Q&A

Is Rhabdomyolysis a threat to runners?

7/28/2017

Q - Coach, this past week I read a New York Times article. It was about a woman who after a spin class experienced a serious condition called Rhabdomyolysis which I’ve never heard of.

Apparently the woman's legs throbbed with excruciating pain, her urine turned a dark shade of brown, and she felt nauseated. And she he ended up in the hospital. The article didn’t say anything about runners, so I’m wondering if you’ve ever heard of it. And so does my non-running wife who unfortunately read the article too...

A - I am aware of this condition., Rhabdomyolysis is a condition in which damaged skeletal muscle breaks down and some of the breakdown products, such as the protein myoglobin are harmful to the kidneys and may lead to a potentially dangerous kidney failure. It's also a very tough word to use in scrabble...

By the way I did read the July 17 article you're referring to. It was titled "As Workouts Intensify, a Harmful Side Effect Grows More Common". Here's a link to it.

This condition is not new and has been scientifically investigated with runners as far back as 1978 - see HERE.

But it happens so rarely. In fact in over 4 decades of associating with runners and clients, not once I have encountered it directly or indirectly.

If you (and your wife) need reassurance, check out this 2007 study of runners which over a 6 year period only observed 7 cases of runners who experienced the condition and all recovered: HERE

For a really in depth review of this subject, you can check out this very lengthy review published earlier this year (2017) HERE

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Shivering After Run

7/28/2017

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Q - Coach - I had a strange thing happen to me last week after my long run. It was a hot day but soon after I finished my run I began really shivering. It was a first for me. Is this a worry?

A - Actually this is not an uncommon physiological phenomenon Granted, it does seem somewhat paradoxical that it might occur after a run in warm temperatures.

I refer you to a good article published in 2012 by the highly respected magazine, Scientific American. The article provided a very readable explanation. The article is entitled “Running and thermoregulation: the post-run "shivers". and a link to it is HERE.

And here’s an excerpt from the article which is over 1,200 words long, but as I say, is quite an easy read.

"When I stop running, the heat loss and sweating will stop fairly quickly. But remember, my core temperature is still elevated. This means my skin temperature, though I won't be sweating, will remain high and I'll still lose some heat to the air. And because my heat production is down (I'm not running anymore), my heat loss is going to be greater than my heat production. At first, this is good because my core temperature is a little elevated, and this will lower my core temperature. As long as I don't lose heat too quickly, Everything will go back to normal. But in my case, I may lose heat too quickly."

Rest assured that this is a common phenomenon, and I would say a 10 to 15 minute mildly warm temperature shower should take care of it.

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Smelling Salts for Runners

2/18/2017

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Q – Coach, I’ve noticed a lot of hockey players in the NHL are inhaling smelling salts before the start of games. Just wondering if they might be good for distance runners. I haven’t seen any of the elite runners at the big marathons using, but just wondering what your opinion is.

A – Funny you asked this because last night I particularly noticed the super rookie Leaf player, Auston Matthews, taking a whiff of the salts. BTW, Leafs lost the game to Columbus….

First, let’s be clear of what we’re discussing.

Smelling salts, also referred to as ammonia inhalants can come in packets about the size of small tootsie rolls. The usual active compound is ammonium carbonate and when released causes the muscles that control breathing to work faster.

Vial of Smelling Salts

Traditionally they've used to revive consciousness after fainting or on boxers,. But this is no longer recommended and in many sports is banned because it may inhibit or delay a proper and thorough neurological assessment by a healthcare professional

Use by Hockey Players

The subject of it’s fairly common usage by NHL hockey players has certainly been publicized in the print.

In March 2016 there was a Sports Illustrated article (see here). And in 2014, the New England Sports Network (NESN) published a very funny article that included a GIF showing Phil Kessel’s reaction to inhaling the product (here).

Phil Kessel reacts to a whiff

The author of the SI article, which included comments from some of the players and a coach summed it up: “So, at most, it provides a temporary boost and perhaps a slightly longer placebo effect, depending on the individual.

Coyotes veteran Shane Doan, who, according to the article, says he hasn’t used them in three years, compared the experience to a quick window wipe at the gas pump, flushing out eyes weary from the road or the rink’s fluorescent lights.”

Use by Runners ?

You"ll often see track sprinters slapping themselves on the legs or face before the start of a race, with the aim of arousing themselves for the very intense effort ahead; but I've never seen a sprinter use smelling salts in the final moments before going to the blocks.

One might think that sprinters would be apt to employ the salts but then it’s very important for the sprinter to be calmly focusing on responding to the starter’s instructions and reacting to the gun; so taking a whiff of salts just before going to the blocks might risk undermining this process.

And as for the long distance runners, there's a huge difference between a hockey player's 40 second shift and a 40+ km. marathon lasting hours.That you haven’t seen any of the top marathoners imbibe is a strong indicator that the salts are not deemed to enhance performance. After all, as has been demonstrated coaches and athletes are forever exploring anything that might give an edge. Besides, the last thing you want to do is get over aroused risking too fast a pace in the beginning.

In fact, the only item I’ve come across is some lay speculation that the woman’s gold medalist in the 2008 Bejiing Olympic Marathon, Constantina Tomescu-Dita, of Romania, at age 38, may have inhaled smelling salts in the latter stages of the marathon (see here), but I haven’t seen any verification for this. BTW, it's not and illegal substance.

Constantina Tomescu-Dita

Scientific Evidence

I’ve scoured the scientific literature and I’ve only come across two recent studies on this topic:

The first is a student’s Master thesis study conducted with young (early 20s) men and women at Old Dominion University, in Norfolk, Virginia, entitled,
The effects of pre-maximal exertion inhalation of ammonia and the performance effects during deadlift maximal tests (abstract here).

And the conclusion was that within the limitations of this study, there is no basis for the support of ammonia inhalation to improve 1-RM efforts in training, competition, or any other circumstance.

Deadlift

The second study was in New Zealand entitled,
Cerebrovascular, cardiovascular and strength responses to acute ammonia inhalation (abstract here) .

Fifteen healthy males completed two trials.Trial one investigated cerebral artery blood flow velocity, heart rate and arterial pressure response to ammonia inhalation. During trial two, participants performed a maximal single mid-thigh pull (MTP) .

Mid-thigh Pull

Despite the marked cerebrovascular and cardiovascular response to ammonia inhalation no ergogenic effect was observed during the MTP, irrespective of the timing of administration.

Given all this, I have to give the idea of distance runners using smelling salts a...

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Importance of Balanced Leg Strength

6/24/2016

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Q - Coach: I'm a runner (half marathon PB of 1:50). In late March I was playing soccer with my son and badly hurt my hamstring when I stepped on the ball and fell awkwardly. It's taking me awhile to get back to the running and my one leg feels weak. Do you have any suggestions?

A - Sorry about your mishap...Kids... But your question provides with me a good excuse to deal with a related situation that might be of some help to you:

All car owners appreciate the ‎importance of insuring their car's wheels are equally inflated and balanced. ‎The consequences of this not being the case are uneven tire wear, ride bumpiness, and side pulling.

Well, I say the same is true for runners, and suggest that if one leg is stronger than the other, it may result in dominance, resulting in an uneven, less efficient stride. And if this continues, the discrepancy may become magnified and theoretically increase the susceptibility to injury.

Does that not make common sense?… after all, if you were to build a robotic runner would you build it asymmetrically? I don’t think so…. Engineers don’t design symmetry in planes, cars, etc., for no reason.

CAUSES

Why a strength imbalance might exist in the first place may be due to a number of reasons such as:

injury
the development over time of uneven ‎flexibility
skeletal differences
unconsciously learned coordination pattern

SO HOW DO YOU KNOW?

Most runners have no clue as whether they are evenly strong. Understandable. Determining whether a strength imbalance exists is not as obvious or easy as dealing with a car where you can simply pull in to a gas station and inspect the tires for uneven wear and check the tires' air pressure.

For runners the symptoms may not be so obvious, and in the early stages be hardly noticeable, if at all.

HERE'S A CASE STUDY

A couple of years ago a client told me in the interview that a year previously she had severely sprained her right ankle. She had been unable to run for 5 weeks but then resumed easy running, and over the next couple of months she gradually built up to her normal previous distances.

However she was frequently having new aches and pains in other areas of her legs that would become intolerable and at times cause her to take several days off. Despite the discomfort, she said was able to continue running (how many of us have been so guilty?). [Note - I have previously dealt with the perils of running when a discomfort is present - see here.]

In search of a possible cause, this client agreed to my suggestion to have her strength balance tested.

HOW TO MEASURE

Now to effectively determine if strength imbalances exist, I recommend accessing a fully equipped fitness centre and that you have a coach or trainer serve as a tester in order to insure objectivity via blind testing. By that I mean, the person being tested should not know what weight (or # of plates) are being used for the various measurements.

And the tests employ single leg exercises for both legs. And by the way, in the many years of working out in gyms I have rarely observed folks doing single leg exercises as a part of their routine, even when being supervised by a personal trainer. Admittedly, it does take a little more time.

Now the exercises I use for the testing, which don't need to be done all in one session, are shown in the gallery of images, below

And many thanks to a great website, Ex.Rx.net, which I strongly recommend, for the following GIF images. Position your cursor over the image and click to see an animation of the movement and description of each of the exercises.

CAUTION

To avoid hurting yourself while performing the tests, it’s extremely important to warm up before the testing by doing 10 minutes of easy to moderate effort running, or biking, or elliptical, as well as 3 or 4 reps of each exercise with increasing weights leading up to the maximal efforts.

Also, the testing should only be done if there is an absence of any muscle discomfort.

THE MEASUREMENTS

I measure 2 aspects:

1) maximum weight that can be handled for 2 reps (an indication of basic strength);

2) the number of repetitions for 1 set with about 75% of the maximum established in (1) ( an indication of endurance).

HOW TO CORRECT ANY IMBALANCES

Now, if the measurements reveal strength differences, and in the case of this woman, as an example, there were very significant differences, I strongly recommend you use weight training which will enable you to objectively know for a fact the number of kg. or lb. being moved.

How so? I recommend 2, or, ideally, 3 sessions per week, working with 3 sets of 10 to 12 reps. exercising the legs separately. So, for each of the single leg exercises, do 3 sets with the weaker leg first to determine what it's capable of - striving to achieve higher rep and/or higher weights.

Whatever number of reps the weaker leg does, you simply match it with the stronger leg and then stop when you reach that number.So you are content to maintain the stronger leg's levels until the weaker one “catches up”.

This single leg approach admittedly takes more time but once the muscles have evened up, you can go back to doing 2-legged exercises. However, every so often (e..g., 4 weeks or so) I would test again to see that you're still balanced.

Returning to our case study, it‎ took this woman just 8 weeks, weight training 3 times per week to even herself up and the annoying aches and pains cleared.

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Hill Training

5/13/2014

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Q - What's the point of hill training?

A - Hill training is a form of "resistance training", meaning that the training causes your running muscles to contract at levels that exceed what they normally would when running on the flat - the resistance to propelling the body forward is much greater than usually encountered. Weight training is another form of resistance training.

Thus the main reason for hill training ( typically running uphill for less than 60 seconds ) is to increase the power of the legs - increasing the springing forward capability. Increasing the power in turn increases the speed potential - after a hill training phase the runner can hopefully translate the increased leg power into an ability to running faster over 100 meters.

And basic running speed is the ultimate determinant of running performance at any distance.

For example, if you want to run a 4 minute mile (1,609.3 metes), you need to be capable of running about 30 seconds for every 200 meters of the 1,609.3 metres. Most of us can't run this fast - even for 200m - not because of our lungs, or heart, but simply because we lack the basic speed/leg power and/or coordination required.

But common sense will tell you that just being able to run 30 seconds for 200 meters isn't going to be good enough because one can't sprint for an entire mile. In fact, to be capable of running 4:00 minutes for the mile you should be capable of around 24 seconds for 200 meters.

As a matter of fact most of my clients are not limited in achieving there goals by basic running speed - relative areas of weakness are more typically Maximum Oxygen Intake and Specific Muscular Endurance. Hence their training programs may not require an emphasis on hill running whatsoever other than to incorporate hills during the course of their straight runs, which is particularly useful for preparing for races where the routes are hilly, e.g., Boston Marathon.

There is another valid argument for incorporating resistance training in one's program and that is increasing the power (from hills ) and strength (from weight training) will help to reduce the ever present chance of injury since any given running speed will require the muscles to contract at a reduced percentage of their maximal capability.

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Basic Speed vs. Long Distance Running Performance

4/20/2014

[Athletes are 2012 London Olympic 100 m. gold medalists, Usain Bolt & Shelly Ann Fraser-Pryce]

Q - Coach, one of my buddies was telling me that I need to increase my speed over 100 metres if I want to improve my 10 km. time. what say you?

A - It certainly could be. Sometime ago I wrote the following blurb which addresses this subject:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Ever wondered how your speed accurately compares to the world’s top sprinters?

Now, if you're runner who strictly runs in 5 km. and longer road races, you may question the value of one’s 100 metre capability. Well, trust me, it’s a very important parameter for anyone having specific time goals.

After all, common sense will tell you that your basic speed capability is the ultimate determinate of how fast you can run for any longer distance.

In fact, there is an inter-relationship between basic speed and what you can run for any distance... obviously you can’t run a 5 km. or a marathon at a pace faster than what you can run for 100 metres - so there's a minimal level of basic speed required over shorter distances in order to have a chance of being capable of achieving any specific goal at longer distances.

For example, in order to run 25:00 for 5 km. you should be capable of about 21 seconds for 100 metres. (BTW, I talk about the inter-relationship between the 400 metres and the 1 mile in one of my Audios, here. )

Knowing the inter-relationships provides me an important guide when designing a client's training.And a main reason to cautiously include hill training, fast short intervals, weight training, plyometrics, etc., in a program is to insure that the level of power/speed is developed to anecessary level.

Of course, having the pre-requisite speed doesn't insure you can run the long distance goal. Even Usain Bolt would not come close to running a 4 minute mile unless his training adequately addressed the development of other running fitness parameters, e.g.aerobic capacity.

On your marks....

Interval Training: Almost anyone can do

4/30/2013

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Q - I see that you are now supervising interval workouts on Thursdays, but all my running has consisted of straight 6 to 8 km. straight, nonstop runs. So I'm wondering if you think I could do interval workouts (?).

A - see Coach Pimm's answer in the following video:

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How to recover from the Marathon

4/25/2013

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Q - Coach, what do you recommend for recovery after running a marathon?
A - see Coach Pimm's answer in the following video:

Also - an abstract of the study referred to by Peter can be seen here. Technical correction: In Peter's response he recalled the study mentioning that the muscle biopsied in the marathoners was the soleus. In fact, it was actually the gastrocnemius which is the calf muscle overlying the soleus.... but hey, the study was in 1985....

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Resting Heart Rate Has Value

3/17/2013

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Q - Hey Coach, a couple of my running buddies were telling me that the lower your resting heart the faster you are able to run a 5 km.

I've never paid much attention to it, except maybe when I have my medicals. It's usually around 60 bpm. Is that good ? Is there any point in paying attention to it ?

A - Ok. I do have a point to share that may not be too commonly appreciated.

But first here are some points many readers probably already know:

1) With high enough intensity and duration of aerobic training that results in increases in Aerobic Capacity (VO2max), resting heart rate substantially drops in an untrained person (e.g.,from 70 to 50 is not uncommon) due to a greater amount of blood being pumped out with each beat by a stronger and enlarged heart;

2) Elite distance runners often have resting HRs in the mid-30s. But not all of them. I recall reading that the former great American runner and World record holder at the mile, Jim Ryan, had a resting heart rate in the low 50s.

You see, it depends on where you're starting from. Although the average resting heart rate in untrained adults is around 70ish, that’s an average, and some may be in the low 60s, while others are in the 80s. I suspect an untrained Jim Ryun might have had a resting heart rate in the 70s.

And I can tell you that one of my fellow university runners used to handily kick my ass, although I had a resting heart rate that was at least 10 beats lower than his....no bragging rights there....grrrr.

Anyway, here's a practical use of resting heart rate that folks may ignore:

Resting heart rate is a barometer of your current level of aerobic fitness. And so, if and when your training is being severely compromised either by injury, prolonged illness, or life circumstances, it can provide a very good indication to what degree your fitness is being compromised, and when it has returned to normal, once the previous level of training has been resumed.

Thus, an injured runner, who is able to cross train (e.g., pool running, biking, elliptical) can use resting HR to monitor the success of the cross training efforts.

So I recommend you determine what your resting heart rate by taking it at various times of day - you may find there's a range depending on your last previous bout of physical activity, state of mind, time of day, etc. But several monitorings will give you a potentially useful bead.

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Warm up for 5 and 10 km.

3/17/2013

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Q - Coach: I've read a load of suggested warm up strategies before a race, but I'm just wondering what your thoughts are on this if I'm getting ready to race a 5 or 10 km. ?

A - Ok, pertinent to this issue is a study that was done with runners several years ago. The mad scientists inserted thermosensor electrodes into the runners' calf (actually the soleus) muscles, and then observed the temperature of the muscle tissue before exercise and while running on a treadmill.

They observed that the temperature of the calf muscle tissue rose steadily over the resting value for a period of 12 minutes and then plateaued. Why? Because at rest there is relatively little blood flowing through the muscles and a much lower metabolic level of activity - but once you begin to exercise, the pipelines of blood (arteries, arterioles, capillaries) dilate considerably, allowing up to 10 times more blood through the tissues which, along with the greater metabolic energy, results in increasing the temperature of the acting muscle tissues, and thereby increasing their performance capacity while reducing the risk of cramping or worse.

So, my suggested warm up for someone who has trained to aggressively run 5 or 10 km is to run easily for at least to 12 to 15 minutes, then do some running drills, then run 5 x 80 to 100 metres ("strides") at a pace which is faster than the intended race pace (with about a 1:00 to 1:30 walk back between each stride).

Ideally, the last stride should be completed within 10 minutes of the race start. Of course, this is not always possible in the mega races where runners are required to check in to corals. So, while you are waiting for the start, you should keep yourself warm (e.g., dance gangnam style or in the style of the viral Michelle Jenneke lol - just keep moving) and perhaps keeping discardable clothes on if the temperature is cool until the last minute.

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<<Previous

Is Rhabdomyolysis a threat to runners?

Shivering After Run

Smelling Salts for Runners

Importance of Balanced Leg Strength

Hill Training

Basic Speed vs. Long Distance Running Performance

Interval Training: Almost anyone can do

How to recover from the Marathon

Resting Heart Rate Has Value

Warm up for 5 and 10 km.

Do you have a question for Coach Pimm?... then send it along.

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