Building Proper Posture

Recently I injured my shoulder by exercising poor judgement at the gym. One thing led to another, and I found myself at the mercy of a physical therapist. On my first visit, she explained that shoulder injuries are always treated by first addressing posture deficiencies. . . regardless of age, she hesitantly added. I reminded her that I had sustained my injury exhibiting super-human strength at the gym, not because I was old. She had no reply.

Proper Posture Devolves Over Time

Athletes suffer from the SAID Principle, or Specific Adaptation to Imposed Demands. Any given sport will produce adaptations specific to the activity performed. If you’re a figure skater, you’d adapt to the specific strength demands required for figure skating. For runners to develop the endurance for long distances, we must train by running long distances. Adaptations occur in the muscles and systems that are stressed by that activity.

With repetitive movement (or non-movement such as prolonged sitting), the muscle and soft tissue remodel to become stronger in the direction of stress. This is good as it relates to our sport, but long term repetition can create muscular imbalances that slowly devolve into poor posture. As posture deteriorates, joint movements become restricted allowing muscles to weaken. The joints then try to compensate causing pain, stiffness and loss of mobility.

A quick review of exercises that improve posture yields a variety of core strengthening exercises. Most athletes rely on a strong core, and we already spend a fair amount of time on the effort. However, good posture is not only derived from a strong core, but also from the neck, shoulders and hips. Although my strengthening exercises were effectively targeting the core, they were not targeting these other areas that are also essential to good posture.

The Crossed Syndrome

Photo: Triathlon-Hacks

A cyclist‘s position on the bike causes tightening of some muscles while the opposing muscles lengthen and become weak resulting in upper crossed and lower crossed syndrome. Both have negative effects on posture and efficiency for cyclists.

Pinterest Photo Origin Unknown

Upper Crossed Syndrome occurs when the back muscles of the neck and shoulders (upper trapezius, and levator scapula) become extremely overactive and strained. The muscles in the front of the chest (the major and minor pectoral is muscles) become shortened and tight. Potential injuries include headaches, biceps tendonitis, rotator cuff impingement and thoracic outlet syndrome.

With Lower Crossed Syndrome the gluteals (gluteus maximus, gluteus medius, gluteus minimus) and abdominal muscles become weak or inhibited, and the hip flexors (rectus femoris and iliopsoas) and lumbar erector spinae become tight. Injuries can include hamstring strains, anterior knee pain and low back pain.

One-sided rotational sports (such as tennis, golf, hockey, baseball…) can also cause this type of muscle imbalance, although all athletes are at risk of injury from muscle imbalances regardless of the cause.

Uncovering Posture-Enhancing Movements

Over these past few months of recovery, I’ve formulated a routine that stretches and strengthens those muscles that cause our posture to devolve over time while also targeting the core muscles that are normally part of a runner’s strengthening regimen. The goal was to create a sequence that was easy to remember, could be completed in about 10 minutes, and wouldn’t require equipment.

There’s dozens of exercises that target the neck, shoulders, core and hips, so it’s easy to add or substitute other exercises to more intensely target one area or another. This basic routine provides a good starting point, however, as to the types of exercises you would want to include in a personalized program.

This program hasn’t completely replaced my regular strengthening program, but it’s been an effective way to build core strength in a way that also helps support proper posture. The 10 movements include:

  1. Standing Half Forward Bend
  2. Camel Pose
  3. Child’s Pose
  4. Classic Plank
  5. Side Plank – Left
  6. Push-Up
  7. Side Plank – Right
  8. SpiderMan Stretch w/T-Spine Rotation
  9. Up Dog
  10. Child’s Pose
Disclaimer: If you are just beginning an exercise program, you’re dealing with a back, neck or shoulder issue, suffer from high or low blood pressure or have other health issues, please consult your physician or a physical therapist before performing this or any other exercise regimen.
Hold each position for 30-60 seconds, for 5-10 breaths, or as long as you can. Perform 1-3 complete sets.

1. STANDING HALF FORWARD BEND

Courtesy: Pinterest

Uttanasana: Sanskrit word combination: ‘ut’ means Intense, ‘tan’ means Stretch, and ‘asana’ refers to Posture.

Primary muscles involved: stretches the hamstrings and low back.

Tips: Keep feet shoulder width apart and parallel. Bend at the hips (not the waist). Beginners should bend the knees if necessary, but don’t worry if you can’t touch the ground. Go as far as you can. Don’t forget to breathe.

Variation: STANDING FORWARD FOLD WITH HAND CLASP

Courtesy blog.myfitnesspal.com

This pose stretches your hamstrings and low back, while the hand clasp opens the chest and shoulders. Keep a soft bend in your knees and use a strap or towel to make the pose more accessible. If you can, keep your torso long and your knees even.

2. CAMEL POSE

Courtesy: yogabycandace.com

Primary muscles involved: Shoulders, Chest, Core, Hip Flexors

Tips: Keep the legs vertical, and push the hips in the forward direction. Bend the head and the spine backward without straining, and don’t allow the shoulders to extend past the feet. Relax the muscles and breathe normally.

Variation: an easier variation of this pose is to position the palms on the lower back while slightly bending the head and spine backward. Relax the muscles and breathe normally.

3. CHILD’S POSE

A relaxation and resting pose that normalizes circulation, and gently stretches the hips, thighs, ankles and spine. Leave the arms stretched out in front, or rest palms beside your feet.

4. CLASSIC PLANK

Courtesy: lifehack.org

Primary muscles involved: biceps, neck, and shoulders

Secondary muscles involved: arms, biceps, core, thighs and gluteus.

Tips: Keep your torso straight and rigid, the body in a straight line from ears to toes with no sagging or bending. This is the neutral spine position. Ensure your shoulders are down, not creeping up toward your ears. Your heels should be over the balls of your feet.

Variation: TALL PLANK

Courtesy: wikihow

5. SIDE PLANK – LEFT

Courtesy: bodybuilding-wizard

Lean on your left elbow and forearm in a side-lying position, with your shoulders and hips parallel to the floor. Raise your hips until your body forms a straight line from your ankles to your shoulders. Brace your core by contracting your abs forcefully as if you were about to be punched in the gut. Place your right hand on the hip. Hold the position without letting your hips drop.

Primary muscles involved: deep abdominal muscles (obliques, transverse abdominis), quadratus lumborum (muscle in the lower back)

Secondary muscles involved: erector spinae, adductors, gluteus medius, gluteus minimus.

Variation: SIDE PLANK ON HAND

Courtesy: bodybuilding-wizard

6. PUSH-UP (perform up to 30 reps, or as many as you can)

Courtesy: healthline.com

The New York Times says, As a symbol of health and wellness, nothing surpasses the simple push-up. The push-up is the ultimate barometer of fitness.

Starting from the tall plank position, keep the pelvis tucked in and the neck neutral with palms directly under the shoulders. Keep the back flat while lowering the body by bending the elbows until the chest barely grazes the floor. Extend the elbows and repeat as many reps as possible.

Primary muscles involved: chest muscles/pectorals, shoulders/deltoids, back of your arms/triceps, abdominals, the “wing” muscles directly under your armpit, called the serratus anterior.

Variations: bend your legs at the knees to make the pushup easier. If necessary, start out doing the exercise against the wall instead of the floor or from the edge of the kitchen counter.

To make the pushup harder, adjust the position of the hands either wider or more narrow, use the fingertips instead of the palms, or place your feet on a high surface such as a bench to increase resistance.

Advanced: The Hundred Pushups Training Program (a 6-week program)

7. SIDE PLANK – RIGHT

Courtesy: plankexerciseroutine

8. SPIDER-MAN STRETCH W/T-SPINE ROTATION (perform 10 reps each side, or as desired)

Courtesy: skimble.com

According to the renowned strength coach Mike Boyle, the Spider-Man is extraordinary because performing it to one side simultaneously develops mobility in both hips. The movement requires you to tilt your pelvis backward, which prevents your back from arching and forces you to stretch the opposite side’s hip flexors, Boyle says.

Take a long lunge forward. Place fingertips or palms on the ground in line with the front foot. Make sure the knee is on the outside of the arms, not between them. Keep back knee off the ground. Look up and create a neutral spine. Step through and repeat with other leg. After attaining a neutral spine, lift the outside arm towards the sky. Watch your hand as your lift the arm.Attempt to create a straight line between your arms.

9. UP DOG

Courtesy: yogabycandace

Stretches the chest and abdominal muscles while strengthening the shoulders, triceps, forearms, and low back.

The palms should be aligned under the shoulders, the shoulder blades engaged and pulling the shoulders down and away from the ears, the chest open, and the eyes looking forward.

Only the palms of your hands and the tops of your feet should be touching the floor. Push strongly into both.

Primary muscles involved: Chest, shoulders, abdominals, triceps, forearms, low back

10. End with CHILD POSE

Read More:

Yoga For Runners, Darebee.com

8 Neck and Shoulder Stretches to Relieve Pain: Work and play both stress the neck and shoulders. Here’s how to recover; OutsideOnline

5 exercises to correct lower cross syndrome in cyclists, Canadian Cycling Magazine

The End of an Era

A few years ago my husband gave me a choice of getting a new Jeep, or a facelift. Not the everyday, run-of-the-mill decision. The conversation was prompted by his proprietary spreadsheet, which plots out the timing of our major financial decisions. The spreadsheet had told him it was the prime time to replace the Jeep. Or, alternatively, we could take care of a few wrinkles here and there. I wasn’t at all unhappy with the Jeep.

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My husband found it at a dealership in Atlanta, and negotiated the deal by phone during our last few weeks living in Ecuador. When the day came to move back to the U.S., we drove from Cuenca to Quito with our four dogs for a midnight flight to Atlanta. Our first chore after landing the next morning was to pick up my Jeep. I didn’t take it for a test drive. It was perfect, and me and that Jeep have weathered some wonderful years together.

This year seemed like the right time to finally make a change though, and we’ve retired the Jeep for good. My husband cleaned the glove compartment a few days ago, and I thought we might get a kick out of what he found. These contents seem to tell the story of the last 6 years.

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Every good EMT is taught to keep a pair of latex gloves on hand in case of an emergency, and there’s a tube of lipstick that may or may not have been used in several years. Same with the sunglasses, which were last used during kayaking class in 2014.

Occasionally I’ve taken private lessons from my Kung Fu Sifu using a favorite weapon, one of which is the knife. And the dog collar was around Bentley’s neck when I brought him home (in the Jeep).

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My husband insisted on buying the Mace pepper spray to attach to my waistband on long runs. Dogs are plentiful and run free on the quiet back roads of these mountains, and they scare the living bejesus out of me – I never did wear that Mace on my waistband though.

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My long runs have always started at the top of the mountain where I’d leave the Jeep in the Balsam Community Center’s parking lot.

You never know when you might need a pair of gloves, or what degree of thickness may be warranted. And if it was an especially cold or windy run, I’d tie a bandana around my neck. There’s never too much chapstick, and I’d be really mad with myself if there was a little niggle that I had forgotten to tape. Mad money was a staple, whether a couple of dollars or a twenty-dollar bill.

I have to remind myself not to wave at every Jeep I encounter these days – there is a protocol for that you know. And, by the way, I didn’t get a facelift either. You never know though, that spreadsheet could decide some day that it’s the prime time.

 

Continuations of Thought on Arbitrary Topics (writing a blog)

Artificial Intelligence has been newsworthy for some time, but never before has my curiosity been more piqued than when Jeremy Kahn (Bloomberg) published a story this week in Fortune: “This Article Is Fake News. But It’s Also The Work of AI”.

The story explains that OpenAI, a non-profit artificial intelligence research group in San Francisco, has unveiled a machine learning algorithm that generates synthetic text, or fake text, after being prompted with arbitrary input. The program even adapts to the style of the input – chameleon-like in generating realistic and coherent continuations about a topic of the user’s choosing.

In Kahn’s example, only two lines became the input: “A train carriage containing controlled nuclear materials was stolen in Cincinnati today. Its whereabouts are unknown.”

With no human guidance, the language model finishes the story by explaining in great detail that the incident had occurred on the downtown train line, which runs from Covington and Ashland stations, and that the U.S.Department of Energy was working with the Federal Railroad Administration to find the thief. It claimed the stolen material was taken from the University of Cincinnati’s Research Triangle Park nuclear research site, according to a news release from Department officials, and ended with a quote from the U.S. Energy Secretary, “We will get to the bottom of this and make no excuses.”

OpenAI’s company website reveals other fake news examples generated by the program, including reporting on a war of the orcs, Miley Cyrus caught shoplifting on Hollywood Boulevard, a remote herd of unicorns discovered that spoke perfect English, and JFK has just been elected President after rising from the grave.

In every case, the language model finishes the thought with a completely unexpected, relative and captivating narrative – sometimes on its first try. The implications and potential abuse of this new technology are frightful, but I can’t help being intrigued by the program’s ability to create such colorful stories from a random thought – perhaps because this is also the most compelling challenge of your everyday blogger.

In six years of writing to this blog I don’t think I’ve ever created a cohesive narrative on the first try, no matter how unexpected or captivating the topic. And while it seems like writing a big, fat, fake narrative would be fun, fiction seems to be the most difficult of all writing endeavors. I realized early on that my writing would be limited to reality.

Fortunately even the most mundane ’real’ topics seem fascinating material in those early years of blogging – and they flowed like water.

I had only published 30 posts when I decided to write about my foot. A quick search revealed the Statue of Liberty had been designed with toes just like mine. I named the post, ‘The Normal Variation: A Lesson On Morton’s Toe,’ and the rest is history. That post was the number one read post on this blog for the first five years. Bloggers everywhere will probably understand when I say, who knew?

But you never really know which topic will interest readers. I’ve written two poems – they were both about a day in the life of one or all of my dogs, and I’ve written extensively about my personal running adventures. When there was nothing of interest to write about within those topics, I’d go fishing for a topic.

On one such occasion my searching uncovered comments made at the annual meeting of the American College of Sports Medicine in June of 1999 by Dr. Stephen Seiler. He had coined the phrase, the “black hole” of training, which, in the athletic world, meant the no-man’s land of mediocrity — a place where an athlete’s high-intensity effort is performed too slow, and the low-intensity effort is performed too fast, resulting in every training effort being performed at medium-intensity…. which accomplishes nothing. I could completely relate to this newfound advice, and wrote a passionate study on how to avoid the moderate middle of training. ‘Training’ became the topic of choice for several years as I explored the depths of distance running myself.

I became enthralled with Arthur Lydiard’s base building philosophy after a Kung Fu classmate had mentioned it in class one week. I spent months working through the program and writing about each phase. That’s about the same time I began to realize just how many runners across the World are also interested in all things running. Readers have visited from over 100 countries, and I love that no matter where we live, we have things in common.

When I went back to school in 2014 I wrote about kayaking, hiking and climbing, but I also learned about Hans Selye’s General Adaptation Syndrome that year, and wrote how that theory, and our response or adaptation to stress, can help athletes in their training. Life provided the blog topics, and for awhile it seemed they’d never dry up. Eventually they do, even if only temporarily.

This is where I imagine the OpenAI language model could have stepped in and turned this little blog of mine on its head. I could provide dozens of arbitrary thoughts, and AI could create a captivating post; although the easy answer is not always the right answer.

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Eventually I had a crazy idea to write an entire series about runner’s injuries – taking them one body part at a time, and ‘The Anatomy of a Runner’ was born. The first post I wrote was loosely titled after Meghan Trainor’s song, “It’s All About That Bass,” and it took over the number one spot last year for the most read post. I was nervous about taking on human anatomy, but it has been the most challenging and rewarding writing I’ve done so far.

Beginning this blog has changed my life most unexpectedly. I love to write. To tell a story. And it doesn’t really matter the subject. I’ve risked alienating my fellow runners by writing about my garden, the dogs, our life, or my interior design adventures. It is always a tough decision to do that, but every topic requires that you adapt your style of writing somewhat, and I like that challenge.

I’ve wondered lately how blogs end. Do you plan that last post, or maybe you write a post one day and never return. Maybe the problem is that we run out of ideas, or life no longer seems exciting enough to write about. Maybe life gets too busy to write, or the reason you started blogging in the first place isn’t going so well. Who wants to write about something they no longer do or enjoy.

In 2013 I created a document on my iPad that I named ‘Draft.’ I write my entire post into that document, and edit it several times before I paste it into WordPress (where it undergoes another several gazillion edits). Sometimes my draft document also contains random thoughts or ideas I’ve found to use in other posts.

At the top of the document right now is a quote from Nordstrom’s co-president, a quote from Eleanor Roosevelt, and an idea for the title of a future post. There’s also a reference from a study about the known predictors and injury rates of recreational runners who steadily train in long-distances, and the remnants of a post I started last week about our living room, but then deleted out of frustration. Sometimes my draft document is completely empty – correctly reflecting the number of ideas in my head at that time. As my husband says, “Close your eyes.”

There’s dozens of potential topics left to explore though, even if only the first two lines of thought have been generated. As the saying goes, the only way to get better at writing is to write – to encourage yourself to go ahead and write about that arbitrary topic that came to mind in the middle of the night. After all, practice is the only way to get good enough to write an unexpected and captivating story on the first try – without artificial intelligence, of course.

The Anatomy of a Runner: Phalanges Maintenance

The Runner’s Pedicure in 3 Easy Steps:

  1. Choose the Proper Equipment
    A large nail clipper works well. Avoid scissors or knives. An emery board is important for filing down thick nails or smoothing rough nail edges, and a pumice will aid in reducing calluses.img_4113
  2. Wet or Dry?
    Trim your toenails when they are dry. Dry toenails are less likely to bend or tear when you cut them. For thicker toenails, cutting is easier after a shower.
  3. Use a Straight Cut

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Trim the nail straight across using two cuts – the first cut should be with the clippers slightly off the side of the nail to create the straight edge; the second cut removes the rest of the nail following the line of the straight cut. Smooth the edges with an emery board.

img_4108Don’t cut in a curved pattern or cut too short, as this may lead to ingrown toenails.

A good standard is that you should be able to run your finger across the top edge of your toe and barely feel the toenail. Trim often to maintain this length; approximately every 4-5 weeks in cool weather, and every 2-3 weeks in warmer weather.

 

Why it hurts.

Black Toenails: A subungual hematoma (bruising) under the nail that is generally caused by trauma resulting in a collection of blood underneath the nail. This collection not only causes the nail to become discolored, it also generates a tremendous amount of pressure, and can cause intense pain.

Black toenails may eventually lead to the loss of the entire nail (it will grow back). If there is pain or a foul smell (indicating an infection), seek medical treatment right away.

Fix it: the easy answer is to keep toenails short. Trauma occurs from the toenail hitting the end of the shoe.

Some suggested remedies include wearing larger shoes. While it is important that your shoes aren’t too short or small, shoes that are too large will cause other problems, such as blisters. Shoes that feature a larger toe box may help alleviate trauma to the nails, but the best place to start is to simply keep nails short.

If there are no underlying conditions, such as an infection, the nail will eventually fall off, a new nail emerges, and the injury heals without intervention.

It is possible to have a black toenail that is relatively painless. However, if pain is persistent, the hematoma can be drained to relieve the pain and pressure. Visit the doctor earlier rather than later to ensure the new nail regrows normally.

Brave runners may choose to drain the hematoma themselves. Jeff Galloway’s website contains step-by-step instructions for this procedure.

Some runners, such as ultra trail runners, may continue to be plagued by painful black toenails even after taking every precaution. Occasionally these runners will have their toenails surgically removed.

Note: black toenails can also be caused by a fungal infection, common in immuno-compromised patients, or they may indicate underlying melanoma (a malignant tumor consisting of dark-pigmented cells called melanocytes). In the case of an underlying infection, there may be pain associated with redness, swelling, foul odor, and discharge.

Thick toenails: nails can thicken with age, because of a fungus, infection, or trauma. Any alteration to the nail plate, nail bed, or root of the nail can result in thickening. This damage may be temporary or permanent, depending on the cause.

Runners may experience thickening of a nail from the repetitive pressure or continual striking of the nail against the shoe (trauma) causing it to separate from the nail bed.

Thickened toenails may or may not be painful, but they are difficult to cut, and they can increase one’s susceptibility to infection.

Fix it: use an emery board or nail file to immediately reduce the thickness of the toenail. This is the first and easiest thing to do. File the thickened nail each time you trim your nails, or as needed.

  • Soak your nails for at least ten minutes in warm, soapy water.
  • Completely dry your toenails.
  • Use the emery board or file to reduce the thickness of the nail.
  • Keep the nail trimmed, starting at one corner and continuing straight across to the other corner. Smaller cuts with the trimmer will prevent splitting or chipping thick nails.

One important note:  do not use cuticle pushers, which disturb the natural barrier that prevents the introduction of potential pathogens.

Prevention: A shoe with a larger toe box may help by giving the toes more room inside the shoe. Consult a physician if you suspect the problem is caused by an infection or other trauma.

Ingrown toenail: occurs when the edge of the nail irritates and eventually breaks the skin. Ingrown toenails are caused by several conditions, including genetics, trauma, infection, repetitive stress (usually in sports that require sudden stops), improper footwear, or improper trimming (too short or not straight across). The most common digit to become ingrown is the big toe, but ingrowth can occur on any nail.

Fix it: consider seeking immediate medical attention, or consult a nail specialist who will understand how to resolve the ingrown nail. In other words, treat yourself to a pedicure, or two.

A mild ingrown nail can be removed with careful clipping, but if it is deep or painful, consider a trip to the podiatrist. An unresolved ingrown toenail can lead to infection.

Prevention: proper cutting leaves the leading edge of the nail free of the flesh, precluding it from growing into the toe.

Never cut a V shape into the middle of your nail. Many people believe this technique is useful for preventing ingrown toenails, although it has been proven ineffective.

Footwear that is too small or too narrow, or a too shallow toe box, will exacerbate any underlying problem with a toenail.

Callus: areas of thickened skin caused by repetitive friction, or by abnormalities of the bony structure of the foot. Usually painless, calluses are a natural protective reaction of the skin over pressure sites.

Fix it: when a callus first develops, file it with an emery board or a pumice stone after bathing, and apply petroleum jelly, lanolin or other moisturizer to soften the area. Repeat this process as often as necessary. If a thicker callus has formed, you could use a peeling and softening agent such as Ultramide 25 lotion.

Runners may not want to totally remove calluses since they provide protection at pressure sites. However, if a callus becomes too big, it can crack, become tender, and it will be painful.

Calluses can also become tender on long runs or races from prolonged exposure to moisture from sweat. Blisters may also form under calluses. Resolve what is causing the callus, and it will go away on its own.

It’s good to regularly moisturize the feet (even for men). Consider products that contain tea tree oil since they are naturally antifungal.

Blisters: are small pockets of fluid under the skin caused by friction that can be a result of shoes that fit too tightly or too loosely. As your feet get wet with sweat the skin softens and leaves you at even greater risk.

Fix it: always leave a blister intact since an open blister can become infected. Cover the blister with an adhesive bandage/moleskin to protect it while it heals.

If it is particularly painful or uncomfortable, it may be necessary to drain the blister:

  • Wash your hands with warm water and antibacterial soap.
  • Using a cotton swab, disinfect a needle with rubbing alcohol.
  • Clean the blister with antiseptic.
  • Take the needle and make a small puncture in the blister.
  • Allow fluid to completely drain from the blister.
  • Apply antibacterial ointment or cream to the blister.
  • Cover the blister with a bandage, moleskin, or gauze.
  • Clean and reapply antibacterial ointment daily. Keep the blister covered until it heals.

You should visit a doctor if fever, nausea, or chills accompany a foot blister. This can be a sign of an infection.

Prevention: the most important step in preventing blisters is to identify the underlying cause.

  • If the blister is caused by friction, check your shoes to see if they are rubbing your foot in that area. Sometimes a seam or another design of the shoe can be the culprit.
  • If moisture seems to be the issue, apply foot powder to reduce sweating, (Dry Goods Athletic Spray Powder or Jack Black Dry Down Friction-Free Powder are two examples).
  • Wear moisture-wicking socks specifically designed for athletes. Socks with individual toes in the sock helps reduce friction between the toes that may cause blisters in some runners.
  • Over-striding can also cause blisters. This stride causes the foot to land in front of the body, absorbing the energy of the stride with a braking force that allows the foot to slide inside the shoe. Keep the stride short enough that the foot lands beneath the body rather than in front.

Bunions: a bunion is an (often unsightly) protuberance at the base of the big toe that forms when the metatarsophalangeal joint (MTP for short) is stressed over a prolonged period of time, causing the first metatarsal to turn outward and the big toe to point inward. (Bunions can also occur on the pinky toe.)

Fix it: the most important first step is to change your shoes.

High heels and pointy-toed shoes should be eliminated since they force the body’s weight forward, forcing the toes into the front of the shoe. Choose running shoes with a wide toe box, and consider shoes that have a lower heel drop (the height difference between the heel and forefoot often measured in millimeters).

Apply ice, use acetaminophen/ibuprofen, or visit your doctor for a cortisone injection for temporary pain relief. Using moleskin, gel-filled pads, or shoe inserts for arch support may also help.

Prevention:

Wear a toe spacer, starting with no more than 30 minutes a day. Two options are Correct Toes and  Yoga Toes.

Try shoes that are wider at the end of the toes than at the ball of the foot and that do not have an elevated heel—what is known as “zero drop.” (This website has more info and specific shoe suggestions.)

Do a bunion massage – a bunion massage stretches the adductor hallucis.

Read this article in Runners World.

Numbness or tingling sensation: numbness in the toes (unrelated to the cold weather) is often caused by shoes that are too tight or from tying your shoelaces too tight, but can also be caused by Morton’s Neuroma. This condition is caused when the tissue inside the foot becomes thicker next to a nerve that leads to a toe. The pressure against the nerve causes irritation and pain, usually between the third and fourth toes.

Morton’s Neuroma symptoms include:

  • tingling in the toes that may get stronger with time;
  • a burning sensation or numbness;
  • feeling like a pebble may be in your shoe, or that the sock is bunched up;
  • there may also be a shooting pain around the ball of the foot, or the base of the toes. 

Fix it: 

Choose shoes with a larger toe box.

Over-the-counter metatarsal pads can relieve the pressure, or your doctor may prescribe orthotics that are custom fit.

Some people find relief with cold therapy, which involves applying extremely cold temperatures to the irritated nerve to kill some of the nerve cells. There are also permanent surgical options, or a doctor may prescribe a corticosteroid shot.

Some runners have had success in resolving Morton’s Neuroma symptoms with a daily supplement of Vitamin B12.

Prevention: wearing high heels or shoes that are too tight can cause the tissues in the forefoot to thicken over time causing the neuroma. Be sure shoes fit correctly and that there’s plenty of room for the toes to move around inside the toe box. Women suffer from Morton’s Neuroma more often than men.

Read More:

Common Running Foot Injuries and Issues; Very Well fit

Thick Toenails (Onychomycosis); Healthline

Ultrarunning Problem, Solved for Good; The New York Times

Blister Prevention; Fellrnr.com

The Evolving Science of Hydration

On a hot and humid summer day of 1904, thirty-two runners started a 24.85-mile course in St. Louis where water was provided at just two stations. The current thinking was that drinking during exercise was unnecessary. In fact, to compete without nourishment was a worthy achievement.

The high metabolic heat produced during exercise causes our core temperature to rise to dangerous levels (normal core or internal temperature is 98-100 degrees). The body’s counter measure is to increase the heart rate so that blood flow is maintained to the exercising muscles and the skin to allow for the dissipation of heat through sweating. When sweating becomes the primary means of heat dissipation, however, sweat loss must be matched by fluid consumption to avoid dehydration.

By 1923, the topic of exercise physiology was advanced by studies that emphasized the risks of dehydration during exercise. This research was the primary impetus for the “cardiovascular” model of physiology and thermoregulation, which predicts that there is a point at which increases in heart rate can no longer compensate, leading to reduced blood flow to the skin, an increase of core temperature, risk of heat stroke, or myocardial infarction (heart attack).

For decades, substantial research into hydration and performance supported the position that exercise performance is impaired when a level of dehydration due to sweating reaches about 2% body mass loss. The 1996 position stand of the American College of Sports Medicine (ACSM) stated, “Even a small amount of dehydration (1% body weight) can increase cardiovascular strain as indicated by a disproportionate elevation of heart rate during exercise, and limit the ability of the body to transfer heat from contracting muscles to the skin surface where heat can be dissipated to the environment.”

But these recommendations famously ignored evidence that some of the fastest marathon runners had incurred a water deficit exceeding 4%. Using data from a review of these marathon runners, when the relationship between running speed and percentage dehydration was plotted, the best-performing runner was dehydrated by some 8%, while the only runner to prevent body mass loss of >2% was the slowest (Fig. 1). The data suggests the effect of dehydration in excess of 2% did not impair performance significantly.

Figure 1: American College of Sports Medicine

By 2007 ACSM’s revised consensus statement regarding fluid consumption during exercise reflected the new thinking that preventing all dehydration may be unnecessary, and that there may exist a level of “tolerable dehydration“.

It’s important that athletes maintain adequate hydration levels before and after training as well. Any fluid that doesn’t contain alcohol can hydrate. Food counts too!

New research has suggested that it is whole-body hyperthermia (defined as core body temperature exceeding 40°C; 104°F) that impairs performance rather than dehydration levels per se. In one study (Trangmar SJ, Chiesa ST, Kalsi KK, et al.), participants were placed under sufficient heat stress to either raise skin temperature or to raise skin temperature and core temperature. The participants with elevated skin temperature did not experience impaired exercise performance, whereas participants with an increase in whole body temperature did. This suggests a high sweat rate prevents a rise in core temperature (hyperthermia) even though it also results in a water deficit (dehydration). The higher sweat rate allowed the faster athletes to run faster than the slower runners because they were able to dissipate more core heat through sweating. We began to see that the best hydration strategy could only be determined by the athlete’s individual requirements rather than a one-size-fits-all recommendation.

The latest position (2016) of the ACSM: ”Dehydration/hypohydration can increase the perception of effort and impair exercise performance; thus, appropriate fluid intake before, during, and after exercise is important for health and optimal performance. The goal of drinking during exercise is to address sweat losses which occur to assist thermoregulation. Individualized fluid plans should be developed to use the opportunities to drink during a workout or competitive event to replace as much of the sweat loss as is practical; neither drinking in excess of sweat rate nor allowing dehydration to reach problematic levels.”

Hydration theories have taken many turns. For example, we now know that a mixture of glucose, maltodextrin, fructose, sucrose and galactose – in other words, carbohydrates (also written as CHO), improves endurance performance by maintaining blood glucose and muscle glycogen stores, resulting in a levelling-off in core temperature. And so it was, with a mixture of sugar, salts and lemonade, the first sports drink was born.

Lucozade – basically citrus flavored sugar water – launched in 1927 and was the earliest traceable ancestor of the sport drink. Owned by the Beecham Company, they merged with SmithKline many years later. Gatorade launched its first product in 1967.
Photo Courtesy: Precision Hydration where you can get more info on sports drinks and take a free online sweat test.

The problem with these early sports drinks and gels is that our stomachs don’t always do well with high concentrations of sugar. Frequent GI distress prevailed over the next few decades of running.

A more recent innovation for providing fluid and CHO during exercise is the use of alginate. Alginate is a naturally occurring anionic polymer typically derived from seaweed and commonly used in oral drug delivery, wound healing, and tissue engineering.

Maurten is one such company delivering gels that are a combination of Alginate (extracted from the cell walls of brown algae) and Pectin (found in apples, lemons, carrots, tomatoes, etc.). When mixed with water, the resulting ‘sports drink’ converts to hydrogel in the acidity of the stomach, encapsulating the carbohydrates. Athletes that experience gastric (GI) distress from sugary sports drinks will appreciate that there were no reports of GI distress with any drink including the alginate hydrogel. And because it is engineered to encapsulate the carbs with the process beginning only when contact is made in the stomach, it is also better in terms of dental health.

Dental health is an important issue with CHO-based sports drinks. A survey at the London 2012 Olympic Games found that 18% of athletes reported that their oral health had a negative impact on their performance and 46.5% had not been to a dentist in the past year. (The latest ACSM position statement also addresses oral health in the wider culture of sports health care and health promotion.)

The next evolution in hydration began in 2014 when the Brazilian National Football Team asked Gatorade to help them prepare for the World Cup. The team didn’t end up winning the World Cup, but the pilot opened new doors for collaboration and innovation at Gatorade.

Smart Design worked with the Gatorade Sports Science Institute (GSSI) to research heat stress and dehydration during exercise. A systemized approach was developed to test and analyze how each athlete sweats—how fast, how much and in what concentration. The resulting product was a hydration platform – a bottle with a “smart cap” that’s built on the hypothesis that personalization is the next frontier of improving athletic performance.

The new Gatorade squeeze bottle utilizes Drinkfinity beverage pods, allowing quick delivery of sport-specific or individualized player formulas. Courtesy: PepsiCo
Courtesy Gatorade

Today’s consensus is that drinking to thirst is the body’s best hydration strategy, and in most cases will protect athletes from the hazards of over and under drinking by providing real-time feedback. It’s important to research and practice various hydration approaches during training runs to understand your specific needs, and to develop a personal strategy. Some athletes are less aware of their hydration requirements and may benefit from technology, such as a fluid calculator. But the quantity, amount, or combinations of food and/or fluid consumed while exercising should always be guided by your individual palatability and tolerance.

There is still a widespread misconception that you should ‘stay ahead’ of your thirst. Drink early and often was the advice we were given years ago; advice too many runners still follow.

Slower runners generally sweat less, but have been told to drink copiously. If you ingest more fluid than you lose through sweating or urination, however, you dilute your blood’s sodium levels – a condition called hyponatremia, or water intoxication, caused by drinking too much. Osmosis then draws water from the blood into body cells to equalize sodium levels, and those cells swell. If the cellular bloating occurs in the brain, it can be fatal.

The latest position statement from the International Marathon Medical Directors Association (2006) included a Final Word:

“There are no shortcuts toward great achievement, and marathon running is no exception. Clinicians and scientists must resist handing out unrealistic ‘‘blanket advice’’ to individuals seeking simple answers, but rather should encourage athletes to explore, understand and be flexible toward their own needs. By providing guidelines and advice on how to appropriately understand individual fluid replacement needs, we can eliminate future fluid balance problems by avoiding the temptation to generalize one rule for every situation and every athlete.”

My husband believes this more individualized protocol of hydration will serve to open up the sport to runners that may have otherwise found it too uncomfortable or difficult to participate. That in some way, having technology that explains how to hydrate will win them over to the sport. Maybe it’s even a marketing ploy on behalf of the corporations involved. I’m not sure I disagree.

To a seasoned runner, technological advancements may seem unnecessary. To a new runner, they may provide much needed guidance in a world of overwhelming challenges. It may or may not make you a better runner. Some would say technology is most useful at the far ends of the spectrum – in this case, for new runners and elite runners.

Many years ago I wore a special shoe with a piece of plastic in the bottom that could tell me how far I’d gone and at what pace. Some of you may have worn those same shoes. I suppose it helped me learn to pace myself better, but mostly it was new and fun.

When I ran in Kenya, a group of runners were heading out on a 40k training run. Knowing water was not easy to come by, I asked the runner I was with how often they would drink. He smiled and told me, “When they’re finished.” I used to never drink on a training run of any length. But there also came a time that I hid extra water bottles on my route and ate a peanut butter sandwich along the way. My main hydration strategy for race day was to try to avoid having to stop at the port-a-potty.

These new guidelines, and even more recent studies, emphasize that we are all unique and our hydration strategies will be equally unique. This left my husband feeling empty. He wanted something more absolute. I told him that now there’s an app for that.

 

Additional Reading:

The Best Hydration Plan Is to Drink When You’re Thirsty, Sweat Science at OutsideOnline.com 

Don’t Ring The Bell

This was the week that we learned Washington Wizards’ point guard and five-time All-Star John Wall will have season-ending surgery to address bone spurs in his left heel. Wall had secretly suffered through several seasons in pain before consulting with a specialist who recommended surgery. I’ve been following Wall’s condition closely since a bony heel protrusion showed up on my own right foot this past summer.

It’s called Haglund’s deformity. Mine and John Wall’s. A bony englargement on the back of the heel, or essentially a bone spur on the heel. I will only say that if you’ve got one, you’ll feel it every day forever. The last thing the doctor told me was that it would never go away. Given John Wall’s level of play, his doctor warned that the stress from the spur could eventually rupture the Achilles’ tendon. Thus the surgery, and six to eight months’ recovery.

In retrospect, I can see that I floundered a bit during the second half of 2018. Previous injuries could always be resolved with rest. Give it enough time, and whatever ailed me would get better. This time the injury turned out to be permanent, and it changed everything in life as I knew it.

Running has defined nearly half my life. Years before I even acknowledged myself to be a runner, I ran five miles every day. I didn’t take rest days because I didn’t realize you needed rest days. Memories of every place I’ve lived revolve around the running routes associated with that city. Life revolved around running, and I’ve loved every minute.

Once your mind and body have adapted to not working out, however, it’s pretty easy to convince yourself to give up on your previous level of exercise altogether. It has taken me awhile to come up with a plan.

The most common thread among athletes of all rank is injury, but it’s a short list of athletes that make a come-back from catastrophic injury. Peyton Manning had multiple neck surgeries, Serena Williams had pregnancy complications, Kobe Bryant’s shredded knees, and Ben Hogan’s serious car accident. Then there’s Tiger.

A list of Woods’ surgeries prior to his second microdiscectomy operation in Sept. 2015. 
photo courtesy: abcnews.

It’s easy to quit. It takes courage – and a plan – to stay in the game. And if you’re not moving forward, you’re losing ground.

How you plan forward momentum is dictated by your present condition, but your present condition should never prevent you from moving forward.

My husband and I have researched my injury from every direction. I’ve tried every homeopathic solution ever mentioned – he discovered a new one just yesterday that’s already on order. He also bought me a pair of minimalist shoes with the thought that they would help strengthen the muscles and tendons of my foot and ankle over time. So far so good.

I stopped running (again) in November in favor of walking. Since then I’ve focused on a strengthening routine and increased my walks to an hour, six days a week – roughly 4 miles each. By February, I hope to incorporate a few days of running, and plan my next steps from there. Surgery may still be in my future, but we’ll try every other avenue first. It’s a process.

I’m reminded of my first lessons in Kung Fu and Wing Chun. The translation of Kung Fu is time and effort. There are no short cuts. The foundation of Wing Chun is to always move forward and aim for the center.

Naval Admiral William H. McRaven, ninth commander of U.S. Special Operations Command, gave an amazing and powerful 20-minute commencement speech at the University-wide Commencement of The University of Texas at Austin in 2014. The speech was about the lessons McRaven had learned from Navy Seal training, “To me basic SEAL training was a life time of challenges crammed into six months.” A few of the key points from his speech seem to provide a nice conclusion to my thoughts. (Read the full transcript here.)

Don’t Be Afraid of the Circus. Every day during training you were challenged with multiple physical events—long runs, long swims, obstacle courses, hours of calisthenics—something designed to test your mettle. Every event had standards—times you had to meet. If you failed to meet those standards your name was posted on a list and at the end of the day those on the list were invited to—a “circus”. A circus was two hours of additional calisthenics—designed to wear you down, to break your spirit, to force you to quit. No one wanted a circus.

But an interesting thing happened to those who were constantly on the list.  Over time those students-—who did two hours of extra calisthenics—got stronger and stronger. The pain of the circuses built inner strength-built physical resiliency. Life is filled with circuses.

Get Over Being A Sugar Cookie And Keep Moving Forward. Several times a week, the instructors would line up the class and do a uniform inspection.  It was exceptionally thorough. Your hat had to be perfectly starched, your uniform immaculately pressed and your belt buckle shiny and void of any smudges. But it seemed that no matter how much effort you put into starching your hat, or pressing your uniform or polishing your belt buckle—- it just wasn’t good enough. The instructors would find “something” wrong. For failing the uniform inspection, the student had to run, fully clothed into the surf and then, wet from head to toe, roll around on the beach until every part of your body was covered with sand. The effect was known as a “sugar cookie.” You stayed in that uniform the rest of the day—cold, wet and sandy.

There were many a student who just couldn’t accept the fact that all their effort was in vain.  That no matter how hard they tried to get the uniform right—it was unappreciated. Those students didn’t make it through training. Those students didn’t understand the purpose of the drill.  You were never going to succeed.  You were never going to have a perfect uniform. Sometimes no matter how well you prepare or how well you perform you still end up as a sugar cookie. It’s just the way life is sometimes.

If You Want To Change The World Don’t Ever, Ever Ring The Bell. Finally, in SEAL training there is a bell.  A brass bell that hangs in the center of the compound for all the students to see. All you have to do to quit—is ring the bell.  Ring the bell and you no longer have to wake up at 5 o’clock.  Ring the bell and you no longer have to do the freezing cold swims. Ring the bell and you no longer have to do the runs, the obstacle course, the PT—and you no longer have to endure the hardships of training. Just ring the bell. If you want to change the world don’t ever, ever ring the bell.

The 2019 Plan

Another remodeling project is taking shape. It’s like being in the early days of training for a marathon; you choose a training plan, and begin to work your way through the program that will culminate in a magical place – although finding yourself at the finish line seems so far away that it’s impossible to believe it will ever happen at all.

Most of the remodeling of our little cottage was completed in 2018. The kitchen finally escaped the 1970s, the master bath stole enough square footage from the center hall for a shower and two sink cabinets, and we converted the 2nd bedroom into a proper walk-in closet.

The next projects on our list include the addition of a 300 square foot conservatory (with all its required excavation), remodeling the hall bath, updating kitchen appliances, adding an attached carport and a she-shed for yours truly.

If you’ve tuned into The Fartlek for these occasional design and renovating stories, this could be a plentiful year. And if you’re a runner, please don’t despair. The year will be more about running than it may currently appear!

Conservatory

The 19th century was the golden age of conservatory building, primarily in England. In a residence, a conservatory would typically be attached to the house on only one side, and by definition must have more than 50% of its wall surface glazed. Our new room does not technically meet the ‘conservatory’ standard, but it’s the aesthetic we’re going for.

The conservatory will connect to the rear of the cottage through an existing closet. A vaulted ceiling, 6’ windows, a wall of bookshelves and two closets make it the most functional 300 square feet we’ve ever added to a home (a third new closet is accessible from the master bath). It will lack the feel of a full conservatory because of the wall of bookshelves, however, that side of the room only looks onto the neighbor’s house. Bookshelves are more practical. French doors at the back of the room lead to the she-shed and a view of the back garden.

Carport

originating from the French term “porte-cochère“, referring to a covered portal, renowned architect Frank Lloyd Wright coined the term when he used a carport in the first of his “Usonian” home designs: the house of Herbert Jacobs, built in MadisonWisconsin, in 1936 (Wikipedia).

The driveway encroaches the property’s setback restrictions on our left side, which precludes the construction of a garage. A carport complements the little cottage perfectly anyway.

Excavation

In the early 1900s, Lake Junaluska’s Epworth Lodge was built where our house now resides. I admit that I’m secretly hoping a buried treasure or rare artifact from our property’s historic past will be unearthed during excavation.

Another dozen trees were removed a few weeks ago and the excavator is scheduled for the first of the year. The plan is to tear out the tree stumps and dig out the hill to render the whole area level (i.e., flat/perfect/divine). 

A french drain will probably be required near the conservatory, but the excavator has promised to fill in with gravel throughout the yard to prevent any issues in the meantime. . . my husband was completely unsympathetic to the plight of my future garden being full of gravel.

A bucket truck was used to cut sections off the tops of the trees until they reached a manageable height, although sometimes the guys just climbed the tree to reach the top (notice the man in a yellow shirt barely visible at the top of the tree to the right).
What the back yard looks like at the moment (a.k.a. a mess).

She-Shed

We’ve decided on a combination greenhouse/shed that provides enough space for my bicycle(s) and a Kung Fu wooden dummy. We prepare the foundation and the prefabricated structure comes ready to assemble, supposedly in just two days – given the right amount of help I assume.

I have big plans for this little building.

The Kitchen

As fate would have it, Paul has helped us install tile every November for the past three years in whatever house we were remodeling at the time. This November he installed a marble backsplash in the cottage kitchen. We’re choosing black appliances to finish things off.

Space is limited so we decided to use dishwasher drawers to avoid a door that drops down into the room. The Fisher Paykel version is about the only one on the market, except they don’t come with a certified installer in our area. We’re waiting on an installer to drop by from Asheville after the holidays. Once we see the true ‘black’ of the dishwasher finish, we’ll choose the most exotic matching stove and refrigerator.

We’ve decided on the Hallman stove in either glossy or matte black to go with the Fisher Paykel double-drawer dishwasher. My new favorite refrigerator is a Gaggenau unit with antique finishes added by Italian firm, Restart Srl. . .  although at a starting price of $10,000 USD, maybe we’ll keep shopping. 🙂