed he was mostly walking but for some reason I never saw him again after that aid station. A federal Strava investigation using judicious amounts of taxpayer dollars revealed that “walking” at that point must have meant a 8:00/mile pace.

 There's a Lot of this

There's a Lot of this

 overlooking the canaan valley from Rocky Ridge before descending 

overlooking the canaan valley from Rocky Ridge before descending 

 more overlooking

more overlooking

I could not get down that mountain quickly enough. My quads had passed “GO” 10 miles earlier, taken the $100, and spent it on comic books and booze. Worthless. Get a job loser(s). After all I’ve done to/for you!

The final section of road where I was able to give a good push last year seemed to take forever. I reached the final aid station at mile 37.6 a full 10 minutes after my 2016 finish time. And I still had a few miles to go despite my begging and pleading to the aid volunteers. Still, no tears were shed. At least not by me, in public, at that moment. I knew others around me were not having stellar days. Wife coach would want me to continue onward knowing that another race is always on the horizon. I held my chest high and shuffled down Freeland Road as quickly as three fully functioning quadriceps muscle fibers could move a person.

 somewhere in canaan

somewhere in canaan

 and somewhere else

and somewhere else

An hour slower than last year, I finally arrived to the lovely sights of a finish line. I’m really happy with that, considering the circumstances. It certainly made for another level of challenge. One that I do not need to replicate again.

Thanks for a great event again this year Dan, Adam, and Highlands Sky volunteer army.

This article has been dedicated to the memory of Virus 349XY who passed in the early morning hours in Davis, WV while doing what he loved to do most. He is survived by his cousin, the mutated form 349XZ, currently residing in 127 different humans, mostly ultrarunners, across Pennsylvania, West Virginia, Virginia, and North Carolina.

Map: https://www.strava.com/activities/1041547950

Stuff I ate: ½ Gu Stroopwafel, 6 Gu gels, 6 Clif Bloks, couple handfuls Pringles chips, at least 16 oz. cola, 9 oz. ginger ale, 2.5 bananas, 8 dill pickle spears, handful of grapes, several mini Snickers bars, 3 handfuls of watermelon, 2 strawberries, my pride

Stuff I wanted to eat: freeze pops, more pickles, elk burger

Brain Training For Capturing Your Next PR

Do you ever wonder why some athletes are so consistent in their performance while others are all over the map? If factors like nutrition, training, and physiological capacity are similar between two people, especially at elite levels, there must be a hidden difference or two in why one person consistently outperforms another.

A huge piece of that difference is psychological. One athlete might catastrophize when things don’t go as planned. Prior experience may lead that athlete to experience negative emotions, increased stress, and increased self-doubt. Once a moment of negativity is allowed to creep in, it leads to a steady performance decline. But somehow, another athlete faced with the same issues might continue to excel despite encountering a hiccup. Just how can they do that? Are we born with these skills or is it the result of dedicated practice?

Brain-Body Connection

There is no denying a connection between your psychological state and physiological outcomes. All you need is to feel a little stressed and you can watch your heart rate and blood pressure rise. What if you could reverse engineer this brain-body connection and use it to work for you instead of against you?

Through dedicated practice, focusing consistently on a single task and being aware of that present moment, you encourage control of your emotions and enhance your self-awareness. Perhaps you can decrease the more intense physiological responses that accompany stress. Even though endurance sports, like running, are fatiguing and sometimes uncomfortable, the brain can be diverted to a single focus of operation: to get the primary task done.

I have a theory that the most successful athletes (e.g. happy, consistent) use their sport as a form of meditation. Some have suggested that we naturally seek out altered states of consciousness and exercise is just another gateway to this state. Perhaps this ability to refine and control thought is a key to enjoying exercise instead of dreading it. Sure, there are people that still look at meditation as being a 1970s hippie phenomenon, so they automatically won’t like the idea. But consider it just another skill within a toolbox of physical and mental skills. No psychedelic drugs necessary. By exercising in this semi-meditative state, the brain learns to function and focus in a precise way during that activity.

What is Mindfulness Meditation?

Practitioners of mindfulness meditation emphasize remaining observational and non-reactive to what you might sense during meditation (see footnote below). One result of remaining mindful is improved decision making simply because you have greater knowledge. You then respond to your findings without excess reaction, without judgment. It’s similar to someone telling you, “don’t overthink it.” Who doesn’t want or benefit from improved decision making?

A search of the NCBI database reveals that using mindfulness techniques during exercise is a relatively new research area. Mindfulness concepts are commonly utilized in research on yoga and martial arts. It is also more common to see meditative techniques used in addition to exercise for treatment purposes (e.g., chronic pain, depression, etc.). Mindfulness and meditation are becoming more popular topics, so you can expect more research will begin to pop up.

Using a Body Scan to Control Pain

Endurance sports involve cyclical movements (e.g., steps while running, pedal strokes while cycling, etc.)  that provide ongoing feedback from the body. That feedback is useful, if you are listening. You might refer to this listening as a “body scan.” It’s a technique used in mindfulness-based meditation and has been studied for treatment of depression, anxiety, stress, obsessive-compulsive disorder, insomnia, various cancers, chronic diseases, and chronic pain.

Athlete or not, one of the biggest goals of a body scan is to increase your awareness of your body’s signals, top to bottom. During constant activity, the best athletes are able to continuously monitor and adjust their status at any given moment, much as a person would in mindfulness meditation. The athlete is monitoring the important factors as they encounter them, responding with only the absolute necessary changes so that, over time, physical and mental energy are conserved.

While scanning, I frequently discover that I will shrug my shoulders when running harder or becoming fatigued, so I immediately know to drop my shoulders. Or I notice my breathing becomes too rapid and shallow, which reminds me to take a cleansing breath. No surprise, there’s always an immediate improvement in mood, performance, and comfort.

Within an event or training day, one key is to continuously perform the body scan to the point that any small problem is detected and corrected before it becomes a big problem. Maybe some people would consider this a waste of mental energy, and maybe it would be for the unacquainted. Instead, with practice, I would expect it to decrease mental fatigue because it’s far easier to address a small problem intermittently than to become stuck obsessing over a more catastrophic and constant state of stress that causes a flood of negativity.

Other Mindfulness Techniques

Bringing your attention to the present, with something like basic step counting, can push out negative thoughts. You might initially just count four steps before your focus diminishes but with practice it could be 50 steps or 100 steps. Count steps until the next maple tree comes along or the next aid station.

Some athletes are better able to apply meditative techniques if they have a mantra to rely on. Much like step counting, the job of the mantra is to hold your attention. It is a word or phrase that you return to when you find your attention has drifted. It can be something like “long and strong” or “I can, I will.” And still others are able to focus on their breathing count and pattern with great success.

The cyclical nature of an endurance sport also lends itself well to this internal or mindfulness approach because you can become completely lost in the total movement, the breathing pattern, or even the individual footsteps. I’m so stuck in this mode from running that I struggle with counting repetitions while strength training. I become so internally focused on the technique and how the movement feels with each rep (the way I would with running) that I don’t care about the number.

Regardless of your choice, focusing on any of these patterns requires attention to factors other than your fatigue-induced discomfort. They all provide a rhythmic pattern, a consistent place to focus after a distraction, a point of fixation.

Being Stubborn Isn’t Enough

This isn’t simply about being stubborn. Stubborn can get most people only so far. When you finally break at your point of maximal stubbornness, there must be some other tactic to fall back on to hold yourself together mentally.

An experienced ultramarathoner isn’t going to rely on being stubborn through an entire race, though it may appear that way on the surface. They are likely getting to the point that simply feeling their breathing or arm and leg movements can provide a point of focus as the distance gradually ticks away. It’s more about executing at that very moment while turning off emotional and judgmental tendencies.

Application to Training and Competition

In training, try to maintain a body scan or an intrinsic technique focus during short, hard intervals of 30-60 seconds. The goal can be to move quickly and feel discomfort while focusing only on one or two technique trouble areas. You can make the intervals increasingly longer (eg. 5-10 minutes) as you have more success sustaining a focus during the shorter lengths.

Use your miserable days as a primer. Gross weather? Feeling generally crappy? Don’t bail. I hate to spoil this for you but 99.9% of competition days are not going to go as planned. To truly be prepared, you need to experience less than ideal conditions in advance. The rough days are an opportunity to see if you can bring yourself together mentally and maybe even surprise yourself.

Started out a race too hard? Don’t panic. Accept the situation and move on, responding only to your requirements at that very moment. You can’t change the past so stop getting caught up in it. Feeling inefficient? Focus on a component of movement, like arm swing, that you can control. Continuously thinking “this hurts” or “I’m getting slower” is harmful to performance and enjoyment. Once those initial thoughts begin, you will almost certainly begin to slow down and have even more negative thoughts.

You aren’t going to wish an opponent into slowing down and you aren’t going to wish yourself into going faster. Focus on factors that you can control and you just might go faster. But that’s not going to happen without maintaining an internal locus of control - meaning you become solely responsible for and controlling of the outcome.

In longer events, like a marathon, it is wise to not only avoid deep analysis and judgment of your overall condition but to address the basics of what you can at that very moment and reassess after a mile or a few minutes later. Just because you are beginning to feel miserable one minute does not mean you are destined to feel that way 10 minutes later.

According to the book “Running With the Mind of Meditation: Lessons for Training Body and Mind” by Sakyong Mipham Rinpoche: “Ignoring the pain takes enormous mental effort. The first step is to acknowledge the pain. The pain is one thing, and the mind reacting to the pain is another, so the second step is not to overreact. Becoming startled by the pain only exacerbates the pain, like throwing gasoline on a fire: our reaction to the pain makes it even worse. Therefore we acknowledge the pain, but we avoid having the immediate reactionary response.”

Your preferred method of mindfulness may also change with the intensity or duration of exercise. Through most of an endurance competition I’m doing a body scan. Late in a competition I might begin to use a mantra, often rhythmically with the movement. I also like to create a mental picture of how I am moving as a whole, as if I’m watching myself in a mirror.

Find What Works For You

If you have never tried any of these mindfulness techniques before, don’t expect it to be easy and automatic the first time. There is no wrong way to do it; try a few methods and see what sticks.

Some people have the perception that meditating while exercising would require you to completely shut off the outside world. But you have the choice to turn off and to turn on those inputs. If you have to be on high alert for a moment to make sure you don’t miss a turn of the trail in the woods, then stay on high alert. Go back to whatever technique you like once you make the turn. You don’t become a zombie while doing a body scan.

The bonus of these techniques is that you can transfer this behavioral control to other sports and aspects of life like school or work. After developing the mental skills necessary to get through a tough training or competition day, taking that college exam or giving that presentation to your boss might not seem so tough.

It’s worth looking at the various mental skills you can develop while exercising so it isn’t all just a frustrating slog. Certainly, exercise can provide a fantastic time to step away from our stress and problems. And not every moment of exercise needs to be a test of will or focus. Just don’t be afraid to consider the importance of mental skills training if you are seeking performance gains.

Main points:

  • A body scan, mantras, step counting, and breath counting can all be useful methods to improve performance.
  • A body scan can be used to continually monitor movement and discomfort levels. It allows you to attend to small running technique flaws or areas of excess muscle tension before they become large and painful problems that will undoubtedly be mentally fatiguing and detract from performance and enjoyment.
  • Practice the mental focus in training with hard and short efforts initially and then progress to longer and harder efforts.
  • Bringing your attention to the present, with step counting, breath counting, or a mantra can push out negative thoughts.
  • Realize no competition is going to proceed 100% as planned. Use your most unpleasant training days as an opportunity for preparing your mental state.

Please share this article with your running friends! To receive updates as each blog comes out, complete the form below. And if you have any questions, please email me at derek@mountainridgept.com.

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Sources:

1 According to a 2010 article from Birrer and Morgan: “Mindfulness techniques emphasize the non-judging awareness and acceptance of present cognitive, affective and sensory experiences, including external stimuli and internal processes. Stimuli that enter awareness are observed but not judged, and internal experiences (thoughts, feelings and sensations occurring through internal or external stimulation) are instead accepted as natural, transient facets of human existence.”

http://www.atrailrunnersblog.com/2017/06/stealing-fire-ultrarunning-and-pursuit.html

https://www.ncbi.nlm.nih.gov/pubmed/26406766

http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0838.2010.01188.x/full

http://onlinelibrary.wiley.com/doi/10.1111/aphw.12063/full

http://www.huffingtonpost.com/2013/07/22/meditation-in-action-running-mindfulness_n_3625110.html

http://www.runnersworld.com/meditation/why-you-should-try-meditating-while-running-and-how-to-do-it

 

8 Essentials For Recovering From A Running Injury

1. Don’t assume you should stop running entirely. There’s a good chance you will make the situation worse by fully stopping. One or two days off is reasonable. Your body’s tissues maintain themselves best when there is a baseline frequency of exercise. Take that particular baseline away for several days and those tissues have no reason to maintain their adaptations to exercise, so they will actually weaken and regress. Tendons, muscles, ligaments, it doesn’t matter. All of these tissues begin to degrade without regular use. It’s the same reason astronauts become weak and lose muscle mass when they travel to space. The frequent demands of gravity here on earth are suddenly gone so their body says “if you aren’t going to use this *fill in tissue name here* anymore, then I’m going to start to break it down - it’s a waste of energy to maintain it for nothing.” You don’t want to lose more of these hard-earned adaptations than you have to.

2. Don’t be afraid to deviate from your previous running pace and distances in order to stay active. If there is one thing that happens very commonly after an injury takes hold, it’s that folks assume resting fixed their problem entirely when the pain *appears* to go away. So what if you took two days off? Expecting to jump back in at the same level of pace and distance is often disastrous. Just as I mentioned above, the tissues maintain a certain level of adaptation. By jumping back in at the previous intensities and distances you may actually be stressing the tissue at a rate greater than it can adapt. Remember, this was injured tissue that caused pain just a couple days earlier, which probably means it wasn’t adapting quickly enough to begin with. It is unlikely that magically, with a short little rest, that the area suddenly became “normal” uninjured tissue again and you can start beating it down with your typical training. Temporarily decreasing the intensity and distance to decrease (but not eliminate) the overall demand on the tissue is often a better solution for overuse injuries. It typically takes weeks and months for an injured area to remodel and you can certainly progress again during this time if the running is dosed appropriately.

3. If you have a competition coming up and it’s something like one to two weeks away, there’s a good chance you can still compete and do so at the level you had hoped - if you play your cards right and don’t panic. How much measurable fitness do you really think you were going to gain from that one last long run? This is more of a psychological barrier than a physical one. If you had been training consistently for two or three months, or years for that matter, then you have the necessary fitness. Yes, it’s frustrating and a blow to the ego. Nothing ever goes as planned anyway, does it? It’s usually not worth testing things to their limits when you can easily increase or maintain fitness with things like cross training.

4. Cross train, but do it right. Yes, I understand that no other form of exercise seems to cause the same type of wonderful fatigue and satisfaction that running does. Which, again, is why people try to push the distances and paces prematurely. But if you need to cross train, doing hard interval or tempo work everyday on the bike or elliptical isn’t the right way to go. I would hope you wouldn’t do that running (although I know people who do). The same principles apply to cross training as they do to running:

  • super easy recovery to stay warmed up and loose after harder days
  • aerobic work for aerobic fitness
  • intervals and tempo work for improving anaerobic fitness
  • maximal efforts for improving that nerve/muscle connection and gaining more anaerobic fitness

I am absolutely convinced that a semi-experienced runner can cross train for several weeks, never run, and still achieve their goals if they do it correctly.

5. Don’t forget about this current injury when the next injury comes along. More often than not, these injuries will be connected to one another. Every week I see people who had a low back injury that eventually played into a hip problem that became a calf problem which morphed into a foot problem. Our body’s are so good at compensating for pain, loss of motion, and weakness that we can nearly always get the job done - for a little while. The trickle-down and displacement of forces doesn’t bode well in the long run. Fixing problems correctly the first time around will play out better.

6. Some medicines are actually inhibitory to normal healing processes if taken for prolonged periods. This is partly due to the fact that inflammation is a desirable and necessary part of healing. It is just that inflammation is accompanied by pain and we all want to get rid of that part of the equation. Taking drugs to modify the inflammatory response over a longer period of time (>2 weeks) may result in an incomplete cycle of healing. Here’s one recent review (https://www.ncbi.nlm.nih.gov/pubmed/22744434). These drugs are also an important factor to consider in bone healing from issues like stress fractures, as reviewed here: http://bjsm.bmj.com/content/39/2/65.

7. Prevention is the best medicine. Remember, you can have too much of a good thing. Exercise and running are good only up to a certain point and that point is different for each of us. Maybe if you had just taken a full day off every week for the past month, then perhaps this injury wouldn’t have happened. You will do best by emphasizing proper recovery time, doing regular soft tissue maintenance, refining your running technique, attending to nutrition, and being consistent with slow progressions in training. If I had a dollar for every time I’ve heard “well, I felt good so I decided to go an extra four miles” from people that aren’t feeling so good right about the time I see them in the clinic. There is always a breaking point and you can find it by throwing caution to the wind. (Not saying I haven’t done these things myself!)

8. Don’t “test” an injured tissue repetitively and expect a different result. Here’s a common scenario: Monday I tried to run and my leg hurt within 200 yards, so I stopped, figured I would just rest a day. Tuesday I tried to run again (because Monday was a failure) and the pain started again at around 150 yards. Ugghh, I hate being hurt. Wednesday I’m really aggravated and surely the last two days of “rest” have fixed it so I run for 300 yards, even though pain started at around 200 yards again, before I reluctantly quit because of the pain. Thursday I’m really angry and try to run again. Friday again... Notice a theme here? Numerous days of testing the injury, pushing until and through pain, ultimately delays improvement. It’s clearly not going away. The right thing to do is seek help from an injury treating professional, not a personal trainer and not a coach unless they are going to refer you to a valid licensed professional. It is important to consider what pain intensity we are referring to. If it’s enough to make you consider quitting the run, that’s probably a good sign that you should indeed stop. Nor would it be good to push through pain that makes you change your technique for pain avoidance. If the pain is occurring early in the run and worsens rapidly, you aren’t going to win the fight. Every time you test an injury like this, it’s just inflaming the tissue all over again after it has tried to calm down.

Please share this article with your running friends! To receive updates as each blog comes out, complete the form below. And if you have any questions, please email me at derek@mountainridgept.com.

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Coopers Rock 50K Race Report

This turned out to be a very interesting event this year. After a taste of warmer spring weather for the past couple weeks, Mother  Nature changed her mind and dumped a few inches of snow in the area on Thursday into Friday. With Coopers Rock State Forest being at the higher elevations of around 2000 feet, the snow and colder temperatures stuck around for the race on Saturday.

At race start, the temp was about 29 degrees and the woods had a varying 2-5 inch blanket of snow. I can’t recall  competing in this much snow since the Snowflake Chase 5 Miler in McHenry, MD, some 20 years ago. Last year we had the perfect dry, cool conditions. I guess you never know what spring will bring around here from one year to the next.

The 50K course begins with a 1.5 mile road section and a simultaneous half-marathon start, which does cause a slight confusion for placement estimation. Fellow 50K runner Travis Simpson started off harder and faster than I typically ever do, even if it were a marathon. But that’s just his style.

As a result, I exited the pavement as the second 50K’er and wondered how big of a gap I would have to close for that first position. It certainly took a while. I finally saw Travis pop up just before the 6-mile point as we entered the Mont Chateau trail, where the half marathoners split off, but it took me until mile 7.6 to catch and pass him at the bottom of that trail. Here, next to Cheat Lake at 650-700 feet of elevation, there wasn’t a bit of snow.

 Warmer

Warmer

The lake happens to be the turnaround point of a short out and back where we began a 1300 foot climb back to the top of the state forest. It didn’t take long while climbing back up this overlapping portion to pass the 3rd through 7th place 50K runners. There must have been good technical runners in that group. Travis finally didn’t seem too interested in pushing at this point so a gap formed between us, although it shrunk back down as we approached Rock City.

We ran Rock City together and then I separated from him again as we hit the Underlook Trail (a challenging world of boulders, this time covered in snow!) It is on this trail that you have to hike and climb quickly on large rocks that are surrounded by other, even larger rocks. All are gradually breaking away from the cliffside every couple hundred years. Rhododendron abound and provide a saving handle sometimes. The footing was so uncertain that you have to constantly watch where your feet are landing. At one point this focus caught up to me because my peripheral vision was also slightly inhibited by the brim of my cap and I managed to ram my left shoulder straight into one of the boulders at full fast hiking speed. Ouch. Five minutes later I cracked my right knee off of a boulder. More ouch.

 Underlook Trail

Underlook Trail

I entered Aid Station 2 at mile 10 feeling pretty well despite playing geology tackle. Following this portion, we do another out and back to the Raven Rock overlook. That design quickly lets you know the gap to the next competitor - and it wasn’t far. Maybe 60-90 seconds. I tried my best to remain steady on that section and approaching the McCollum Campground as it was still too early to push the pace.

 Raven Rock

Raven Rock

 Please don't pass me

Please don't pass me

Then we hit Aid Station 3. I checked my watch and noted that my time was basically on par with my time from last year. This was a bit of a problem considering the course was perfectly dry last year and this year it was a muddy, slick, snowy mess. Somehow I was still climbing well.

I headed out to the Powerline trail off Clay Run. As I reached the top of that mile-long climb I could still see Travis trailing me by a similar time gap. Isn’t he getting tired yet? But I knew we had had similar performances in 50Ks in the last couple years.

 Ever instruct a dizzy runner?

Ever instruct a dizzy runner?

Returning back to the same aid station again, I began the not so fun trip on the Roadside Trail toward the front entrance of the state forest. It reminded me of running on horse trails. The many giant footprint divots in the snow had melted partially yesterday and must have frozen again overnight, creating some nasty, unsure footing.

In some ways I was happy to arrive at the paved Henry Clay iron furnace roadway to get off of that trail. I tried to eat the banana I was carrying but it had frozen nearly solid so that didn’t quite work as planned. Unfortunately, midway down the road Travis came barreling by me. I might have tried to hang on if this was a 5K, but it wasn’t, so I watched him gradually drift to a quarter-mile lead.

It was at this point that I *slightly* regretted helping Travis with his hamstring strain injury earlier this week with dry needling in my clinic. Next time Travis, I may use more of a “sham” treatment technique if we are going to be in the same race that week. I’m kidding, of course.

When we hit the Advanced Ski Trail I started to reel him back in again. We chatted a little and then I separated from him again down the Intermediate Ski Trail. Making it to the next aid station at the frontmost parking area, Travis came in just 20-30 seconds behind me. I was starting to feel like crap and I don’t think he was feeling great either. We coasted along the new swampland known as Scott Run trail. My quads were clearly unsure of their function. Travis surged on me again, I fell back about 5 seconds but then caught him once again up the final technical climb.

Having seen his stellar road running abilities, I knew I was in trouble with the design of the final portion of this course. Travis threw another surge as we exited the final aid station and entered Roadside Trail again. He has too much raw power for me to counter on those flats! I tried to stay strong, but without any more climbs or technical sections, my ability to catch him again became substantially inhibited.

He would end up taking the first spot while I came in a short distance back. He executed that final part very well. Over the entire event we were never really more than two minutes apart from each other. Third place, Aaron Horrell, didn’t take too long afterward to come across the finish line either. Three of us coming in well under 5 hours in those slick conditions was quite surprising. And as much as I would like to have won, I was really happy to see an individual that I helped with a new injury overcome the odds and run to their fullest potential.

 Would be a sweet view if these guys would move

Would be a sweet view if these guys would move

Looks like there were 40 total finishers in the 50K, although I’m pretty sure we started with closer to 50. It was definitely a day to test limits.

This is the second year for the event, and I thought the course markings were even better than last year’s, though I am a little biased for having known the course already. This year for entering we received “A Guide to Coopers Rock State Forest” along with the SweatVac brand synthetic shirts, which run a little on the large side. Last year we had the same shirts but received a durable map of the forest lands. Unique swag.

I definitely must thank the volunteers who braved the cold for hours to come out to help with this event. It’s not comfortable and not easy to stay warm when you can’t move around much. We all appreciate the ability to get food and drink in at the aid stations.

Here are the results on the Coopers Rock Foundation site. 

Favorite Statistics:

  • Average power: 228 watts
  • Average pace: 8:57/mile
  • Elevation gain: 4967 feet
  • Amount of time climbing: 2:15:05

Strava link

Strava Flyby Player 

Nutritional intake:

  • Breakfast - egg and bacon on english muffin and coffee, trail mix, frequently sipping water all morning
  • Thirty minutes prior to start - one banana
  • In race - 5 Gu gels, 1 Gu stroopwafel, ½ banana, ½ peanut butter and jelly sandwich, 2 pickle spears, 2 pieces boiled potato with salt, 1 cookie, about 40 oz. water, about 8 oz. Coke/Dr. Pepper sodas

Please share this article with your running friends! To receive updates as each blog comes out, complete the form below. And if you have any questions, please email me at derek@mountainridgept.com.

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20 Cold weather running tips and tricks

The warm weather of spring will be here before you know it...or not. I don’t love the cold, but I’ve learned to appreciate the unique challenges of snow, wind, rain, ice, and that abominable snowman from Rudolph the Red Nosed Reindeer (hot cocoa!). Here are some thoughts on surviving this less pleasant time of year.

First off, it’s about mindset. If you keep telling yourself it’s going to suck to be in the cold, no surprise, it will suck. Have the attitude that you are adaptable and that the conditions are fun or unique in order to shift your perspective. If you have the guts to commit to consistent exercise, you have the guts to tolerate the cold for a bit.

If you struggle with the initial shock of cold when heading outside, try getting your core temperature up indoors first with 2-10 minutes of indoor biking, treadmill running, push-ups, air squats, running in place, butt kicks, or high knees.

It’s never as cold as you think it’s going to be - as long as you are consistently moving. Pretend you are dressing for a temperature that is 10-15 degrees warmer than the actual thermometer reading.

However, if you would happen to become injured by the aforementioned abominable snowman and had to stop moving, how long do you think you would stay warm? Probably not as long as you think. This is where it is smart to carry an emergency item or two, especially if you plan to be far from civilization, home, and other people. We’ve all heard about dressing in layers, but I like to dress with the intention to pack away the outer layer. A tightly packable, waterproof jacket is a great addition, especially on those damp 40-degree days. It’s there if you need it but not a hindrance if you never use it. In a pinch, a simple kitchen trash bag with a hole ripped in the bottom for your head can be used as a rain, cold, and wind barrier. Cheap, simple, and effective, but don’t expect it to be breathable. Space blankets are a great compact option. On long, adventurous trail runs, my ultimate choice would be a bivy sack, especially for going out into a more risky environment that would be less accessible in an emergency. Of course, this is overkill for running roads in a city. Consider that even if you had to stop moving for 60 minutes while waiting for help, a bivy sack or space blanket would be a welcome and potentially lifesaving item that weighs very little. Though it’s a little larger and heavier, the bivy is more ideal than a space blanket because you can actually get inside of it.

It’s not just the temperature that you have to consider. Wind and water will make the temperature feel at least an extra 5-10 degrees cooler. But if the sun is out, it can easily feel an extra 5-10 degrees warmer. The hardest conditions to dress for are when it is raining at 35 to 48 degrees. That’s perfect hypothermia weather. There’s a definite need for a breathable, waterproof jacket in that instance if you plan to stay out for 30 minutes or more.

Wool is an awesome material to layer, especially for socks. Many people love wool for the heat retention it maintains while wet, which can easily happen if you sink a foot in a puddle of slush. The Smartwool socks I’ve had have been amazingly durable and are my favorites so far. Anything but cotton, please!

In full-on cold muck, around 34-48 degrees, consider a waterproof/windproof sock, like this one from Sugoi. I’ve used these intermittently over the past five years. They definitely weren’t manufactured as a hiking and running product as they do slip around in the shoes a little. And they have external seams that might annoy some people. But they are flexible and my feet would only get a bit damp from sweat. (Keep in mind the dampness from sweat can cause chilling though.) They are useless if you dunk your foot deeper than ankle depth.

Check out some running gaiters if the snow is getting deep or if it’s slushy and muddy. Even a thin gaiter can keep debris from accumulating in your shoe. And if the weather is really poor, you might have a hard time untying the shoe to get that debris out in the middle of a run. Prevent it in the first place.

A single, thin layer can go a long way toward improving comfort. You don’t always have to use heavy, thick layers to get the job done. And the nice thing about a single layer is that it is still very breathable. This is why I hang onto a 15 year-old, super worn pair of tights that my wife would like to throw away. They are perfect for the 30-40 degree days. I’ve found that some areas are more sensitive to cold than others. My shins don’t need much coverage so one layer there is often plenty. My hands are super sensitive though and I’ll need to layer up a liner gloves and possibly mittens.

Carry a Buff or other similar multi-purpose garment. Options are nice. This can cover and protect your neck, face, ears, and head in one fell swoop, in any combination.

Cover your hands in a thick moisturizing and protective barrier like Bag Balm, beeswax, Aquaphor, or petroleum jelly. I have pretty poor blood flow in my hands and this, at the very least, buys me some additional time before my hands start to ache and lose blood supply. And it seems like the act of massaging these products onto the skin is helpful to increase blood flow even before going outside. If it was super cold out, I would put this same protective barrier on my face as well. I’ll carry a little tube of this stuff on a long run for reapplication and chaffing problems.

Sheet metal screws tightened into the bottom of your shoes make for cheap, light, and effective studs on slick surfaces. Just three to five of them can go a long way towards enhancing your stability if they are thoughtfully placed.

Cross train on snowshoes, cross country skis, or just go for a hike. Nobody feels their most fit when exercising in the cold. The clothing is restrictive, breathing is difficult, everything feels stiff, and the footing is horrible. These other activities are more than acceptable to provide an aerobic workout. As a bonus, they break up monotony and train your body in ways you might not normally. Were you going to PR today anyway?

Keep in mind any food you take will become more firm, perhaps more… chewy as it gets colder. Which means you will probably have a desire to drink more while eating. If you tuck the food close to your body prior to eating, it won’t be so darn hard to chew.

Similarly, if you use a hydration pack, tuck the tubing into your jacket so that it doesn’t freeze up. Depending on the size of pack, you may be able to place it under an outer layer of clothing. Drink small amounts from the pack often to keep the water moving. The real hard-assess of winter running mix a little vodka or whiskey into their water to help prevent freezing. It doesn’t take much to lower the freezing point.

Warm liquids are amazing in the middle of a long, cold bout. My dad always brought a small thermos of hot cocoa for me when I was a little kid hunting in the cold. I promise you, in the middle of a cold long run there is nothing better than hot tea or chicken broth. I haven’t found a thermos that works better than a Zojirushi

Carry back up charcoal hand warmers. Just don’t expect them to heat up quickly. For that, there are more instant hand warmers. Or make your own out of these inexpensive flexible heating pads.

Make loops that include public buildings where you could warm up for a few minutes if necessary.

Don’t tie your car or house key to your shoe in wintery conditions. Your hands might be too cold to untie the knot or the knot might just be completely frozen. There is no worse feeling than standing outside a locked warm car or house when you are super cold.

 That's disappointing

That's disappointing

Find someone to hold you accountable to getting your run done. A consistent training partner can be a great motivator who won’t let you slack off and make excuses. Training groups can provide that same motivation. Plus it’s safer for everybody involved.

Bonus: Make a game out of it. A Hash House Harrier run is the best example of this game atmosphere. You will be so busy wondering where you are on the random course and where you are supposed to be going that you just might forget about the cold.

Bonus: Cellphone batteries die very quickly when exposed to the cold. Keep your phone closer to your body to keep it warm. If it does die, getting it warm next to your body may breathe some life back into it again.

Let me know if you have questions: derek@mountainridgept.com

Tips for assessing last season and planning next season, part two

In the last article we reviewed suggestions to analyze past workout data. Now for an overview of preseason planning.  

Establish training and competition baselines for comparison.

  • Maybe very recent or older, like a couple years ago, as long as you have the old data for support.
  • Considerations include baseline times for a specific distance, maximum distance, highest average power values, best pacing execution, or just about any factor you would like to see improve.

Find the events you would like to attend.

  • Seek out something new. You never know when you might find an event that you like more than your usual races.

Analyze the specific demands of your planned events.

  • Course layout
  • Distance
  • Elevation gradients and totals
  • Average temperature and typical weather

Set primary performance goals. Don’t be afraid to set lofty goals as long as they are achievable. These can vary drastically, likely being the most specific for an experienced athlete. For example, it could range from:

  • “I would like to finish a marathon.”
  • “I would like to finish the San Francisco Rock ‘N Roll Half-Marathon with a time of 1:40:00.”
  • “I want to run the Boston Marathon in 3:15:00 with the pace never dropping below 7:30 minute/mile or going faster than 7:00 at any time.”

Set midpoint performance goals to determine if progress is being made. For example:

  • Perform a weekly total activity duration of 8 hours and a single longest effort of 2 hours after 8 weeks of training.
  • Perform 7:00 minute/mile pace for 8 miles in a threshold/tempo workout.
  • Achieve a single day of long distance of 17 miles after 8 weeks of training.

Set the component or technique goals that must be met to achieve the primary and midpoint performance goals. Without executing these component steps, you can’t expect to reach the performance goals. For example (these values are theoretical):

  • Consume and tolerate 12 ounces of fluid per hour while at race pace.
  • Consume and tolerate 200 calories per hour while at race pace.
  • Maintain an average of >170 foot strikes per minute for at least 2 hours.
  • Maintain a run power between 200-250 watts for at least 2 hours.  

Go slower to get faster.

  • I’m a fan of higher volumes of low intensity work with only occasional high intensity work. It’s probably not an accident that professional athletes in any sport lasting for long durations have adopted this strategy. You can’t train hard every day. This is especially the case with older athletes because they just don’t recover as fast as their younger counterparts.
  • As you get closer to an “A” event, emphasize increasing the higher intensity work while decreasing overall duration and distance.

If you are planning to do a lot of competing to “race into shape,” you must come to terms with the fact that not every event can be a PR event.

  • You will need to give up some hard workouts to do the competitions instead. Define which events are the real priority and just let the others go as hard training days.

Allowing a longer build period is generally a safer option because it allows for greater physiological and more gradual structural changes.

  • Our connective tissues adapt much slower than our fitness. That’s why we often end up with physical injuries instead of metabolic problems.
  • Shorter races require less progression time.
  • Longer races require greater progression time.

Plan for strength training.

  • This overlaps with performing those exercises that the evil PT gave you. I doubt every muscle in your body is at its optimal strength level.

Plan for other cross training.

  • Your cardiovascular system doesn’t know what activity you are doing. Your tendons, muscles, and nervous system need to adapt and learn the pattern and load of running to be efficient and prevent injury but performing other types of exercise, like swimming and rowing, will not detract from those abilities.

Involve your friends and family.

  • Where would your family like to go for a trip or vacation?
  • What events are your friends doing? This might get you a new training partner, which is great if you are occasionally struggling to leave the house in the winter. But it might backfire if you are the one always providing the real motivation.

Consider other equipment to more objectively measure performance.

  • I get the idea of simplification. Maybe you can and should get by with a basic watch if that has always worked for you. But if you get injured often or can’t seem to break through plateaus, then the extra data from a power meter, GPS watch, or phone app isn’t going to be harmful and may actually help you see where the mistakes are happening. You can always collect the data without looking at it immediately, and analyze it later.

If you have an injury that keeps recurring, get professional assistance to take care of it in the off-season, not a week before your “A” race.

  • Most injuries should be objectively improving within a month when properly treated. If they aren’t, there better be a darn good explanation or else I would find another professional to look things over.
  • Don’t expect miracles though. Sure, I can often provide somebody help (a.k.a. less pain) in just a couple visits but that doesn’t mean the problem is gone. You have to be reasonable with the rate of improvement and do your homework regularly.

Plan for rest and recovery. If you don’t plan it, you won’t take it.

  • Plan for periods of recovery from individual workouts within each week, from blocks of workouts over a series of weeks, and after the entire training cycle that brought you to a big competition.

Tips for assessing last season and planning next season, Part one

Whatcha’ gonna do with all that data? Use it to plan next season, of course.

We log workout data, and some of it never sees the light of day again. Whether you like the old school pencil and paper method or the website technology of Strava, Garmin Connect, Mapmyrun, or others, it’s worth reviewing from time to time. I favor the digital side. Mostly because it makes the math easier and I can make some pretty sweet maps and graphs afterward. There are few things I appreciate more than maps and graphs.

 My 2016 running heat map

My 2016 running heat map

So why are you really tracking all of this information? Most would say to allow the ability to see when they are improving. Bingo. But there are a few more reasons to keep track of and analyze the information regularly.

  • Increase the chances of short term and long term success
  • Compare real objective measures to what you *think* is going on
  • Improve your time management
  • Determine where injury or overtraining may have occurred (a breaking point)
  • Determine whether you met your full true physiological potential (or if you were just slacking off)
  • Make it easier for a coach to analyze (currently or on down the road)
  • Remind yourself of events and workouts you never want to do again
  • Remind yourself of events and workouts you would love to do again
  • Determine overall strengths and weaknesses
  • Prevent burnout
  • Define reasonable future goals
  • Recognize any past goals met
  • Discover what aspects of training and competing are really important to you

I started keeping a training log when I was around 15 years old.. Too bad they didn’t have these new-fangled wrist-worn GPS devices back then. There was more guesswork at distances and paces, especially because I was just making courses up. And sometime in college I tried logging everything into a Microsoft Excel spreadsheet, but that felt too cumbersome. Somehow, there are people still doing this! I salute your ability to tolerate the pain delivered from the software equivalent of a Ford Model T.

A spreadsheet isn’t specialized in its design, but it has the potential to be more informative than a paper logbook. Now the GPS watch companies produce some pretty decent metrics and there is additional software like Golden Cheetah and websites like Training Peaks that gobble up and produce more information than anyone can ever want or use. I love it.

At the least, take a look back at these basic measures:

  • Total yearly time
  • Total yearly distance
  • Average daily, weekly, monthly, yearly mileage
  • Average daily, weekly, monthly, yearly pace/speed
  • Competitive performance times, distances, paces

If there is one thing I can emphasize, it is that you should pay attention to trends, not single workouts, weeks, or even single months. Success is not built upon these brief intervals of time, nor is failure. Most injuries are not the result of what happens in a short period of time either.

Monitor the trends of speed, mileage, and duration for each week, month, and year. Following these trends, you can determine if there is consistent improvement or recognize unexpected losses before it is obvious in your performance.

 Average speed across 2016. Trend line peak coincides with June event where I wanted a best performance. 

Average speed across 2016. Trend line peak coincides with June event where I wanted a best performance. 

Solely considering mileage, sure, you can progress each week greater than the generally recommended 10%, but should you do it for several weeks in a row? Most people are not going to withstand those increases. If you don’t look at the long-term trends, then you may just very well forget that you progressed 30% in volume for two weeks in a row just a month ago.

The same would apply to the quantity of high intensity work. Progressing too rapidly in the volume of intense exercise can be a problem, even if total amount of time or distance stayed the same from one week to another. Progressing too rapidly will eventually cause a problem one way or another.

Were you injured this year? Compare the time frame where you were injured to the time frame just prior to injury. Was there a fluctuation in intensity or in mileage volume? Maybe it’s something you can’t quite put your finger on.

That’s when you realize that miles, pace, and distance do not tell a full story. This is where more advanced measures become helpful. These advanced measures are likely to be most beneficial to an athlete that is trying to make a large amount of progress or achieve their peak fitness:

Fatigue points

  • In terms of time, where did you begin to bonk or have a drop of pacing? Where did you think “this stinks” or begin to mentally struggle with the work being done?
  • These points are commonly where technique breaks down. It’s good to have a specific goal for when these moments arrive. For instance, if you know your cadence starts to slow, let’s say to 165, then focus entirely on keeping it higher, like 175.
  • Mimic these moments in training in order to determine the resolution that allows you to avoid injury and performance decline. You will probably never fully avoid these points but with training you can keep shifting them further away to prolong the time before trouble strikes. Of course, this is dependent on other factors that would need to be duplicated, like speed and distance. With that in mind, this clearly isn’t something you would try to work on everyday.

Acute:Chronic Workload Ratio

  • Calculated as the most recent weekly mileage or duration divided by weekly mileage or duration total during the last 4-8 weeks. This is a newer consideration, yet so simple. It was introduced in the 2015 research with a study on rugby players. They found that having a high ratio of 1.5 or greater was a associated with onset of injury. Interestingly enough, a ratio of 0.85 to 1.35 was found to be protective to injury acquisition. Even though the research was done on rugby players, it’s easy to calculate, so I would suggest applying it to your training if you can measure volume. The result is similar to a 10% weekly progression.
 Pressing my luck with an acute:chronic workload ratio of 1.7 for a little while there. 

Pressing my luck with an acute:chronic workload ratio of 1.7 for a little while there. 

Average daily, weekly, monthly, yearly heart rate

  • Yes, I know heart rate isn’t the most fabulous measure. But if you are using only the basic metrics, this is a good place to start because devices are now measuring heart rate at the wrist and the chest straps are way more comfortable now than 5 years ago. Trends in heart rate can demonstrate overtraining habits or improvements in performance. For instance, if I am ramping up my base miles I can compare performance on a certain loop at the same pace/time and might see a lower average heart rate for the same speed.
 Average heart rate was at its lowest while heading into June as well. 

Average heart rate was at its lowest while heading into June as well. 

Elevation gain/loss

  • Someone unfamiliar with the impact of elevation might mistakenly call an average pace of 10 minutes/mile “slow.” They aren’t accounting for the fact that the average mile climbed was 200 feet. This is the main reason I do not believe in online running pace calculators for training or competing on hilly terrain. This is why power will be a much better measure of effort and stress. So...

Power

  • A newcomer to the running world. Just give it a couple years and many of you will have power data on your fancy GPS watches.
  • Although the current power meters for running don’t directly measure the force produced by your body, it’s still more accurate than guessing based upon how you feel.

With software like Golden Cheetah or Training Peaks, you could dive even deeper with these calculated measures:

Critical velocity

  • Critical velocity is the pace that you could theoretically sustain for an indefinite amount of time. Training at or above critical velocity is one way to focus on becoming faster.

Training stress scores

  • Training stress is a measure calculated by considering heart rate (as a measure of intensity) and time.
  • Acute or short-term training stress (stress over the last 7 days) vs.
  • Chronic or long-term training stress (stress over the past 42 days)
  • Training stress balance is about managing the balance between the two in order to provoke higher competitive performances
 Training stress graph for 2016

Training stress graph for 2016

Next post I'll go over more planning tips. Please let me know if you have any questions at derek@mountainridgept.com. 

Seeking improvement? Make friends with vulnerability.

Have you ever wanted to improve at something? Shooting a basketball, playing a guitar, public speaking - the task doesn’t necessarily matter. If you’ve ever thought “I could do this better than I am right now,” then you clearly wanted to improve. But did you actually take the steps necessary to create that improvement?

The problem is that there is a lot that goes into any improvement: seeking guidance, planning, good old-fashioned work, patience, practice, discomfort, commitment, nasty emotions, vulnerability. Improvement arrives only with overcoming these obstacles.

By trying to become better at anything, you open yourself up to the judgment of others and to self-ridicule. After all, we are often our own worst enemy.

I understand that for patients to seek treatment for an injury they are sticking themselves out there, making themselves vulnerable to some stranger’s judgment. But once that ball is rolling, it’s unusual to see someone regret the momentum.

Fear of failure is undoubtedly most of the reason we fear vulnerability. And there are also those who have a fear of success. Perhaps it’s just fear of change. Change leads to other obstacles, more demand, and the cycle never stops.

In any circumstance, it’s easier to maintain the status quo. You are less likely to attract attention or to be exposed to your peers. Maintain at all costs, we think, simply because it’s comfortable.

Improvements in performance (and often in life) are made when you venture outside the zone where you are comfortable. Without the discomfort of the unknown, there is no learning, nothing gained, probably no real experience you will recall at a later time when faced with challenge.

It can be oddly addictive to enter the unknown provided that some good experience comes of it. If you succeed, the psychological reward is substantial and probably reinforcing enough to have you sustain your behavior.

Of course, if you fail (whatever that means) then your attempt to go beyond your perceived limitation is punished. Maybe that has already happened with enough potency or frequency that you don’t seek the unknown any longer.

I suppose this risk versus reward balance is why some people jump out of airplanes. Now that’s definitely a place of vulnerability. A significant adrenaline rush counteracted by the potential for an ultimate failure.

But I’m not asking anyone to jump out of an airplane. I’m suggesting that if you want to truly improve at a task that you must venture into it without thinking too much about the concept of failing.

Because, really, what is the result if you “fail”? Nobody dies. The consequences are rarely as inflated as we make them out to be. You could take comfort in knowing that you can often return to the status quo. Or should you?

There is a difference between feeling vulnerable and truly being vulnerable. Failing makes people feel vulnerable but really it is just a step in a process to making gains. Left unchecked, emotion won’t lead to development, but that is what most of us use to make our decisions. It’s perfectly okay to feel vulnerable but letting it be a barrier to forward progress is where most people succumb, so they never realize improvements.

Success is a potent ingredient in the formula to overcoming any fear and vulnerability. Really you are the one providing your personal definition of success. Perfection does not exist, therefore success cannot be perfection. Success is a belief that you can achieve something greater. The reality is no one else is analyzing the daily minutiae of your life. If they are then they must be really bored, or perhaps jealous.

You don’t ever know exactly what is going to happen, even by taking the comfortable solutions and sticking to the norm. Why not try something different? Make yourself vulnerable.

A new method to predict marathon race times with wanderings and wonderings about base versus interval training

Prediction of running performance is nothing short of an intriguing concept. Everybody wants to know what they are capable of achieving, according to internet math, even if they don’t actually pull it off in real life. Predictive measures have been used to obtain expected race times for multiple decades, and I would like to think they are more accurate now than in the 1970s. There is nothing like a true performance at a specific distance to guide your training and racing. But for a beginner or someone that has done just a handful of events, a race predictor can be really helpful to determine appropriate pacing.

I recently came across an article on a new marathon time prediction method that can be found here. The calculator is found here. It is based on research by the same author, available at this page. The researchers used my favorite statistical method, regression analysis, to create a prediction model for amateur runners, based on amateur data. This differs from previous predictors which were largely created from the performances of elite runners.

Runner’s World recently updated their predictor to this same format because it tends to generate a slower time than other predictions would develop. Why is that important? To keep you from blowing up badly, particularly if you are mid-pack or slower runner.

The nice thing about this specific calculator is the fact that it considers your average weekly mileage in the equation. This lets you see where training can play a role. You can really ask yourself if that extra 10 miles per week is worth it when the gain is just one minute over the course of an entire marathon.

For some, of course, the answer is “yes.” But for others that extra 10 miles each week can result in frustrating injuries that could keep them from training and racing altogether. And maybe during that 10 miles you would rather be playing with one of your kids. There is also research to indicate a lessening health benefit of higher mileages (http://www.mayoclinicproceedings.org/article/S0025-6196(16)00068-9/fulltext). The predictor provides a nice method to weigh the diminishing levels of improved performance with the benefits of health and sanity.

This had me thinking, it would be interesting to see how training type plays a role in the goal performance for a given individual. In other words, do you gain more improvement from a focus on long, base runs, or on high-intensity interval work? The average marathon training program is going to include both, because they work different metabolic systems, but I would be curious to know which is more critical for a given person. Sometimes it is obvious, sometimes not.

Let’s say you want to run a 3:30 marathon on 25 miles per week but the predictor expects you to do a 3:35. Is there a certain type, frequency, or amount of anaerobic training that could make up the difference while keeping the mileage that low? Maybe that’s not reasonable and it really comes down to making sure you get in increased mileage to gain that five minutes.

It will undoubtedly vary depending on training history and genetics. The Crossfit nation would try to make us believe that it’s all about the interval training. I would argue that lack of familiarity with longer distances weighs more heavily in a new runner than any amount of anaerobic ability gained with high-intensity intervals. Once you have some base training and long racing experience, then feel free to focus on both or just on harder intervals. I venture a guess that intervals and tempo efforts gain fitness for many people simply because they haven’t stressed themselves in that specific manner. That fitness won’t help much if you mentally crack at mile 23 because it’s all new territory.

To think you can do a marathon well and only do long runs of six or eight miles seems like a recipe for disaster in the uninitiated, though. For a 5K or 10K race, I suspect that many amateurs could rely heavily on interval training two to three times each week for multiple weeks in a row and never once do continual easy or moderate paced runs. Yes, it would still be useful to at least occasionally cycle through weeks of longer, slower base training to stress the aerobic physiology. It is not common to fluctuate training this dramatically, though. Yeah, the mileages would be all over the place. I may have to use myself as a test subject. Maybe it’s a little different way to consider “polarized training.” If nothing else, it is a definite change of pace.

The variation of training stimulus could keep injury rates lower yet continue to change fitness. I recall reading a research article many years ago indicating performance gains in elite level endurance athletes because they essentially doubled their base aerobic training time. These are athletes that are already at the top of their game but they swung the training pendulum one direction and changed their program so dramatically that it helped get them through a plateau. This can clearly work both directions.

My only concern is to be cautious of injuries. Hyper-volume training is surely a recipe for overuse injuries. Too much interval work could be a problem too, especially if you were trying to keep overall weekly mileage high, if your interval running technique was drastically different than your normal slow technique, or if your muscles and tendons were just not up to either task because of strength deficits (a.k.a. start strength training in any case).

Send questions and comments to derek@mountainridgept.com. 

Foot and ankle pain from posterior tibial tendon and muscle injury

Anatomy:

The posterior tibialis muscle originates on the back of the tibia, turns to tendon, and runs behind the bump at the inner ankle (the medial malleolus), and inserts into several of the bones within the arch and underside of the foot.

 image courtesy aafp.org

image courtesy aafp.org

Function:

In a standing position, when the posterior tibialis muscle contracts, the inner arch of the foot tends to rise away from the ground. In walking or running the tendon receives its biggest demand when we arrive at midstance and have all of our weight on that single foot. Some pronation during this moment is great for shock absorption but it should meet an end point. That end point is controlled partly by this muscle. This muscle plays a very important role in controlling the amount and rate of pronation occurring at the midfoot.

Causes:

Because the posterior tibial tendon takes a bend around the back of the tibia, the tendon is subjected to tensioning loads as well as compressive loads. To make matters worse, that area of tendon has a poor blood supply.

As usual, progressing intensity or volume of exercise too rapidly is a common finding in people with pain from the muscle or tendon.

There may be weakness of nearby muscles, like the gastrocnemius or soleus, resulting in greater demand on the posterior tibialis muscle.

Some people will aggravate the posterior tibialis tendon indirectly because they lack full ankle dorsiflexion range of motion. By losing motion at this one joint, the adjacent joints can be placed under additional demand. That stress is then controlled for by greater posterior tibialis muscle and tendon activity.

A change in footwear or foot orthotics could be related to onset as the demand on certain tissues could increase.

Poor balance, stability, and positional control of the hip, knee, and ankle may contribute overuse demands to the tissue.

Some people are predisposed to a more flexible and flat foot structure that will, in turn, place greater forces on the posterior tibialis tendon and muscle.

Other rare cases may have a tendon that wants to pop out of the groove that it is resting within, which is associated with a previous traumatic ankle injury.

Signs and Symptoms:

Pain typically comes on without trauma and is usually directly behind the medial malleoli if the tendon is involved but can be at the calf and bottom of the foot if the symptoms are coming more from the muscle. It is interesting to note that an aggravation of the posterior tibialis muscle can mimic an Achilles tendon pain. Take a look at the muscle referral pattern.

Decreased ankle dorsiflexion motion is common. We would measure the joint angle in the clinic, but consider it a bad sign if you can’t squat fully while keeping your heels on the ground or if you can’t lift your toes and forefoot off the ground a couple inches while keeping the shin perpendicular to the floor. Here I have used a ruler as a reference. The ruler maintains its position while I pull the foot toward my shin. Notice the size of the gap between foot and ruler in the second picture. While decreased motion could be from weakness of the anterior tibialis muscle, shortness of the calf muscles is often a contributing problem.

There may be localized tenderness and swelling just behind the medial malleolus. Especially as the condition progresses, you may notice a clicking sensation at the inner ankle region during ankle movement. This could be particularly bothersome if it is simultaneously painful.

When performing a single leg calf raise there can be pain and weakness, especially at the end point of the motion where the heel should be twisting inward a small amount, as in the picture below. You should be able to perform at least 10 repetitions of a single leg calf raise in a row, one set with the knee straight, one set with the knee bent.

Balance and stability should be sufficient enough to maintain a single leg stance with your eyes closed for 30 seconds.

If the destruction of an early tendon injury worsens, the inner arch will flatten as the tendon lengthens abnormally, causing a “flat foot deformity.” This is the reason you really want to catch an injury to the tendon early, before any long-term structural changes have occurred. If the normal structure has been modified then you will have a much longer road to recovery.

Other possible or related problems:

Pain at the inner ankle and lower leg can also be caused by a few other issues. This is where seeing a trained professional helps to rule out these other problems. If you are experiencing severe pain, numbness, tingling, pins and needles, general calf swelling and tightness then definitely don’t try to self-treat.

  • Ankle sprain
  • Blood clots in the lower leg
  • Sciatic nerve compression and irritation
  • Lumbar nerve compression and irritation
  • Tibial nerve compression and irritation
  • Sacroiliac joint alignment/stability problems
  • Hip region muscle trigger points/muscle tissue dysfunction
  • Flexor digitorum longus tendinopathy/trigger points/muscle tissue dysfunction
  • Flexor hallucis longus tendinopathy/trigger points/muscle tissue dysfunction
  • Abductor hallucis trigger points/muscle tissue dysfunction
  • Loss of hip mobility from decreased muscle flexibility or hip joint problems
  • Fracture or stress fracture
  • Tarsal tunnel syndrome

Treatment:

General treatment goals are going to consist of some combination of the following:

  • Decreasing pain
  • Increasing lost motion
  • Increasing stability and balance
  • Increasing muscle and tendon endurance
  • Increasing muscle and tendon strength
  • Resolving any abnormal movement patterns
  • Preventing recurrence

Short-term rest, ice, and NSAIDs are generally appropriate in healthy people for immediate care of a new injury to decrease pain. I am always going to emphasize that it is important to determine why the injury occurred in the first place as these methods do nothing to address the real causative factors.

Supporting the arch of the foot during the stance phase of foot strike can be helpful in decreasing load on the posterior tibialis temporarily. This can be achieved with taping, temporary or permanent foot orthotics, and footwear modifications. You should not become reliant upon these devices to keep your deficits at bay forever, though.

Strengthening the posterior tibialis muscle and tendon can be a beneficial method to increase tissue integrity. The most common strengthening method for a moderately calm tendon is a single leg calf raise performed with the knee straight and the knee bent. If that is too painful, the individual can perform these with double leg support or perform ankle inversion with a cuff weight or band until the calf raise can be performed with moderate or no pain. When strengthening tendon, the current research indicates that it is acceptable to cause mild discomfort in the area of tendon injury but you would not want to push the tendon so far that it remains painful for hours or worsens the following day. In many people holding the topmost portion of the calf raise for 15-30 seconds, known as an isometric, can help decrease pain.

There is no substitute for having full ankle range of motion. If ankle motion is lost, you may need to work on a combination of stretching, joint mobilization, and other soft tissue work to regain mobility. Soft tissue techniques are of benefit to improve any excess muscle tissue tone and gain length. This includes foam rolling, massage stick rolling, massage, myofascial release, and dry needling.

More aggressive treatment can include the use of a walking boot for immobilization and corticosteroid injections. These injections will coincide with a risk of tendon rupture, however, and should be avoided if possible. Another type of injection is PRP (platelet rich plasma). Some physicians will provide patients with nitroglycerin patches to improve local blood supply to the tendon. Surgical intervention is the last thing you want but may be particularly necessary if the tendon has remained inflamed for such a long period that it cannot glide smoothly in its sheath or has split longitudinally. A newer minimally invasive procedure to help chronic tendon injuries is called Tenex.

Please share this article with your running friends! To receive updates as each blog comes out, complete the form below. And if you have any questions, please email me at derek@mountainridgept.com.

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