Running (Downloadable Runner's manual)

Running is one of the best ways to keep in shape. Running inside or outside or even on machines such as treadmills or elliptical trainers.

Running has the advantage of maintaining good cardiovascular fitness and has been called the “fountain of youth” for sports. Studies involving older master level runners, have noticed less of a decline in Vo2 max and fitness when compared with people who don't run. Running is also a sport that can be open to all levels of fitness. Anyone can pick up a pair of running shoes and start.

Outdoor running in Manitoba usually starts in the spring with common goals of local 5 and 10km road races and possibly a marathon. Often runners will “do too much too soon”. This is a big cause of injuries and causes runners to be absent from the sport completely.

Runners should first have a basic level of aerobic endurance that they can then build on to progress towards races. This is particularly important in longer races like the marathon or half marathon where advanced training should begin at least 4 months prior to these goals.

By progressively training, athletes will adapt themselves to longer and harder workloads without getting an over-training injury. Recovery and days off are necessary for runners of all levels, as the body cannot be pushed faster than its ability to respond to increased workloads.

There many excellent running clinics and clubs to help runners progress and improve. The Running Room, runs specialized clinics in 5km, 10km, half marathon, and full marathon goals, providing training and peer group support to help achieve these goals.

No matter how well the program is designed, runners should still listen to their bodies. A good program should include specific consistency (sticking with the plan week by week and training for running by running). Usually, gains in performance are greater at first but become slower after months of training. Long-term goals can be realized but practiced and consistency is needed.

Unexpected injuries, illness, life stresses and other factors can all interact with a well planned training schedule, and every training plan must recognize this and ease up the expectations if they become unrealistic. There is no shame in downgrading from a full marathon to a half if the weather is dangerously hot or if the runner is in recovery from a slow healing injury. In fact, it is considered smart to downgrade since you can always choose another race at a more convenient time.

Warm-ups

Warm-ups prepare the body for exercise. This prevents muscle strains and will allow a faster recovery form strenuous workouts. Starting with a light jog or bicycle ride increases the heart rate and gets blood flowing. Next, stretching the major muscle groups involved in running. A sustained stretch of 15-30 seconds is suggested although recommendations vary.

Cooling down

Cool down after the exercise brings down your heart rate, breathing, and minimizes muscle strains. Keep moving at a slow pace for 5-10 minutes, this will help to flush lactic acid out of the limbs. Once breathing and heart rate are normal, stretches similar to the warm-up should be done. These are held for longer periods and this phase should last 10-15 minutes.

Running Surfaces

Soft earth, dirt, and cinder, give good shock absorption. This requires more exertion but is easier on joints. Grass also has good shock absorbency but can be uneven. Sand and beaches can predispose to injuries. If you have to run on this surface stay near hard packed sand and limit time on this surface. Pavement is the worst surface for shock absorbance. Asphalt is better than concrete. Many city streets are “caterwauled” that is slanted to allow drainage. Running on this type of surface can lead to overuse injuries. Try to run on the most level portion of the road.

Frozen roads in winter are even worse for impact. On hot summer day's roads will be much hotter than soft cooler grassy areas. Tracks that are rubberized are good but if they are too small, (i.e. 12 laps to a mile) the excessive torsion on turns can limit safe fast running.

Hills – Hill training should be done carefully. This type of training is helpful in improving performance. Running uphill uses more energy (but you never get an equal advantage when running downhill) so try to keep your exertion level consistent when going uphill. Going down the hill should be done even more carefully to avoid “breaking” or “falling” while navigating. Practicing good form is essential in both situations to conserve energy and avoid injury.

Some Running Work-outs

Interval Training- involves running at a race pace of faster for small segments with recovery breaks to minimize stress on the body. These help to improve performance. The recovery phase starts after each segment. The goal is to achieve incomplete recovery to develop aerobic and anaerobic fitness and to prevent you from running too fast. One way to tell is to resume running once the pulse rate drops below 120bpm, and then start the next interval. Some coaches' use timed rest breaks.

Intervals should be challenging but controlled, not too often, and may require an extra day of recovery. A good coach to maximize benefits but not cause too hard a workout should follow serious interval training.

Hill Training -can both cause and prevent injury. Hill training is different than hill running (which is to get up the hill efficiently). Training involves doing hard workouts, which will use different leg muscles and improve efficiency of running. Because this training is intense, it may also require an extra day of rest. Downhill training is useful in teaching runners to stay in control as they descend.

Fartlek Training – (Swedish for speed play) Involves changes of pace over ranging terrains and distances. It helps runners get used to different speeds and switching gears.

Tempo Training – involves running at a challenging, steady pace. The goal is to train to fatigue (or close to your lactic acid threshold) without exceeding it. This teaches runners to run faster and further before their lactic acid threshold is reached.

Cross Training - helps maintain overall fitness. It is usually very hard for intense athletes to give up running but it is often explained that it is better to miss a month or two rather than have six months of poor performance and not feeling well. It is always easier to begin treatment of overuse and over training injuries earlier than later as neglect just makes the problem worse.

Marathon Training – marathons are the ultimate race. Proper training should begin many months in advance and for novice runners the guidance from a coach or running club is appropriate. A tapered program gradually peaking in mileage, week by week, and then easing up before the event should be well controlled every step of the way. This is something we actively encourage our patients to research carefully to optimize their training realistically and safely.

Coaches are particularly valuable in evaluating running form (poor form uses more energy) and offering suggestions. Coaches and support from friends and family help sustain motivation.

Over training is often the insidious response to doing too much too soon. The body does not adapt to an excessive workload or the recovery is not enough. Runners usually notice a decrease in performance (“Staleness”), extended fatigue, and increased incidence of being sick.

An increase in the resting heart rate of 5-10bpm in the morning is a sign of over-training but this can also be a late sign when other symptoms have happened. The best treatment is rest. Eating well and sleeping well will help but stopping running for a while is often what works best.

Running Shoes

Although cross-trainers may be adequate for someone who does many sports, running shoes are essential for runners. The most expensive are not necessarily the best. A good running shoe should fit your foot in length and width. People with foot irregularities benefit best from a shoe that helps give them the support they need.

• People with medium arched, semi-curved feet and neutral pronation need stability shoes
• People with low arched feet, straight feet or are over pronators (foot rolls inward when running) generally need a motion control shoe (shoe with straight shape, hard heel counter, firm mid-sole). This extra reinforcement prevents the over pronation of the foot during running.
• People with high arched, curved feet, and under pronate (also called supination) generally need a cushioning shoe that helps absorb shock better by having more cushioning and flexible forefoot.
• Heavier runners may also benefit from the cushioning type.

We recommend athletic shoe stores that deal with a large running clientele and a large selection of running shoes. They will do an assessment in the store and make sure the shoe is a good fit. Measuring your foot at the end of the day (or after a run) when it is slightly swollen will give the best measurement. Women's feet are generally wider in the forefoot and narrower at the heel and because of this, women should not wear men's shoes.

Racing shoes are generally lighter but less supportive. We do not suggest using them if you already have a biochemical problem that requires an orthotic.

Orthotics are customized inserts made from molds of the feet, to compensate for imbalances in the foot strike. They also correct over-pronation, and leg length discrepancy. They are commonly used by runners but may not always be needed as sometimes a good running shoe for that person's foot can eliminate the need for an orthotic, which may cost over $300. Over the counter orthotics are much cheaper. Usually orthotics are recommended when there are several imbalances or pain. Unnecessary orthotics can also make things worse.

Sports Podiatrists (foot doctors) and therapists, will make a mold of the foot and the orthotic is fashioned in a lab out of polypropylene or fiberglass, which is strong, light, and can allow return to running.

Replacing Shoes

New shoes should be considered after 300-500 miles, depending on the weight of the athlete. The mid-sole wears out before the sole and this loss of shock absorbency is slowly noticed. Try wearing a new pair of shoes in comparison with old ones and if the difference in bounciness is obvious, it is time to replace your shoes.

Making Your Shoes Last Longer – rotating 2 pairs of shoes every 48 hours will allow them to last longer than wearing 3 consecutive pairs. This is because the mid-sole cushion requires some time after a run to slowly re-expand. Also by storing shoes carefully to avoid compression, extreme heat or cold, and minimizing perspiration build-up (by air-drying them) will extend their use.

Sports Nutrition For Runners

Runners will optimize performance by following a balanced diet suggested by the Canada Food Guide. Additionally high carbohydrate diets help build-up necessary glycogen storage before (and replenish them after) workouts. There is evidence that high fat, low carbohydrate diets, may damage athletes and are generally discouraged.

Pre-run and during the run, carbohydrates also help. For races, absorbable carbohydrates in sports drinks and gels are commonly used. Caffeine does make people more alert and can improve performance. But caffeine can also lead to more urination and upset stomach, and may worsen some people's performances. Fasting prior to the run is a bad idea as it deprives the body of glycogen fuel.

Water Intake – fluids before, during, and after runs are essential for performance. In hot races, dehydration and hyperthermia is avoided by regular fluid intake. Even cold running requires water as these runners can also become dehydrated.

Running Conditions

Running In Hot Weather – constant fluid intake is important. Run in shade if possible or arrange your practices to run into the wind near the end to maximize cooling. Running singlets will not take up sweat like cotton shirts and are more comfortable. During extended races, officials may limit activities if the ambient temperature is too high. (measured by a wet-bulb thermometer) Don't push too hard if it looks too hot. Some races just aren't worth it!

Running In Cold Weather – be careful about icy surfaces. Wearing a layered approach will minimize cooling without over-bundling. Using a scarf or muffler will prevent irritation to the mouth and keep a humidified space of air for you to breath.

Running In The Rain - rain is generally fine for running but if there is any chance of lightening this should be avoided. Listening to weather notices can help and recently a commercial instrument that measures electrostatic activity in the atmosphere has been advocated as a predictor of lightening.

Women Runners – should watch if there periods become irregular or absent while training. A significant decrease in body fat can prevent regular ovulation with decreases in estrogen. This low estrogen in turn, may lead to early osteoporosis, which in this situation of running excessively makes it very easy to get a stress fracture. To monitor this, we check levels and will even suggest to female runners to go on a birth control pill. This is not for the purpose of contraception, but to ensure they get a good dose of estrogen each month.

Pregnant Runners – the American College of Obstetricians and Gynecologists, recommends for women with uncomplicated pregnancies, to let their own stamina and abilities be their guide for exercising. In low-risk pregnancies, there is currently no data to confirm that exercise has any deleterious effects on the fetus. These women are cautioned to decrease their activity to below pre-pregnancy levels. Exercise within comfort is recommended. Most women runners cut back to ½-1/3 of their intensity in the last 8-12 weeks of pregnancy.

Suggested Guidelines:

• Adjust pace as pregnancy advances. Aim for the same perceived effort and don't go by heart rate since pregnancy itself alters testing heart rate.
• Increase fluids to at least 12 glasses of water per day.
• Shorten runs in hot weather. Severe over-heating of the body (core temperature >37 or hyperthemia) is not realized during normal exercise since the body regulates this. Extremely intense workouts in hot weather can raise core temperature and this is suggested to cause damage to the fetus.
• Stretch carefully since pregnancy increases flexibility and it is possible to overstretch joints.
• Run on stable surfaces. With an altered center of gravity, it is easier to strain an ankle.
• Seek medical help if pain, bleeding or water breaks.
• Cool down after running.
• Pregnant women should still gain about 25-35lbs in pregnancy. Check with your obstetrician throughout pregnancy.

After a normal birth, some women have returned running 2-3 days after, and 1-2 weeks after caesarian section but each pregnancy is different.

Running When Sick

In general, if you are feeling sick you need proper rest to get better quicker. Runners may use the “below the neck rule”. If symptoms are above the neck – runny nose, scratchy throat, slight headache, or sneezing, you probably have a minor cold and should run cautiously. If symptoms like head pounding, or below the neck symptoms – fever, muscle ache, vomiting, diarrhea, loss of appetite, or hacking cough – you should not run.

Running will prolong illness and very rarely viral illnesses of the heart can cause myocarditis, leading to sudden death in athletes. After recovering from any illness, return to running gradually. If you have lost endurance or strength, there is nothing you can do except train properly and gradual regain them.

Air Pollution

Running in areas of high pollution can make you less fit with over-exposure to carbon monoxide and ozone.

Children

In general, children under six years old should be encouraged to run as part of general play and are not usually interested in racing. Running should be constructed and fun with no adult values superimposed. Ages 6-12 may wish to run, but some experts limit them to 400-1500m races.

The American Academy of Pediatrics, states it is not appropriate for pre-adolescent children to compete for awards in adult orientated events. One concern is the increased risk of muscle and bone injuries in children younger than 12-14 years old. It is important to emphasize athleticism (activity for socialization and fitness) over organized sports (activity for competition and extrinsic rewards). Children encouraged for athleticism are more likely to be more physically active.

Baby Stroller Running

Run at an easy pace and maintain control up and down hills. Make sure the stroller is made for jogging. Many excellent models are available. Dress children more warmly than yourself since they will be susceptible to wind-chill without exertion. Some running groups do not recommend strollers in races. The reason is that races can lead to potential injuries for race participants and children.

Running Injuries

Many injuries may be at first, slight strains with minor discomfort. At this point, carefully consider the following:

• Are you doing too much?
• Any changes in mileage, speed or hills?
• Are you giving yourself enough rest to recover from workouts?
• Do you have a foot problem – over-pronation, over-supination or un-equal leg length?
• Do you warm-up and cool-down properly?
• Do you have enough flexibility and do you stretch properly and frequently?
• Do you have previous injuries and have they been treated correctly?
• Do you have good running form?
• Do you have good equipment – shoes, running socks, clothes?
• Do you eat correctly?
• Do you have any other injuries/changes in workplace?
• Are you sleeping well?
• Are you under any other types of stress?

We recommend seeing a doctor if you injury significantly limits practice or daily activities. Persistent pain can be a symptom of a significant ankle strain or boney injury. If an injury is present the sooner definitive treatment is needed to fix the problem.

Running on an over-use problem will only make the total down time from running longer. Untreated stress fractures need rest from weight-bearing in order to heal. Cross training is beneficial in giving the part that is injured a rest while engaging the rest of the body to minimize loss of endurance, strength, and flexibility.