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The quest to give a more complete view of strength training and endurance sports continues!

In my first two articles in this series, I discussed the impact of strength training on your ability to consume oxygen (no major impact) and the impact on running economy.

In the article on strength training and running economy, I explained how 8-12 weeks of 2-3 sessions/week is required to see any change.  Heavy weight, low rep exercises seem to trump plyometrics and high rep exercises.   On top of this, masters and female runners are more likely to be responders.  I also discussed how simply running more, if you are a low volume runner, should be the first step in trying to get faster (of course there are other benefits to strength training if you are thinking beyond speed). 

Now, since there are so many multisport athletes who read this column, I thought I would address how strength training impacts cycling economy specifically.   Surprisingly, the relationship isn’t quite as clear!

Intuitively, you’d think it would almost be the opposite in the minds of most- that strength training would be more helpful to cycling than to running.  It kind of makes sense to speculate that cycling requires more powerful, larger muscles to smash big gears, while running requires light legs and next-level cardio.  Therefore, lifting weights should help cyclists more, right?  Wrong!

When we look at studies like THIS ONE, we see that cycling economy isn’t something that’s nearly as difficult to develop as running economy.  As studies like this one show, runners with no cycling training tend to have pretty good cycling economy, while cyclists have horrible running economy.  Cycling economy isn’t hard to train, but running economy is!

That’s also why we see that V02max is a great predictor of longer cycling event performance, while V02max does not do a great job of predicting running performance.  

So when we look at the studies on strength work and cycling economy, we get mixed answers. 

Click HERE to read the rest on the Run Waterloo magazine.

Welcome back to my series on strength training for endurance athletes.  Last article took a look at the role (or lack there of) of strength training and our ability to consume oxygen.    

That being said, we still know that strength training does have a positive impact on performance in endurance athletes.  The caveat: it has to be the right type of athlete, with the right type of deficiency conducting it at the right time in training.

So how do we decide how and when to implement strength training?  Learning the science of how it impacts us helps to guide these decisions in the best possible way.  This series most definitely is not a clear-cut, quick-fix answer, nor is it remotely all inclusive.  The more you learn, the more you will realize there is to learn!  Heck, I went to school for 8 years after high school in human-physiology related fields followed by 10 years in working and coaching in the field- and I definitely still feel like the more I learn, the more confusing it can become at times!  

That being said, the more information you arm yourself with, the more you will be able to start to tell the difference between pseudoscientific advice and real, efficient and effective performance-boosting advice.  Our next step toward this direction: How it impacts our exercise economy…  

CLICK HERE to read the rest on the Run Waterloo blog.

By: Sayaka Tiessen, Hons. BKin, MSc (PT)

It’s been a while! Life has been insanely busy the past couple months. You might have noticed on my social media feeds that I have moved my physiotherapy practice to join forces with Delanghe Chiropractic & Health/Health & Performance. Pumped for what this opportunity will bring!

So what’s on the agenda today? In honour of a few patients I have seen recently for a variety of running related injuries, we will be addressing the question: do injured runners run differently?

I will be drawing from an article by Christopher Bramah published in 2018 that looks at this very issue. He compared healthy runners (no reported injury in over 18 months) to injured runners to see if there were any run gait characteristics that were predictive of current injury. He specifically looked at the four most commonly cited soft tissue injuries in the running population: Patellofemoral Pain Syndrome, Iliotibial Band Syndrome, Medial Tibial Stress Syndrome, Achilles Tendinitis.

(Let’s just acknowledge the fact that I haven’t used Microsoft Paint in possibly a decade. How is it still a thing?)
(Let’s just acknowledge the fact that I haven’t used Microsoft Paint in possibly a decade. How is it still a thing?)

You might not have heard of these conditions before, but you have probably experienced them. Here is a quick breakdown of what each of these injuries involve in the simplest of terms:

Patellofemoral Pain Syndrome (PFPS): pain around the patella, aka the knee cap at the front of the knee

Iliotibial Band Syndrome (ITBS): pain at the outside of the knee

Medial Tibial Stress Syndrome (MTSS): AKA Shin Splints (the bane of my existence for many years), pain around the inner part of the bottom 1/3 of the shin.

Achilles Tendinitis (AT): pain at the Achilles tendon.

I have to say, it’s always pretty neat when the findings of a study are similar to what you experience clinically. After analyzing the running biomechanics of the injured and non-injured study participants, Bramah’s team found that the injured runners presented with:

overstride.jpg
A straighter knee and ankle dorsiflexion (toes pulled up to the shin) when landing. This is essentially what we would call overstriding/overreaching while running – your foot is way out in front of your center of mass when you first hit the ground.
forward lean.jpg
Increased forward trunk lean. This can be caused by low back and gluteus maximus weakness/fatigue. We need to strike a balance of leaning forward too much and sitting back like you’re in a La-Z-Boy. Photo is from the Bramah et al. 2018 article.
trendelenburg.jpg
A significant drop in the opposite hip to the one they are standing on, also known as a Trendelenburg. This can be a sign of weakness of the hip stabilizing muscles on the leg they are standing on because they cannot keep the pelvis level. Note that the hip drop was found to be the most accurate at predicting if the runner was injured.

These are pretty important to note because they can actually exacerbate your injury by adding stress to the already injured tissues. Talk about adding insult to injury!

I do have to acknowledge that not every runner is the same. There are some runners that are FAST, have a wicked hip drop, and are totally functional. But as a physiotherapist, it is good for me to keep in mind that these running traits are often present with an injured runner.

What are the implications?

If you are a runner dealing with any type of injury, come in and get assessed. The weather is warming up and nothing is more of a bummer than not being able to get out there and enjoy it.

I do not believe that all runners should run the same way. However, I am not opposed to tweaking your run form to help iron out some of these movements patterns. Gait assessments are a great way to get a second set of eyes on your run form and see if there is anything we can adjust with cueing.

On top of running tips, I always give some homework to help you move better. I typically assign a short list of exercises that are targeted to your concerns – all business, no filler.

Don’t let nagging injuries keep you on the couch! Let’s work together to get you back out there! Click here to book now

By: SAYAKA TIESSEN, HONS. BKIN, MSCPT

In both kinesiology and physiotherapy school, we were taught anatomy. The sheer volume of knowledge was overwhelming. Where does each muscle attach? What nerve controls which muscle? It felt like we were learning everything there was to know about the body. That was incredibly naive of me, as research has plowed on and has shown just how complex our movement systems are.

This post will take a closer look at the infraspinatus, one of your four rotator cuff (RC) muscles. Located just under the boney ridge of your shoulder blade, it is commonly injured, especially in overhead athletes (throwers, climbers, etc).

When I learned about the infraspinatus, we were told that it was a muscle that externally rotates, or turns your arm outward (see below for a picture showing that position) and that it is controlled by your suprascapular nerve. But within the last 20 years or so, researchers have found that the infraspinatus has three distinct regions, each innervated by its own mini branch of the suprascapular nerve; the superior, middle, and inferior infraspinatus subregions.

Why does this matter? Well, turns out that the subdivisions serve slightly different purposes, kind of like how your municipality functions within the province. The province of Ontario has an overarching goals, but Waterloo Region will function in a different way than say the GTA. They also will take on more or less burden depending on the task at hand (regional containment of COVID19 being a prime and timely example). This goes for the subregions too – some sections might turn on more or less depending on the degree of arm elevation, your plane of movement, and resistance.


If that’s the case, then is there a way to make rehab more specific by targeting movements that bias one subregion over another?

I was hoping the answer would be yes, but the research isn’t there yet. It seems as though there are still some discrepancies in the research about which subregion does what. Furthermore, the role of the inferior infraspinatus has yet to be determined.

I have summed up 4 key takeaways below in terms of the roles of the subregions:

  1. All three subregions of infraspinatus are more active the higher your arm is in front of you (eg: they will work harder if you are reaching into a high cupboard, and will work less if reaching for something at waist height).
  2. The superior infraspinatus has a shared insertion on the top of the arm bone with your supraspinatus (another RC muscle that will have its own blog post next). It is thought that both muscles contribute to shoulder stabilization, and that redundancy allows for people to have tears and still be strong.
  3. The middle infraspinatus is more of a pure external rotator.
  4. There is minimal evidence for the role of the inferior infraspinatus.

What does this mean for rehab?

  • When you are dealing with a fresh injury, start with exercises where your arm is low and closer to your body, like farmer’s carries. Any load on your arms will turn on your rotator cuff, and this is the least provoking position to be in.
  • You can start with isometrics (exercises where you are not moving your arm through range) if you cannot even move the shoulder without pain.
  • You don’t have to rotate your shoulder to get your infraspinatus. You can just do an arm raise and it will work all three subregions. The higher your arm, the more the infraspinatus will be working.
  • Generally, strengthening external rotation follows the same principle. The movement of rotating your arm outward will be more challenging the further away your upper arm is from your body (overhead vs tucked into your side).

Check out the video below for 4 different exercises that target the infraspinatus, ranging from lower muscle activation to the most, using the principles I outlined above. Some of these exercises are based on articles published by researchers at the Digital Industrial Ergonomics and Shoulder Evaluation Laboratory at the University of Waterloo (local shout out!).

The next write up will target the supraspinatus – yet another notorious RC muscle that also has 2 subregions despite being super slender. As I eluded to above, superior infraspinatus shares an insertion with supraspinatus, and we will talk about why that is so important for shoulder stability and how you could approach rehabilitation for a torn supraspinatus. Stay tuned!

Sayaka is an evidence based physiotherapist in Waterloo. Click here

to learn more about her!

How long until we officially race again?  I would say probably at least a few weeks, wouldn’t you?  While I’m sure many of you miss toeing the line, there are some positives.  For instance, one of the best ways to take advantage of this extended offseason is to work on weaknesses that are normally tough to address.

Constantly acting in A-race mode, followed by tapering, followed by recovering can definitely result in short term spikes in performance. But often the long term, gradual development is sacrificed.

A great way to take a swing at improving your baseline ability to perform is a full strength program. However, it is not as logical to include when in close proximity to an A-race.  If you’re anything like me, you’ve thought of introducing more strength work throughout the pandemic.  If you’re not like me, you’ve actually done it- good for you, you jerk!

The questions that I get from the team on this topic are endless.  I have written about the topic in short before such as here.  However, I thought it was finally time to take a deep dive into strength training for endurance athletes.

CLICK HERE to read the rest in the Run Waterloo Magazine. 

So, apparently masks are a thing this year!  Despite how much good they can do, there still is some push-back out there.

However, when you look at the evidence, when you’re around other people, if everybody is wearing a mask, the odds of infecting each other goes down.  If you personally are unsure, take a look here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here…..

However, a legitimate question that I get asked is how does wearing a mask impact performance when we’re exercising?

CLICK HERE to read the rest in the Run Waterloo Magazine. 

With numbers going up, let’s just do a refresher of our policies that will help to keep the office safe for everybody. We have a number of at-risk and elderly patients, so we really appreciate your cooperation in all of this!
 
  • Masks are now mandatory to enter the building.
  • Complete your online screening questionnaire before entering (or the paper copy upon entering)
  • Do not enter if you have any signs/symptoms of COVID-19 or contact with anybody who has tested or is a suspected positive.  
  • Please let us know if you later learn you test positive or came in contact with a suspected or confirmed positive case in close proximity to your appointment. 
  • Come at exactly your appointment time, no sooner.
    • Patients of Lance Dawson- wait outside until he comes to get you
  • Come in alone
  • Wash your hands or use hand sanitizer upon entering
  • Avoid using the washroom
  • Pay with tap if possible 
  • Avoid bringing in peripheral items as much as possible

As always, we have virtual appointments available for those who are still not comfortable coming to the office.

Thank you so much with your help in making the office safe for all!
 

Nowadays, most runners use some sort of social media as a part of their running lives.  Whether that be posting your runs on Strava, updates on Facebook, or post-run selfies on Instagram, the number of runners who do their thing with an absolute zero online presence seems to be dwindling (but they are out there)!

Over the last few years, I’ve been encountering discussions more and more frequently with the athletes I coach, so I figure now would be a good time to discuss this topic: Is posting on social media about your running a good, bad or neutral thing?

Before I get into some of the research, I would like to preface this article but saying that I don’t have a good answer, as I normally would, with clear science (like how many grams of carbs you should take for optimal performance). The reality is, the use of social media is highly individualized and requires real self-awareness and self-reflection to decide how it works for and against you and your unique situation.

CLICK HERE to read the rest on the Run Waterloo blog. 

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marathon

By Rachel Hannah, RD, DIP. Sports Nutrition IOC

There are a lot of myths around carb loading. That confusion mixed with pre-race nerves, and you’ve got a recipe for a tummy disaster. But carb loading is actually pretty straightforward. There are a few key numbers and rules to follow so that you’ll have all the energy you need to start your quest for that big marathon breakthrough.

What is this “carb loading” I keep hearing about?

First, let’s start with removing the shroud of mystery around the carb load. What the heck is it, and why do marathon runners do it?

Simply put, to carb load is to put a bigger emphasis on getting in an increased ratio of carbohydrates in a couple of crucial days leading up to a big distance race of over about two hours, like a half-marathon for most, and certainly a marathon. The reason for doing this is to make sure your body is full stocked with something called glycogen, which is the energy used by your muscles to fire during your run.

Glycogen is your storage form of carbohydrates and the body can only store up to a certain amount, making fuelling throughout a Marathon distance race very important. Ever heard of the infamous “wall” runners hit when the marathon gets really tough? That wall goes up typically when your body is depleted of glycogen. It’s why races put Gatorade on the course, and its why runners stuff their faces with pancakes the day before the race.

Pancakes… sounds like fun! But how do you get carb loading just right?

Make a Plan

When working with athletes of all ability levels or going into my own marathons, the first thing I do is make a carb loading plan. It’s not necessarily a menu of exactly what to eat, but more of an outline of when to start the load, examples of great food options, and specific numbers that are easy to calculate so that its clear just how many carbs are needed each day before the big race.

Here’s what it looks like:

You should start your carb load 36-48 hours before race morning. So, if the marathon is on a Sunday, begin focusing on carb-rich foods on Friday at breakfast. You’ll hear about athletes going on a “carb depletion” diet for the week leading up to the marathon, starving themselves of glycogen so that, supposedly, their body will horde the sugars thrown at it during the carb load. There are conflicting studies on this strategy, and the science is leading towards saying it produces a negative outcome in most situations, so just eat normally for the period leading up to the carb load.

Keep your calorie intake relatively normal

A common myth is that you should stuff your face during the carb load. This may cause some serious tummy issues and water retention, so instead, just focus on getting the percentage of carbs within each meal and snack to overwhelm the ratio to protein and fat. Fat intake should be kept low (<20% of calories) during the carb load, but you should focus on getting a consistent amount of protein at every meal and snack like you normally would.

Because you’ve reduced you the amount of exercise during the taper, if you maintain your peak season diet, you should be coming in pretty well stocked up on calories.

Focus on the Math

Here’s the magical formula to follow during the carb load:

8-12 g/kg of your body weight of carbs per 24 hours.

So, if you weigh 65 kg (or just over 140 lb.) you should be consuming about the middle range of that formula, meaning 650 g of carbs in a day. A small banana has 14 g of carbs, so you’ll have your work cut out for you to get them all in without starting to hate certain go-to snacks. You’re going to have to find simple ways to make sure you get that amount all in.

Eat what you love

Stick with things you enjoy eating, and I mean really enjoy. Carb loading is the opposite of what you typically would eat to stay healthy. I also need to add carbs that I wouldn’t normally add during the load. This may sound ridiculous, but I will even bring packets of jam or honey with me, and smear them on things like crackers and bread if I feel I’m not hitting my goal carb number for the day.

Use a fitness tracker

Keeping track of all those carbs can be daunting. I recommend either doing the math in advance and making a meal plan for that 48 hours (think of it as fun; you get to eat waffles and maple syrup for dinner!) or use a basic calorie counting app. I rely pretty heavily on MyFitnessPal, a free and fairly detailed nutrition tracking app you can get on your phone that will do the math for you.

Beware of fibre

Crushing carbs can be fun, but you have to be mindful of those with loads of fibre. You’ll want to focus on simple carbs for this crucial 36-48-hour period. You don’t want to pack your guts with fibre before heading to the start line, for obvious reasons.

On the eve of the race, switch to liquid carbs, like fruit juices or sports drink, in order to keep your stomach in check while continuing to get those glycogen stores stocked. Choosing the sports drink you will use during your race is a good idea the night before.
Spread Your Snacking Out

Aim to eat about five or six times per day, spread out, particularly if you have pre-race nerves and your digestion is slowed down. Focus on eating every three-four hours, but feel free to snack a bit in between and take in fluid.

See the carb load as the final fun workout

Just like training, view the carb load as a sort of food workout. Stick to your numbers, stay focused and see it as the final building block in order to have a big breakthrough in your goal race.

Rachel Hannah is a Pan Am Games medallist in the marathon and a registered dietitian.  Learn more about her HERE or book online HERE. 

 

 

4 months later, and here we are!  With many of the fall races now officially cancelled, this article is even more relevant than when I originally started to think about this the topic of how much one should train in a time of uncertainty.  Of course there is the chance that something will happen race wise, whether it be in the form of a small group or virtual race.  In the meantime, knowing how much training you should do to maintain fitness is a key question.

No training at all 

With my last article, I looked at just how much fitness we can lose if we completely stop.  You can read the full thing HERE.  In summary, I discussed how:

  • You would likely lose 5-10% of your VO2max in a couple weeks
  • It would take a very long time to lose your running economy
  • The longer it takes the develop an adaption, the harder it is to lose it

How much is enough?

There are many reasons to be optimistic and to believe that non-optimal training will leave you not that far removed from your best performance.  But just how much is enough?

CLICK HERE to read the rest on the Run Waterloo Magazine 

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