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Ask the Practitioner:  Barefoot Running - Why (or Why Not), What, How?


For this edition of Ask the Practitioner, we connected with Adam Daoud, an experienced runner and medical student, who while at Harvard worked extensively on research in the Skeletal Biology Lab.  His website states, "My current research interest lies in investigating the ways in which the human body is suited particularly well for endurance running and determining why Homo sapiens possess such incredible endurance running capabilities."  As a co-author of the studies cited below as well as work published in the journal Nature, Adam has narrowly focused in on the plusses, minuses, and implications of a growing trend among running enthusiasts, barefoot and / or minimally shod running.  Have you ever wondered if barefoot running would be good for you?  Read on for Adam's perspective......




rc: What are the potential benefits of barefoot running or running in minimalist shoes?

 

AD: I think that the biggest potential benefit of the barefoot style of running is reduced injury. The barefoot style of running that habitually barefoot and minimalist runners tend to use is a forefoot strike, landing on the outside ball of the foot before easing the heel down under the control of the calf muscles. This style of running minimizes the forces experienced at impact, which may help to avoid injury. Notice that this focuses less on what is under a runners’ feet and instead considers how footwear affects how runners use their feet and how this changes their style of running. My recent work looking at foot strike and injuries in collegiate runners found a nearly two-fold reduction in running injuries among forefoot strikers, none of whom were barefoot runners (Daoud AI et al. Foot Strike and Injury Rates in Endurance Runners: a retrospective studyMSSE, 2012.). This was a study about running form, more work especially prospective work needs to be done to look at the interplay between footwear, running form and injury. A singular focus on what runners strap to their feet can easily lead a runner into danger.

Another potential benefit would be financial savings. Since forefoot strike runners do not use the cushioning of a shoe to reduce the impact, shoes can be worn for many more miles before being replaced. As a forefoot strike runner, I usually wait until the upper is pulling off the lower before tossing shoes.

Studies on running efficiency have gone both ways. Our lab recently found that running in minimal shoes is more efficient regardless of foot strike and that there was no difference between heel striking and forefoot striking in terms of running efficiency (Perl DP et al. Effects of Footwear and Strike Type on Running EconomyMSSE, 2012.). While Rodger Kram’s lab has found that barefoot running is less efficient than running in lightweight, cushioned shoes (Franz JR et al. Metabolic Cost of Running Barefoot versus Shod: Is Lighter Better? MSSE, 2012.). But in general, a less injured runner is a better-trained, fitter runner so even if forefoot striking is not more efficient there may be performance gains by avoiding time off due to injury.

rc: What are the risks?

AD: While the major benefit of the forefoot strike running is injury reduction, the greatest risk is increased chance of injury during a runner’s transition from their current running form to forefoot strike running and possibly doing so in a more minimal shoe. Forefoot strike running puts very different stresses on the lower limb compared to heel striking. The muscles of the calf and foot have to do more work each time the foot strikes the ground while the bones of the foot incur impact and bending forces that are different than those experienced in heel striking. In addition, running barefoot or in a more minimal shoe will require increased muscle force to stiffen the arch of the foot and the bones of the foot may be subjected to less evenly distributed forces. Recent case reports have described instances of metatarsal injury in runners transitioning to barefoot running. Though if case reports were written up for all of the injuries sustained by “normal” runners, sports medicine journals wouldn’t have room for anything else.

Other risks are quite obvious such as injury to the sole of the foot due to surface conditions if a runner chooses to run completely barefoot. Though these risks can be greatly reduced by using your eyes and choosing smooth surfaces that are free of jagged debris. A hard surface such as a road or sidewalk can be a good surface.

 

rc: What are some sensible ways to experiment with barefoot / minimalist running to explore whether it is appropriate for you?

AD: The first thing to do is to decide whether or not your current form is working for you. If in your years, possibly decades of running you’ve found shoes that fit your running form and you’re not plagued by injuries then why change? But if you’ve struggled with injury as a heel strike runner then you might want to consider trying out forefoot striking. Unless they ask, my running friends don’t hear a word from me about running form until they get injured. This not only gives me a chance to figure out how much they’ve been injured in the past, but also transitioning to forefoot strike running can line up perfectly with returning from injury since you’re already running at a reduced volume and intensity. Transitioning should be done slowly and in accordance with what your body is telling you, just as you would any other new training technique such as weightlifting or plyometric exercises.

Concerning form, jump straight up in the air. Where on your foot did you just land? You should do the same when you run. Try out running completely barefoot on a track or smooth paved surface to try to get a feel for what it should feel like. Your bare feet will encourage you to run correctly as it will hurt to do otherwise. Don’t run barefoot on overly soft ground to learn good technique since the cushioning of the ground will allow you to run without good form. You can find more information including videos of forefoot strike running in various footwear on my past lab’s website.

The biggest mistake a runner could make would be to buy the newest, coolest pair of minimalist shoes and then go out and continue running in the same way they always have – heel striking – in their new minimal shoes. The heel cushioning of a standard running shoe will no longer attenuate the large impact forces of heel striking. Another mistake would be to consider the barefoot style as a panacea and to suddenly switch 100% of your running to forefoot striking. Your muscles need time to grow stronger and to learn the new firing pattern of a new gait pattern. And your bones need time to strengthen and remodel to adequately deal with the new loading patterns of forefoot strike running.



Our philosophy is to train at current fitness level to race at peak performance.  For that reason, we don't use goal times.  Instead, we use your past race performances to generate your pace chart and training schedule.  This is the safest way to progress to the next level. 

With that said, we encourage you to consider running a shorter distance race prior to your goal race (for example, a 5K or 10K).  We expect that as you start to condition, you will run an equivalent faster non-goal race.  The system will then update all your training to match your new fitness level.

To enter your new race time, follow the steps below:



ACS_croppedParticipating in a race for a personal cause or organized charitable organization has become an extremely popular way to experience race day.  Some of the largest marathons can boast of millions of dollars raised per year for great causes in this manner. Charities in almost every segment of the non-profit world have found their way into the action, offering race numbers for a variety of challenging endurance events.

If you are an experienced racer looking to try your next goal race with this additional motivation, or if you are seeking your first long endurance effort and wonder if the charitable piece would help you get to the finish line, here are a few things to consider when making the commitment.



imgresAsk the Practitioner:  Blisters!

For this installment of Ask the Practitioner, we connected with Michelle Toy, Assistant Athletic Trainer at Santa Clara University.  Michelle has worked with the cross country teams at Santa Clara, as well as high school athletes as the Strength and Conditioning Coach at Woodside Priory school.  This summer, Michelle will again serve as a trainer for the Bay Area Running Camp.  In short - she's seen some blisters!


RC: Why do runners typically get blisters?

MT: The most common reasons that runners get blisters are: their shoes don't fit right, they aren't wearing thick enough socks, they are running with improper mechanics, they are running on uneven surfaces, or they are running in new shoes that haven't been broken in long enough.



RC: What can you do if you develop a blister, but still need to get out there and run?

MT: If you have a blister, you can help protect it by wearing a band-aid over it or wearing a gel pad called second skin or skin lube.


RC:  What are some good ways to prevent blisters before they occur?

MT:  Good ways to help prevent blisters are to wear shoes that fit properly, wear thicker socks, run on even ground, break new shoes in over the period of a week, or wear skin lube over hot spots.



kinesio_foot

Adam Kemist, C.Ped and his wife Michelline own the On Your Mark running and walking store in Los Altos, California.  A long time health and wellness professional, Adam is a Board-certified Pedorthist with biomechanics expertise and also has several years of experience as an FNF member.  This month in Ask the Practitioner, Adam answers a few questions about Kinesio tape, which has become an increasingly popular tool among professional and recreational athletes.

FNF: What is the Kinesio Taping Method and how did it come about?

AK: In the mid-1970s, Dr. Kenzo Kase was a well-known Japanese practitioner licensed in chiropractic medicine and acupuncture.  He could not find a tape to give him the results that he desired for himself and his patients. So he developed Kinesio Tape.

The Kinesio Taping Method is designed to facilitate the body’s natural healing process while allowing support and stability to muscles and joints without restricting the body’s range of motion. It is used to successfully treat a variety of orthopedic, neuromuscular, neurological and medical conditions. Both Kinesio® Tex Tape and the training protocol have shown results that would have been unheard of using older methods and materials.



Ask the Practitioner - Sciatica

Written by Dena Evans January 30, 2012
sciatica_pointThis month, we sat down with Dr. Michael Fredericson, Director of the Physical Medicine and Rehabilitation Sports Medicine Service at Stanford Medical Center.  Dr. Fredericson has spent a career addressing the needs of athletes at all ages and ability levels, and here, he provides some insight on sciatica, one of the most common ailments for adult athletes.

 

FNF: What is sciatica and what are signs you might be suffering from it?

MF: For most people, it relates to a bulging or herniated disc in your low back that is pressing on a nerve.  You feel it through the sciatic nerve.  That nerve goes all the way down your leg, so you’ll feel it there as well.  Sometimes your back is fine, and the problem is pirformis syndrome.  Your sciatic nerve goes through the pirformis, one of your smaller backside muscles that helps rotate your hip. That muscle can get tight and it can compress your sciatic nerve.  The biggest reason to see a physician is that you want to make sure it is not a bulging disc pressing on your nerve, as this requires more aggressive treatment.

 

FNF: How do you typically treat sciatica?

MF: First, we try to figure out if there was something that got them into this situation.  A lot of people don’t realize that it isn’t from their activity, but from their work.  Maybe they sit too much or drive a lot, which can put increased pressure on their discs.   The piriformis muscle can also get tight from driving too much.  So a lot of it is getting them out of the activity, and then calming down the inflammation.  We’ll advise over-the-counter products like Aleve or ibuprofen, and then prescription anti-inflammatories and so forth, in combination with physical therapy.   If it is a bulging or herniated disc in the back, sometimes we recommend an epidural corticosteroid injection and very rarely, surgery.

 

FNF: What can we do to prevent sciatica?

MF: Everyone is typically given core exercises as a part of their physical therapy, so that is something we should do prophylactically as well.  It takes pressure away from the disc.  We also should take care with our back mechanics.  People don’t think about simple things throughout the day such as how you lift, or how you sit and stand. You should.   Also, it is wise to be careful with the downhill running.  It is easy to get out of control downhill running and put too much stress on the low back.  Likewise, overstriding [landing with your foot too far in front of your body] can lead to overstress on the back. 

 

 




pilates_cropped

Can the Gym Help My Running?

Personal Best - January 2012


January is a time to set new goals.  Runners of every age and experience level often seek ways to improve performance and results outside of the time spent out on the roads.  As coaches, we are often asked if weight training, yoga, cross training, or other gym-based activities will assist an athlete toward their running goals.  This month in Personal Best, we consider the question with a few guidelines and tips.

Why not just run?
Certainly, the best way to improve your running is to run; however, moving your body in different ways can address various weaknesses that have built over time due to the repetitive nature of running. In addition, ancillary activities can help put the finishing touches on the fitness gains from a workout regimen begun in search of weight loss or aesthetic goals.

It all starts with the core....
If time and resources are limited, there are a number if ways to help your running with some simple core work.  Exercising the core helps strengthen the area from your chest to your hip flexors, allowing you to maintain good form and posture when at the end of a race. Your core stabilizes you not only when you're tired, but helps center your running form even when fresh, assisting in the achievement of good posture and range of motion in your stride.  We discussed the importance of one of these muscles, the transverse abdominis, in a previous column, along with a few easy and simple exercises to address it when you can steal a few minutes on the carpet after coming in from a run.

If you enjoy the social nature of classes they are a great way to stay on track with your core strength objectives.  In addition to stabilization, a strong core, and good spinal / pelvic alignment can help you maximize efforts spent on strengthening other muscle groups, another reason why it is a good place to start.

Flexibility is your friend

Activities like Yoga and Pilates are also tools used by many runners to help increase flexibility and strength when muscles are extended.  Greater flexibility can be a huge asset in the effort to stave off injuries, so if that is a big goal for 2012, these might be good options for activities to incorporate into your regimen.

Boost your metabolism and body composition
Along with general weight training, some of the latest trends in fitness include CrossFit, P90X, TRX, and a myriad of home and gym-based programs to challenge your body in a multi-directional, muscle-strengthening fashion.  Some of these also include a cardio component, and many of them build upper body fitness, demand lateral movement, and require more ballistic activities than a normal running routine.

These high intensity activities can complement your training by adding a new dimension of athleticism increasing your power.  However, anything along these lines should be carefully taken into account – some body composition changes are helpful, some are not, and anything that compromises your running by creating too much and untimely fatigue, may be more detrimental than it is worth.   Any of these activities are best safely incorporated with the help of a fitness professional at your local facility.


Ease strain on joints and muscles

Every runner occasionally requires a time of recovery or the need for a day or two of cross training.  Others enjoy incorporating spin classes, swimming, elliptical, or even a fitness activity such as Zumba into their regular routine.  If you are looking for a way to integrate in an additional day of cardiovascular exercise, but are concerned about the strain on joints and ligaments, one of these low or non-impact activities could be just the ticket to keep you headed in the right direction.

 

In short….the bottom line

Cross training and multi-dimensional movements can be beneficial for distance runners.  Consider some of the disciplines below to have an even better and more balanced 2012.

Core strength exercised, Yoga, Pilates:  At home, with an instructor, or in a class setting.  These primarily address needs for flexibility, core strength, and spinal / pelvic alignment.  Low / no impact, more meditative. 

Want to try a home-based core workout?  Check out Focus-N-Fly’s favorite whole body workout here:  

Weight / circuit training, CrossFit, P90X, TRX, etc:  At home, with an instructor, or in a class setting.  These require more dynamic, powerful movements, perhaps with greater intensity and resultant muscle development.  For those who enjoy an up-tempo addition to their week, and who are looking to add more power / speed.

Indoor cycling, elliptical, Zumba, swimming: At home, with an instructor, or in a class setting.  These activities can increase cardiovascular training time with minimal strain on joints and bones.  Could be used for variety or as a prelude to including an additional day of running into the schedule.


Focus-N-Fly Plyomterics and Warm-up Drills:  These can be run on a track, road, sidewalk, path or grass.  Even if you do not have time for an additional training session or two, these can be efficiently integrated into your already scheduled running to help strengthen your core and provide greater range of motion. 

Questions about the above?  Email us at info@focusnfly or tweet us a question to @focusnfly.

 



postmarathon

Personal Best - October 2011

Race Weekend Tips for Friends and Family

Every athlete must marshal the vast majority of effort needed to accomplish a big goal race.  However, many runners and walkers who embark on an ambitious training season must rely also on the help and support of family and friends.  Whether providing rides, fluid support, space in the family calendar, or just emotional support, oftentimes these individual can be difference makers, especially since they are often the motivation for the individual to keep trucking when things get tough on race day.

 

While athletes get a great deal of advice and tips on how to manage their training and race, friends and family can be left empty handed when wondering how best to support their runner or walker.

 

Here’s a road map for every support person or team to take into consideration (since we wrote it – you don’t have to feel selfish about handing it out)!

 

Designate a czar of logistics

One common situation is that the decision for a large group of friends and family to come to the race creates additional stress for the athlete.  Everyone definitely means well, but numerous calls to ask about where to stay, when they can visit with the athlete, where they should watch on the course, and so forth, can increase the perceived pressure when nervousness may already exist.  Designate a family member who will serve as the traffic cop for this type of planning, someone who will coordinate flights and airport trips, hotel stays, dinner reservations, and various rendezvous with all those who wish to be included.  This person should be well versed in the details available on the race website for the course, the expo, and the post-race reunion area.  If a new person pops up who wants to support the athlete, the athlete can then confidently connect them with the logistics czar, who can walk them through the plans already in place.

 

Consider the Athlete

It is not uncommon for friends and family contingents to begin to build a life of their own as race day approaches.  Interest in various sight seeing expeditions, brunch or dinner locations, matching t-shirts, expo shopping trips, and more ideas may continue to grow and expand.   There is absolutely nothing wrong with making plans that don’t include the athlete, respecting the runner’s need for rest and calm before (and rest and recovery after) the race.  However, keep in mind the race that your runner has trained for and the needs they have in final preparation.  For example, if everyone wants to eat dinner at 9pm at an exotic restaurant, but the athlete expresses a desire to eat simple pasta at 5pm and go to bed early, consider compromises and alternatives (such as having one person from the group have dinner early with the athlete).  Race weekend isn’t a democracy; it is a narrowly focused time period with one specific and very demanding aim..  Be proactive, and ensure the physical and psychological needs of the competitor are paramount.

 

 

Determine a simple post-race plan, including a fall back plan if things haven’t gone well

At smaller races, athletes are easy to connect with after they finish.  However, at many large races, the post-finish process can be very crowded, and may take some time.  Cell phones have been left at home, at the hotel, or in the race baggage, so old-fashioned methods of communication must be relied upon.   Races often offer reunion areas, but it may make sense to pick an alternate landmark or process to find each other as the reunion areas may be clogged.  Friends and family need to be patient with post-race logistics.  Oftentimes races require a lengthy cool down area, and the competitor may not feel especially perky after running a 10, 13 or 26-mile race. If more than one person is racing, they may also want to greet each other within the finish area before heading out.  Determine a plan for reunion if things go as planned, and an option if things do not.  The runner should have a plan if forced to withdraw mid-race (read the race materials), and the czar of logistics should be well versed in this process as well.  The same goes for brunch, lunch, dinner or whatever is the first item of business after the race.  Consider that the athlete may not be in a position to eat a large meal, walk a long distance, or sit in the car for an hour.  Try to plan accordingly and be prepared to be flexible.

 

Marshal the energy of the support group into loud and visible demonstrations of support

Make a plan to provide an inspirational boost to the competitor or competitors in the race.  Large signs, strategic course placement, and clear visibility can be a huge boost, but require an organized plan to account for pacing and transportation variability.  Don’t miss out!  Think through how the group will get from point to point and how the problems that might occur can be addressed.  HOWEVER, again also consider the athlete’s needs.  Should they prefer a lower-key approach, respect their wishes and support as requested.  It is their day!

 

Race weekend can be an intense, but significant and memorable weekend on many levels.  Everyone involved wants to provide support, but the greatest energy must be saved for the actual task itself.  Keep that focus in mind at all times, and hopefully your athlete can look forward to a happy and unified reunion when the finisher’s medal has been finally placed around their neck.



You're in the race - now what?

When we choose a goal race, we are often preoccupied with the deliberation leading up to the final clicks on the screen.    When the rush of the final commitment wears off, we are left with the training to be done – which of course is where we come in!

Certainly, the start of your program is the most important thing. However, it also makes sense to begin planning travel as soon as possible, to ensure your race weekend experience is all that you hoped for.   Here are a few tips to optimize your goal race travel.

Read the race participant info early...and often

Most big races require number pick-up at a participant expo the day or two before the event.  Some races may also have a fairly complicated process set up for start area arrival and finish line departure.   Race directors know thousands of people need to get in and out and have thought through how best to get everyone where they need to be.

Before you set up any travel plans, make sure that you have a good sense of the logistical tasks required of you by the race.  The flight that arrives at 5pm may be the least expensive, but you may be out of luck if the expo closes at 6 and your flight is delayed.  Even if you are local, securing a ride or a forming a carpool to the start and away from the finish can make the difference between a successful day and one that turns south when you are rushed and hurried, or forced to stay outside in the cold while waiting for a ride.

Even if you review race day details upon initial registration, it makes sense to return periodically to ensure you have not missed any updates.  If the race’s plans have been forced to change by unanticipated construction, a different level of participation than originally expected, or any other reason, you will want to make sure you have plenty of time to make your own adjustments.

Check out the race-sponsored travel options, but don’t limit yourself to those.

Many races partner with local hotels and even some airlines to provide options for participants.  These may very well offer the best prices for places to stay within walking distance to the start or finish.  As such, they should be checked first as they often sell out early.  Before you act on a pre-pay option, however, consider hotel reservations with a closer cancellation date in case of injury or change of plans.  Also consider other ways to stay in favorable locations relative to the race.  If you are early enough, travel websites that offer flight / hotel options in combination may provide value as those negotiated prices might have been made before the race blocks were established.   Vacation rental sites like vrbo.com or airbnb.com may offer houses or condos for rent at reasonable rates, particularly if you bring the family along for the big day.  Finally, never underestimate the power of a call directly to an onsite reservations agent or even the front desk of a small hotel.

Consider your regular pre-race routine and sketch a travel scenario that will allow for as much familiarity as possible.

Do you prefer to eat dinner at a certain time?  Do you try and head to bed at a certain time?  Do you prefer a certain type of food in the evening or morning before the race? Take these preferences into account when you make your initial travel plans.  How long might it take to get to and from the expo?  Where will you likely eat and how close is it from your hotel?  If you want coffee in the morning, where will you get it and are they open at that hour?

For these reasons and others, it often makes sense to arrive two days before your race so you have a day to take care of whatever you need to do without being rushed for time.  Similarly, if time and finances allow, you may be well served to depart the day after your race instead of that same afternoon.  You never know quite how you will feel or how long it might take to exit the finish area, and no one should be rushed after a terrific race effort.

If you need to make a choice between staying near the start or the finish of a marathon, by all means, stay by the finish.

Unless the start of your race is extremely early or in an obscure location, definitely err on the side of staying by the finish.  You can always get up 10 or 15 minutes earlier to get to the start with all your energy intact, but anyone who finishes a marathon will be glad that a hotel room is close by.  Very glad.

If planning a general vacation in concert with a goal race, plan to race at the start of the trip whenever possible.

Many people combine travel to a new destination with an opportunity to complete an exciting goal race.  If you do so, consider how much more you will be able to enjoy your surroundings without the concerns of a race over your head during the “fun” part of the trip.  You’ll want the freedom to walk without worry of fatigue in your legs, the freedom to eat adventurously and the flexibility to have a schedule that doesn’t demand eight hours of sleep. Yes, distant travel may require a couple days to adjust to a new time zone before the race.  However, it is always best to celebrate the completion of your goal with the bulk of your vacation after the race.

 

 



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