Running Healthy

This week, on Fall break, I read a book that radically changed my outlook on running. It has been awhile since I found a running book that did that for me. (There are lots of books that I skim through sections for tidbits of new ideas, but this one is worth the read cover-to-cover.) The book is called Anatomy for Runners by Jay Dicharry. I believe that some of the advice in this book is a bit controversial, or at least out of the norm for typical/general advice on running and injuries. Perhaps I've just been blind to the truth for too long. Before going any further, I think it is important to point out that Jay Dicharry is one of the foremost experts on running and running injury right now. He is the Director of the SPEED Performance Clinic and the Motion Analysis Lab Coordinator at the University of Virginia. In short, he knows what he is talking about. Jay recently contributed to an article (and a video) for Running Times on determining if you are ready for minimal running. The thoughts and ideas behind that article are central to his work in the book and improving health and injury reduction.

I'll be honest in saying that book is somewhat textbook-like as he describes our bodies, the parts that make them up, and how they are impacted by the forces of running -- leading to injury. Jay does an incredible job of balancing the overwhelming mechanics of the human body by using analogies and giving examples. In addition, he breaks down the high injury rate (82% is the figure he uses) and how we can change it. He points out that running is not bad for us and that the vast majority of injuries are due to imbalances in the body that can be fixed, allowing many more people to run healthy. And he shows you how!

Toward the end of the book he walks the reader through a series of tests to determine where their structural/mechanical deficiencies are in order to create a plan for running healthy. All runners should take his series of tests and come up with a plan to fix any imbalances that exist. At one point he makes a somewhat sobering point -- most of us do more maintenance on our cars then we do our bodies! The very nature of training is that we never fully recover from a run before embarking on the next one. It is inevitable that scar tissue will build up and must be "flossed" away.

I learned quite a bit about the body and the misconceptions about health and injury. Here are a few:

1. Stretching must be done for 3 - 5 minutes per stretch every day for 10 - 12 weeks to be effective in actually lengthening a muscle. Fortunately few injuries are actually a result of a muscle that is too short necessitating this work.
2. Tendons can be strengthened and rewired with 40 - 60 eccentric reps per day for 4 - 6 weeks.
3. The big toe is critical for running: about 85 percent of your foot control comes from this one toe.  (Most of us wear those that are way too narrow and are actually deforming our feet and inhibiting the big toe.)
4. Strength training is most effective for runners when they train for explosiveness (think big weight, low reps).
5. Distance runners rely on energy return from tendons and stiff muscles, so we don't necessarily have to be the most supple athletes in the world.
6. The majority of running injuries stem from an imbalance in core control/strength and stiff hips.
7. There is very little research that supports any type of shoe for either increased performance or injury reduction. (The possible exception is that support shoes have been shown to increase sheer force on the knees.)  That said, as it pertains to health and running, we would all be better off working toward light weight, zero drop shoes, with wide toe boxes to improve proprioception and bio mechanics. (Notice I didn't say we should all jump into them for our long runs tomorrow.)
8. Light weight shoes have shown a better running economy than running bare foot (though running barefoot can be a good tool to improve running cadence.)
9. To reduce impact on our body's, increasing cadence and avoiding over-striding is much more important than where we strike on the foot. In fact, there is little research that supports one foot strike as superior to another. That said, the most efficient runners do typically strike with the forefoot or midfoot.
10. NSAIDs interrupt recovery, compromising tissues and their ability to ever return to 100%.
11. Running through an injury is often appropriate because the majority of injuries are not healed by rest. The symptoms may disappear with rest, but the cause still remains. In many cases, rest is a measure to control pain so that you don't alter gait and do more damage. (Note that this is not a universally true statement, it depends on the nature of one's injury.)

That is just a small list of the things that stood out when I read it. But you would have to read the book yourself to understand the importance of these topics. You cannot fully appreciate the abbreviated list above without the additional context the book provides.

I am inspired after reading this book; I want to run healthy again. It seems like it has been many months since I ran fully healthy. I have known of one imbalance that exists in me -- a leg length discrepancy that results from a rotated pelvis and weak core -- and really never taken the time to fix it. I am tired of seeing the chiropractor every month in an effort to work around this injury. Jay's series of tests confirmed that my core is weak and a little unstable.  This isn't too surprising considering that I sit in at a desk with poor posture all day. In fact, this is the single most common challenge that many runners must overcome to run healthy.

And one final thought, the key to all of this is to view it as on-going maintenance. Most of the exercises in the book will help in 6 - 10 weeks, depending on the nature the deficit being addressed. But, that doesn't mean that you stop doing these things after that period of time. High-level training demands that we continue to maintain a strong, healthy body. I believe the reward will not only be healthy running, but also some unlocked gains in fitness and athletic potential -- more PRs!