Everyone is searching for the quickest route to recover from a long run or a strenuous race. The recommendations are found throughout the magazines and across the internet. I have my own special regimen that speeds my recovery, and once again has helped me progress to almost complete resolution of muscle pain and weakness after just 48 hours. Let me list the process I underwent after my marathon:
1. Cool Down
It is recommended in all research I can find that a runner should not stop to stretch or lie down after a strenuous exercise. The cool down can be a simple walk or jog after the race. I walk for at least 10-15 minutes without sitting or stretching to ensure the muscles have time to cool down with a light stretch from regular motion. Sitting or lying down will allow cramping. Stretching may overstimulate the stretch mechanism in an exhausted muscle and produce cramping or even injury. Stretching can be done after the cool down and is a good idea if done at the right time. If the cool down is done effectively, it will alleviate some of the after marathon recovery.
2. Refuel
Any amount of exercise utilizes the glycogen in muscles as an energy source, with blood glucose and free fatty acids. As the exercise level progresses to longer exercise or more strenuous exercise, these sources become depleted more quickly and "anaerobic" (without oxygen) mechanisms are utilized to produce lactate. The lactic acid in muscle fibers or even the muscle breakdown to obtain necessary energy can lead to muscle pain and stiffness. The speed of muscle recovery is determined by the amounts of lactic acid or protein (muscle) breakdown is required to repair the muscles (especially after an exercise is completed).
The University of Illinois did a study on rats in 1999 that showed quicker muscle recovery from this depletion with refuelling with foods containing Leucine (an amino acid) immediately after exercise. They showed muscle stiffness and soreness would subside more quickly. More recent studies have found 30 minutes to be the key time for muscle recovery. The foods eaten in the first 30 minutes after exercise help rebuild the muscles, while foods eaten later have less benefits for muscle repair.
Leucine is found in protein products such as meats and dairy products, as well as in protein bars and some sports drinks. It is not recommended, however, that pure amino acid supplements be taken, because the beneficial amount is not known. In the study, they made the following findings: "It [Leucine] stimulates muscle protein synthesis, provides fuel for the muscle and helps to maintain blood glucose. What really surprised us was that its activity is not seen when leucine or protein is consumed before or during exercise. Instead it has a dramatic impact on protein synthesis during the recovery period after exercise."
So how do I refuel after a race? After any run, and especially after this marathon, I drank a large glass of milk withing 30 minutes of completing the exercise. Fluids are also imperative as are some other carbohydrates to help further maintain blood glucose and reduce lightheadedness from low blood glucose. When I don't want to eat within 30 minutes after an exercise, I eat anyway, especially the large cup of milk and/or a yogurt to get the Leucine benefits.
3. Fluids, Fluids, Fluids...
Part of refueling is getting the necessary fluids to replenish the body. I have a tendancy to start sweating when I think about exercise. I therefore must replace a large amount of fluid after any form of exercise. This replacement is both for refueling and for providing the reservoir for flushing out waste products from the body and especially the muscles. It requires more fluid to carry all these waste products out of the muscles into the kidneys for excretion. Try to drink 6-8 ounces of water every 2-3 hours during the initial recovery period.
4. Hot or Cold?
Everything I have read recommends ice baths or ice massage after a strenuous exercise, and often they recommend avoiding the heat after exercise. I will say now that I aggressively treat my muscle soreness after an exercise (even after the marathon) with soaking in a warm bath or hot tub. Let me explain the scientific basis for my actions. (Note that for me this works really well and decreases my muscle soreness significantly within the first 24 hours and reduces it nearly completely by 48 hours.)
The body reacts to hot and cold by dilation or contracture of blood vessels. Cold (ice) will reduce(vessel contracture) the blood flow into the area or cause the body to pull the blood from the area. Heat will increase (vessel dilation) the blood flow to the area and allow increased blood flow through the area. Since muscle pain is often due to lactic acid in the muscles or other waste products of "anaerobic" muscle metabolism (contracture), heat will allow blood flow through the muscles that can remove these waste products. Heat is only recommended by me during the first 12-24 hours. Ice can be utilized at anytime, but is rarely necessary if I undergo my usual exercise recovery regimen.
I have found through the use of these 4 simple techniques that I can continue to run, recover quickly and not suffer for days - weeks after a strenuous exercise. I plan to continue to train and run marathons and will evaluate the benefits of this regimen after any strenuous exercise. The proof will be in my recovery. Currently I am basically painfree the Monday after a Saturday 26.2 miles...I hope this helps.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
Showing posts with label leg pain. Show all posts
Showing posts with label leg pain. Show all posts
Monday, April 20, 2009
Tuesday, March 24, 2009
Shin Splints Can Be Avoided
Commonly runners are sidelined or limited by the presentation of leg pain during and often after runs. The pain is usually located at the sides of the "shin" bone and can be debilitating, even limiting the ability to walk. Over the years, this has been a problem that I sometimes have encountered in my running. Since I love running (and don't like not running), I have researched over the years some ways to limit the presentation of shin splints while training for a race, or in my case a marathon. I will discuss some ways that we can "run smart" and limit the injuries that have been commonly classified as shin splints.
What is a shin splint?
A shin splint can be located on the medial (inside) or lateral (outside) of the lower leg below the knee. Medial shin splints are commonly inflammation of the muscle attachment to the shin bone (tibia) and hurts as from pressure to the muscle just inside the bone. Lateral shin splints are commonly inflammation to the tendon (posterior peroneal tendon) and adjacent tissues in the front of the outer lower leg. In either case, the pain can present during a run, immediately following the run or sometimes the next day.
What causes shin splints?
The exact cause of shin splints are not known, but usually it is related to rapid increase in running or jumping (or sometimes walking fast), changes in shoegear, or pronation (flattening of the foot). Some secondary causes may be balance problems (leaning to one side during a run), poor training technique (progressing too fast, poor running technique or surfaces), leg length problems or even injury.
What I have learned...
1) Using correct shoes.
Since commonly over pronation (excessive flattening of the foot) or over supination
(increased arch height - rolling out) can cause stress to the muscles or tendons in the area and create shin splints, a quality exercise or running shoe will help improve and prevent these symptoms. In choosing a shoe, price is not the most important, but cheap priced shoes are usually cheap shoes. Get a quality shoe, designed for the exercise you are doing (running shoe for running or walking, basketball shoe for basketball, etc.).
2) Training smart.
As you run or train, Run Smart! Let me explain…
If you are running on a track, understand that always running the same direction on the track will work muscles differently than switching directions. One of the possible causes for shin splints is working muscles at different rates, therefore switching directions regularly will work all muscle of the legs equally and reduce the chances for shin splints.
If you are running on a road, most roads in most locations throughout the country are canted (or tilted to improve water runoff). Therefore, running against traffic always will cause supination of the left foot and pronation of the right foot. With supination, you will work the lateral (outside) muscles of the leg more than the medial (inside) muscles of the leg. Pronation does the opposite. By switching sides periodically, you will again work all muscles equally and prevent the presentation of shin splint symptoms.
Lastly, in running smart, the speed of training should be carefully controlled. Start slow and progress slowly to the amount of running you desire. Give the leg muscles time to get strengthened before forcing them into harder regimen. The speed of progress will require understanding of how much running you have done and where you should start. Cross training (elliptical or bike) can also help even the muscle strength as you progress.
In all these aspects of running smart, it should be understood that shin splints are caused by overusing a muscle group and creating an injury. By adjusting the training to reduce this overuse, you will have a more enjoyable run.
3) Evaluation for possible "gait" abnormalities.
“Gait” abnormalities are best described as running or walking abnormalities. Do you have a leg length problem? Do you over pronate or over supinate? Do you have imbalance issues, back problems, knee problems, or other reasons to overwork a muscle group that may cause your shin spints?
Let me discuss some of these running issues:
Leg length abnormalities (left leg longer/shorter than right) can be a large problem when running. The APMA has found that running produces 4-5 times your body weight through your feet. If one leg is shorter, the body is designed to adjust…you will pronate the shorter foot to make it longer and supinate the longer foot to make it shorter. This will lead to overworking the muscles and cause leg pain and possibly shin splints. A simple adjustment to your shoes (or orthotics) will alleviate this problem and produce continued running without pain.
Imbalance issues, often caused by weakness of ligaments (like chronic ankle spraining) or ear problems. One of my patients is deaf in one ear and runs lopsided (towards the deaf side) and has issues with shin splints. With a simple orthotic, a custom item to replace a shoe insert in your running shoes that maintains your foot in neutral position and helps the foot function as it should, his shin splints have been eliminated.
Pronation or supination is also a form of imbalance of the feet and can cause overuse of some muscles and may also lead to shin splints. Orthotics are the answer here also.
By being evaluated for your running, your “gait” abnormalities can be evaluated and often adjusted to help you return to running without the pain.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
What is a shin splint?
A shin splint can be located on the medial (inside) or lateral (outside) of the lower leg below the knee. Medial shin splints are commonly inflammation of the muscle attachment to the shin bone (tibia) and hurts as from pressure to the muscle just inside the bone. Lateral shin splints are commonly inflammation to the tendon (posterior peroneal tendon) and adjacent tissues in the front of the outer lower leg. In either case, the pain can present during a run, immediately following the run or sometimes the next day.
What causes shin splints?
The exact cause of shin splints are not known, but usually it is related to rapid increase in running or jumping (or sometimes walking fast), changes in shoegear, or pronation (flattening of the foot). Some secondary causes may be balance problems (leaning to one side during a run), poor training technique (progressing too fast, poor running technique or surfaces), leg length problems or even injury.
What I have learned...
1) Using correct shoes.
Since commonly over pronation (excessive flattening of the foot) or over supination
(increased arch height - rolling out) can cause stress to the muscles or tendons in the area and create shin splints, a quality exercise or running shoe will help improve and prevent these symptoms. In choosing a shoe, price is not the most important, but cheap priced shoes are usually cheap shoes. Get a quality shoe, designed for the exercise you are doing (running shoe for running or walking, basketball shoe for basketball, etc.).
2) Training smart.
As you run or train, Run Smart! Let me explain…
If you are running on a track, understand that always running the same direction on the track will work muscles differently than switching directions. One of the possible causes for shin splints is working muscles at different rates, therefore switching directions regularly will work all muscle of the legs equally and reduce the chances for shin splints.
If you are running on a road, most roads in most locations throughout the country are canted (or tilted to improve water runoff). Therefore, running against traffic always will cause supination of the left foot and pronation of the right foot. With supination, you will work the lateral (outside) muscles of the leg more than the medial (inside) muscles of the leg. Pronation does the opposite. By switching sides periodically, you will again work all muscles equally and prevent the presentation of shin splint symptoms.
Lastly, in running smart, the speed of training should be carefully controlled. Start slow and progress slowly to the amount of running you desire. Give the leg muscles time to get strengthened before forcing them into harder regimen. The speed of progress will require understanding of how much running you have done and where you should start. Cross training (elliptical or bike) can also help even the muscle strength as you progress.
In all these aspects of running smart, it should be understood that shin splints are caused by overusing a muscle group and creating an injury. By adjusting the training to reduce this overuse, you will have a more enjoyable run.
3) Evaluation for possible "gait" abnormalities.
“Gait” abnormalities are best described as running or walking abnormalities. Do you have a leg length problem? Do you over pronate or over supinate? Do you have imbalance issues, back problems, knee problems, or other reasons to overwork a muscle group that may cause your shin spints?
Let me discuss some of these running issues:
Leg length abnormalities (left leg longer/shorter than right) can be a large problem when running. The APMA has found that running produces 4-5 times your body weight through your feet. If one leg is shorter, the body is designed to adjust…you will pronate the shorter foot to make it longer and supinate the longer foot to make it shorter. This will lead to overworking the muscles and cause leg pain and possibly shin splints. A simple adjustment to your shoes (or orthotics) will alleviate this problem and produce continued running without pain.
Imbalance issues, often caused by weakness of ligaments (like chronic ankle spraining) or ear problems. One of my patients is deaf in one ear and runs lopsided (towards the deaf side) and has issues with shin splints. With a simple orthotic, a custom item to replace a shoe insert in your running shoes that maintains your foot in neutral position and helps the foot function as it should, his shin splints have been eliminated.
Pronation or supination is also a form of imbalance of the feet and can cause overuse of some muscles and may also lead to shin splints. Orthotics are the answer here also.
By being evaluated for your running, your “gait” abnormalities can be evaluated and often adjusted to help you return to running without the pain.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
Subscribe to:
Posts (Atom)
