Endurance training

When thinking of endurance training, some of the first things that come to mind are half marathons, marathons, triathlons, Ironman competitions, ultra marathons, and the Tour de France. However, endurance training doesn’t just relate to these types of sports. Sports that require short bursts of energy and speed over a prolonged period of time, such as football, basketball, and swimming are also dependant on endurance training. It is something that should be incorporated into every fitness routine.

What is endurance training?

It is actually a purposeful way of exercising to boost one’s stamina and endurance. This type of exercise is aerobic in nature versus anaerobic. Aerobic exercise strengthens and elongates muscles for extended periods of use. It improves cardiovascular function, enabling blood and oxygen to be delivered more efficiently to the brain and throughout the body, thereby improving the body’s ability to utilize oxygen. This is also a key factor in enabling the body to recover following exercise.

The benefits of varying your routine

Focusing solely on only one type of exercise is not ideal for the body or the mind. Endurance training requires strength and stamina, so incorporating different elements into your workout will help your body to perform better at your chosen sport. Boredom can also creep in without some variety in your routine. Incorporating cardio and weight training along with bodyweight training elements together in a routine will improve overall performance.

Diet

Changing from three larger meals a day to six to eight small meals is an essential component in endurance training. This will help to boost your metabolism and allow the body to use nutrients more effectively. Switching from heavy foods with little actual nutritional value to a diet filled with foods high in fiber such as fruits and vegetables, and drinking lots of water will promote a healthy body from the inside out.

Know when to rest

It is important with any type of exercise to listen to what your body tells you and to take proper rest breaks. Failing to do so puts you at risk for injury and burnout. The body will be unable to repair minor (or micro) injuries resulting from overuse and overstressing without these important breaks. Knowing when your body needs a break from exercise is key.

However, varying one’s exercise routine can also function as a type of rest, as long as you aren’t pushing your body too hard again in another way. Simply going for a relaxing bike ride or long walk can be a good change-up to your exercise regime. Getting a proper night’s rest with a full eight hours sleep is essential as your body copes with the new and increased demands on it.

Starting Endurance Training

Endurance training is vital to success in any athletic endeavor, but must be built up gradually. It cannot be achieved overnight. Allow your body to adapt and give it the tools it needs to function at peak performance – a varied routine, a healthy diet, lots of water, and proper rest. An integrated approach is required. You can then enjoy the many benefits of endurance training for years to come.

Spice Up Your Cross Training for Running

Running can become tedious after a while.  It takes a toll on your mind and body so you gotta trick your brain and make it think that running is FUN.  It’s good that you cross train with weight training at the gym, climb stairs or aerobics at the gym, but it can get boring just staring at the machines or running the same routine all the time.   So here are some ideas you can use to spice up your cross training.

I participate in a lot of sports such as rockclimbing, dragonboating, snowboarding, swimming, softball, ultimate, yoga, squash, cycling and more.  But those are not my main sports, I don’t tie myself to any one of them.  I pick them because they have a unique feature in them that will help me improve my running, whether it be in upper body strength, speed training, core strength, breathing, stretching and the list can go on.   So you can also pick a sport or multiple sports that you not necessarily enjoy, but have access to and you can add to your cross training routine.

I’ll give a highlight of each sport and their benefits to running.

Rockclimbing – helps build arm, quad and calf muscles.

Dragonboating – helps with upper body strength, arm strength and stamina.

Snowboarding – helps build co-ordination, quad muscles, breathing in cold weather and strengthens your ankles.

Swimming – helps build overall body strength, core strength, and breathing.

Softball – helps build arm strength, hand eye feet coordination, and sprint training.

Ultimate – helps immensely in building stamina in speed and sprint training, also helps you control your breathing, and pushes your lactate threshold.  Highly recommended for long distance runners to help with speed work.

Yoga – helps build core strength and with stretching.

Squash – helps with sprint training and stamina.

Cycling – helps strengthen legs.

All these sports are great if you already have a high level of stamina as with most long distance runners.  You will be able to last longer in each sport but try to exert yourself to the max when participating in them.  In other words, running slow to first base or biking at a very low speed and intensity, just doesn’t cut it.  Push yourself to 100% each time you run.  If you get tired, just think it’s only for a few more minutes.  Ultimate or Softball runs don’t last long, they are just tiring because it’s short sprints across the field.  I know that soccer and volleyball are also great sports to participate in but I’m just wary of all the injuries with sprained ankles and dislocated joints.  I don’t want to injure myself in secondary sports for my primary sport of running.

Overall, have fun in your sports and try to pick a mixture of low to high impact sports.

Be a Better Runner—No Running Required

By Amanda MacMillan

Once a week I park myself in the living room, but it’s not to watch TV. For 30 minutes I cycle through six moves that will—hopefully—help improve the way I swing my arms, kick my legs, and plant my feet as I run.

I’m training for the Shamrock Half Marathon to be held in Virginia Beach in March with the help of Coach Mindy, owner and head coach of The Running Center. Yes, I’m still doing some real running during my thrice-weekly jogs. But I’ve also added these “Runditioning” exercises, which were developed by Coach Mindy to help improve running form and performance and to prevent injuries. Here’s a breakdown of my new regimen.

 

• "Running Arms": Holding five-pound hand weights, I stand with one leg in front of the other. Keeping my elbows bent at 90 degrees, I alternate my arms, swinging them forward and backward in controlled movements. I am careful not to cross in front of my body or let them flail out to the side.

• Leg Strengthening: I wrap a resistance band around my ankle and anchor the other end of the band to a couch leg. Facing away from the couch, I raise my leg up till the knee is bent to a 90-degree angle, 12 times per leg. Then I switch positions to face the couch and kick back, 12 times per leg.

• Balancing: I must simply balance on each leg for 30 seconds. Finally, something I’m good at! Since only one foot is touching the ground at a time when running, my body needs to get used to supporting all my weight on one leg. Coach Mindy taught me to use a balance board (shown at top left), but solid ground works too when I’m not at the gym.

It feels a little strange to use my couch as a training partner and to stand around on one leg in my living room, but if I stick with it, I should run more efficiently during the race.

And this isn’t the end of the indoor fun. At midnight on Saturday, for example, I’m hopping on a spin bike and will pedal away for an hour in the middle of Manhattan’s Grand Central Terminal.

No, I’m not crazy. It’s part of New York Sports Clubs’ Saints and Spinners ride, for which they’ll set up 100 spin bikes for 24 hours. For $100 an hour you can donate or fund-raise for a great cause: Dr. Mehmet Oz’s HealthCorps charity, which educates schoolkids about nutrition and exercise.

Jogging/Running Frequency – The Balance Between Fitness And Risking Injury

Have you ever wondered how much is too much exercising? We know that fitness level is a function of how often we exercise, how long we do it and at what intensity level we workout.  You may have often come across the banal ‘thrice a week for 30 minutes’ phrase. There is research-backed reason for this lower limit. However, there are upper limit cautions as well.

As per the ACSM (American College of Sports Medicine), each session should ideally last from 20 to 60 minutes (duartion) and should be performed 3 – 5 days a week (frequency) at a an intensity level measured by heart rate (60%-90%).

In the first 15 minutes of aerobic activity, glycogen within the muscles is used to provide energy for the workout. Fat metabolism for energy does not begin about 15-20 minutes after the exercise has begun. Taking a margin for level of intensity of your workout and your weight and body type, the lower bar has been set to 30 minutes minimum for workouts.

Aerobic activities longer than an hour also contribute to burning fat. However, the rate of burning fat reduces after the first one hour. Also, the chances of injury caused by fatigue increases exponentially beyond the 1-hr mark. Aerobic activity more than 5 times a week is also risky for similar reasons besides it not getting adequate rest facilitating recovery to tissue and muscles. Listen to your body signals, rest, sleep and eat well in the non-workout days.

 

Preventing and Treating Running Injuries

By: Seamus Kennedy, BEng (Mech), CPed

Running has been referred to as the king of all workouts. It is an activity that has been embraced at varying levels of competence by nearly 11 million adults in the United States alone, according to the American Running Association. Running doesn't require the purchase or use of expensive equipment; it is possible to do it indoors or outdoors, usually year round. Not only does running provide a fantastic cardiovascular workout, it allows you to burn calories and clear your mind, leaving you with that relaxed, feel-good sense for many hours afterward. However, to reap these benefits on an ongoing basis, it is important to take precautions to prevent debilitating injuries.

For all the benefits of this great activity, there is no doubt that the repetitive nature of the stress it places on key joints can lead to breakdown. While there is some debate about what constitutes an injury, it has been estimated that up to 70 percent of runners will sustain some form of overuse injury during any one-year period. Anyone working in the orthotics, biomechanics, or sports medicine professions will see his or her fair share of running injuries. These injuries can be broadly classified as acute or chronic. Acute injuries are those due to sudden motions or twisting, such as an ankle sprain, which lead to soft tissue and/or osseous injury. These need to be treated immediately and allowed to heal.

Chronic injuries develop over time and are the result of repetitive stress that eventually leads to breakdown; e.g., patellofemoral syndrome. Chronic injuries account for well over 80 percent of running injuries, and they can develop from either an anatomical cause or a biomechanical issueand sometimes a combination of both. Because of its impact forces on the body, running greatly magnifies the extent of these anomalies. When experienced runners develop a chronic injury, it is often necessary to investigate what they have changed in their training practices.

To get a clear picture of any injury, it is necessary to do a full biomechanical exam. Evaluate the patient in stance and motion, non-weight bearing and weight bearing, in shoes and out of shoes. It is vital to follow the entire kinetic chainnot just treat the symptomto investigate the root cause of the problem. John Connors, DPM, a New York-based sports-medicine specialist, insists on watching his patients function in order to determine underlying causes. He will even run with his world-class patients in order to diagnose their etiology.

Common Running Injuries

Heel pain: Heel pain is a common complaint among runners. This is hardly surprising, given that the majority of runners who train on level ground at low to moderate speeds are heelstrikers. This running style produces an impact-force peak early in the stance phase, which can range from one-and-a-half to five times the runner's body weight. These impact forces are considered a primary cause of overuse injuries.

The classic sign of plantar fasciitis (PF) is heel pain that presents first thing in the morning and then decreases with activity. In the early stages, the patient usually can still exercise, only to be faced with more severe pain following a run. Typically, pain will be felt at the plantar-medial aspect of the calcaneus or at the middle aspect of the calcaneus.

There are other causes of heel pain that should not be ruled out without further radiographic examination. A calcaneal stress fracture may present like PF, but typically the pain does not subside as the day progresses. A positive calcaneal compression test can indicate the presence of such a fracture. Other considerations for heel pain include tarsal tunnel syndrome, neuritis of the first branch of the lateral plantar nerve, and tendinitis of the flexor hallucis longus.

Achilles tendinitis (AT): Achilles tendon injuries may be due to inflammation of the paratenon or the result of the degeneration of the tendon itself. It is broadly classified into two groups: insertional (occurring at the tendon/bone interface) and non-insertional (occurring proximal to its insertion, in or about the tendon proper). A physician's diagnosis will confirm the location and type of condition. AT can develop when the tendon contracts and tightens and is then over-stretched during exercise. There may also be a biomechanical component to the condition, given the tendon's broad insertion on the posterior calcaneus. Due to the cyclic rotation of the STJ from pronation through supination, there can be increased tension on the medial and lateral aspects of the tendon's insertion.

Iliotibial band syndrome (ITBS): This is a debilitating injury that presents as pain along the lateral aspect of the knee joint. It is sometimes accompanied by a clicking sensation. Current thinking is that ITBS results from weak core and hip muscles that fail to prevent tightening and strain the IT band.

Medial tibial stress syndrome (MTSS): Commonly known as "shin splints," this pain is typically noted along the lower third of the posterior medial surface of the tibia. It can often result from improper biomechanics or by not following the training considerations described earlier.

There are many other injuries that you are likely to see in runners such as posterior tibial tendon pain, knee pain, and a variety of stress fractures. Forefoot pathologies can include functional hallux limitus, sesamoiditis, and second metatarsal phalangeal joint (MPJ) capsulitis, in addition to regular blisters, corns, and neuromas. Much has been written on each of these conditions and their specific rehabilitation treatments. "How to Detect and Treat Running Injuries," by Brian Fullem, DPM, (Podiatry Today, May 2005) covers the basics. It is an excellent resource.

Preventative Measures

Over the years, I have developed a great love for running, so I can say from personal experience as well as patient interaction that nearly all running injuries result from training errors. I try to follow my own advice on injury prevention as outlined above. I begin a run by forcing myself to stretch; I change out my running shoes as necessary, even if they look almost new; and I vary my workouts with swimming, yoga, and sometimes bicycling to ensure adequate rest. I am pleased to say that I am injury free. However, when injuries do occur, treatment will generally follow a protocol of relieving pain, resting, icing, stretching, focused strengthening, and improving biomechanics. Good support from shoes and orthotics, good running form, and good training habits, such as always stretching, will prevent the return of many of these injuries. I believe foot orthotics, whether custom or not, play an essential role in keeping a runner injury free by aligning the body properly. Regardless of foot type, appropriate orthotics will increase shock absorption and prevent end-of-range-of motion, thus protecting tendons, muscles, and joints.

Another strategy for preventing running injuries is to advise your patients to modify their running style. Recently, I have begun using a technique called ChiRunning© ( www.chirunning.com). In essence, ChiRunning aims to lessen the forces that most runners experience by introducing a slight forward lean and a biomechanically efficient flow to their running style. It advocates running with relaxed lower legs and using a mid-foot strike to avoid the braking and impact of heel strike. Since adopting the ChiRunning approach, I have found running even more enjoyable, not to mention less strenuous.

Hopefully, armed with this information and more, you can help your runners achieve their goals.

Séamus Kennedy, BEng (Mech), CPed, is president and co-owner of Hersco Ortho Labs, New York, New York. He can be contacted via e-mail atseamus@hersco.com, or visitwww.hersco.com

Training Considerations

Increasing mileage and/or speed: Make any changes in distance or tempo gradually.

Breaking in new shoes: Break in new shoes slowly over a few runs. Ensure that the last and sole design match the runner's foot type; i.e., pronator, supinator, or normal/neutral.

Running in old or worn-out shoes: It is recommended that runners switch out their sneakers every 300-500 miles. If sneakers are over-worn, they lose shock absorption and their ability to control rearfoot and subtalar joint (STJ) motion.

Running on unforgiving surfaces: Elite runners usually avoid running on roads too often due to the unrelenting hard surface and the banked edges. It is best to look for firm trails with some forgiveness, such as dirt, woodchips, fields, or boardwalk. Slightly uneven terrain also helps avoid an exact repetition of each stride.

New running style: Any change in running technique should be applied slowly, to allow the body to adapt.

Be aware that a change in weight, and even aging, can contribute to the onset of an injury.

 

To Stretch Or Not To Stretch

Author: Stan Reents, PharmD

If the average person was asked to define "fitness", he/she might point to the ability to run a distance race (ie., "aerobic fitness") or the ability to lift a large amount of weight (ie., "muscular strength"). But, flexibility is a component of fitness too, even though it may not get as much attention or respect as its siblings.

This brings us to the concept of stretching. Almost all athletes — from elite athletes down to the weekend warrior types — stretch. Thus, it seems intuitive that stretching prevents injuries….why else would everybody be doing it, right?

Indeed, recent studies have shown that stretching can influence the viscosity of the tendon and make it significantly more compliant. Thus, many believe that increasing the flexibility of a muscle-tendon unit promotes better performances and decreases the number of injuries. Because of this belief, stretching exercises are regularly included in warm-up and cooling-down exercises. However, the sports medicine literature is divided on whether stretching prevents injury.

But, before we get into the science, let's review some basics:

TYPES OF STRETCHING

To be precise, stretching can be classified into 5 different types:

• Ballistic Stretching: This is defined as: rapid lengthening (stretching) of a muscle by the use of jerking or bouncing movements, for example, bouncing down to touch your toes. This type of stretching is not recommended. In fact, it mimics the type of sudden stress that produces muscle injuries in the first place. Jerking a muscle into a full stretch causes it to lengthen beyond a safe stretch and may injure the muscle…exactly the opposite of what you are trying to achieve with stretching.

• Static Stretching: This type of stretching is characterized by a slow and sustained (eg., for 15-60 secs) lengthening of a muscle by the athlete without help from a partner. This is one of the best types of stretching because it does not pose the risk of injury to muscle and connective tissue as ballistic stretching does.

• Passive Stretching: Passive stretching is identical to static stretching, except that a partner is used to gradually move the arm or leg. The advantage of using a partner is that a greater range-of-motion can be achieved compared to stretching without a partner.

• Isometric Stretching: Isometric stretching is simply static stretching with the aid of an immovable object.

• Proprioceptive Neuromuscular Facilitation (PNF) Stretching: PNF stretching sounds more complicated than it really is. Technically, PNF stretching involves passive muscle lengthening with the use of a partner after an antagonistic muscle is contracted. PNF stretching is considered to be an excellent technic however the risk of injury is slightly greater than the other methods since the range of the stretch can be greater.

STRETCHING TO IMPROVE FLEXIBILITY

One of the benefits of stretching is that it does improve flexibility, albeit, short-term. Stretching, combined with warming up, has been shown to increase the flexibility of the ankle, hip, and knee joints (Thacker SB, et al. 2004). However, an improvement in flexibility does not automatically mean fewer injuries or improved athletic performance. This is where there is confusion in the literature.

STRETCHING AND MUSCLE PERFORMANCE

As mentioned above, while stretching does increase the flexibility of specific joints, greater flexibility, in turn, does not always lead to improved performance. After static stretching, the muscle-tendon unit is weaker for 10-15 minutes (or longer, see below). This phenomenon has been called the "stretch lag" period, or, "tendon slack".

In fact, in some cases, stretching actually worsens (measurements of) muscle performance. Stretching has been shown to impair maximal voluntary contraction force (Behm DG, et al. 2001), muscular endurance (Kokkonen J, et al. 2001), and one-repetition maximum (Kokkonen J, et al. 1998) when it occurs just prior to the performance assessment.

A study of 40 females using a vertical jump test to assess muscle performance revealed that adding PNF stretching to a general warm-up routine worsened jumping ability (Church JB, et al. 2001).

Another study shows the effect of stretching on muscular strength over time (Fowles JR, et al. 2000). Subjects performed 13 stretches of the plantar flexors, holding each stretch for 135 seconds during a period of 33 minutes. Maximal voluntary isometric contraction (MVIC) was assessed 6 times during the ensuing 60 minutes. MVIC was depressed as follows:

Time / Percent Strength Decrease

• Time 0: -28%
• 5 min: -21%
• 15 min: -13%
• 30 min: -12%
• 45 min: -10%
• 60 min: -9%

The authors concluded that an intense prolonged stretch (of the plantar flexors) reduces maximum voluntary force for up to 1 hour after stretching.

STRETCHING TO PREVENT INJURIES

Contradictory findings regarding the ability of stretching to prevent injuries have been reported in the literature. Stretching recommendations are clouded by misconceptions and conflicting research reports. Apparently, no scientifically based prescription for stretching exercises exists (Witvrouw E, et al. 2004).

One fundamental issue to consider is that, even though stretching improves flexibility, most injuries occur during an extremity's normal range of motion (ie., during eccentric contraction). Thus, it is illogical to conclude that improving flexibility will prevent most muscle injuries (Shrier I. 2000).

In 1999, Shrier reviewed the literature on stretching to prevent injuries. He found 12 papers with acceptable study design. Of those, 4 showed that stretching was beneficial, 3 showed that stretching was detrimental, and 5 showed no difference (Shrier I. 1999).

Australian researchers reviewed the literature in 2002 and found that stretching had no beneficial effect on delayed-onset muscle soreness (DOMS) and did not reduce the risk of injury (Herbert RD, et al. 2002).

A subsequent literature review, published in 2004 (Witvrouw E, et al. 2004), was much more revealing. These authors proposed a possible explanation for why there is disagreement on the issue of whether stretching prevents injury:

Witvrouw and colleagues believe that the type of sports activity in which an individual is participating needs to be considered. Sports that involve a lot of bouncing and jumping activities with a high intensity of stretch-shortening cycles (SSCs) (eg. basketball, football, soccer, tennis) require a muscle-tendon unit that is compliant enough to store and release the high amount of elastic energy that benefits performance in such sports. If the muscle-tendon unit is not compliant enough, the demands in energy absorption and release may rapidly exceed its capacity. This may lead to an increased risk for injury of this structure. Thus, when a sport demands stretch-shortening cycles (SSCs) of high intensity, such as jumping or abrupt changes in direction, stretching may be important for injury prevention.

In contrast, when the type of sports activity contains low-intensity, or limited SSCs (eg. cycling, jogging, swimming), there is no need for a very compliant muscle-tendon unit since most of the forces come from active muscle contraction to generate motion. Strong evidence exists that stretching has no beneficial effect on injury prevention in these sports.

In other words, whether or not stretching prevents injury depends on the type of activity being considered.

Witvrouw and colleagues believe that if this point of view is used when examining research concerning stretching to prevent injuries, the reasons for the contrasting findings in the literature are in many instances resolved.

USE OF STRETCHING TO HASTEN RECOVERY AFTER AN INJURY

While stretching to PREVENT an injury is not always helpful, the use of stretching to hasten recovery AFTER an injury has been shown to be beneficial:

• Hamstring Injuries: A Greek study randomized athletes with hamstring strains to light stretching (once per day) or a more vigorous program (4 times per day). The study was conducted from 1996-2001 and randomized 40 athletes into each of the 2 plans. All 80 athletes received RICE (rest, ice, compression, and elevation). The stretching involved static stretching for 30 seconds per stretch session.

The authors found that normal range-of-motion was achieved earlier in the 4 times per day group (5.6 days vs 7.3 days) and the time elapsed prior to achieving full athletic activity was also shorter in the 4 times per day group (13.3 days vs 15 days) compared to the once/daily group (Malliaropoulos N, et al. 2004.).

• Plantar Fasciitis: For plantar fasciitis, also known as "painful heel syndrome" or "proximal heel pain", stretching of the Achilles tendon has been shown to be beneficial in reducing pain, stiffness, and increasing range-of-motion (McNair PJ, et al. 1996; Porter D, et al. 2002). One study reported that a non-weight-bearing stretch of the plantar fascia was better than the classic standing Achilles tendon stretch (DiGiovanni BF, et al. 2003).

SUMMARY

Thus, while there still is some controversy regarding stretching to prevent injury, some conclusions can be offered:

• Stretching to PREVENT injury is most helpful in sports that involve sudden changes of direction, such as football, soccer, or tennis or sports that require lots of jumping such as basketball or volleyball. Stretching appears to be less helpful in sports that produce less shock to the muscles, such as cycling, jogging, or swimming.

• Do not stretch extensively (if at all) within 15-60 minutes prior to a competitive event.

• If you do stretch prior to a competitive event, work that muscle group for a few minutes to help the muscle(s) recover to their normal length and power capacity. For example, if you have just stretched your hamstrings and the front of your thighs to get ready for a race, do some light jogging for several minutes before the race begins.

• Avoid ballistic stretching: It is more likely to cause injury than other technics.

• Stretching injured muscles does appear to hasten recovery.

FOR MORE INFORMATION

A very succinct, yet thorough, review of the sports medicine literature on stretching was published in the Sept./Oct. 2002 issue of ACSM's Health and Fitness Journal (see Bracko MR, below). Although this publication is intended for sports medicine professionals, the article is written in an easy-to-understand style.

For a "how-to" book filled with diagrams, get the classic Stretching by Bob Anderson. Even though this book was originally published in 1980, it demonstrates every kind of stretch and stretching routine you can imagine.

REFERENCES

Behm DG, Button DC, Butt JC. Factors affecting force loss with prolonged stretching. Can J Appl Physiol 2001;26:261-272. Abstract

Bracko MR. Can stretching prior to exercise and sports improve performance and prevent injury? ACSM's Health and Fitness Journal 2002;6:17-22. (no abstract)

Church JB, Wiggins MS, Moode FM, et al. Effect of warm-up and flexibility treatments on vertical jump performance. J Strength Cond Res 2001;15:332-336. Abstract

DiGiovanni BF, Nawoczenski DA, Lintal ME, et al. Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain. A prospective, randomized study. J Bone Joint Surg Am 2003;85-A:1270-1277. Abstract

Fowles JR, Sale DG, MacDougall JD. Reduced strength after passive stretch of the human plantar flexors. J Appl Physiol 2000;89:1179-1188. Abstract

Herbert RD, Gabriel M. Effects of stretching before and after exercising on muscle soreness and risk of injury: systematic review. BMJ 2002;325:468. Abstract

Kokkonen J, Nelson AG, Andrew C. Acute muscle stretching inhibits maximal strength performance. Res Quart Exerc Sport 1998;69:411-415. Abstract

Kokkonen J, Nelson AG, Arnall DA. Acute stretching inhibits strength endurance performance. Med Sci Sports Exerc 2001;33:11A. (no abstract)

Malliaropoulos N, Papalexandris S, Papalada A, et al. The role of stretching in rehabilitation of hamstring injuries: 80 athletes follow-up. Med Sci Sports Exerc 2004;36:756-759. Abstract

McNair PJ, Stanley SN. Effect of passive stretching and jogging on the series elastic muscle stiffness and range of motion of the ankle joint. Br J Sports Med 1996;30:313-317. Abstract

Porter D, Barrill E, Oneacre K, et al. The effects of duration and frequency of Achilles tendon stretching on dorsiflexion and outcome in painful heel syndrome: a randomized, blinded, control study. Foot Ankle Int 2002;23:619-624. Abstract

Shrier I. Stretching before exercise does not reduce the risk of local muscle injury: a critical review of the clinical and basic science literature. Clin J Sports Med 1999;9:221-227. Abstract

Shrier I. Stretching before exercise: an evidence based approach. Br J Sports Med 2000;34:324-325. Abstract

Thacker SB, Gilchrist J, Stroup DF, et al. The impact of stretching on sports injury risk: a systematic review of the literature. Med Sci Sports Exerc 2004;36:371-378. Abstract

Witvrouw E, Mahieu N, Danneels L, et al. Stretching and injury prevention: an obscure relationship. Sports Med 2004;34:443-449. Abstract

ABOUT THE AUTHOR

Stan Reents, PharmD, is a former healthcare professional. He holds Personal Trainer and Lifestyle Counselor certifications from the American Council on Exercise and has been certified as a tennis coach by USTA. He is the author of Sport and Exercise Pharmacology (published by Human Kinetics). 

 

Recovery strategies to enhance performance and reduce injury

By Shawn Talbot, PhD.
In the realm of elite sport, scientists, coaches and athletes are aware that a hallmark of top-level athletic performance is an outstanding ability to recover from intense workouts and competition. And understanding how nutrition is linked to recovery is essential. For trail runners, full recovery after a big day pounding the dirt is often the difference between staying healthy and injury free or being stuck indoors due to illness or chronic pain. The Downside to a Good Workout An exhausting trail run can leave your body dehydrated, depleted of glycogen (carbohydrate) stores, overexposed to free radicals (leading to cellular damage) and cytokines (leading to inflammation) and suffering from tissue damage (mostly leg muscles and lungs). This "depletion" is what causes sore muscles, stiff tendons, creaky joints and low energy levels for a day or two following a hard effort. Studies from the Australian Institute of Sport and from Appalachian State University show that after a middle-distance race (five to 13 miles) as much as 70 percent of participants experience an upper-respiratory tract infection such as a cold, flu or sore throat due to a temporary exercise-induced suppression of the immune system. An ideal recovery strategy involves immediately replacing what your body lost during exercise through proper recovery nutrition. Nutritional Recovery Triad Three aspects to optimal post-exercise recovery are hydration, glycogen replacement and "biochemical balance," which involves reducing inflammation in joints and muscles, reversing oxidation, repairing tissue and restoring the immune system. Oxidation and inflammation are related chemical reactions that cause cellular damage, leading to problems such as fatigue, infections and muscle soreness. Since it can be difficult to drink enough during long, intense sessions, assume your body is dehydrated post-run and drink more than your thirst demands. Electrolyte beverages with a low sugar concentration are superior to water in the body’s ability to absorb and retain the fluid. Despite the wide variety of bars, gels and beverages, the bottom line is to select something that tastes good and your stomach can tolerate. A post-exercise snack immediately replaces the sugar stores burned off during exercise. Consuming carbohydrates and protein in liquid form (such as one-percent chocolate milk) is a convenient way to refuel and rehydrate simultaneously. As a rule of thumb, consume around 300 to 500 carbohydrate calories as soon as possible following exercise. Great snacks are banana with yogurt, a handful of nuts and an apple or a bowl of whole-grain cereal topped with berries and one-percent milk. Wash down solid food with plenty of water or sports drink. While rehydration and glycogen replacement replaces what your body lost, biochemical balancing restores the body’s chemistry to normal levels. Exercise-induced inflammation and oxidation damages muscles, lung tissue and temporarily suppresses the immune system. Until you have rested, you are at increased risk of colds, flu and other respiratory tract infections, injuries such as tendonitis, strains, stress fractures and overtraining which characterized by lethargy, depression and general moodiness. Anti-oxidant-rich berries (blueberries, blackberries and raspberries), most fruit juices (orange, grape, and apple) and dietary supplements containing flavonoids and inflammation-reducing enzymes help repair tissues. Foods containing these nutrients are pineapple and papaya, roasted soy nuts and other soy products containing immune-balancing beta-sitosterol. Powerful Protein Although regular moderate exercise is associated with strengthening the immune system, intense training and competition suppresses immune function. The longer the event, the longer this affect can last. A marathon-distance run can leave an athlete susceptible to infection and viruses for up to two weeks, during which time the body cannot effectively fight off infections or repair exhausted muscles and joints. Protein is made up of amino acids and is essential for rebuilding damaged muscle tissue and restoring immune system function. Protein-packed foods, such as milk or yogurt (non low-fat varieties) or a palm-sized portion of beef, poultry, fish or legumes (beans), provide amino-acid building blocks for tissue repair. The immune system uses proteins made up of glutamine and the three branched chain amino acids (BCAA) as fuel. Whey protein, found in some post-exercise recovery drinks and dairy products, is a decent source of all four essential amino acids, but some studies suggest that amino acid uptake is faster when consumed as isolated nutrients in the form of dietary supplements. Look for products that deliver effective levels of BCAAs (1500mg) and glutamine (1000mg) in the proper ratios for post-exercise immune system support. Don’t fall for the "more is better" gimmick, but instead look for products that back up their formulations with research studies on runners. All protein-containing foods will have some BCAAs and glutamine, but dairy products (because of their whey component) are a particularly good food source. Recovery-enhancing nutrition may be the most reliable method to improve your trail running. Don’t just eat something after coming off the trail; instead, give some thought to "functional eating." When to Eat What Immediate after-workout snack Within two hours of your run, consume an easy-to-digest carbohydrate- and protein-containing snack with plenty of fluid. A peanut butter and jelly sandwich is a great choice, but eat to satisfy your personal tastes. Immediate post-exercise snacks jumpstart your body’s repair process. Evening Post-Workout Meal Your post-run dinner is a major source of tissue-repairing nutrients. This meal should include adequate protein (such as a palm-sized portion of chicken breast), carbohydrates (one or two fist-sized portions, such as pasta), antioxidants (two handfuls of brightly colored fruits or vegetables, such berries or citrus) and some added fat (a golf ball or shot-glass sized portion of full-fat salad dressing or olive oil or butter). Over the Next Week Before the Next Big Outing Continue taking your amino acid supplements–BCAAs and glutamine–to ensure adequate immune system function and repair any lingering muscle or lung damage. Dehydration can persist for several days following a long run and even modest levels of dehydration can inhibit recovery, so be sure to hydrate adequately (indicated by clear urine) before your next trail run. Shawn Talbott holds a PhD in nutritional biochemistry and MS in Exercise Science, and practices recovery principles after his trail runs in Utah’s Wasatch Mountains. He can be reached at smtalbott@supplementwatch.com.

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