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Anatomy and Physiology

The Eyes Have It

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Taking a break from Covid-related news, I came across a 2018 article in the ACSM Health and Fitness Journal extolling our marvelous (and maybe underappreciated) eyes.  Certainly those with impaired vision do not take their eyes for granted.  My father in his 80’s suffered a mini-stroke and woke up effectively blind.  He lived another 10 years but his enthusiasm for life waned as he was a voracious reader.  Many others have had sight complications earlier in life or even at birth.  But for most of us, we rely on our eyes without thinking a whole lot about them.

So, James Peterson’s article “Ten Nice-to-Know Facts About the Eyes” caught my eye, literally, and I thought my blog readers might find this interesting.  So a bit rephrased, here are his 10:

  1. Our eyes are nearly full size at birth.  The rest of the body grows around them!  For those with normal vision about 80% of what we learn and remember is due to sight.  
  2. After the brain, eyes are the most complex and powerful organ in our bodies.  With them we distinguish shapes, colors, depth, and adapt to changes in light.  The tiny muscles controlling the eyes don’t get time off — they are on 24/7.
  3. The eyes feed images to our brain for translation, allowing us to see.  If anything disrupts that transmission, all is blank.
  4. We blink about 5 million times a year, helping to lubricate the eyes and remove debris.
  5. The eye is composed of over 2 million working parts (rods, cones, muscles) and over 100 million cells.  A stack of 100 million dollar bills would be 7 miles high!  These types of numbers are hard to fathom.
  6. Eye color is determined by the amount of melanin (a natural pigment) in the front layer of the eye.  Melanin has protective properties.
  7. Eye health is affected by our diet.  Fruits and dark leafy greens are particularly good for eyes.
  8. Our eyes have 256 unique characteristics, whereas fingerprints have 40.  Meaning, eyes will probably become increasingly used identifiers.
  9. Regular eye exams will alert us to glaucoma, macular degeneration, and cataracts, conditions typical in older adults and which early detection may allow for treatment.
  10. Eye transplants are not in the offing.  Connecting 100 million nerve fibers is beyond the current or foreseen abilities of medical technology.  If we’re fortunate, we get one good set of eyes to use and care for.

So, on your next run, perhaps you’ll find yourself thinking about the many virtues of our eyes while navigating the trail, watching flowers, birds, and the bikers, walkers, and other runners coming along (with or without masks).  And then go home and enjoy a kale salad!

Pliability

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I’ve been reading Anatomy for Runners by Jay Dicharry (Skyhorse Publishing, 2012).  It’s conversationally written.  You can picture yourself in a seminar setting with Jay presenting PowerPoints, cracking jokes, and noting anecdotal evidence.  The book covers the entire gamut of running, with a focus on injury prevention.  It’s pretty opinionated but includes an extensive reference list from which he draws.  Dicharry is a seasoned clinician and has no doubt seen many versions of all the injuries about which he writes.  He discusses in depth a concept worth expanding on — pliability, which Webster defines as “flexible, supple, yielding.”   Dicharry uses it in the context of muscle function.

We all know what it feels like to be tight and stiff.  This, often in spite of regular stretching and taking it easy between hard efforts.   As Dicharry explains, the tension in muscles is not the same up and down the line.  And does not dissipate evenly.  Let’s look at hamstrings, the oft strained muscle in runners.  The biceps femoris attaches both at the hip and below the knee.  With insertion points crossing two joints, the tension varies along the hamstring.  For example, when running, one end of the biceps femoris contracts concentrically while the other end is eccentrically contracting.  Talk about inherent differences in tension along the hamstring!  So how can we realistically expect recovery will be the same along the entire muscle?     

Another reason for uneven recovery Dicharry discusses is accumulated scar tissue,  He notes  scar tissue results in a random orientation of muscle fibers.   Collagen, a primary component of muscle, provides a framework, when intact, has muscle fibers lining up in parallel so they pull in the same direction.  But when scar tissue sets in, a “sticky” grid impedes smooth muscle function.  Dicharry suggests this can be from not only traumatic injury but also the cumulative effects of hard workouts from which we have not fully recovered.  And that lack of recovery can build incrementally from week to week, month to month, and even year to year.  Further, this deviating grid ensures tension along the muscle will vary, meaning some parts have to absorb more tension than other parts along the muscle, which can then lead to strains and tears.  It’s a repeating cycle we are all too familiar with.  We have a strain, let it rest some, come back to action, and after a while incur an injury at or near the same location.  The key then is to break the cycle.  How can we do that?

There’s not a simple answer that applies the same for everyone.  But universal is a need to realign the collagen in parallel so the load can be more equally distributed, eliminating the stress points of reinjury.  Naturally, we’re better off if we can keep up with the damage as it incurs by mobilizing the scar tissue early in the cycle.  But each of us is where we are, with our own injury history and have to start somewhere.

Dicharry describes some ways to mobilize scar tissue.  Deep tissue massage by a trained massage therapist is certainly an effective way, but one with the cost of time and money.  Perhaps the easiest way is to incorporate foam rolling before and after exercise as well as strategic rolling on a softball or lacrosse ball.  The latter is painful but can be applied from the hip at the tensor fascia latae — the top of the ITB and the glute medius as well as along the hamstrings, quads, and calves right down to the Achilles.  As to foam rollers, I recently saw an ad for a vibrating roller.  I was skeptical at first, especially since it was promoted by TB12, Tom Brady’s sports equipment and consulting arm.   But I looked at the options beyond TB12’s $150 model and found some good ones for $100.  Looking through the reviews, I think this could be a good addition to an array of home exercise equipment.  Whatever we do, we will benefit by smoothing out the rough edges of our muscles and increasing our pliability. 

Squats

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We’ve all seen those guys (and increasingly women) at the gym in the squat racks lifting several times their body weight.  They hold the bar behind their neck (back squat) or over their collarbone (front squat.)  It can be intimidating to watch this, and we might easily conclude “that’s not for me.”  But I’d like to convince you otherwise, based on my own experience.

First, let’s look at the squat and why it is considered by most strength and conditioning coaches the most complete strength exercise.  For starters, it’s a multi-joint exercise involving at least the hip, knee, and ankle joints.  The squat also builds our balance and flexibility.  In total, you get more bang for your buck – the squat is efficient!  In addition, the involved muscles get a dose of concentric, isometric, and eccentric contractions.  And speaking of muscles all of the big ones in the lower extremity are engaged: quads, hamstrings, calves, front and back leg muscles, as well as those in the ankle and feet.  And the back gets a quality workout too, assuming good form and depending on the type of squat done.

With this kind of payback, why do most runners avoid squats?  It’s based in part on misconceptions that squats are bad for our knees and back.  We see the butts of those weightlifters crouching below their knees and think “ouch.”  But the reality is our joints are lubricated by weighted movement and if we keep a neutral (straight) spine, and we build up progressively, squats won’t hurt us. 

So, progression is key.  You wouldn’t jump into deep squats with heavy weights any more than you would begin doing speed work with all-out sprints.  Our bodies are designed to respond to an overload by building up over time. Technique is vital!  Those lifters have probably been coached or prompted along the way.  We can’t see ourselves as well as someone looking at us.  This is especially true if you’re using a bar.  Which is why I suggest starting (and maybe sticking) with goblet squats, named because you hold a free weight or kettlebell in front of you with both hands as if you’re holding a goblet.

To develop proper form, start with bodyweight squats.  Watch yourself in the mirror and ideally have an experienced lifter give you feedback.  Don’t be shy – people are willing to help! The important thing is to evenly distribute your weight as you descend so you maintain your base of support.  If you find yourself rocking up on your toes, this will impair your ability to lift and likely have you falling forward, feeling foolish, and possibly hurting yourself.  On the upward return, push up from/through your heels.  At first you may find it difficult to go deep (thighs at least parallel to the ground) but keep at it.  It may take three to four weeks to get really comfortable with your form.  Work your way up to 12 reps and do two or three sets with ~60 seconds rest in between sets.

Once you get the hang of bodyweight squats, start holding a dumbbell against your chest.  Start light, say five pounds.  Notice how even that amount of weight changes your center of gravity and how you must adjust to keep your balance.  Same deal – work up to 12 reps with 2-3 sets and do this at least three times per week.  Ideally you have a gym with dumbbells going up in 2.5 lb. intervals up to 25 pounds.  Above that the increments are usually five pounds.   That type of increase – from 5 to 7.5 to 10 to 12.5, etc. is a good way to progress.  There’s no hurry to get there.  You will likely find adding 2.5 lbs. per week about right.  Do not progress until you find 12 reps comfortable with perfect form!

I was a skeptic when I started doing squats.  But perhaps over time you too will find yourself looking forward to this exercise.  While you will not likely be lifting the heavy stuff in the racks, it’s cool to watch and feel yourself go deep into your squats and feel all the muscles working and the joints getting internal grease.  My guess is you will find it helps your running, enabling a smoother and more powerful stride and leave you feeling less stiff afterwards.  We’re unlikely to show up at a weightlifting contest (unless to watch!) but those weightlifters probably won’t be present at our next road race.            

It’s a Stretch!

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In our Biomechanics of Human Motion class, we’ve been looking at the topic of flexibility and range of motion – i.e., stretching.   I thought I knew a thing or two about this topic.  In reality, I knew a smidgeon.  Humbling!

Let’s walk through what we’ve covered in class.  As with most biomechanics, it’s important to start with the micro and build up from there.  In describing this, I’ll draw heavily on Joseph Hamill’s book Biomechanical Basis of Human Movement, 4th edition, p. 116-118.   This text is an amazing compendium of everything biomechanical, from anatomy and physiology to muscular force production.  Not an ideal nighttime read, but after a good night’s sleep and with a strong cup of coffee, this book has plenty worth exploring.

Hamill defines flexibility as “the terminal range of motion of a segment,” such as a hip or leg.  This is comprised of both active and passive elements.  For example, during the running stride, our hamstrings actively engage to pull our leg behind us and then passively engage as we reach the top of the range to terminate the forward “swing phase” in preparation for the quads to pull the leg down.   If we are inflexible, then this total range of motion is limited and we begin the “stance phase” (when our foot meets the ground and pushes us forward) before enjoying the benefits of a full stride length.  This results in less “float” (the time we’re airbound), which gives muscles a chance to momentarily relax and regenerate force.

There are two main components that contribute to flexibility:

  1. Joint structure
  2. Soft tissues (muscle and fat) and connective tissue, primarily tendons and ligaments  

Healthy joint structure does not always follow the textbooks.  We’re not all built exactly the same.  Some of us have larger bony projections than others, with the fit of the femur onto the tibia, for example, varying among people.  While important, joint structure is not the major determinant of flexibility.  Rather it’s the muscle and connective tissue length and elasticity, which can be enhanced with stretching.   It follows that if we increase our range of motion, this will help our running.  

I’ve been testing this out the past four months incorporating a pretty rigorous stretching routine 5-6 days a week encompassing all the major lower extremity muscles including the soleus, gastroc, hamstrings, quads and various hip flexors.  This isn’t new – I’ve been stretching for years.  But what has changed is that instead of holding stretches for ~5 seconds, I’m holding them for a full 30 and doing multiple sets.   These are easy stretches – pain, no gain!  The second and third sets show noticeable increased range.  After three sets, change is minimal, so I call it quits.   Suffice it to say, this stretching routine is a big commitment.  It takes 20-25 minutes, so about two hours a week in total.  When time is tight, it cuts into my running mileage. 

Has this helped my running?  I think so.  For example, last month I ran the New Hampshire 10 Miler at a pace four seconds per mile faster than at that race three years ago.  The age grade tables say to expect a 14 second per mile decline over those three years, so for my age that’s an 18 second per mile delta and for 10 miles a three-minute age-graded improvement.  I’ll take it!  But perhaps more important, it feels better running.  I start training runs less stiff and after a mile or two more easily up the tempo.  When racing, assuming a good warmup I generally feel ready to run with a bit more “bounce” in my step.  That’s not to suggest the racing is easy!  We test our limits, whatever the time and place achieved.  

Regrettably, stretching is one of the last things runners take time to do.  The aim of this post is to get you excited about regular stretching!   There are two types of stretching — dynamic and static.  Each have their place with easy dynamic (moving) stretching good before our runs and static (holding) afterwards.  The order is important.  The research shows dynamic stretching before runs positively impacts running – getting us ready to run – whereas static stretching negatively impacts us.  The reasons for this are somewhat technical, but the short of it is our muscles and joints loosen up during exercise and thus are more receptive to stretching.  This allows for a more relaxed and deep stretch, which if done consistently can permanently increase our range of motion (assuming we consistently follow the program.)   

As with all things running, training is a complete package, balancing aerobic and anerobic running with strength and flexibility work.  It’s hard to maximize our potential at any age without a serious commitment to all four aspects.  I’ll look for you on the stretching mats at the gym!

Take a Knee

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Football season is about to begin.  You may recall, when a player’s knee hits the ground and he’s touched by a defender, play is called dead.  Often the quarterback “takes a knee” to stop the clock.  But this post is not about football!  Rather a look at our marvelous and incredible knees, the mid-point of our lower extremities — the runner’s drive train.  Since knees are the most common site of running injuries, it’s worth reviewing how they function.  

Pictured below, the knee is the largest joint in the body.  The knee actually has three joints:  the tibiofemoral (largest, lying between our thigh and lower leg and generally thought of as the knee joint), the patellofemoral (kneecap), and the tibiofibular (below the kneecap and not directly part of the knee movement.)  I’ll focus first on the tibiofemoral joint here, which functions as a hinge.

Unlike the hip joint, where there is significant bony structure, most of the knee’s stability comes from soft tissue – ligaments, tendons, muscles, cartilage, menisci, bursa, and fat pads.  This constitution allows for significant range of motion – for example, we can bend our knee to touch our butt with our foot. 

When looking at knee anatomy, physiology, and biomechanics, one quickly realizes how much is going on.  Being in the middle of our lower body kinetic chain, if something is not right in the hips or ankle/feet, it usually wreaks havoc in the knee.  Amidst all the knee hardware is a lot of viscous synovial fluid, the lubricant that reduces friction.  We think ice is slippery.  But the inherent friction in a normal knee joint is 20 times less than walking on ice!

First, let’s address a misconception that running is inherently bad for our knees, that we wear down our precious cartilage with each step.  It’s not that simple!!  In fact, the research shows a runner in good health and lean weight will likely have more cartilage than a person who does not perform weight-bearing exercise.  This follows Wolff’s Law, which holds that bone (and other types of connective tissue, such as cartilage) adapt to loads under which they are placed.   Further, cartilage has no blood or nutrient supply – this is provided by the synovial fluid that bathes the cartilage within the knee capsule.  And that bathing is enhanced by vigorous movement.  So weight-bearing exercise stimulates the integrity of cartilage rather than damaging it.  

But here’s the rub: the bones and cartilage can’t do it alone.  The knee’s stability relies heavily on strong muscles, tendons, and ligaments to ensure undue weight is not placed directly on the articulating surfaces of the knee joint.  Running exerts a force roughly three times body weight on the knee, so all of these components need to be doing their job to avoid damage.   It’s true undue stress can wear down our cartilage.   Also as we age, we experience a slower rate of tissue replacement and repair, decreased water content (healthy cartilage is 80% water!) and have less robust muscles and tendons.   We cannot defeat all of these aging processes but the rate of change can be mitigated.   Strength training is one way to do that.  For example, properly performed squats strengthen all the muscles surrounding the knee.  However, one of the last things runners seem to take time for is resistance training.  

Virtually all runners have had a bout or two (or more!) with knee pain.  In fact, the knee is the most prevalent site of runner injuries, clocking in at about 40% in any particular year.  Runners may have acute knee injuries, from a fall, an awkward twist, or from activities other than running.  But the most prevalent issue for runners is chronic pain, with patellofemoral pain syndrome (PFPS) at the top of the list.  

The patella (our kneecap) is tightly surrounded by muscles, tendons, and ligaments.  It covers the patellofemoral joint (PFJ) and serves as a fulcrum when we bend and straighten our knee.   The pain, often called “runners knee,” is due to the underside or sides of the patella rubbing against the bone below it. The alignment of the knee and the strength of the muscles surrounding it, in particular the quadriceps, can help keep the kneecap on track and ward off PFPS.

Another debilitating source of knee pain is osteoarthritis, a self-perpetuating condition where depleted cartilage results in bone-on-bone friction.   Ideally a strength training program begun early in a runner’s career can help avert this condition.  In any event, osteoarthritis is a complicated condition warranting its own blog and that will be forthcoming.

Suffice it to say, knees are vital to lifelong running.   And it behooves us to give them their due attention and care!  

Gait Keeping

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Webster’s defines a gatekeeper as “one who controls access.”  And in a sense, this is what our gait does.  Regardless of whether we are running or walking it determines how we move through our day.  

Several things come to mind when looking at gait:

  1. To walk or run we engage the entirety of our lower kinetic chain, from the hips to our tippy-toes.
  2. The muscles, ligaments, tendons, and joints in that chain are intricately designed to do certain things and if those elements are not functioning properly, our gait is compromised.
  3. Gait deteriorates with age.  However, vigilance can allow us to forestall many common effects and even partially reverse some of what may have taken hold.  

First, let’s underscore the importance of gait.  A. E. Patla, a reknown researcher in gait, notes “nothing epitomizes a level of independence and our perception of a good quality of life more than the ability to travel independently under our own power from one place to another.” Aside from our ability to think, being mobile is arguably the most joyful thing we do.  It’s a rare person who has not been laid up for a time.  We go stir crazy!  And can’t wait to get moving again!!  Sometimes to our peril we come back too fast and hard.  But that’s a topic for another post.

Now let’s look at gait anatomy.  Starting at the hip, which is not a separate structure, rather a ball-and-socket joint formed by the articulation of the acetabulum (a concave indention in the pelvis) and the round head of the femur (our thigh bone.)   Aside from the shoulder, this joint has the body’s greatest range of motion.  Its stability is enhanced by cartilage, ligaments, and labra with movement controlled by 22 distinct muscles pulling in various directions against the articulating bones.  If any of these muscles are too strong, weak, or inflexible, it affects our gait. 

The femur, which resides between the hip and the knee functions as a long lever.  It is the largest bone in our body and comprises about one-quarter of our height.  When running, the femur normally moves (flexes and extends) at the hip joint about 105°.  The four quadriceps in the front of our leg and the three hamstrings in the back are key drivers of leg motion.  If the quads are considerably stronger than the hamstrings, often the case with runners and cyclists, this can lead to a pulled hamstring, which every runner knows is debilitating!

Heading south, we arrive at the complex knee joint.  The anatomy books show the end of the femur fitting neatly onto the upper notches of the tibia (our lower leg) to form the tibiofemoral (knee) joint.  It’s not always such a perfect fit and small changes in angles at this joint can lead to all sorts of problems.  As a synovial hinge joint it resides in an enclosed capsule and functions largely in one plane.  This allows for knee flexion and extension, critical movements when we run or walk.  In the front is our kneecap, the patella. The most common injury in runners is knee pain at the patellofemoral joint, which among other things can be triggered by a knee collapsing inward upon impact.

Below the knee, the tibia provides the majority of the support down to the foot, with the parallel fibula largely functioning as an insertion point for various muscles.  Our biomechanics place a lot of force on the tibia, and that is where many stress fractures are observed.

We finally arrive at the foot/ankle, thinking there is already enough to worry about above it!   But each foot has 26 distinct bones, 20 articulating joints, and over 100 muscles, tendons, and ligaments.  Any of these malfunctioning can cause a problem!  To boot, there is probably more variation in foot motion among athletes than any other part of the body.  So a lot to keep track of!  

With basic lower extremity anatomy covered, the last part of this post hones in on what we can do to be gait keepers.  Ferber & MacDonald (Running Mechanics and Gait Analysis, 2014, Human Kinetics) note there are four factors to consider in gait assessment:

  1. Anatomical alignment
  2. Biomechanical gait patterns
  3. Muscular strength
  4. Tissue flexibility (and range of motion)

I would add a fifth factor – a commitment to continually address at least the last two items, over which we have the most control.  While exercise science explains how the lower extremity kinetic chain functions, we know less about what exercise programs most effectively address gait deficiencies.  Fortunately, technology is on our side.  Nic Fiorentino and Ryan McGinnis, professors in biomedical engineering at UVM, are developing wearable technology to measure various parameters of gait.  This would extend gait measurement beyond the lab, where reflective sensors are used to detect movement, to anywhere, anytime monitoring.  Just as activity trackers have revolutionized the monitoring of physical activity, such technology would provide vital feedback on gait for both researchers and individuals, whether or not they are participating in studies.

Regarding strength, the key to propulsive foot movement is activated plantarflexors. These include our calf muscles (gastrocnemius and soleus) and three deep muscles in the back of our leg (tibialis posterior, flexor hallucis (big toe) longus, flexor digitorum (smaller toes) longus.  These muscles propel us forward.  When we go “up on our toes” it is the plantarflexors that get us there.  When these muscles are weak, we lose “pop” in our step.  Biomechanically, the other side of story is our foot extensors.  They too have long names but in short enable us to lift up (dorsiflex) the front of our foot as we begin the gait cycle.  If the extensors are weak we slide into the step and shuffle along.  We often see this in older runners and non-runners alike.  An invitation to trip and fall!  

Running speed is a function of stride length and rate (cadence) and is linked to gait.   If our muscles or joints are stiff, range of motion is hampered.  Thus, even if cadence remains intact we slow down.  Impaired range of motion decreases “flight time” — when both feet are airborne.   Studies confirm a decrease in flight time negatively impacts speed.  Additionally, a decline in average stride height not only affects speed but also leads to more tripping and falling.  This is where a corollary to walking comes in: regardless of speed, if we are not sufficiently lifting our feet, we tend to stub our toes and trip.    

As to exercises, calf raises (first with body weight and then weighted), marching with high leg lift, and simple jumping and skipping will send the right message to these muscles.  One can then progress to long jumps (OK, maybe short jumps to start!) and low box jumps as well as progressive skipping and jumping drills.  Following up these exercises with several sets of 30-second static stretches will enhance hamstring range of motion and can be done with ropes or bands

Gait is a big topic and I’ve barely scratched the surface.   Subsequent posts will dig deeper into ways to enhance it.  Bottom line, gait is vital to us regardless of age.  But perhaps more so as we age.   Let’s be gait keepers!

Smart Recovery

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I wrote a blog post in 2015 entitled the Art of Recovery.  The gist of that post was to run slow, really slow, a couple days a week and particularly after a race.  Well enough, but there’s a whole lot more to consider.  Also, that post was not specifically geared to masters runners whereas this one is.  I’m drawing some points made by Peter Reaburn in his comprehensive book, The Masters Athlete.

The main purpose of recovery is to avoid injury.  As masters runners, we are particularly vulnerable to injury after races or an extremely intense workout or series of workouts.  For a 5K, the recovery period is three to five days, for a half marathon a couple weeks, and several weeks for a marathon.  Research suggests one day of recovery for every mile raced.  However, this assumes the following:

  1. We went into the race sufficiently trained and rested.  If we trained long and hard up until the day or two before the race, then we likely had muscle and tissue damage lingering, which the race added to.  This means more than the standard time to fully recover.
  2. Our fundamental biomechanics are sound.  If we excessively pronate, for example, and have not taken steps to correct that, then our muscles, bones, and joints in the hips and lower extremities will be heavily stressed.  Again, suggesting the need for more recovery time.
  3. We’ve been doing the requisite strength and flexibility training.  Training for everybody shortens and tightens muscles, which restricts our range of motion.  But us masters also have less forgiving tendons and ligaments.  Both basic exercise science and the effects due to aging dictate a need for regular static stretches, held for 15-20 seconds for full benefit.  On the strength side, masters lose muscle faster than younger runners and we need to work diligently to replace what we can.  The pounding from a race, probably run in racing flats, calls on these diminishing muscles to absorb the shock before it impacts our joints. 
  4. The course and conditions were somewhat “normal.”  If the weather was abysmal, as was the case for the 2018 Boston Marathon, all body systems are excessively stressed.  If the course has many steep ups and downs (or in the case of Mt. Washington just one hill!), this too adds stress. 

Assuming there are no red flags flying from these four points (please be honest with yourselves on each point), then we have to look at our weekly training schedule to make sure we’re not training too hard or long or competing too often.  

Specifically with respect to recovery, racing puts stress on various systems.  There is an emotional and hormonal rush from racing we don’t experience in our daily training.  That’s great and it can help us go faster, but we can’t go to the well too often or it runs dry.  And during the recovery period, it’s good to ratchet down the volume.  We’re not going to lose our fitness if we run 25-30 miles for a couple weeks instead of 40.  But we might slow down our recovery and set ourselves up for injury if we continue a normal load.  Our muscles are working hard to repair the damage – let’s give them a chance to do their work!

I am assuming race times and efforts are meaningful to you.  They are to me!  My race schedule (always subject to change) is set at the beginning of the year.  And it behooves us to space our races so we have the best chance of being prepared to have both good race times and an enjoyable experience .  Sometimes the schedule is beyond our control.  For example, this year the first two USATF-NE Grand Prix races are just 13 days apart, the first being a half marathon and the second a 15K.  Then two weeks after the 15K, the BAA 5K (a large marquee race during the Marathon weekend) comes along.  I never would have chosen this schedule but it is what it is.  Thus, it’s important to check expectations and make sure to allow for sufficient recovery between these races.  For me, that means a lot of days in the pool!

Let’s always keep the long view in mind.  Most of us have had enough injuries to know what tips things out of kilter.  We can learn from that and stay in the game instead of on the sidelines!        

Aging and Performance

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With 2019 almost upon us, it’s a good time to think about topics for my blog next year.  Immediately, the description of what I’ve gone back to school to study blips up: aging and performance.  Informed by what I learned last semester, let’s look at these terms. 

Aging.  What a huge topic!  There is muscular, bone, joint, ligament, neural, and mental aging, all drawing on changes in our cells that make up those structures.   For runners, and all athletes, these factors simultaneously affect us in varying ways and at various stages of life.

First, it’s important to distinguish between chronological and biologically aging.  Many elements of aging begin to show themselves around age 40.  In Bending the Aging Curve (2011), Joseph Signorile suggests there is a huge difference in neuromuscular function (a combination of many of the above-listed things) among life-long trained athletes, who have the highest NMF, those who started training at 40, and those who have never trained.  This is good to remember and hardly a surprise.  But whatever our starting point, we do experience changes as we age.  Let’s consider three.

First, Type II (fast-twitch) fibers tend to increasingly turn into Type I (slow-twitch) fibers after age 40.  Which means top end-speed is affected more than our 10K or marathon pace.  For the distance runner that means we see a declining kick and slower timed repeats.  If we used to find a 6:00 minute/mile pace a reasonable benchmark, that becomes increasing hard or impossible to achieve.  The good news is that the more resilient Type I fibers hang on longer and allow us to continue with solid long-distance racing into our 50s and well beyond.

Second, maximal cardiac output (CO), which is the product of stroke volume and heart rate, decreases with age.  CO is the amount of blood we circulate in one minute. For most people, at rest it approximates total blood volume, meaning our entire blood supply circulates in about one minute. During strenuous exercise that circulation rate roughly triples with our muscles screaming for an increased amount of blood replenished with oxygen and nutrients.  Training helps our bodies build this capacity in both production and efficiency of use.   But even highly trained athletes see decreases in their top-end CO.  The standard formula for maximal heart rate is 220 minus age.  While this varies by individual, the formula suggests a maximal rate of 200 bpm for a 20 year old and 150 bpm for a 70 year old.  Based just on HR, this suggests a 25% decrease in CO.  And stroke volume, a measure of blood pumped with each beat, is also taking a hit, as even healthy arteries stiffen with age.

Third, ligaments and tendons slacken.  While we may feel more tight and sore after running now than in our youth, in fact much of our connective tissue is looser and less dense.  Tendons and ligaments serve as elastic springs for muscles and joints.  This elasticity gives us lift and bounce when we run.  Take the Achilles tendon.  We rely on the Achilles for push-off, which enables gait height and stride length.  As the Achilles becomes less elastic, our ankle, which functions as a biological hinge, doesn’t have the same pop. We’re working hard, but not moving as far with each step. 

Perhaps that is enough about the physical impacts of aging for this round!

Performance.  Webster’s defines performance as “an action or process of carrying out or accomplishing an action, task, or function.”  Well enough.  Certainly this means different things to different people.  Unfortunately for some, navigating the activities of daily living (ADLs) is a form of performance.  

For this blog, I am looking at this from the perspective of exercise physiology.  Permit me to pose a question: Is someone running a 60-minute 10K “performing” in the eyes of a 38-minute 10Ker?  Maybe, maybe not.  And that 38-minute runner who clocks a 40:00 may mutter, “I was off today, I didn’t show up.”  The point is performance is relative to each of us.  And it changes as we age.  Running is a sport that requires us to live in the present while inviting us to remember (and celebrate!) the past.  I regularly run with a friend who ran a 4:10 mile in college.  Today, at 63, he’s pushing (really pushing!) to hit 6:30 mile repeats.  He knows he’s a few pounds overweight and due to job and family responsibilities not consistent with his training.  But I know he considers himself a performer when he toes the line at a local race.   Another case is a 27 year-old extended family member training to run her first marathon.  Based on her long runs, I think she’ll do well to run 4:30.  If the question is put to her, yes, she will be performing!

Thus, I suggest performance is something of a state of mind.  At the collegiate level, there are standards to meet if one is to compete in a conference, regional, or national event.  And there are qualifying times for the Boston Marathon.  However, for most of us, those times are irrelevant.  We look at our planned race schedule, set target times, and broadly determine what kind of training quantity and quality will be needed to meet those goals.  We are indeed expecting to perform!

As the year unfolds, I am sure to come across many avenues to explore on this topic of aging and performance.  There are no simple answers.  Ultimately, we must be forthright and honest with ourselves about what running means to us, and then gauge our commitment and the trade-offs we are willing to accept to attain a level of performance we are satisfied with.    

90 Minutes a Day

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As I move through the fall term at UVM, I’ve crossed paths with various people in the research and academic world. There is a ton of research being done in the applied sciences, much of it related to chronic conditions and disease mitigation. This is where the money is! Understandably, the NIH is not going to prioritize funding for developing interventions to maximize athletic performance into the golden years. This funding will likely come from private sources, supporting entrepreneurial researchers and practitioners looking for answers and strategies.

After a conversation last week with a professor about why he has chosen to research chronic conditions, I thought about why I am interested in interventions to preserve and extend athletic performance. And it hit me straight on: I see athletics as a true celebration of life! Certainly as much as good music, art, literature, or academic achievement. Those of us fortunate to have retained our fundamental capacities have a choice to pursue athletics at a high level or dabble at physical activity here and there and lament our declining abilities. I then thought about what it takes to retain this prowess and decided in simplistic terms it takes 90 minutes a day, on average. Not once or twice a week, rather every day.

I’ll break that down. There are three fundamental aspects that enable a high level of performance: aerobic training with anaerobic overload, strength training, and flexibility.   Aerobic training is the base for a runner. On average 45-60 minutes of the 90 minutes should be spent there (at an 8 to 9 minute/mile pace, that is a 5.5 to 8 mile run) with anaerobic overload (track, hill, tempo workout or a race) ideally a couple times a week.  On the strength front, we all know people who spend more than 90 minutes a day just in the weight room. More power to them! But that cohort is unlikely to read my running blog. My advice is to look to do strength and flexibility training with the other 30-45 minutes, probably in tandem with the aerobic/anaerobic activity. This amounts to a good block of time. To be clear, this is actual workout time, not the time getting to the gym/track or time spent dressing, showering or chatting with others in the gym. So, if you’re a morning person and you need to be someplace by 9:00, you’ve got to start your workout by 6:30 or so. If you’re an afternoon aficionado, a 5:30 p.m. start may mean you’re not home for dinner until 7:30 or 8:00.

On days we do longer runs or tempos, the entire 90 minutes (or more!) might be taken up with running. On average is the key here. We need those longer aerobic workouts and must build those in. But it’s important not to short-shrift the strength and flexibility work. A primary reason why chronic conditions develop in runners is too much running combined with too little weight work and stretching.

Good to insert a thought here about running equivalents (REQs).  I need to do a post focusing on these.  But suffice it to say, as we age (or even before we age!) we should incorporate non-running aerobic exercise into our weeks.  At this stage I run four, maybe five times a week.  The other 2-3 days generally involve deep-water running and/or Stairmaster workouts.  It’s a balance that has worked over the years.  Some prefer the bike or elliptical for their REQs.  Whatever, works for you, as long as you take days off from running!

What do I mean by strength training? We have hundreds of muscles, joints, tendons, and ligaments we simultaneously use to run. Which means we can’t rely on just five or six simple exercises. And since running creates forces about three times our body weight, it’s important to do some exercises with weights. I regularly perform about 20 weight-bearing exercises during the course of the week, mostly with machines or free weights. Since I do eight to 12 of these each day, each exercise it done roughly three times a week.

Flexibility is both a before and after affair. It’s good to start running days with 5-7 minutes of easy dynamic stretching. The body needs to be warmed up – even more so as we age – before we engage in vigorous physical activity.   If you feel tight in the beginning of a run, stop and do some more stretching. Then, after your run or aerobic workout stretch on benches in between weight reps and always, always, always do a bunch of eccentric heel dips (please see my November 2015 post on those!)

There is nothing new here. We inherently know all of this. But the Nike adage applies – “Just Do It!” It’s easy to get side-tracked and do first things first and let the second and third things slide. Maybe we could do that in younger years. But it catches up. Regardless, every day is a new day. And I encourage you to set aside 90 minutes today for your aerobic, strength, and flexibility training!

Ignorance is Bliss?

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It’s hard not be somewhat aware of the effects of aging on our running – it shows in our race and training times! We slow down and at root we grudgingly accept that.   But to be honest, my understanding of all the elements driving this was rather vague. Aside from injuries and accidents I was holding up pretty well. Something has changed, however, in the past couple years. The age grading tables suggest my per mile 5K pace should have slowed 11 seconds over the past three years. But I’m seeing a slowing approaching 30 seconds! So what’s up?

For one, I’ve spent much of the last year studying exercise physiology in preparation to return to grad school for research in aging and performance. I’ve been a sponge – absorbing anything I can find about why we slow down as we age.   Most of the constraints are explained by impacts on our muscles, bones, cardiovascular, and breathing systems. A somewhat comprehensive list I’ve compiled includes:

  1. Changes in muscular and connective tissue quantity and quality
  2. Decline in the number of neurons and a slowing of how fast nerve impulses stimulate our muscles
  3. Reduced key hormonal production such as growth hormone
  4. Retardation of pulmonary ventilation and gas exchange
  5. Declining cardiovascular function resulting in reduced VO2max
  6. Changes in bones, joints, and overall body composition
  7. Behavioral aspects affecting exercise adherence

So how does this knowledge play out? No doubt I’m both consciously and subconsciously carrying this stuff with me as I attempt to motor around the track, thinking:

(1) My maximum heart rate has decreased, which means I’m pumping less oxygenated blood to my muscles;

(2) The muscles getting this blood are fewer – both Type I and especially Type II muscle fibers – and they are all smaller;

(3) The contractile mechanism in muscles allowing for movement, technically called the “actin-myosin cross bridge” gets more sticky over time creating internal friction, detracting from useable muscular output;

(4) My joints, tendons, and ligaments are either less tensile or stiffer and certainly less flexible, putting a drag on my range of motion and stride length;

(5) The air sacs in my lungs are less pliable and I can’t help but notice it’s harder to breathe while racing or running intervals on the track.

So, I conclude, as I beg my GPS to show faster splits, that for all these reasons I am of course running slower while having to work as hard or even harder than ever!

On top of everything, on these hot summer days I’m aware the declined ability of our aging bodies to vent heat – I feel the heat and humidity in a way I hadn’t previously noticed.

So I ask myself, is all this new knowledge an added burden, as if I’ve gained 10 pounds (which I have not!) to lug around? Time will tell, as it usually does, what’s real and what is imagination. Meanwhile, I can’t put the genie back in the bottle – it’s out there and I have to live with it. The upside, I suppose, is that if I’m going to study aging and performance, I can include myself as a subject. I can be part of the experiment and try to learn something every day as I lace ‘em up and give it a go. Not exactly what I had in mind when I started this adventure. Maybe ignorance IS bliss!

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