Friday, December 4, 2009

Pain-Free Running, Part V

I promise not to mention either Mr. Bean or Pee-wee Herman in this post. Oops. Let's talk about arm swinging.

Is there a useful limit to arm swinging? A useful minimum? Should my arms be more bent, or more straight? It turns out, there is lots of discussion online about arm swinging. While everyone had an opinion, and some differed significantly, unlike the foot strike discussions, there was very little religious warfare. Bottom line, the arms should feel like they are doing work, and not just swinging passively.

I thought about what my arms did when hiking with poles, or alpine (cross-country) skiing. Sometimes I'm using my arms to push along with my legs (uphill and downhill), and other times my arms swing more freely to provide smoothness and stability (fast, flat conditions). Running shared all of those situations. How can/should my arms support my run?

I next did a series of test runs on a fairly flat road, varying only the swing of my arms, holding my elbows at 90 degrees while keeping my stride and cadence constant. It immediately became clear that if I wanted to use a heel-push and a short stride with a high cadence, I would have to swing my arms hard to smooth things out. And I had to swing them fast. The next runs explored how big an arc, and where the arc was centered (elbows more up in front, or more up in back).

I really wish I had started with the arms instead of the feet. Really. I clearly remember the first run I had when all the pieces started coming together. My arms were swinging like I was a Rock'em-Sock'em Robot. I tried swinging my arms as hard as I could, and found I was literally lifting myself off the ground, amplifying my heel-push, which made it much easier to run without a toe-push. A forceful arm swing could nicely balance the removal of the toe-push!

My level stride came together. Soon I had run 1 flat mile several times, with no foot or joint pain! This was really a magical moment, so I didn't look at how long it took to do each of those 1 mile runs. Success mattered far more than speed!

Next, I added very small hills. I'm pumping my arms hard on my flat run, and the first tiny hill approaches. Like hiking, I let my stride get shorter. But now my arms were swinging too much, so I had to shorten the swing as well, while still keeping the cadence the same. But going up hill needed more force, and my arms were doing less! So I dropped my hands slightly to add more inertia to each swing of my arms.

And I felt like I flew up that hill! It was the easiest uphill run I could ever recall. When I got to the top, I brought my elbows back to 90 degrees, increased my arm swing, lengthened my stride, and resumed my flat run. All at the same cadence. I felt like I had gears!

The mild downhill came next. Back in my earlier days, downhill running always gave me shin splints, and I never learned how to avoid them. It seemed clear that if lowering the hands helped uphill, raising them should help downhill. And I flew downhill. The best part? No sign of shin splints! I never tried to slow down (though I may have). I maintained cadence, and used my arms to adjust for the terrain.

I wish I could describe how I felt coming off that run. It was as if I had been touched by the Hand of God, and my crippled run was miraculously healed! Sure, I knew the work it took, but that's how it felt right then.

I did several more 1 mile runs over the coming weeks, and gradually increased my distance. I soon found that it was almost impossible for me to hold a 90 cadence past the first mile, but a slight drop to 85 worked fine. The best part was that I was soon covering 2 miles in under 20 minutes. I had gone from having no running at all, to having a sub-10:00 mile!

Of course, the next thing I did was go looking for another miracle: Sure, I could run on the flats, and uphill and downhill, but how fast could this new pace go?

One problem: When I'm already swinging my arms at an 85 cadence, with no easy way to increase it, what do I do to go faster? Clearly, I'd have to lengthen my stride. But wouldn't that change everything? Would the hard heel strike return? How would my arms compensate? Was I going to have to start all over again?

How to go faster? Well, there was that mysterious saying I had encountered earlier: "To run faster, lean forward!" So I leaned forward. And I went faster!

But what was really going on here? What changed? How did I do that?

Surprisingly, my arms already knew what to do, and they did it. When I leaned forward, my elbows moved back, maintaining my center of balance, but letting it shift forward just enough to match my slightly longer stride.

It turns out, this had happened to me before! When going uphill, I had leaned forward and my elbows had gone back. But I was so focused on the bend of my elbows and the shorter uphill stride, that I hadn't noticed that my elbows had changed were they were going!

That's about where I am today. I'm still doing my 2 mile run twice a week, though I've been adding in occasional longer runs: I did a 5 mile run 2 weeks ago, pain-free! My first in over 16 years.

I forgot to tell you how fast I went in my speed tests: My PR for my 2 mile run is 16 minutes flat. That's an 8:00 mile! However, my normal 2 mile run is consistently around 17 minutes, and is never slower than 18 minutes.

I can't believe it. Sixteen years ago I was running at a 7:30 pace with bad pain. Now, at age 53, I'm running at an 8:30 pace pain-free. Lose the pain, add 16 years, lose only a minute.

I'm OK with that. Because it means I'll be doing my first Olympic distance race next year, and a half-IM doesn't look impossible for the year after.

Yeah, I'm really, really, really OK with that.

Pain-Free Running, Part IV

Some of my favorite memories from my earlier running years center on "zoning-out" during long runs. This was different than the euphoric "runner's high", since for me that only happened after I broke through a wall of pain. My "zone" was more of a meditative place, where I could let my body do its thing, and my mind was free to look at everything happening around me. If I managed to zone-out during a 10K race, I knew I was running near peak efficiency, since any body problems would always keep me out of the zone.

My new long-distance swim skills had allowed me to experience a similar meditative feeling, but it wasn't quite the same, since it was more of a turning inward, where the running state was more outward. I realized I would dearly love to not only run again, but to have a stride that would work on "autopilot" and permit me to "zone out" and cruise through the miles.

My most recent attempts at shortening my stride, easing my foot impact, and increasing my cadence/turnover, were about as far from "zoning out" as I could imagine. But I was beginning to feel I may be on the right track.

I figured I needed to look at the whole picture, at what each part of my body was doing while I ran, and stop focusing exclusively on my feet and legs. Where am I holding my head? What are my shoulders doing? What is my spine doing? What are my arms doing?

One of the best web sites I found that took a similar whole-body view was Chi Running. No, I didn't buy the book, but what I gathered from online discussions helped me realize I may be on the right track. My new stride must involve my whole body, and poking at isolated pieces of the puzzle would no longer suffice.

I researched the parts of a stride, and how they fit together. I looked at my old stride, and tried to identify what was actually going on with it. I examined the strides of other runners to learn about the range of variations in running technique. It was tough going, since I was very suspicious that what I thought I was seeing may be completely different from what the runner was actually doing! I simply didn't know enough about how the human body moves, and I wasn't about to master body kinematics to figure it out.

I decided to change how I observed other runners. Instead of trying to figure out what all the pieces were doing, I'd first see which runners looked smooth and relaxed. If they weren't in pain and weren't flailing about, they probably had all their pieces working well together. I looked at both "natural" runners, and those who were heavy and/or old.

My online searches sometimes led me into interesting corners. At one point, I started looking up some running-specific terms I had previously stumbled across. The one that interested me most was: "To go faster, lean forward." That didn't make much sense to me, unless the goal was to land on your face. What does it really mean to "lean forward" while running? Was it just a psychological thing, to "think forward", or was there a real physical change involved?

I saw lots of videos and pictures online, but none of them made sense to me. Sure, the runner sometimes looked to be "leaning forward", but nobody explained how they stayed in balance! What happened to the center of gravity? Did the stride get longer to restore balance, or what? I was left with more questions than I had started with.

Not all the searches led to corners. There was lots of common advice when it came to the parts of a run. The most prevalent was: "Keep your head up." That made sense, since it would reduce stress on the neck and upper back. Something else also became clear: "Lean forward" did not mean tilting your head forward, for that would violate the "head up" rule.

I next looked at the core, the torso, from the hips to the shoulders. What was going on there? The fastest runners, and the smoothest runners (independent of speed), all ran with very little bend in the spine, and very little twisting of the hips relative to the shoulders. Those that did run with lots of twisting were generally quite young (in puberty or younger), or had unusual weight distribution around the body.

This was especially evident for heavier runners who had far more weight below the belt line than above: It seemed the upper body had to do lots of extra twisting to counter-balance the motion of the lower body. When I looked closer, however, it was clear that not all low-heavy runners had lots of twisting. Some had no twist at all, and it wasn't immediately clear to me why not. But what was clear to me was that those who did the least twisting tended to be the better/smoother/faster runners.

I also looked at bounce, but learned nothing from it. It seems that some runners bounce, and other runners don't, and both can be excellent runners. But I did notice that most short-stride runners looked as if they bounced more than long-stride runners. Perhaps they did have more up-and-down motion, but the short stride could have simply made it an optical illusion. Since I had no reliable way to measure bounce, I also set it aside.

OK. What did I think I had learned so far? Not that much: Head up. Minimize torso twist. Short stride. Heel push. Fast turnover. I didn't quite see what kind of stride I could assemble from those parts. All that was left to examine was the arms. What should my arms be doing?

Once again, I looked a bit closer at some of the basics online. Every site always said: "Swing your arms!". Well, I thought that was just too obvious: Only Mr. Bean and Pee-wee Herman could run without swinging their arms. No way was I going to run like that! So arm swinging did indeed seem way too obvious.

But what if I were to swing my arms more or somehow differently? That's for the next post.

Pain-Free Running, Part III

To recap the prior post: As I became fatigued while running, my feet started to slap the ground, which set off a whole cascade of pain. This confirmed that I would never again run as I did in my youth. It was clearly time to change my stride into something that would work better with the bones and muscles I had today.

This wasn't the first major change I had encountered on my path toward becoming a triathlete. While I had owned up-market road bikes for 35 years, I had never competed. When I started training for triathlon, I finally started to learn what competitive cycling was all about. It all comes down to two basic things: Minimize drag, and use muscles wisely. Some would add a third basic item: Get a power meter. But my budget hasn't made that possible.

When Joe Friel was the guest speaker at a TCSD meeting, I heard about "mid-sole cleat positioning". Since I have flat feet, I was already positioning my cleats just behind the ball of my foot, to provide some support to my plantar fascia. Joe showed that moving the cleats further back would greatly reduce the load on the calf muscle, freeing up energy that would then be available for propulsion.

My bike shoes have very long cleat slots, and I was able to move my cleats back a centimeter. The effect on my feet and calves was literally night-and-day: Since pressure on the ball of my foot was further reduced, my plantar fascia never hurt, no matter how hard I pedaled, and no matter how rough the road (bumps and corduroy used to hurt my feet). Even better, my calves stopped cramping when going up steep climbs.

I found it hard to believe that such a small adjustment could possibly have such a large impact on my riding. I wondered if something similar would be possible for my running.

I did lots of running research online. I found no sites dedicated to the "bad/broken runner". There were sites for doing physical therapy and rehab on injured and post-surgery runners, and lots of sites focused on making slow runners into faster runners, but none for those of us who just can't run any significant distance due to non-fitness issues.

The odd thing was, there were lots of sites for non-swimmers, and non-cyclists, but not for non-runners. The only advice I found, repeated over and over again, was this: "Start jogging. Then start running." Not exactly the advice I was looking for.

So I went offline and started looking a bit closer at other runners, particularly those with physical limitations of some kind. Two common limitations soon became clear: High weight, and great age. So I focused on watching very heavy and very old runners. And one thing was immediately obvious: The best runners in both groups tended to run with a rapid, short stride.

So I tried running with faster, shorter strides. And I felt as if I would shake myself apart. It wasn't a pretty sight, and I had trouble getting around a single block. And I still hurt when I finished, but in all-new places: My butt and lower back hurt.

When I went back online to research different running strides, I stepped into the endless discussions and religious wars concerning heel-strike versus toe-strike versus mid-sole strike. Google for them if you are curious. The one thing I did take from the discussions was that I did not, necessarily, have to strike so hard with my heel.

The mid-sole strike got me thinking about how mid-sole cleats had affected my biking. In particular, could I use my calves less while running?

So I tried an experiment, and replaced my toe-push with a heel-push. Using a heel-push wasn't new to me: When hiking with a 60 lb pack on my back, the only way to get up steep hills was to use a heel-push, never a toe-push. Use the big muscles instead of the little ones. And when the going was steeper, take shorter steps: Sometimes, my feet overlapped, moving only a few inches up and forward with each step. I've hiked up a few mountains that way, making it to the top with lots of energy.

Trying to run with a heel-push and a short stride is vastly different than walking with one. The running toe-push seems to be programmed in at almost a genetic level, and it was extremely difficult for me not to use my calf muscles. The resulting stride still lacked smoothness, but it was somewhat more comfortable than my prior short-stride test. Getting around the block was still a struggle, but it was much less uncomfortable.

Back to the net, where I found no discussions of heel-push running. Nada. Zilch. Bupkus. Oh, sure, people will rage about foot strike, but not the push. Obviously, it was too obvious to discuss. Obviously, I was on my own.

One thing was immediately clear: If I was going to run with a short stride, and if I ever wanted to run fast, I was going to have to make those short strides happen very quickly. In cycling this is your pedaling "cadence". In running, I learned it was called "turnover". The general consensus was that higher turnover was better, but that whatever your "natural" turnover was would be best.

I had no way to measure my turnover, so I purchased a shoe-pod for my Garmin 305. It goes well with the bike-pod, and serves a similar purpose. Some running web sites recommend using a metronome, but I also want to record my cadence during a run, and my Garmin 305 with the shoe-pod would that too.

On the bike, I had worked hard to get my normal cadence on the flats up from the low 70s to 90, and my speed improved with it. Should I try to run with a 90 cadence as well? I did some short test runs, and it seemed faster was actually better, since it made my shorter stride "flow" better. But holding a 90 pace was just about impossible.

My stride still needed more work.

Pain-Free Running, Part II

Last post, I described how I started to get back into running, and how it wasn't working for me. This time I'll describe where I went from there.

First, I'll share my definition of "pain-free" running: No joint pain, no foot pain, no back pain or any other structural body pain. No shin splints. No plantar fasciitis. No tendon pain.

Muscle pain, though not desirable, should not be unexpected. If cramps occur, they should be taken as a clear sign of over-doing it, and are an excellent reason to end the run and start walking. Tendon pain must be prevented and avoided to the greatest extent possible, but when it does occur it must be treated as an injury.

While doing the 1/2 mile runs described in the prior post, I noticed some pain in the front and side of my knees that tended to ache and fade slowly. I scheduled an appointment with my GP, who promptly referred me to Dr. John Fellow, a sports medicine specialist.

X-Rays revealed some roughness on the inside of one of my knee caps (mild chondromalacia), and Dr. Fellow also detected a small amount of patellar tendonitis on both knees (not unexpected at my age). After performing some mobility and stability tests, Dr. Fellow's final diagnosis was ITB Syndrome (ITB = IT-Band = IllioTibial Band, the tissue along the outside of each thigh). This too is very typical of people getting into running, and Dr. Fellow was not too concerned. He prescribed some stretches, which I added to my normal (and very thorough) stretch routine.

A note about stretching. Over the years I've put together a great 20-minute active stretch routine that borrows from yoga, modern dance, martial arts, strength training, massage therapy, and, of course, doctors. It has kept me extremely flexible and very limber, and has provided many benefits beyond flexibility: I'm much more resistant to accidental injury, since I can bend before I break, and I'm more able to catch myself when I stumble, instead of falling. I can't recommend highly enough the value of a proper and safe stretch routine!

Over the years, I've accumulated some basic rules about stretching. These are my rules, based primarily on my own experiences. Since I'm in no way a stretching expert, you should take them only as basic advice, not as laws.
  1. Never stretch a cold muscle. This is #1 for a reason, since it is the easiest way I know to rip muscle and tendon. Don't do it. Never, ever. Always warm up a muscle before stretching it.
  2. Never stretch immediately before hard exercise. Recent studies have shown that stretching decreases both muscle strength and endurance when done before hard exercise. Stretching is best used as a recovery activity, or as part of a series of low-intensity exercise or training activities (such as in a fitness class). Think of stretching more like vitamins: Something you want to take daily, but not right before a big race.
  3. Always activate the muscle being stretched. Never "relax" into a stretch. Work against the muscle being stretched, but don't over-do it. Mild to medium activation is all that's needed.
  4. Never "fall" into a stretch using gravity. Gravity may be used provide a slight assist, but should not be used to force a muscle to lengthen. Re-orient your body (such as lying on a mat) so gravity can't help over-do the stretch.
  5. Never "bounce" in a stretch. This is another great way to rip a tendon or muscle. The worst general error in this area concerns stretching the groin and Achilles tendons. Be very careful!
  6. Never "force" a stretch. Go gently and slowly to the limit of motion, then hold using dynamic tension (pull using opposing muscles, and stay in the same place). Excess force can cause a range of injuries, including joint dislocation.
I won't go into the "why" behind each of my rules, but I will say they are generally based on my own mistakes, or watching the mistakes of others. I won't describe my specific stretch routine here, though that may be a topic for a future post.

The bottom line is to make no assumptions about stretching: If you don't know what you are doing, then stick to doing an easy warm-up followed by very gentle stretches, with muscles activated (stretch against a tense muscle using the opposite muscle), without any gravity assist.

Back to the main topic: I did only easy 1/4 mile runs while waiting for the new stretches to help correct my ITB Syndrome. When all was well, I resumed my 1/2 mile runs, this time without knee pain.

When I extended my run to 1 mile, I started huffing and puffing at the limit of my fitness, and the old ankle and hip pain returned (without knee pain this time), I also had shin splints, and my feet hurt. I was running with the same style I was using 15 years ago: A long stride with a hard heel strike. Immediately after that run, I took off my shoes and probed my feet and all my joints. My plantar fascia were tender, and my joint stabilizing muscles all were tight, much tighter than I had ever noticed before.

Some Googling led me to several running and sports medicine web sites, which helped me put together a picture of what was probably going on: When running faster and farther, as I started to fatigue my hard heel strike caused my foot to slap onto the ground. That slap sent a shock wave up my leg that caused my shin splints. The foot slap was also stretching my plantar fascia, which was making my foot hurt when I pushed off of the ball of my foot. The stretched plantar fascia was making my foot less stable, which in turn was causing me to tighten my ankle for additional support. The ankle support muscles soon tired, and the knee tried to provide the needed stabilization. But my knee was now more limber, so rather than taking more damage and hurting, it became weaker, and the weakness traveled up to my hips.

I had gone from running using my feet, legs and muscles, to running on flippers under stacks of wobbly bones. No wonder I hurt!

At this point, it was clear I needed to do things differently. My next thought was simple: If I could get rid of that foot slap, perhaps I could completely prevent the rest of the joint pain. More about that in the next post.

Pain-Free Running, Part I

This is the first in a series of posts on my year-long evolution from a broken/painful non-runner to now being a pain-free runner.

First, some history: I started running while I was in the Navy ('75-'81). I ran 1.5 miles twice a year. That was about it. While in college ('81-'86) I ran even less.

But at my first job immediately after graduation, I shared an office with an engineer who ran all the time. And he hated to run alone. So he dragged me out, kicking and screaming (literally), and coached me until I became a runner with a 7:30 min/mile and a 10K time under 45 minutes. I should mention this engineer was married to one of the fastest women in San Diego, and was her coach. I once watched her win her age group while she was 8 months pregnant!

I should also mention that I have long narrow feet that are utterly and completely flat. Like pancakes. And I have skinny ankles that were always getting twisted or sprained. And I'm a bit bow-legged. Not exactly the ideal legs for a runner. My coach and I worked diligently to find a stride that was fast, efficient, and comfortable for me. I was overjoyed that I was able to do consistent 7:30 miles.

After a few years I stopped getting faster, and I grew tired of running 10Ks and not improving. At that point, the universal advice was: "If you can't go faster, go longer." So I started training for half-marathons. I extended my training runs to 7 miles, then 8, then 9, then 10, at which point I experienced lots of pain in all my leg joints; hip, knee and ankle. Even the soles of my feet hurt.

Following advice, I took a few days off from running to wait for the pain to face, then tried my original training run. The pain immediately came back. I took more time off, then tried a shorter run. More pain. After a few months, it was getting to the point that the pain was taking longer and longer to fade between runs, and I had some joint pain when getting out of bed in the morning (though it never affected my sleep).

At that point, I made an appointment with my GP, who said I had no detectable damage to my joints. He recommended no physical therapy, since once the pain faded, my walking was completely unaffected. So I retired from running, and pursued other sports.

One year ago last August, after 15 years without running, I became involved with triathlon. I quickly changed from being a non-swimmer to being a fish (2 miles in 1 hour). My bike performance started to improve as I went on TCSD club and sponsor rides. But my main concern was the run. I didn't want to start running again until I was as prepared as I possibly could be.

My first step was to see how running shoes had evolved over the prior 15 years. My old shoe was the original, classic, Nike Air Pegasus. I lost count of how many pairs of that shoe I ran through. On the advice of my triathlon sensei and swim instructor, I went to the San Diego Running Institute (SDRI).

Jesse at SDRI first did a battery of measurements, with my foot under load and unloaded. Then he brought out not 2 or 3 pairs of shoes to try, but six pairs! I tried the first pair on, walked a bit, jogged a bit, then switched to the next pair. After trying all 6 pairs, the list was narrowed to two. I put each of them on and ran a bit more. Then I took one shoe from each pair and ran, then again with the other shoe from each pair. Soon enough, the best pair was clear, and after one final short run, I took home a pair of Mizuno "Wave Creation 10" shoes.

I started running just 1/4 mile at a time at an "easy" pace, ready to stop immediately if I felt any discomfort. After a couple weeks, I went to 1/2 mile, and I started to feel the same old twinges in my joints.

At this point, I realized either I was not going to return to running, or I had to find a whole new way to run. I clearly chose the latter, since this wouldn't be a series of posts otherwise.