Recently, we added the Alter-G treadmill to our clinic, the first of its kind that is open to the public in the Boulder/Denver metro area. The decision to add this piece of equipment was a relatively easy one to make. By incorporating differential air pressure technology to decrease the amount of weight on the lower extremities, the Alter-G allows patients to safely return to full weight-bearing running and walking quicker during the rehab process while reducing the amount of impact on the body. Already used by many professional/collegiate sport programs and Olympic-level athletes, the Alter-G has quickly become a valuable training tool to safely progress running volumes and intensities allowing athletes to train harder and recover faster. Whether recovering from a stress fracture, rehabbing after surgery, improving your neurological efficiency, training for a marathon, or transitioning to minimalist running, the Alter-G is fast becoming an essential part of modern endurance and rehabilitation training. These units have recently been featured in many news publications including: Triathlete Magazine, Running Times, Runner’s World, Competitor Magazine, New York Times, Active.com, Denver Post, CBS New York, NBC New York, and Livestrong.com. The ability to train safely, rehab quickly, and recover faster utilizing this unit is a nice luxury to have, especially with the winter weather fast approaching. To inquire about testing out the Alter-G for free at our clinic or for additional questions, call us at 303-442-0355 or email Dr. Hansen at email@example.com.
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*Originally written for the Boulder Triathlon Club as part of their monthly newsletter
Over the past few years, research has shown the adverse effects of static stretching prior to working out. We grew up thinking and being told flexibility was a good thing, and the best way to attain that was by putting our bodies through a stretching routine before we exercised. However, flexibility is relative to your biomechanics and activity preference. If you were a gymnast or kung fu master, you would rely heavily on having flexible and pliable tissue to torque your body in a wide variety of positions. However, as endurance athletes, we need to have some tension through our tissue to create joint stability, as well as elastic momentum to propel us forward (like the recoil of a stretched rubberband). Too much or imbalanced tension is obviously an issue that can create strain on the muscle/tendon/ligament, but too little tension or too much flexibility can create instability of the joint.
Now, where does static stretching fall into the realm of proper joint mobility and right amount of flexibility without compromising the stability? Personally, I think in most situations you can do without static stretching as it tends to fatigue the tissue. But, if you feel the need to incorporate some aspect of this component into your training program, the best time would be after your easy sessions. The problem with static stretching (meaning holding a stretch for a period of 30seconds to a minute) is that it can reduce eccentric (lengthening) strength and peak force of the muscles for up to 60 minutes following the stretch; you need some tension in your muscles to optimize the elastic component of the tissue during the workout, and by placing a static stretch on tissue that is not already engaged or prepared for that component, the body’s muscle spindles will reflexively activate to resist the stretch. So, the body can actually become tighter as a protective mechanism when static stretching is performed. Therefore easier effort days would be, in my opinion, the only time to do some sort of static stretching, following your workout, as these days recovery and flexibility should be the goal, not muscle tension for performance optimization. Prior to workouts (regardless of intensity and duration) and before/after harder and longer effort days, a dynamic routine should be implemented to properly engage and activate the tissue while minimizing the effect the stretch reflex can have.
What do I mean by a dynamic warm-up? I typically recommend a series of lunges called the lunge matrix (from Coach Jay Johnson, developed by physical therapist Gary Gray) followed by a series of leg swings prior to any exercise. A lunge, although inherently a strength exercise, is a terrific stimulus to activate all the muscle of the leg prior to working out. Additionally, drills such as skipping, bounding, body squats, side walking, backwards walking/running, mountain climbers, and karaokes are all examples of dynamic exercises to get the legs prepared for the demands of your workouts.
Today, I had a great converstation with Coach Jay Johnson about what type of strength training (if any) is appropriate for distance runners. As we spoke, we covered a wide range of topics and various opinions from different coaches, athletes, researchers, and trainers. It made me realize that the thought behind incorporating this type of work differs depending on who you ask, regardless of what current research might state. So I thought I’d throw this poll out there to see what opinions we might get back. Additionally, I’d like to open this up as a discussion with the type of workouts you currently do (if any) outside of running and why? The more comments, the better the discussion, so please leave your input.
It’s been a while since my last blog post and part of that is because I have been consumed with the fall cross country season. This year was my first as the head coach of the Peak to Peak cross country team in Lafayette, Co. It was a pretty exciting season that saw the boy’s team qualify for the state meet placing 12th overall (after finishing second in our region, they were 5th last year) with a ridiculous 25 second pack time, as well as one girl (who had never run cross country before) qualify individually and place 53rd overall. One of the biggest aspects of our training this season was the addition of a number of ancillary routines pre and post-workout with each having a specific purpose or goal. One of those routines is what I called the hip mobility progression. I picked this up from Coach Jay Johnson (he calls it the cannonball cooldown)and modified it for the purpose of making it a mobility routine. The reason I modified his original routine was some of the exercises in the original routine I would consider strength work (which we do in some of the other routines) rather than strictly mobility and because there would be instances when time becomes an issue, so I try to limit each routine to under 5 minutes to make sure we can get in the desired work. The routine that our team does is 20 reps on each leg in the following order: iron cross, scorpions, active straight leg raise, groiners, and hurdle rolls (or hurdle seat exchange from the video). Why do we do this? I look at this routine as a series of exercises to open up the hip capsule while creating dynamic flexibility in the surrounding tissues. Depending on the exercise being performed, there is a certain level of eccentric loading taking place on the hip flexors, hamstring, adductors, quads, and lumbar paraspinals. Additionally, the various exercises help prevent the hip capsule from getting impinged (that can occur during running) while avoiding over-stretching (that can happen during a static stretch where the surrounding muscles are relaxed, reducing their protective control over the joint). We would do this routine about 3 x’s/ week, typically after harder workouts or long runs, as a way to flush the tissue out. As I told Jay, of all the routines that we do, this is the one that I feel had the greatest effect in helping to keep the kids healthy throughout the season. It should also be noted, that I have given this routine to patients in practice who have experienced anterior hip impingement, excessive hamstring tightness, Psoas or Quad overactivity, and TFL/Glut Med/ITB tightness.
My wife and I have recently begun following a modified paleolithic diet, excluding a lot of gluten/wheat, incorporating minimal dairy and raw sugars, and eating mostly organic fruits/veggies and organic grass-fed or free-range meats. In doing so, we have noticed a tremendous improvement in a number of health-related aspects (such as daily energy, quality of sleep, mood, recovery after exercise, etc). Our reasons for choosing this way of eating came after reading literature on the types of toxins that are included in processed foods and the nutritional value (or lack thereof) that is found in commerically grown and raised produce and meats. We agreed that our bodies react based on the fuel we give it. So we might as well put our bodies in the best position to perform well.
However, following such a diet comes with its share of challenges. First off, it is by and large more costly and time consuming to eat this way. For example, a dozen commercially raised eggs costs around $1.99, where as organic free-range eggs may cost around $3.50. But, the saying “you pay for what you get” rings true. The omega 3 (essential fatty acids with anti-inflammatory capabilities) to omega 6 (unsaturated fatty acids that in excess can increase the risk of a number of diseases or conditions such as heart attacks, stroke, diabetes, and cancer) ratio is one example of this. The ideal ratio of omega 3 to omega 6 has been suggested to be between 1:1 and 1:4. According to the book, The Omega Diet by Artemis P. Simopoulos, MD and Jo Robinson, this is right in the range that organic free-range eggs fall (about 1:1 to 1:3), where as commercially rasied eggs have a ratio as high a 1:20. The same can be said for organic grass-fed beef, whose ratio is around 1:5, where as commercially raised beef is around 1:20. Also, the number and types of products that contain some form of wheat or gluten is staggering. Gluten may be present in commercially made soups, tomato sauces, salad dressings, meatballs, prepared hamburger patties, yogurts, cheeses, etc. Why are we choosing gluten-free? Wheat and gluten are not necessarily bad for you, especially if you don’t have a gluten intolerance like those affected by Celiac Disease. We, however, choose to opt-for gluten free foods or fruits and veggies as our sources of carbohydrates because of the effect wheat/gluten may have on your immune system. In a 2007 study in the American Journal of Industrial Medicine, workers exposed to wheat flour had an elevated levels of IgG and IgA (serum antibodies that help protect against invading pathogens) indicating that a systemic immune response was being triggered. In a 2005 study in the Bioscience, Biotechnology and Biochemistry Journal, wheat gluten was given to a group of healthy individuals over a 6 day period and their immune system response was measured. Following the 6 days, natural killer T-cell levels were significantly increased in each of the individuals in the test group. So although we aren’t intolerant of gluten, we choose to opt for non-gluten containing foods to optimize the performance of our immune systems.
It is difficult though trying to maintain this type of diet while keeping some variety in the types of meals we eat when so many foods and recipes (esepcially when going to a restaurant) contain ingredients that we try to avoid. So I thought I’d share a recipe that we tried this past week that was both delicious and followed a lot of the self-imposed dietary restrictions we now abide by. Hope you try it out and enjoy it as much as we do. Additionally, if you have any recipes that follow a more gluten-free / paleolithic way of eating, please share those as well as we are always looking to expand our cooking repertoire.
Sweet Potato Waffles:
Prep Time: 10 min (not including boiling the sweet potato)
Cook Time: 5 min
- 1 cup boiled then cooled mashed sweet potato (we skin ours and slice it first to help it cook faster)
- 1 1/4 lowfat (preferrably organic) buttermilk
- 1 egg (we use organic free-range as stated above)
- 1 tbsp canola oil
- 2 cups gluten-free pancake mix (we use Pamela’s brand)
- 1/4 cup raw cane sugar
- 1/2 tsp. cinnamon
- we sprinkle unsweetened coconut and diced strawberries on to
- Preheat Waffle Iron
- In a medium bowl, combine sweet potato, buttermilk, egg, and oil
- In a separate bowl, whisk pancake mix, sugar, cinnamon, then stir in sweet potato mixture into dry ingredients. Batter will be fairly thick.
- Coat waffle iron with nonstick cooking spray or spoon 1/2 to 3/4 cup batter into waffle iron and cook until crisp
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If you haven’t seen Coach Jay Johnson’s video on implementing a lunge sequence as part of you dynamic warm-up, you can view it here. I love this routine for the simple fact the it engages your muscles dynamically in multiple planes both concentrically and eccentrically before you start to run. Additionally, it is a fantastic way to train the corset function of the abdominals and improve balance. But before you begin the routine, you should understand the simple mechanics of a lunge to ensure that you aren’t promoting a dysfunctional movement pattern.
Normal Lunging Reminders :
- Feet should be shoulder width apart with toes pointed forward
- Torso should be slightly leaning forward while maintaining a neutral lumbar spine
- At least 80% of your weight should be on your front foot and the remaining 20% distributed on your rear foot.
- When Lunging, it is important to keep your tibia in line with your knee and hip to prevent excessive knee valgus and hip adduction
- Don’t let your front knee cross your front ankle
- Keep eyes up, looking forward
Why are these reminders important?
- Keeping your feet pointed forward in the direction of the lunge will help to evenly distribute the force over your lead quad without putting unnecessary stress on either side of the knee
- Keeping a neutral lumbar spine while hinging from the hip to create the slight forward lean while reduce the activity of the lumbar extensions to maintain an upright posture. Also the amount of force being placed on the anterior portions of your vertebral discs will be reduced by limiting forward spine flexion.
- Keeping the tibia in line with the knee and hip will prevent excess force being placed on the medial meniscus of the front leg, as well as reducing the amount of stretch being placed on the already taut IT Band
- Keeping eyes up and facing forward is important as vestibular sense affects position sense. This means that if your eyes are looking down toward your feet, it will cause your spine to flex, placing an additional load on the anterior disc material.
One final thought, I love Jay’s routine like I said, but be mindful of adding in trunk twists if you are doing your runs when you first step out of bed in the morning. Why? When you sleep, your discs swell from excess fluid that accumulates during the night from your static sleeping posture. So you are at your tallest height first thing in the morning. However, this excess height means that your disc pressure is also at its highest point. Placing your spine under a twisting motion, will cause a shearing force on those vulnerable swollen discs leaving you at a higher risk for injury. So it is therefore wise to at least wait an hour after waking up before performing the routine to allow for the excess fluid to be squeezed out by imbibition (process that occurs in the spine from motion and gravity to pump nutrients in an out of our discs).
The lunge routine is a great way to engage the quads, hamstrings, adductors, glutes, hip flexors, and calves. But keep these points in mind when beginning to integrate the routine in order to facilitate proper mechanics and prevent injury.
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Sweating during exercise can cause fluid loss of up to 1 liter an hour, especially in hot humid conditions. Thus, replacing the electrolytes and water lost is especially important to ensure efficient recovery. Murray, et al has shown that a 2% decrease in body weight from fluid loss can be detrimental to performance and that a 2.5% loss of body weight can cause a 15% drop in high intensity exercise lasting longer than 7 minutes. Replacement of elecrolytes (namely sodium and potassium) will help keep blood plasma concentrations balanced and aid in water retention to normalize fluid levels. The problem with many commercial sports drinks (though containing high amounts of sodium and added potassium) is that they are loaded with sugar that can make the stomach upset and feel full following high intensity efforts. Sodium-enriched coconut water on the other hand has been shown to be as effective at replenishing similar amounts of sodium and higher amounts of potassium without the high quantities of sugar that commercial sports drinks contain. Additionally, it caused less nausea and upset stomachs than their sport drink counterparts. So coconut water can be an excellent alternative as your post-exercise recovery drink, especially if you find commercial sports drinks to be too sweet or too hard to drink without feeling nauseous. To read the full article, click here. Enjoy!