How (Most) Running Shoes Cause Pain and Leads to Injury

In 2014 I tore my meniscus in my right knee. I was also diagnosed with “severe” arthritis. That was my wake up call. I was not done competing in the Ironman and did not believe I had to quit. “Certainly, other runners have arthritis and still run”, I thought.  I was troubled when Dr. Braden told me that arthritis was bone on bone and eventually I’d have to have my knees replaced.

I told him perhaps in other people. Not for me.

I had knee surgery in January of 2015 to repair the torn meniscus.

Right after that was my quest to figure all this out. I discovered some stats that troubled me yet led to my discovery that I’m sharing with you today.

Did you know that the United States has the most running type injuries than any country in the world? The country with the least running injuries was Africa. Why is this so?

There are several reasons.

Peaking Past 50 with these 3 exercise variables

spin bikeHave you felt the signs of aging and lost much of your performance? Want to stave off the loss of muscle and lung capacity but would like to still do some fun athletic events? Climbing stairs painful and you can’t catch your breath? If you reached the grand age of 50 or more you’ve experienced a loss of muscle and lung capacity and gained extra pounds around your waist. If so you are not alone.

Aging is not lost youth, but a new stage of opportunity and strength.

—BETTY FRIEDAN

Let’s explore what’s probably happening as you age (or if you’re young what you might expect). Then let’s see what can be done using three exercise variables that anyone can do; from athlete, weekend warrior or someone who just wants to keep fit and active.

Aging Facts (face the truth)

  • Skin loses its elasticity and becomes drier as oil glands slow their production.
  • Fingernails grow more slowly.
  • Hair thins, and there’s more gray hair as pigment cells are reduced.
  • Compression of joints, including spinal discs, causes a loss of height. By age 80, the loss of 2 inches is common.
  • Somewhere around age 55, high-frequency sounds start becoming harder to hear.
  • By age 50, most people need reading glasses as the eyes’ lenses become less flexible, impairing the ability to focus on anything close up.
  • Changes occur in the menstrual cycle before it ceases.
  • Sleep time typically becomes shorter, and the quality of sleep decreases. Waking often during the night is common.
  • Bone minerals are lost, resulting in more fragility.
  • The basic metabolic rate slows down, often resulting in weight gain— mostly fat

(List from Joe Friel;  Fast After 50: How to Race Strong for the Rest of Your Life)

Aging Athletes (its the same for non-athletes too)

The symptoms of aging that concern athletes and non-athletes include:

  • Aerobic capacity (VO2max) declines.
  • Maximal heart rate is reduced.
  • The volume of blood pumped with each heartbeat decreases.
  • Muscle fibers are lost, resulting in decreased muscle mass and less strength.
  • Aerobic enzymes in the muscles become less effective and abundant.
  • Blood volume is reduced.

(List from Joe Friel;  Fast After 50: How to Race Strong for the Rest of Your Life)

What Can You Do to Slow Down Aging

Obviously volumes are written about the science of aging. I know because I’ve read a ton about it. I finished my first Ironman triathlon at age 50. Thankfully I’ve completed a total of 15 but the last 4 were not pretty, walking the complete marathon. Currently at age 59 I want to continue racing for a long time. In 2014 I suffered a substantial decline in my performance even though I trained longer than at any time in my career. That year marked the first year of a series of injuries that put the brakes on me in 2015 with the surgery of a torn meniscus and then a major bike crash ending in another surgery.

I’ll be writing more blogs on what to do to overcome your rapid decline in aging and if you’re an athlete, how to increase performance or at least maintain competitiveness in the future years.

This is post is dedicated to understanding three exercises that are a must for anyone with the desire to improve their health past age 50. My decline in my race performances were because I quit doing these because they always lead to injury. Now I understand why.

Science confirms that as you age your aerobic capacity (VO2max) declines. What’s that and why is it important for you to slow down its’ decline? Aerobic capacity is simple. You deal with it as you exert any harder effort. It’s the amount (volume)  of oxygen that your body can carry to a working muscle over a given amount of time. You see the decline and explanation with this example. Ever see a young person bound up stairs and not hardly be breathing hard at the top and someone older had to labor up them slowly and have to stop and catch their breath at the top? A younger person simply can supply more oxygen to the working muscle.

You can guess why anyone who is aging would want to increase their aerobic capacity. It will allow for better body function and produce more output of activity with less effort because you’ll be able to supply more oxygen to the working muscle.

The aerobic capacity decline is influenced by the other five symptoms of aging athletes and non-athletes.

The 3 Exercise Types to Improve Aerobic Capacity

Anyone, athletes and non-athletes, would benefit from improving their aerobic capacity. You may be a mom who doesn’t work out but would like to get rid of some excess fat and be more active. If you’re a serious athlete you want to improve your VO2Max (aerobic capacity) so you can race faster.

There are many research studies that confirm that as athletes (or non-athletes) age they quit doing as much high-intensity interval training (HIIT) and lose aerobic capacity. Yet in other studies of older high competitive athletes they continued to perform HIIT as a regular part of their training and maintained their higher VO2Max.

vo2-chart

The most accurate way to determine your VO2Max is going to a lab and having a test done. A simple way to estimate your VO2Max is by the following formula:

15 x (Max Heart Rate / Morning Resting Heart Rate) = VO2Max

For me: my most recent maximum heart rate running was 170. My lowest resting heart rate is 55. Therefore my VO2Max is 15 x (170 / 55) = 46.3.

You can see I have the aerobic capacity of 30-39 year old non-athletes, effectively making me 20 years younger than an average person. The test is a way to determine if you are actually improving with your fitness program.

1. What is a HIIT workout for an athlete?

hiitAccording to Joe Friel, “When you perform intervals, the absolute intensity, the duration of the repetitions, the number of repetitions, and the duration of recovery between intervals must be only slightly more challenging than your estimated current capacity for physical stress.”

If you’ve not done these in a while you have to take a cautious approach as you begin this type of training. They are stressful and can cause injury. It’s best to start with no more than 3 intervals of 3 minutes each going hard as described in the subsequent paragraph. The rest period in between intervals is no shorter than 90 seconds (1/2 the interval length) and not longer than 3 minutes (the length of the interval) to receive the maximum benefit.

They need to be done after a sufficient warm up period of not less than 15 minutes but better after 30 minutes. At the conclusion of the workout it’s wise to have a good cool down and stretch period.

Then depending on your fitness level you may need a week or longer recovery period before doing them again.

If you’re a runner then you’d run hard slightly less than at a pace that you could only sustain for 5 minutes. Never start out to hard and have to ease up at the end. It’s better to be able to go slightly harder at the end. You do the interval in your sport. For me as a triathlete I do them in each discipline; swimming, biking and running.

What is HIIT for a non-athlete?

It would be the same personal intensity, i.e., an effort slightly less than what you could maintain for 5 minutes. Yet for you, especially if you’re just starting out after a long layoff but feel your personal fitness would allow you to go this hard, the length of the interval might only be 30 sec to 1 minute instead of the 3 minutes mentioned above. Your recovery time would be the same amount of time as the interval. Only do three to start. As you begin to gain aerobic fitness you’ll be able to increase the duration of the interval with less recovery in between. In time you’d be able to increase the number of intervals.

Like with athletes, rest and recovery in between these kind of sessions is a must.

A typical HIIT for a non-athlete my be a step aerobic class, body pump or strenuous water weights in a pool. Anything that would elevate your heart rate to those levels mentioned.

2. Lactate Threshold Exercise

Okay I know these terms may be foreign to a non-athlete but it really describes the exercise well. Lactate is what the body burns during exercise. The harder the exercise the more it burns. It is mixed with oxygen to provide the muscle energy to contract and do it’s job. At a certain point though, the toxic waste by product of the lactate that was used as fuel is so great the body can’t remove it and you get a burning and stinging muscle. Ouch! The pain is because the lactate is acidic. Lungs hurt too. That is your lactate threshold. It’s easy to determine because of how you feel although testing in a lab is more accurate. For most non-athletes that simply is not needed.

Lactate threshold exercise is the intensity at about 95% of your threshold pace; that which you’d begin to feel a burning sensation in your muscles and lungs. The intervals here are way shorter. In fact, even if you are an athlete you may only want to go 5 minutes cumulative at this intensity. It may be 10 x 30 sec intervals with a full 30 sec rest in between or perhaps 5 x 1 minute intervals with a full minute in between.

Once again caution is warranted. Only attempt these if you feel fit enough to go this hard. If you feel any stress or unusual pain, stop immediately and seek help.  Also, recovery is a must to overcome the tremendous stress your body is under.

What these do is increase your body’s tolerance to lactate and these will also improve aerobic capacity.

3. Weight Training

“Ugggg” you might have sighed if you’re a non-athlete. As you age you simply lose muscle mass. When this happens over time that leads to less hormone capacity and function and that leads to a loss of metabolism and fat gain, mostly around the mid-section.

Weight training needs to be done under the watchful eye of a professional if you’ve never done it before.

There are three types of weight training. First you lift in sets (2 or 3) with reps between 8-15 with less weight. The second kind is lifting in sets (2) with reps between 4-6 with more weight.

Weight training needs rest and recovery in between sessions. That is where the muscle is repaired and in grows. Many people need weight training to keep what muscle mass they have. The more lean muscle you have the more fat you burn because of improve metabolism and hormone function.

A third type of weight training is called functional strength training. It’s usually done with no weight or very little weight other than your body mass. It’s like sit ups and push ups. Or even one legged routines. Pilates and Yoga fall under this category.

Big Big Caution

Long_legs injury
Injuries are a real risk with HIIT. Caution is warranted but the risk is worth it.

I’ve not gone into any detail about the risks associated with HIIT  or weight training. The risks are primarily with the greater chance of injury. If you’ve had a history of heart problems, these three, while beneficial, needs to be under the care of a medical or exercise professional.

The reason many aging athletes and non-athletes stop these activities is due to many factors; too hard, not enough time and even a belief that it is not needed. But the fact remains, they are needed to stay youthful, to increase and maintain aerobic capacity, lean muscle and reduced fat. I believe, looking back now, because I quit doing these as much as I needed and stuck with low intensity and high volume, I became injured running hard intervals. I quit doing any weight training because it was boring. My aerobic capacity I can see now from my training logs has been in decline.

I highly recommend you seek the advice of an exercise professional, coach or your doctor before doing any of these three types.

 

 

The Greatest Possession You Can Ever Own

greatest-possestionWhat’s the greatest possession you own?

Your home, car, big bank account.

Perhaps it’s a relationship; with your spouse, companion, child or friend. Maybe even a parent.

For you maybe it’s your business because you treat it with the greatest of care.

The Greatest Possession You Can Ever Own

For me, I believe the greatest possession you can ever own is a clear vision of your future.

Most people I’ve mentored did not own that vision in the beginning which makes me think that most people in the world do not own that vision. What little part of a vision of their future they did own was not clear and was wrought with doubt.

Why is this the greatest possession you can ever own?

Lewis Carroll’s masterpiece, Alice in Wonderland contains a phrase that perhaps bests answer this question. In an exchange between Alice and the Cheshire Cat said, “If you don’t know where you’re going, any road’ll take you there.” Let’s use an analogy to describe what he meant.

If you were in a thick forrest where it was difficult to see where you were going if might be hard to tell which direction would lead you to safety. If you knew you had to get out of the forrest for your survival you’d at least start going down some path. As you continued on your journey you might be acutally headed in the right direction but you wouldn’t know it because you “didn’t know where you were going” as Mr. Carroll said. You might get discouraged and change directions even though the original direction would lead you to safety. After going in this new direction and again not seeing any signs that it was right, you would again become discouraged. Then you saw another hiker. You became excited. You asked him how to get out. He gladly told you what he thought was right. You were elated and began to go where he told you.

What you didn’t know is this hiker was lost too. That hiker, not wanting to appear stupid and wanting to make you like him, with confidence told you how to get out. This lost hiker didn’t know “where he was going and any path would take him there” as well.

After several days along this route you felt you were as lost as ever. A dark deep discouragement overshadowed you. You stopped going anywhere now.

After several days of just sitting still another hiker approached you. You were skeptical at this point in believing another lost hiker. In fact you now believe that every hiker you’ll ever meet is just as lost as you.

But this hiker is different. This hiker has a map. This hiker looks prepared. This hiker is there to serve you and doesn’t really care if you like him or not. He offers you food and water. But the best thing he offers you is a map and compass. He even teaches you how to use it. Finally, your vision of your future is clear and now all the steps you make are leading you to your final destination.

My Vision of Health

Many years ago I was offered a map to my health. It was called Ironman Triathlon. I knew it would lead me to my goal of health. My goal is to be unrestricted in my ability to choose to be able to attempt any physical challenge I wanted.

before-after-surgeryThis year I’ve entered three Ironman triathlons and one of them is the World Championship in Kona Hawaii on October 10th and the other two are Ironman Coeur de’Alene on June 28th and Ironman Arizona on November 14th.

Those are my clear visions of my future.

On May 7th I had a very bad bike crash accident that dislocated my left clavicle (see above xray) and did major damage to the tendons and ligaments that held it in place. On May 12th I had surgery to repair the injury. I’ve got 12 screws and a plate now in my shoulder.

But I’m still in possession of my clear vision of the future.

Right after the accident I had a few nasty bouts of negative thoughts and discouragement. I had a few “why now?” and “why me?” After all doesn’t God know that I have an important Ironman in Idaho that will prepare me for the World Championship?

Thankfully, with my greatest possession, I was able to dismiss those thoughts and focus on my goals. I declared to those in the ER and to my surgeon that I would race in Idaho on June 28th. They all just looked at me with that, “You’re nuts!” look. The surgeon gave my therapy doctor specific instructions to not move the shoulder for 5 weeks. That would only give me one week to prepare for to swim the 2.4 miles in Ironman Idaho.

My therapy and rehab doctor, Dr. Robert Braden DC, even had doubt at first that I would be able to race in Idaho. But over the three visits I’ve had with him he has now changed his tune. Because I looked him in the eye and through the confidence of my clear vision of the future, I declared, “Doc, to prepare for Idaho while my shoulder heals, I can walk and ride a stationary bike and swim with one arm (the good arm not injured). With your help, I want to give this my all!”

He now has hope too.

You see, hope is all that we have to keep us going and when your vision is clear of your future, you can see the paths that no one else sees. You are the hiker with a map. You don’t get discouraged. You get excited!

The photo in the beginning of the blog is me, this morning, on my first walk only 5 days after my surgery. I have a map. I also have hope.

I have a clear vision of my future. Do you see now? You too can have that same possession.

If you want to keep the knee you’ll have to quit running

knee tearI’m not even sure how to write this blog. I have many thoughts and emotions and writing this will allow me to get them out of my head and onto paper.

I had been suffering from a very painful knee since July 2014. It got really stiff and I was unable to straighten it for about a month following Ironman Boulder in August. My friend and doctor, Robert Braden, DC, finally was able to figure out the routine I needed in order to return the knee to full flexion so I could straighten it and be able to run. I was able to resume most of my training and it allowed me to successfully finish my 13th Ironman in Tempe, Arizona on November 17, 2014.

But the pain continued.

After that Ironman I was committed to really stepping up my running, my weakest of the three disciplines in the Ironman; 2.4 mile swim, 112 mile bike and a 26.2 mile run. I hired Bobby McGee, a world renown running coach, to help me improve. I started to really run well in the month following Ironman Arizona and had seen a reduction in my run time at about a full minute per mile.

But the pain continued.

Finally, Dr. Braden recommended that I have an MRI on my right knee. He knew I had a torn meniscus but wanted to see the extent of other damage that may be part of my pain.

I had the MRI on December 16, 2014 and went and saw Dr. Braden on Monday December 22nd to review the results.

As soon as I saw Dr. Braden I knew it wasn’t good. I could read it on his face. He knows me really well and how hard I’ve worked to be able to finish 13 Ironmans after I turned age 50. He loves athletes and will do everything for them and encourage them to keep participating even though other professionals would say quit. His eyes told it all as he read the results.

Then he said, “If you want to keep the knee you’ll have to quit running.

Bam, just like that my dreams and goals of crossing finish lines were over.

The MRI results from Alison Nguyen, MD read:

FINDINGS:

Minor joint fluid with no Baker’s cyst. Moderate osteoarthrosis, notably involving the patellofemoral articulation. No acute fracture or focal bone contusion. Bony fragmentation of the tibial tuberosity without marrow edema compatible with remote Osgood-Schlatter’s disease (sagittal PD image 11).

MENISCI: Medial meniscal posterior horn complex multidirectional tear (coronal PD image 15, sagittal PD image 20-22). Intact lateral meniscus.

LIGAMENTS/TENDONS: ACL, PCL, extensor mechanism, MCL, and LCL are intact. Intact medial and lateral patellar retinacula.

CARTILAGE: Moderate chondral thinning along the posterior weight- bearing portion of medial knee compartment (sagittal PD image 22). Severe patellar apex and lateral patellar facet chondral thinning centered at the patellar upper to mid pole level (axial image 5-7). Severe chondral thinning along the central and lateral femoral trochlea (sagittal fat-sat image 8).

IMPRESSION:

1. Medial meniscal posterior horn complex multidirectional tear.

2. Moderate osteoarthrosis with chondral injury as noted above, most significant along the patellofemoral articulation and medial knee compartment.

3. Remote Osgood-Schlatter’s disease.

Basically the cartilage is wearing out because there is bone on bone, thus the “moderate” and “severe” diagnosis. If I continued to run I would wear the knee out, have severe pain and then have to have it replaced. Damn it! That would suck I keep telling myself.

What the Ironman Triathlon meant to me

I love this sport! It fits my personality so well. It’s a sport that demands a great deal of discipline. As I’ve said many times, “The 140.6 miles don’t care if you’ve trained or not.” It’s a distant that demands a lot of endurance training to be able to move for 14 hours without injury. For me I was training 15-22 hours per week.

Ironman is such a big part of my life. I identify with it.

It taught me a lot about myself. During many long training routines, the longest being my 7 hour bike rides, I had to keep my mind quiet and focus on completing the session. In the quiet you learn about yourself. If you have any insecurity or weaknesses, they keep popping up in your mind telling you that you need to quit. For me those were rare occurrences. I have a great deal of confidence in myself because I trust the Lord and I have great joy and gratitude in my life. Most of the gains I’ve made in self development have occurred in the 7 years since July 4, 2006, the date I entered my first Ironman.

I loved seeing myself crossing the finish lines in my mind well before I actually did it. I learned that when you focus on a dream and goal and exercise faith, God will deliver the result to you.

I learned to respect everyone because I realize that the Lord blessed all of us with the will and body to achieve anything as long as we co-create with him.

I loved crossing those 13 finish lines. The anxiety before the swim is almost unbearable yet as soon as the gun goes off the fear goes away and then 13-14 hours later I would cross the finish line! During each race I would have unique experiences along the way. From the cold 52 degree water in Ironman St. George to the hot windy conditions in Ironman Arizona. The steep hills in Ironman Wisconsin to the fans partying in the streets  of Ironman Coure d’Alene. To the 29 degree ambient air temperature of Ironman Lake Tahoe, snowing the night before, to the 93 degree hot temperatures on the marathon in Ironman Boulder.

I loved helping and encouraging other younger athletes. The 20 year olds would call me “pop” and “dad” as I would occasionally pass them on the bike. The funniest was the three young ladies in Ironman Arizona 2012 that rode with me for over 60 miles. We laughed and teased each other for several hours. Then in a magical and “Only a triathlete would understand” moment, I taught them how to pee on the bike while riding!

My last Ironman in Arizona I broke the rules and took my cell phone with me so I could communicate with others as I raced including my wife who finally knew where I would be and when. After that I said that I would take it with me on every race after that.

I lost my wedding ring in Ironman Arizona 2014 on the swim. That swim was my best and yet hardest because of all the extra athletes the organizers allow to race as compared 7 years ago when I started. In my first Ironman in Arizona 2007 there were only about 2,400 competitors. In my last, Ironman Arizona 2014 there were about 3,200 athletes. The extra 800 bodies in the water makes the swim more like an MMA match than a swim. Lots of punching and kicking to go along with swimming.

My whole fitness gains were motivated by the vision I had of crossing finish lines. Motivation is so critical in anything we do in life. By signing up to race, sometimes a year in advance, you had the motivation to continue to train and eat correctly. That taught me a lot about creating motivation in all aspects of my life.

My Sadness

When you see a rich big dream of finishing 50 Ironman triathlons and completing one with a son and one with a grandchild and being the oldest to ever finish an Ironman, to now not knowing if that dream is even possible, really hurts. I have joy in my life and I’m very grateful for all that God has blessed me with yet I’m sad. I’m sad for me. I’m sad for my dream. I’ve not had these feelings at any time in my past athletic life. I can’t even remember the last time I was really sad but this last week has been a butt kick for me. I’m humble and I’m seeking the path that now is before me. What is the fork in my road? I know I need to take the path less traveled but I don’t even know what that path is.

Today while walking I wondered if perhaps this might me a blessing to me. I want to keep my knee of course and race at the same time. I’ve walked the marathon in 4 of my 13 events so I know I can walk and finish. Perhaps I can now train harder for the swim and bike, pushing those in the race with the knowledge that I can recover as I walk the marathon. For most it will be swim – bike – run – finish. For me it might be swim-bike-walk-finish.

 What is next?

I’ve scheduled an appointment with a surgeon, as recommended by Dr. Braden, to explore my options to repair the knee. Dr. Braden believes that surgery to clean out the affected areas would allow me to perhaps race one more year without compromising the health of the knee. I’m looking forward to learning more about that.

I’ve scheduled 3 races in 2015. Ironman St. George 70.3 (half Ironman) in May, Ironman Coure d’Alene (my 3rd trip there) in late June and Ironman Arizona (my 5th time there) in November.

I’ve applied to race the Ironman World Championship in Kona, Hawaii in October 2015. I will be notified in April 2015 if my application has been accepted. It’s been on my vision board for a few years to actually race in Kona and live and train over there for a few months prior to the race. I really believe that I’ll be selected and be able to race in Kona. That would be a pinnacle of my Ironman career.

The lesson for me

I honor the feelings of humility. I honor understanding that my joy is based on understanding that God is in control and all outcomes in my life, both abundant and like this, hard, are for my benefit. While I love being titled “the Ironman”, perhaps now something even more abundant will define me.

I hope so.

 

Want to run effortlessly without injury? Follow these 5 simple tips

runningI see so many people running incorrectly and I know in time they will sustain an injury, just like I did, when I ran the same way.

I’ve attached a photo of three women running. Please note their lead foot will land in front of their center of gravity and on their heal in effect putting on the brakes. All that force will be displaced all the way up starting at the heal, foot, ankle, knee, hip and back. If you compound that force over and over again during a run, you can see how you might receive an “overuse” injury, sidelining you from running. Then to compound that, you have use a lot of energy and force pushing off the back foot to keep you moving forward after you just applied the brakes.  running

Please note me running in the top left photo. The things I had to learn were:

  1. I have to keep a straight body, not bending at the waist like a lot of runners lacking core strength.
  2. I have a slight lean and I allow gravity to propel me forward. All I have to do is “pick” my feet up as opposed to “pushing” off the ground. It feels like a controlled fall (which it really is). As you lean forward you feel like you’re going to fall (gravity) but you pick up your back foot and set it down directly under your center of gravity which is slightly behind your head because it’s leaning forward.
  3. Notice my front foot lands directly under my center of gravity so all the force is balanced over all my big muscles and the force is dissipated  with  gravity.

The 5 Tips to Keep You Injury Free

  1. You have to have a straight column. Keep head and eyes forward.
  2. You’ll want your front foot to land “behind” you with a mid-foot strike.
  3. You’ll want to “swing” your legs backward.
  4. Practice a slight forward lean.
  5. “Pick” your feet up instead of “jumping” off the ground.