Time to heal

One of my favoirte places to run is the C+O canal towpath. The painting on the left was done by a local artist of the canal. I love it and was excited to share. Enjoy!

To continue the thought on my recent leg injury, in hindsight one of the key mistakes I made, which you can learn from, was that I disregarded the basics of time required to heal. I let the runner side of me trump the clinician side. What I mean is that when you suffer an injury, there is a certain amount of time that needs to pass before the body can reasonably heal itself. This same concept applies to other areas of rehab. For example, it takes a certain amount of time before a weakened muscle can get stronger, no matter how much effort you put into it.
With my recent leg strain, I tried to rush back too quickly. I barely gave the muscle 24 hrs to heal which is simply too short. I iced, wrapped, and elevated the bugger. It felt better so I tried to get right back to it. As a clinician, I know that there are stages of soft tissue healing whihc were not being respected. The phases of healing are: 1) Inflammatory 2) Reparative and 3) Remodeling. The length of these phases will be different depending on what part has been injured. For example, an injured tendon might take a month to cycle through the reparative phase versus 2.5 weeks for a muscle.

With my injury, an injured muscle, the inflammatory phase happens quickly which is why the initial repsonse is key. As mentioned previously, ice and compression can help tremendously in this stage. I often encourage people to shy away from advil and the like. The reason for this is that inflammation is the first step of healing so we do not want to impede it from occuring. The healing occurs in a stepwise fashion so to block the step which initiates the other steps is not recommended.

New muscle fibers can appear in 18 days from the injury. By day 21 the muscle fiber is able to generate tensile force. So, when you think about the above information, you must consider where you are in the healing process. If you are one week post injury, realise that the muscle simply has not had enough time to heal to the point where it can be asked to perform. Consequently, a runner needs to focus not on running but rather the crosstraining to maintain the current base of fitness. 3 weeks into it is a distinctly different place as far as the healing goes. It is more appropriate to start thinking about actually getting back into the basics of running.

Each person heals differently based on age, sex, medical history etc. Use the above info to stimulate thoughts on managing injury. Obviously, when injured it is best to have a health care provider advising you on an indiviual basis. Happy trails.....

Grasshopper

I knew it had to happen. As a clinician, the statistics on running injuries are pretty ugly. Even still, I have been injury free for years. Of course, there is the little stuff that you can train through like a sore achilles. I had not been forced to stop running since I had torn my meniscus 3 or 4 years ago. All this changed a couple weeks ago.

At the end of a typical loop leaving from the gym, I suddenly had crazy sharp pain in my right calf. Basically, continuing to run was simply not an option. I walked a half mile back to work sort of scratching my head about what was going on. My focus was on what had been different in my training. My experience in the clinic tells me that most injuries occur in a transitional period: increases in miles, intensity, or frequency are typical culprits. The strange thing was that I was not in such a period. I had gently returned to running after the Grindstone 100. I thought about my shoes, which that day were my Newtons. I am new to Newtons but they had really treated me well to date. It was not as if the shoe was new to me. Then I thought about the recent training. I had just done a 19 miler with Team Jackass at a steady clip, marathon pace plus 20 seconds. I felt good most of the way. Thinking back another couple weeks I recalled an ankle sprain on the same leg while on the Rock Creek trails. It was a good sprain, the type where you feel the bones clunk. It hurt, but not horribly. I iced immediately and took a break from running for a few days. Without swelling or pain I took back to running. In hindsight, this might have been my first mistake. The best I could do as far as my leg strain goes was that I was compensating for the twisted ankle which caused me to overtax the muscles of my lower leg.

Second mistake for grasshopper was trying to get back to running too soon. I felt the sharp pain on a Thursday, and tried to run two days later. It was such an amateur mistake. I am embarrassed that the PT in me did not smack down the runner in me. It is a testament to the passion of running in us. So I tried to run too soon and made it significantly worse. I felt a pop in the muscle as I gimped back to the car with my buddy Mike Yuengling. The posterior tibialis was in complete rebellion/ shut down mode. I was done for a few weeks at least.

There are a variety of lessons to be learned here. I should know better how to manage these things because I do it every day. Learn from the clinician Doctor G, not the runner Bobby G!

One quick lesson, with more to follow, relates to listening to your body. I frequently help athletes recover from injury. I ask them to rate their pain on a 0 to 10 scale.

If the pain is in the 0 to 3 range, I am ok with resuming normal activity. For a runner, I ask that if the pain is causing them to limp then all bets are off. Otherwise they can gently try to run.

If the pain is in the 4 to 6 range, it is most appropriate to switch gears to cross training. For a runner, as with most other athletes, I like the stationary bike, elliptical, or the pool. Depending on the injury, one might be better than the other. You want to cross train until the pain drops back into the 0-3 range.

If the pain is in the 7 to 10 range, it is time to just shut it down. Focus on letting things calm down. Go back to the basics: ice, compression, elevation, and relative rest. Do this until the pain subsides so you can begin to gently train again.

A key element with the above recommendations is that the athlete is honest with how they assess their pain. No cheating in other words. It is an accurate assessment of the pain. If your pain is a 5/10 but you really want to meet your training buddies for a run then it does not become a 3/10. Recovery from an injury should be about changing training such that you can stay active and heal at the same time. More to follow on that.....

Ryan Hall

We had a great time over the weekend with the Pacers crew(www.runpacers.com) at a benefit for Ryan and Sara Hall's foundation (http://www.thestepsfoundation.org/). I had fun chewing the fat with Ryan about a variety of topics. You quickly realize that he and his wife are just ordinary people who just happen to be darn fast runners. Ryan is a big supporter of the importance of cross/strength training. This is something that I emphasize with many of the runners I work with so having him on my side is great. It was a thrill to be a part of the event.

I mentioned to Ryan that I would see him in Boston next year. Somehow I think my corral will be a bit further back than his.........

hit the FUN button

You gotta love this time of year for training. The temperatures are cool, the air crisp, and the recent snow adds a certain beauty to the DC landscape. For me, this time of year is a transitional one. I am winding down one season and looking forward to another one. With a focus marathon training program, each workout should have a goal. For example, the goal of the long run is to build endurance by raising aerobic metabolism. The tempo runs are slotted for developing a runner's anaerobic threshold. Following a structured program for multiple races can leaving feeling drained. As a result, it is important to really focus on taking some down time this time of year. Enjoy the freedom of not having a goal for each run or workout. Go for a hike with family, run around playing games, or try a spin class. All of these examples will allow you to be active, maintaining fitness, without the drain of hitting a target pace or distance. Have fun with your down time. Doing so will ready you for the next training cycle. It is better to start next season mentally fresh than still sluggish from too much work when rest is needed.
This time of year I love to get out on the trails in Rock Creek Park. It is a beautiful area with challenging terrain. The uneven terrain gives the balance system a bit of work, and the hills certainly help maintain all the glute strength from the cross training. My gait is constantly changing on the trail which helps reduce the stress load on my muscles and tendons. This time of year is a great time to allow the body to rest and heal. Bottomline is there are times to just have fun. For me, the time is now. Pull on those goofy socks and run just for the love of it. Think about how much fun Boston will be in April.......

Post marathon recovery-stretching

You have that glow about you. The post marathon glow. Maybe it is a post ultra glow. Either way, just enjoy the glow and reward yourself with some much needed downtime. Whether you are a first timer to the marathon, or perhaps recently tried to set a PR, the period after a marathon should ideally be focused on recovery. Forget about one race before you start planning the next. The recovery period is going to be of different length for each runner but should encompass certain key components. Today's blog post will focus onone component, stretching. So, get that chocolate milk down the hatch, wipe that salt off your face, and listen up!

Believe it or not, getting over muscle soreness after a marathon is not about complete rest. In fact, research has shown that recovery is quickest in those athletes who engage in an active recovery. What this means is that the runner is engaging in very low intensity exercise to enhance blood flow with minimal impact to the body which has been recently stressed. A pool is the ideal environment for this because the pressure of the water boosts bloodflow and the buoancy effect unloads the compression effect of bodyweight. After a brief warm up, like a bout of walking in the pool, or gentle swimming, try some stretching to keep the muscles moving and soft tissue mobile.

Think of stretching in the recovery period as more about recovery than actually having a lengthening effect on the muscles. The goal would be to keep things moving versus making the muscles longer. As a result, a good place to start is on active stretching versus passive stretching. What I mean by this is that runner is taking their legs actively through a range of motion which helps to 'stretch' the legs. Starting with the ankle area, a good example is the seated heel raises and toe lifts, collectively ankle pumping. Pretty simple : from a seated position the runner is raising up onto their toes by lifting their heels off the ground, followed by rocking back onto their heels and lifting the toes off the floor. The pumping effect of this exercise helps to improve blood flow and gently take the ankle through a range of motion that lengthens the muscles. Another good active stretch is performed with the runner on theor back. One leg is flexed up bringing the knee toward the chest. At this point the knee is graps and a gentle amount of overpressure is applied. You can alternate legs x 10 reps. This will keep the posterior hip muscles mobile.
Another example of an active stretch which can be done with a rope is the active assisted hamstring stretch.The rope loop is placed around the bottom of the foot.With the runner lying on their back, the hip is flexed such that the thigh bone is perpendicular to the ground. The runner then tightens their quads such that the knee straightens placing a stretch on the hamstrings. Hold 20 seconds and repeat on both sides. What is great about this stretch, along with others with the rope, is that when the quad contracts, it inhibits the muscle opposite to it, the hamstring. This is called reciprocal inhibition.
The rope can be used to stretch the quads while the runner is on their stomach. It can also be used to stretch the leg actively out to the side, hitting the adductors.

Another useful tool in recovery is a foamroller. These devices can be found in most gyms and running stores(www.runpacers.com). They are an inexpensive tool which is essentially using the runner's bodyweight to compress the muscle tissue. The compression of the muscle tissue can help to enhance mobility of the tissue in a variety of planes. For the runner, two of my favorite uses of the roller are on the iliotibial band and the quads. Both areas take moderate stress with running so the roller can be surprisingly helpful. No special techniques here. I typically recommend rolling back and forth over the involved tissue 10 times. Other target areas include the glutes, the hamstrings, and the calf muscles, pictured below.

Be in touch with questions.....

Tapering

It would seem like half of the DC run community is tapering for fall marathons. With Marine corps, NYC, Philly, and Richmond wedged into about a months time, it is a good time to review the concept and value of tapering.



In essence, tapering refers to a gradual decrease in training volume to allow the body to recover from the months of training load. The reduction in training volume has been documented to result in improved race performance. It is worth mentioning that for a dedicated athlete reducing training volume can be quite difficult. After months of a routine of training, taking it easy ain't so easy! Unfortunatley, I feel that most athletes short change the benefits of their focused training by not tapering enough.



A taper for a marathon typically is two to three weeks in duration. A more experienced runner may be able to get more out of a two week taper than a full three weeks. On average, the last three weeks before a race will see a 20%, 40% and finally a 60% reduction in weekly training volume. It is essential to note that there is a reduction in volume but not intensity. The reason for not reducing intensity is that we want the body to recover from the training but not lose its adaptations from the focused training. The intensity work leading up to race day keeps the body primed to perform at the high level of our race day pace mentally and physically.

Interestingly, three weeks from race day is when most runners overdo it. This leads to feeling flat two weeks out at which point the struggle begins to rest up. A gentle reduction in volume three weeks out helps you feel fresh physically and mentally. I feel that is is usually better to undertrain versus the alternative.



Most marathon training programs have a minimum of three specific components: speed work to influence VO2max, tempo work to address lactate threshold, and a long run for endurance. Each of these components will experience a reduction in volume, not intensity. We all have our favorite training programs because they work for our particular needs and schedule. It is important to underdstand that what works for one runner might be ineffective for another. With experience you can decide how much long of a taper you need, and how much volume you need to reduce.

The last month of training for a marathon look like this for me:
speedwork:10x400,8x800, 5 x 1000, and 6x400 race week (all with warm up and cool down)
tempo work:8miles at marathon pace(MP), 5 at mid tempo pace, 10k-3 easy/3 hard, 3@MP
long runs:20mi at MP+15sec, 13 @MP, 10@MP, Race day!

These are the key components of my runs. I have some junk miles and plenty of cross training sprinkled in there. This gives you a starting point. Keeping a training log helps you go back to review patterns when you have a good race. More importantly, when you have a bad race you can actively avoid what might have lead you down that path.

Happy trails.....

Grindstone

It is still hard to believe that two weeks ago I ran 100 miles. I have done a dozen or so ultramarathons, and numerous endurance multi sport events, but this one takes the cake by a long shot. As hokie as it sounds, I look back on it almost like it was an out of body experience. Even though it took me over 25 hours to complete the course, the days seems like a blur.

My buddy Bill Potts did the race also. We were both 'first timers' to the hundred mile distance. What this really means is that we are stupid enough to have raced half that distance many times and now thought we were 'ready' to bridge up to the true gold standard for an ultra runner. We were not exactly wrong to think this, but I look back and wonder is a person is even really ready for a 100 consecutive miles. What we larned was that it is a race of patience, a race ofstarting slow and finishing slower, a race of attrition, and most of all, a race where it is great to have family and friends nearby to support you. Bill and I have agreed countless times since race day that we will look back on the 2009 Grindstone 100 with smiles because of the people who shared it with us: David Mercer, B. Young, Gentry, Julie and The Gillanders Crew, Lisa Potts, Dan, Adam, Clark and so on.

The weekend really started with a bang because we went to the U2 concert in Charlottesville on Thursday night. In hindsight, pulling a 19 hr day before a hundred miler was not the recommended course but as joel said in 'Risky Business' sometimes you just gotta say "what the mailto:f*#@ concert was great and added to the overall experience.

Bill and I towed the pop up camper to Camp Shenandoah, set, checked in , rested, had a panic, and then hit the start line. Off we went at 6pm into the woods whihc were soon dark, foggy, and windy in no particular order. We had run half the course in August going in the opposite direction so it was all new to me. Running at night is quite an experience. Running off road in the dark is just nutty. The headlamps will illuminate the trail but do not give you much in the way of depth perspective. Translated this means that for the first 12 hours of the race I was forever kicking my toes on roots, tripping over rocks, and saving myself from doing a spread eagle on the trail by wrenching my back to stay upright. Ouch.

Aid Stations were placed every 6-8 miles so often you would have a serious amounts of time in between to run with fellow racers and chat. I ran with Elizabeth from NJ, Ben from Nova, and of course Bill Body Potts.

My goal was to get to the half way point in 12 hours which I nailed almost to the minute. Certainly having my buddy david as my crew chief helped immensely. When you are running all night, it is just nice to see a familiar face, and have someone to talk to, even if it is for just a minute. Thanks david.

The Grindstone was an out and back route so when I started on the second half of the course it was started to get light again. I was happy that I made it through the night without getting sleepy. The daylight was welcomed because after the above mentioned tripping/stumbling/bumbling etc, I was ready to see what the heck I was running over.

At the 66 miles mark, Bill and I came into an aid station full of the Gillanders crew. That was awesome! Really got a charge from that. We also picked up our respective pacers- for me that was Bill Young, and for Bill that was a man who needs no first name, Gentry! Between the two of them they had many hundred mile finishes under their belts so we knew that we would be in good hands. I picked up some trekking poles for the last 50km which i knew was going to be hilly. Of course, right, you do not cover 100 miles with 23,000 ft up and 23,000ft down with much that is called 'flat'. Off we went.

We got to mile 80 and I was really starting to feel it. I had been good with eating and drinking but realistically, at a certain point, you get tired. And emotional! At the aid station I had to really work hard to keep it together. It is not a pretty sight to start balling in front of your mom who thinks you are freaking nuts already. So, Julie pepped me up, reminded me that a warrior stays strong to the finish, and off we went.

Lydia Young was feeding us soup, mashed potatos, and mac n cheese to help us move forward over those last 20 miles. I finally settled in around mile 95 and was able to poke my way to the finish with a strong finishing Potts, gentry, and Bill Young.

The grindstone tradition is that you hug the totem pole at the finish and who was I to go against the grain.

As lucid as I was over the previous 25 hrs, the finish was a bit dodgy. I was immediately hypothermic and as goofy as ever. Bother John G helped me get to the showers and back to the camper. It was a lights out almost the instant I hit the bed. That is, after I warmed up and ate a variety of oatmeal, hamburger, chili and whatever Julie was spoon feeding me.

We woke to a beautiful day in the mountains, happy to have finished and earned a buckle. dan made a stellar breakfast which was shared with many smiling faces. After the awards, yeah, Potts first place masters!, we chatted with speedgoat and headed home. Thanks again to all those who supported team bobby potts. We could not have done it without you.

I can't imagine it could have gone much better which perfect for your first 100 milers. Keep your fingers crossed for Western States. We shall ride again!