runner Archives - Mackarey & Mackarey PT

Jury Out on Value for Running Performance

Runners will attempt to conquer 26.2 miles from Forest City to downtown Scranton in the 26th Annual Steamtown Marathon this Sunday. Participants may want to consider new research that suggests the use of compression socks may prevent post race blood clots.

Completing the long and arduous 26.2 mile journey is not an easy task. In fact, the mechanical and physiological toll on your body is tremendous; from painful joints, muscles, tendons, to black and blue toes. Not so obvious, however, is the damage to your deep veins and tissues of the circulatory system. New research indicates that strenuous endurance exercise, such as marathon running, stimulates the clotting mechanisms in your body in response to the multiple micro traumas sustained over 2 or more hours. While most healthy athletes will naturally heal from post exercise clot formation, others may be at risk…those traveling more than 1 hour (by car, bus, train or plane). The risk increases substantially for those with a longer period of travel/sitting post-race, history of previous trauma, blood clots or have the genetic predisposition for clot formation.

What Are Compression Socks? How Do They Work?

Compression socks are familiar to most people as the tight knee-high support stockings worn after a surgical procedure such as a knee or hip replacement to prevent blood clots. They are made with a special fabric and weave design to provide graduated compression (stronger compression at foot and ankle and less at the top of the sock) to promote better circulation and movement of fluids from the foot, ankle and calf back to the upper leg and ultimately the heart. Compression socks work similarly in runners. As the stagnant fluid with lactic acid and other byproducts of exercise is removed from the space, fresh blood, nutrients and oxygen is replaced to foster healing of micro damage to tissue and promote more efficient use of the muscles.

Is There Any Research?

The Journal of Strength and Conditioning Research published a study that found wearing compression socks improved running performance. However, similar studies have failed to support this claim. One finding that has been repeatedly supported in the literature, including The British Journal of Sports Medicine, found that compression socks worn in soccer players and runners improved the rate and magnitude of recovery. Moreover, recent studies, including a study with the Boston Marathon, have demonstrated the reduction in clotting mechanisms in those wearing compression socks AFTER the marathon, as compared with those wearing “sham” socks. Benefits seem to be less obvious for short duration activities or when running 10km or less.

Conclusion

In conclusion, only time will tell if compression socks will improve performance in runners will or be merely a fad based on placebo or true fact supported by scientific research. Based on current wisdom, these socks may offer value and benefit AFTER activities of long duration (more than 1 hour) or long distance running (more than 10km) to expedite the recovery from exercise-induced blood clot formation, muscle soreness from the accumulation of lactic acid and other muscle damage byproducts.

It is this author’s opinion that this product is worth a try. However, whenever you try something new for your sport, trials should occur during practice and if successful used during competition. Consider trying a lower compression to begin (the socks come in different degrees of compression). Even if one is hesitant to use the product while running, it appears the greatest value of the sock is after a prolonged training session or competition to reduce exercise-induced muscle soreness and prevent blood clots, especially in athletes at risk for clotting and those traveling for an hour or more after the race. Additionally, in view of the fact that some studies which showed only minimal to moderate improvement in well-trained athletes, it may be that those in greater need, such as deconditioned individuals attempting to begin a fitness program and novice weekend athletes, may benefit more from compression socks than elite athletes.

TAKE HOME: Runners, cyclists, triathletes, soccer players and others participating in endurance sports should consider compression socks, if not during the activity, certainly following the activity for 24 to 48 hours…especially those at risk for blood clots and those traveling for more than one hour after the race.

Sunday consider trying compression socks and see if they work for you during and more importantly, after your long training runs.

Where to find compression socks:

2XU Compression Racing Sock – www.2XU.com

Scranton Running Company – Olive Street - Scranton

Visit your family doctor regularly and listen to your body.

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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM. For all of Dr. Mackarey's articles, visit our exercise forum!

PREVENTION OF RUNNING INJURIES

It is two months away from the 25^th Steamtown Marathon. This column is dedicated to those dedicated runners preparing for the big day, Sunday, October 9, 2022.

Congratulations and thank you to Bill King, founder and race director, and his band of brothers, for their tireless efforts organizing and sustaining a great race that instills pride for all people of NEPA. It has inspired many people, including me, to transfer the discipline and determination required to complete a marathon by overcoming challenges one mile at a time.

Now, a little marathon history: In 490 B.C. Phedippides, ran 25 miles from Marathon to Athens to deliver an important military message and died immediately. Ironically, the first marathon of the modern Olympic Games in 1896 in Athens was won by Spiridon Louis, a humble Greek peasant, who stopped along the way for a glass of wine and told the owner of the tavern that he would win the race. He was determined to pace himself properly, as he knew the dusty, hilly path better than anyone in the field. He was greeted with jubilation and become a hero and legend.

HOW TO PREVENT RUNNING INJURIES

Avoid the “terrible too’s”

Avoid overtraining: number one cause of injury
- Too much intensity
- Too many miles
- Too soon
- Follow the 10% rule
  - Do not increase weekly mileage by > 10% each week

Only run miles needed to meet your goals

Following the mantra that more must be better will lead to injury
Accumulating “junk miles” causes the body to break down

Avoid inconsistent training

Occurs when you have missed several sessions and you attempt to “catch up” by adding additional miles

Avoid repeating hard workouts without any easy workouts in between

Do not run two hard workouts on consecutive days
- Long runs
- Hill repeats
- Races
- Speedwork
- Allow for recovery, re-building and reduction of injury risk
  - Day of rest
  - Cross training

Consider cross training to avoid overtraining without compromising fitness level

Reduces chance of injury
- Balances muscle groups
  - Strengthens non-running muscles and rests the running muscles(Quadriceps and adductors)
- Develops body parts that running neglects
- Reduces stress on joints
  - Low-impact
  - Swimming
  - Water running
  - Cycling
  - Cross country skiing
  - Stair climbers
- Maintain/improve cardiovascular fitness
  - Increases aerobic capacity
  - Burns additional calories
- Avoids boredom of running
  - Provides mental break from sport to avoid burn-out
    - Especially for the long distance events (marathons)
    - Try hiking!
- Allows continued training despite injury
  - Maintain fitness level while recovering from injury
  - Reduces frustration of inability to run

Treat your feet right

Avoid worn out shoes
- Most common cause of injury
- Reduced shock absorption, cushioning and stability
  - Increases stress and impact
  - Muscle fatigue, shin splints and joint pain (especially knees) may be a signal
- Replace every 300-400 miles
  - Dependent on running style, body weight and running surface
    - Smaller/lighter runners closer to 400
    - Heavier runners closer to 300
    - Running on hard surfaces
      - Replace shoes sooner than if running on treadmill
- Record new shoe purchase
  - Calendar
  - Training log
  - Inside shoe
- Purchase a second pair halfway through the life of the initial pair
  - Rotate shoes
    - Running in different shoes on alternating days provides even stress distribution on feet
  - Extends shoe life
  - Having a fresh pair as a reference
    - Will recognize when old ones need to be replaced
- Shoe type
  - Most important piece of equipment
  - Appropriate for foot type and weight
    - Flat foot: motion control
    - High arch: cushioning
  - Specialty running store
    - Scranton Running Co
  - Tennis shoes not appropriate
- Biomechanical problem
  - Heel lifts or orthotics

Visit your doctor regularly and listen to your body.

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”

For all of Dr. Mackarey's articles visit: www.mackareyphysicaltherapy.com/forum

Spring is just around the corner so it is time for running enthusiasts to lace up their sneakers, get outside and run! Runners are addicted to running for good reason. There is nothing like it! No exercise offers so much in such little time. For example, the caloric expenditure while running is higher than for most other exercises, including biking. Also, it allows for fresh air and beautiful scenery with a minimal investment in clothing or equipment. It requires little skill and time to learn. Runners suffer from less depression, colds and flu symptoms, and experience less pain due to an endorphine release (natural chemical in the brain associated with euphoria and pain control) that is greater than found in other sports and activities. These are some of the motives that cause people to run every day, in spite of the constant loading and wear and tear on the joints.

To be a competitive runner and have longevity in the sport, optimal form is necessary. Moreover, a recent study shows that a runner can decrease the stresses on the lower body and reduce the incidence of stress fractures when trained to run with proper form using visual feedback while on a treadmill. The application of this information has significant implications for training programs for runners for the prevention and recovery from injury. One such low impact method is called the “Pose Running Technique,” by Dr. Nicholas Romanov. It is a “soft landing” method which promotes; an S-like body position with slightly bent knees, a slightly forward lean at the ankles to employ gravity and momentum, lifting the feet up under the hips, and landing on the ball of the foot under the body to absorb the center of mass.

It is my opinion, that the best runners, with the least injuries, such as Jordan Hoyt, speedster from Abington Heights, employ these techniques naturally. Additionally, many of the world’s best runners use coaches and trainers to assist them in their quest for success and injury prevention by using perfect form. However, for the rest of us, we must learn to maximize the efficient use of the body as it works with, not against gravity. We must learn to run “soft” to prevent injuries.

PROPER FORM

Head Position

A slight upward tilt of the head to allow a view of the horizon ahead should be most comfortable. Avoid looking down or up to extremes. Do not rock or rotate the head while running.

Shoulder Position

Loose and relaxed shoulders set the tone for a good run. Keep them level without tilting side to side or rotating left to right. Avoid holding the shoulders in a tight and high position.

Arms

Loose and relaxed arms also set the tone for a good run. A good arm swing is always in forward motion in a linear direction and stays between the waist and lower chest. Never clench the fist. Do not rotate or twist the arms across the body.

Torso

If the head, shoulders and arms are in correct position, then the torso will be upright. An erect running posture is necessary to promote efficient movement and breathing. The posture that you assume when taking a deep breath is the correct torso position for good breathing while running.

Hips

The hips will follow the position of the parts above in a linear forward direction. However, if the torso leans forward because the head hangs down then the hips will tilt downward. If the arms swing and torso rotates side to side, then the hips will also rotate.

Legs/Stride

Sprinters need to lift the knees high to thrust the lower legs forward. Long distance runners cannot maintain a high knee lift for a long period of time, however, a slight knee lift with a shorter but quicker stride is more efficient. Proper running requires the foot to softly strike the ground with the knee slightly bent. If the knee is fully extended in front of the body upon impact, the stride is too long and the force too great.

Ankles/Feet

To excel as a runner, when the foot hits the ground it should land lightly, between the heel and the midfoot. The ankle is flexed and rolls quickly forward to the toes to push off the ground with maximum force. The calf muscle propels the runner forward. Efficient running has a quiet and springy landing. A loud foot slap on impact is a sign of poor form and results in excessive force transferred to the lower leg. The foot should spend as little time as possible in contact with the ground…thus a soft runner “floats” when they run.

SOURCES: Runner’s World, Pose Running Technique (www.posetech.com), Journal of Orthopaedic and Sports Physical Therapy.

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”

Pre-pandemic we saw increased popularity of local races such as the Steamtown Marathon and Scranton 1/2 Marathon. With that, local interest in running was exploding and will hopefully return to normal soon. However, during the pandemic, especially when fitness centers were closed, many took seasoned and beginner runners to the streets to improve fitness and alleviate stress. However, as a health care provider, I am seeing a significant number of first time runners visit my office with a wide variety of injuries that are very preventable with a modicum of good judgment.

Runners are addicted to running for good reason. There is nothing like it! No exercise offers so much in such little time. Caloric expenditure is higher than in most other exercises, including biking. Running also allows for fresh air, beautiful scenery, minimal investment in clothing or equipment, little skill and time to learn. Moreover, the benefits are many; runners suffer from less depression, colds and flu symptoms, and experience less pain due to an endorphin release (a natural chemical in the brain associated with euphoria and pain control.)

This column will be dedicated to those who are interested in beginning a running program for all the reasons mentioned above and more. The program is designed to promote a safe and gradual introduction or return to running as form of exercise. The initial goal is to help you attain 30 minutes (approximately 2 miles) of running at a slow, relaxed and safe pace. This 30 minute goal is the standard used in most research that shows improvement in weight control, cholesterol, heart disease, blood pressure and adult onset diabetes. The 8 week program is a simple and safe program that begins with more walking than running and gradually reverses the proportion. The first two miles are the hardest and once mastered; one can begin to build on mileage and intensity if desired. For those interested in advancing to a half or full marathon, I recommend the book “The Marathon” by Jeff Galloway who advocates a run/walk program as you increase distances. Visit his website at: www.jeffgalloway.com.

Before You Begin

Consult your physician: This is important if you have health issues, have not engaged in exercise for some time or you are 15-20 pounds overweight and over 40 years of age.

Plan a schedule: Get committed. Use a computer, calendar, or fitness Apps such as Endomondo Sports Tracker or Argus.

Get mentally prepared: You will have good and bad days. You have to do it, even on the bad days. Once you get to a certain level of fitness, it gets easier and more fun.

Buy the proper shoes for you: Just because the sneaker fits does not mean you have to wear it! Manufacturers entice prospective buyers with a multitude of colors, fabrics, styles and designs. Instead of focusing on aesthetics, focus on function!

The appearance of an arch in a weight bearing position does not automatically exclude the individual from excessive supination or pronation. Consult a podiatrist or an orthopedic physical therapist to determine the propensity toward supination, pronation or neutrality of the foot and ankle.

Note: New Balance, Brooks, Asics, Mizuno & Saucony all make quality running shoes to accommodate a supinated, pronated or normal foot.

Other equipment: DryTech is great fabric for running which wicks the sweat away from the skin and prevents chaffing. It can be found in shorts, pants, shirts and socks Also, weather and temperature options are important, such as compression shorts in cooler temperatures to prevent muscle pulls.