Friday, January 29, 2010

Common Overuse Injuries in Runners - Stretches and Prevention Exercises

I learned a lot from Repsher and Associates Physical Therapist Matthew Alheim at the Fleet Feet Albany ‘Common Overuse Injuries in Runners’ presentation on January 26, 2010.

What is Plantar Fasciitis?

The Plantar Fascia is a thick band of connective tissue on the sole of the foot. Plantar Fasciitis is the most common foot condition treated by healthcare providers. Weakness in calf muscles, Achilles tendon and a limited ability to move your big toe could put you at risk for Plantar Fasciitis. Runners with Plantar Fasciitis may complain of pain in the heel that is worse in the morning, especially the first few steps of the day. To help prevent Plantar Fasciitis, do not tuck the sheets in at the bottom of your bed. When your sheets are tucked in, your feet naturally move into the ‘pointed toe’ position, which does not allow the Plantar Fascia to stretch.

What is Achilles Tendonitis?

The Gastrocnemius and Soleus muscles come together and form the Achilles tendon, which attaches to the Calcaneus, AKA the heel bone. There are over 230,000 Achilles tendon injuries per year in the United States. Weakness in calf muscles, pronation and high heeled shoes can cause Achilles tendonitis. Runners with Achilles tendonitis may feel pain over the back of the heel, or pain climbing stairs when pushing off of the foot.

What Are Shin Splints?

Shin splints refer to any pain in the leg between the knee and the ankle. Anterior shin splints affect the front of the leg on the outside of the tibia (tibialis anterior), and are seen most often in beginner runners. Posterior shin splints are seen on the inside border of the tibia (tibialis posterior), and affect more experienced runners.

How Can I Prevent Running Injuries? How Can I Find Out if I Pronate or Supinate?

Wearing the correct shoe when running and strengthening the affected muscles of the leg could help prevent Plantar Fasciitis, Achilles Tendonitis and Shin Splints.

I recommend purchasing shoes at Fleet Feet. The staff will ask you to walk and run on their treadmill and take video of your running stride to analyze which type of shoe you need.

This video shows a non-weight bearing Rectus Femoris stretch
http://www.youtube.com/watch?v=pBRjD6dKUKw



If you like standing when performing the Rectus Femoris stretch, be sure to get your leg BEHIND your hip and stretch your foot towards the other side of the body, instead of straight back.

Here is a video of a Gastrocnemius stretch
http://www.youtube.com/watch?v=gyyEILzA6MM


To stretch the Soleus, perform the same movement, but bend at the knee slightly.

To stretch the hamstrings, stand with one leg placed on a hip-high flat surface. Lean over the leg and feel the hamstrings stretch. Lean over the leg again, and turn 45 degrees to the left, then 45 degree to the right to stretch all the hamstring muscles.

To strengthen running muscles in your calves and feet, have fun trying the following exercises:

Place your bare foot on a towel on the ground, grab the towel with your toes and scrunch your toes to pull the towel an inch or two towards your body. Repeat, and practice with both feet.

With a bare foot, tap your big toe on the ground while keeping the rest of your toes motionless. Switch the exercise, keeping your big toe motionless while tapping your other toes on the ground. Practice with both feet.

While sitting, use a tennis ball to massage the underside of your foot. An alternate exercise is to roll a frozen water bottle back and forth on the ground with your bare foot while seated. The water bottle should be massaging the arch of your foot during this exercise.

Practice balancing on one leg. Repeat with the other leg. A Bosu ball or foam pad may increase the effectiveness of this exercise.


When Should I Replace my Running Shoes?


Divide 75,000 by your body weight in pounds to get the number of miles you can run in your shoes before replacing them. If you feel “heat” in the midsole of the shoe when you run, it may be time for new shoes. If you have a pronating or supinating gait, check to make sure the heel of your shoe is perpendicular when you place your shoe on a flat surface. If excessive wear on the inside or outside of your shoe causes the heel to tilt, it is time for new shoes!

Take care of your shoes by unlacing your shoes before you remove them. Forcing your shoes off while they are still laced will compromise the heel portion of the shoe.


To see the schedule for future classes at Fleet Feet, visit their website: http://www.fleetfeetalbany.com/

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Are you training to run a half marathon? Click here to get free nutrition and training tips by email.

Thursday, January 28, 2010

Cancer Patients Can Improve Health, Quality of Life with Regular Exercise

As a runner, I am often asked for exercise advice. If the same thing happens to you, reviewing this information for breast cancer survivors may help you assist a friend or loved one with incorporating exercise into their lives.

The good news is that five-year survival rates for early stage colorectal, breast, and prostate cancer currently exceed 90%. Cancer can be viewed as a treatable chronic illness and not the death sentence it was in past generations. The majority of cancer patients can take positive steps to increase their mental and physical health as well as enjoy a high quality of life. With their physician’s permission, regular aerobic and strengthening exercises can be integrated into the cancer survivor’s daily life.

Researchers at the Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington, published a study in 2008 focusing on physical activity and survival after diagnosis of invasive breast cancer. The scientists noted that previous studies suggest that increased physical activity may lower the risk of breast cancer incidence, but noted that less is known about whether levels of physical activity after breast cancer diagnosis can influence survival. The research found that women who engaged in greater levels of activity had a significantly lower risk of dying from breast cancer, regardless of a woman's age, stage of disease, and body mass index.

The University of Northern Colorado Rocky Mountain Cancer Rehabilitation Institute explored the role of exercise training in cancer treatment-induced alterations in muscular fitness and quality of life in a study published in 2007. The researchers studied breast and prostate cancer survivors as they trained in resistance exercise for six months during treatment or following treatment based on their health status and results from a battery of fitness assessments and health status. They concluded that moderate-intensity exercise is a “safe and efficacious means to augment muscular function and improve the quality of life of cancer survivors.”

My mother died from breast cancer when I was 20 years old. I have responded to the genetic threat of breast cancer by modifying my diet, participating in regular exercise and reducing my exposure to pollutants. If I am diagnosed with breast cancer, data from numerous studies points to physical exercise, including aerobic and resistance exercises, as a strong treatment for improving quality of life, self esteem and the health of my body both during and after chemotherapy treatment. I would like to share the conclusions of these studies with breast cancer survivors and encourage them to add regular exercise to their daily lives.

Exercise Can Improve Quality of Life


Can we really ask a breast cancer patient to exercise after she completes chemotherapy treatment? As a child, I remember my mother was very weak and suffered side effects during her chemotherapy treatment. The following studies make a strong case for starting a program of regular physical exercise.

In 2009, The University of Queensland, Australia School of Human Movement Studies investigated the role of exercise during cancer rehabilitation, the period immediately following cancer treatment completion. The research evaluated pointed to the conclusion that exercise during cancer rehabilitation is feasible and can provide patients with physiological and psychological benefits. Patients participated in aerobic or resistance-training exercises and improvements in physical functioning, strength, physical activity levels, quality of life, fatigue, immune function, hemoglobin concentrations and body composition were reported.

Exercise can be a positive part of rebuilding a life after winning the battle against cancer. Several studies have found that exercise improves quality of life for cancer patients after their treatment has concluded.

In 2010, the Center of Community Alliance for Research and Education (CCARE), Department of Population Sciences, City of Hope, Duarte, CA, published a study exploring the relationship between physical well-being outcomes and healthy lifestyle changes by cancer type. The study found that exercise was significantly related to improving physical well-being for breast cancer survivors.

The University of L'Aquila Sport Science, Department of Medicine, Public Health Biostatistics, Epidemiology Unit, Faculty of Movement in L'Aquila, Italy studied the relationship between physical exercise and quality of life in breast cancer survivors. Strenuous exercise was correlated with a higher quality of life. Absent/mild exercise was inversely correlated with a positive perception of disease severity and with quality of life.

A 2010 study by the Institute of Health and Biomedical Innovation, Queensland University of Technology School of Public Health in Queensland, Australia found that exercise improves quality of life among breast cancer survivors. The researchers found that women under 50 years of age who participated in physical activity over 3 METs reported a higher health-related quality of life at 18 months compared with their more sedentary counterparts.

Exercise Can Lessen Depression in Cancer Survivors


Fighting cancer takes a toll on more than just the body, and beating cancer can feel like a hollow victory if the survivor is suffering from depression. Exercise has been proven to help raise self esteem in chemotherapy patients and reduce depression in cancer survivors.

The University of Alberta in Canada in 2007 reported the results of the six-month follow-up of patient-rated outcomes in a randomized controlled trial of exercise training during breast cancer chemotherapy. Breast cancer patients initiating adjuvant chemotherapy participated in resistance or aerobic exercise for the duration of their chemotherapy. Six months later, the resistance exercise group reported higher self-esteem and the aerobic exercise group reported lower anxiety when compared with a control group. During chemotherapy, patients who participated in resistance exercises reported an increase in self esteem, and kept their levels of self-esteem through the six month follow up. Patients who participated in aerobic exercise did not have an immediate change in anxiety level, but reported a reduction in anxiety at the six month mark.

Researchers at the Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN; and Shanghai Institute of Preventive Medicine, Shanghai, China joined together to study the effects of Exercise, Tea Consumption, and Depression Among Breast Cancer Survivors. The research on Chinese breast cancer survivors found that women who increased their exercise level had lower risk for depression.

Finding the Appropriate Forms of Exercise Can be Frustrating, But Exercise is Well Tolerated by Cancer Survivors

Scientists at the Royal North Shore Hospital, Sydney, Australia studied patient perceptions of arm care and exercise advice after breast cancer surgery. Breast cancer surgery patients were asked to respond to their experience receiving advice about arm care and exercise. Cancer survivors reported inadequate and conflicting advice, lack of acknowledgment of women's concerns about upper limb impairments, an unsupported search for information about upper limb impairments and a fear of lymphedema, a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system.

According to the American Cancer Society, of the two million breast cancer survivors in the U.S., approximately 400,000 must cope with lymphedema on a daily basis. I remember that my mother would always struggle to find tops with sleeves that were loose fitting at the upper arms.

A small study published in 2008 examining the effects of Pilates exercises on shoulder range of motion and upper-extremity function in women who had been treated for breast cancer found that Pilates exercises may be an effective and safe exercise option for women who are recovering from breast cancer treatments.

Breast cancer patients may be advised to be cautious about any strenuous activity that involves repetitive, resistance-oriented movement in the at-risk arm. Flexibility exercises can help patients maintain a wide range of motion, stretching the arm can increase flow in the lymphatic channels, strengthening exercises using very light weights can also be attempted. Swimming can be a beneficial form of exercise for breast cancer survivors because it combines muscle action on the inside with the additional benefit of water pressure on the outside of the arm.

The University of Pennsylvania Division of Clinical Epidemiology published a study in 2010 reviewing controlled physical activity trials in cancer survivors. The researchers found a positive effect of physical activity interventions post treatment on upper and lower body strength and moderate effects on fatigue and breast cancer-specific concerns. A small to moderate positive effect of physical activity during treatment was also seen for physical activity level, aerobic fitness, muscular strength, functional quality of life, anxiety, and self-esteem. The scientists reported that, with few exceptions, exercise was well tolerated during and post treatment without adverse events.

An exciting study from the Yale School of Medicine provides a direct link between exercise and reducing the incidence of breast cancer in breast cancer survivors.

The Yale School of Medicine Department of Epidemiology and Public Health published the Yale Exercise and Survivorship study in 2009, focusing on the results of aerobic exercise on insulin and insulin-like growth factors in breast cancer survivors. High insulin and insulin-like growth factor-I (IGF-I) levels may be associated with an increased breast cancer risk and/or death. The researchers found that breast cancer survivors that participated in 150 minutes per week of moderate-intensity aerobic exercise, like brisk walking, experienced decreases in insulin, IGF-I, and IGFBP-3, and women in the control group had increases in these hormones.

Several recent studies highlight the positive effects of exercise on cancer patients. For me, the possibility of reducing high insulin and insulin-like growth factor-I (IGF-I) levels with exercise is the most exciting benefit of regular exercise for cancer patients and survivors. Other benefits include higher self esteem, lower depression, a stronger body and a better quality of life. Cancer patients can work with their physicians and a personal trainer to develop an exercise program that they can enjoy on a long term basis.


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Are you training to run a half marathon? Click here to get free nutrition and training tips by email.

Monday, January 25, 2010

Funny Video - Running versus Cycling, which is harder?


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Do you run because you should or because you must?

Three great questions from Dr. Oz and Biggest Loser Trainer Bob Harper

On day 7 of Dr. Oz’s Look Younger in 60 days program, the following three questions are asked:

Are you living life from (a) fear or (b) passion?
Are you playing life to (a) avoid losing or (b) to win?
Are your goals based on (a) preserving the status quo or (b) achieving growth?

Answering these questions made me realize that there are two kinds of runners out on the roads – the ones that have A answers and are working out to prevent disease and the runners that answer B answers and are training to achieve a goal of running longer or running faster. There is plenty of room in the sport for both types of runners, and I am excited when an A runner gets excited about running and starts thinking of running in terms of B answers. For me, running is a passion that enables me to discover the strength within myself and achieve growth at the finish line and in all aspects of my life!

I read a story the other day where the writer discovered during his seal training that the body is able to take much more than the mind expects. His observance was that the Seal instructors will fail the trainees if they quit, but they are allowed to continue if they work so hard they faint. For me, half marathon training weeded out the ‘quitter’ inside of me. Of course, when I was injured I was scruplous to follow rehabilitation instructions, but when I was just ‘tired’ and felt like quitting, I went out for the run anyway. I said No to other other commitments and offers so I could say Yes to keeping on track with my training. I said No to fast food so I could continue to say Yes to a healthful training diet. I felt that it was easier to train as an B answer type of runner because I wasn’t running because I “should” run (for my health), I was running because I “must” run – it was my passion and a goal I had publicly set for myself.

What type of runner are you?

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Friday, January 22, 2010

DVD Review “Back to Utopia” by Terry Lyles

I enjoyed this inspirational DVD by Dr. Terry Lyles. Dr. Lyles teaches that our response in the face of stress dictates the path of our lives.

What most helped me as a runner were Dr. Lyles’ comments on Navy Seal training. Lyles explained the ‘drownproofing’ exercise that Navy Seal recruits undergo as part of their training. They are briefed on what will happen in the exercise, but Dr. Lyles points out that just talking about getting tied up and getting tied up are two different things. Once the Seals are physically tied up and led to the pool, they have to deal with emotional stress and fear reactions.

If the Seal recruits don't handle their reactions, they let the situation and others around them handle and control their emotions. This happens in running, too. If the race is important enough to me, I will experience fear at the starting line. On the morning of my half marathon, I woke up terrified. I know that if I do not put myself into a more positive, confident emotional state, I will be guaranteed a poor performance.

Lyles pointed out that challenge and fear are two sides of the same coin. He recommends ‘flipping’ fear into a challenge to handle it. In January 2009, I was sure that I could not finish the Boilermaker. As late as June 2009, I was sure I could not run 13 miles. It could never happen. The 15K race and the Half Marathon were both fears until I made them into challenges. I committed to running the races, took action to find and follow a training plan that would strengthen my body to finish the races, put myself in the company of runners that believed in my ability to run the race and arrived at the starting line positive that I could accomplish my goal and motivated to succeed.

My strength comes from handling weakness. I would not be as motivated of a runner if running came easy and injury free to me. Experiencing injury and handling it successfully to become healed and stronger than before has made me a better runner and opened my mind to expect success in other areas of my life as well. Dr. Lyles calls this ‘failing forward,’ stating that mistakes are useful if we make each mistake only once and learn from our mistakes. As a runner, there are many races in my life. I am prepared to learn from each one, using my mistakes to improve my racing technique and my finishing times.

Dr. Lyles also shared a great definition of emotional health. He said that the measure of performance is how quickly one bounces back, specifically one’s recovery time from distraction. This is critically important in a race. If I run a mile too slowly, do I beat myself up for it mentally for the next ten minutes, lowering my emotional state and allowing fear and frustration to take over, or do I note the mistake and return to a positive state before formulating a strategy to recoup the time? Dr. Lyles says that it is OK to be frustrated, but asks “how long are you staying frustrated?”

Dr. Lyles designed this book and DVD for those working with stress in their jobs and personal lives, but there are several very valuable lessons for runners. I recommend watching “Back to Utopia” by Dr. Terry Lyles.


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Monday, January 11, 2010

Top Three Tips for achieving your Exercise New Year's Resolution


I returned to my high school sport of long distance running after years of stop and go exercise attempts.

Here are three tips for fellow females who are returning to exercise.

1. Do it for yourself. There are many reasons to get active, but the best chance you have to add the label 'healthy body' to your self image is to commit to exercising for yourself, instead of for your family or a spouse. Women are so used to saying yes to everyone else, make exercise a way to say yes to yourself.

2. Set measurable objectives in addition to long term goals. Don't confuse objectives with goals. Your long term goal can be general, like "eat healthful foods and become strong enough to complete daily activities and hobbies with ease," but your weekly and monthly objectives have to be specific and measurable. For instance, my goal is to have a strong, fit body that can run 13 miles and my objective is to run 20 miles this week and complete 3 hours of crosstraining. Adding up weeks and months of achieving your objectives will enable you to achieve your goals.

3. Pick an exercise that you can enjoy for a lifetime. Think of exercise as a new hobby and a part of who you are, not a grueling form of torture (unless you like torture). Do you enjoy golf? Focus your exercise on making you a more effective golf player through weights and cardiovascular exercise. Like cycling? Sign up for a 25 or 50 mile bike ride for charity and exercise by completing a strength and endurance training schedule leading up to your ride. Is dancing your passion? Enroll in a dance class to improve your skills.

I loved running in high school, so in January 2009 I chose to start training for charity 5K races. Completing each race gave me the motivation to try for longer distances, and I worked my way up to a half marathon. The pressure to 'win' every race is off of you when you compete as an adult, so let go of that pressure and enjoy your new identity as an athlete!

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Are you training to run a half marathon? Click here to get free nutrition and training tips by email.

Monday, January 4, 2010

DVD Review – Bigger, Stronger, Faster

DVD Review – Bigger, Stronger, Faster

Steroids as a path to celebrity and admiration

The documentary 'Bigger Stronger Faster' provides valuable insight as to why so many non-professional athletes turn to steroids to make their muscles larger. The majority of the main characters are struggling with an addiction to being admired and we discover the sons' answers to the question 'what do I want my body to look like and what am I willing to do to achieve that goal?'

The mother is overweight, but still cooks fattening food. Is it because she needs the praise that she receives from making delicious foods more than she needs to be at a healthful weight?

She raises three sons, and all three struggle with their weight as children, each turning to exercise to mold their bodies, and eventually steroids to improve their results. The oldest and youngest brothers have become dependant on steroids to provide them with bodies that give them the same kind of approval from others that their mother's cooking gives to her. We see the profile of a "wrestler" who is unsatisfied with coaching other athletes because he wants the limelight, and continues to audition for wrestling stardom. We see a "weightlifter" who only achieves the type of praise he craves when he can lift weights that are too heavy to handle without the help of steroids.

Bell spends part of the documentary linking the American obsession with "winning" and the use of steroids. The Bell family is really not so obsessed with 'winning' as they are with being in the limelight and being admired. For the oldest and youngest sons, steroids are the path that they take to achieve this goal.

The filmmaker tells us that he was disillusioned by the fact that his idols all used steroids, which in his minds invalidated the advice that kids could achieve their dreams through hard work and clean living. They completely missed the fact that each of the 'heroes' gave back by helping others to achieve their goals. Arnold encouraged kids to become physically fit, Hulk was famous for telling kids to say their prayers and do right, and Rocky loved his wife, family and coach. A real role model doesn't just 'win,' they help and inspire others. The one brother that does find a coaching job dismisses the opportunity to share his knowledge and motivate others by saying "those who can't do, train."

As a long distance runner, I achieve the type of body I want through diet, running and lifting weights. I want to compete in a half marathon more than I want to sleep in, eat a tray of brownies or lay on the couch and watch TV, so I dedicate myself to training. It is the same with these brothers and the other athletes that Bell interviews in the documentary. The sticking point is when having a 'normal life' with a happy family, rewarding job and healthy body is LESS important to the athlete than his/her body image and the respect and kudos that are gained by athletic prowess. Steroid use is a warning sign that their lives and priorities are out of balance.

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Are you training to run a half marathon? Click here to get free nutrition and training tips by email.