ARTICLES

“The Big Hurt: Why Running is Painful and What You Can Do About It.”

“The Big Hurt: Why Running is Painful and What You Can Do About It.”

This cautionary tale, dear reader, is shocking but true. I ask only that you gather your loved ones and hold them close as you read my anguished words. And after, as you dab at wet eyes, you will nod with agreement that it would be impossible for all but the most depraved mind to fabricate such a frightful event. This sad case involves one dearer to me than any other, a person of such character and standing that . . . ah, what is the use of this charade, for I am the hapless victim. For me to claim that this episode was an impulsive escapade springing from youthful folly would be nothing but a bald lie. Because, as you well know, I am firmly ensconced in mid-life, even though I regularly feign an adolescent energy by singing along with Lady Gaga and driving like Justin Bieber.

But enough of this; on to my story . . .

One glorious summer day a few years back, I was headed to Vancouver’s North Shore to run the trails and slopes around Grouse Mountain, Mecca for local trail runners. I avoided the mob of Lulufied awesomeness on the Grouse Grind and instead headed east along the Baden-Powell trail, eventually running up the rather cruel “Cut” ski slope to the top of the mountain. But once there, I saw that hordes of tourists and “Grinders” had created a long wait for the gondola ride to the bottom of the mountain. I decided to run down.

So down and down I went, retracing my path up. Arriving back at the parking lot my legs were tired and sore, but nothing I hadn’t experienced before. The next morning, however, I awoke to something quite peculiar: as I rolled out of bed and took to my feet, my legs, painful and tender, nearly buckled as they tried to support me. Alarmed by this feebleness I returned to my bed, where a thousand bleak scenarios ricocheted around my mind. I was gripped by the kind of dread one feels when they realize their body is under attack by those ghastly, multi-word afflictions that, seemingly overnight, ambush the hale and hearty. In my mind’s eye a dark future beckoned, and all that was visible down life’s narrow and ever-shortening corridor was a wasteland of respirators, 24-hour care, and specialists who shake their heads grimly as they speak in whispers to everyone but you.

But after several minutes my rational mind elbowed its way back and the hysteria abated. It was then that I recalled the previous day’s misadventure and realized, blessedly, that my present condition was not going to be one of those things. What this was, in comparison, was really quite prosaic: it was my introduction, rather my re-introduction, to the world of eccentric muscle contractions and delayed onset muscle soreness, a painful world that all athletes, runners in particular, inhabit. I’ve been a visitor to this place many times in the past, as no doubt have you, but it’s always jarring to return and have our bodies remind us, in their own way, that none of us are exempt from the sometimes harsh rules of physiology and bio-mechanics.

We certainly don’t need to run down a mountain, throw a javelin, or fast-pitch a softball to discover eccentric contractions. They occur routinely in everyone, athlete or not. But because of the demands that athletes place on their bodies, eccentric contractions can be more frequent and intense, and their after-effects far more debilitating. So what are eccentric muscle contractions and what can be done, if anything, to lessen their after-effects?

Acting on orders from the nervous system, the body uses three types of skeletal muscle contraction to achieve its goals: isometric, concentric, eccentric. The concentric contraction, where the muscle shortens or contracts, is how we typically think our muscles work all the time, but this is not the case. Have a look . . .

Isometric: muscle does not change length as it fires
Concentric: muscle shortens as it fires
Eccentric: muscle lengthens as it fires

To wrap your minds around this it might be helpful to think of muscles functioning much like the gas pedal and brakes on a car. The concentric contraction (muscle shortens) is like stepping on the gas pedal; it creates force to move or accelerate the musculoskeletal system. The eccentric contraction (muscle lengthens) does the opposite: it acts as a brake to slow and stabilize the body and store elastic energy. Remember, the essence of an eccentric contraction is that the muscle lengthens as it fires. And, as Shakespeare wrote, there’s the rub . . . or in our case, the pain.

The problem is that the biomechanical process at the heart of an eccentric contraction is quite violent. Enormous negative, or oppositional, forces are applied to the working muscles to slow (or brake) them, causing them to pull apart with every stride. There is substantial evidence that eccentric contractions cause damage to the muscle, which is why they increase the risk of muscle and tendon injuries and inflammation, and cause pain for the athlete who hasn’t specifically prepared for them.

The “day after” pain we feel is called delayed onset muscle soreness, or DOMS. The symptoms of DOMS can range from muscle tenderness to intense, debilitating pain that peaks 24 to 48 hours after the exercise and usually subsides within 96 hours. DOMS is common after a race or when runners initiate new, unfamiliar types of training, or even when re-introducing specific training that our muscles have “forgotten.” This could include faster interval or speed training, long runs, and yes, even downhill running. All can be painful if done for the first time or for the first time in a while.

To add insult to injury, the pain from DOMS is also accompanied by an acute loss of strength that can continue for several days after the exercise, even outlasting the soreness from DOMS. This loss of strength is substantially greater than that found in other types of muscle contractions and takes longer to recuperate from.

A side note: For those who hope to run the Boston Marathon someday, prepare well. Boston’s insidious nature reveals itself in the first 4 miles, during which the course loses about 310 feet of elevation; by 16 miles, the course loses another 120 feet, for a total to that point of 430 feet. “So what’s wrong with that?” you may ask. Well, maybe nothing, or possibly a great deal. Because of the strength-sapping nature of eccentric contractions, runners whose legs are not “calloused” for downhill running can feel substantially weakened by the time they reach the Newton hills, beginning at about 16 miles, and the notorious Heartbreak Hill at roughly 20 miles. Their legs, feeling wobbly due to the substantial downhill running in the first half of the course, not to mention the exhaustion of running that far, can often feel exceedingly fatigued in the race’s later stages, much more than on a flatter course.

But fear not, a solution is at hand. Researchers have shown that “muscle damage need not be an obligatory response following high-force eccentric contractions” (LaStayo et al). In other words, if we prepare the body for eccentric work, we can do a great deal to substantially diminish or eliminate their nasty side effects. Even better, “inoculation” to eccentric contractions occurs rapidly.

The irony is that the original cause of the damage and pain is what we use to inoculate against further pain and suffering. This is no different than getting a flu shot, where a watered-down version of the virus itself is used to build an immunity to the specific strain of flu. We introduce the “new,” more specific eccentric work, whether it’s faster interval training, downhill running, or long runs, and build immunity by applying the eccentric stimulus progressively and repeatedly. The protective adaptation occurs quickly, with the effects being felt within 24 to 48 hours of the initial exposure to the damaging eccentric bout (Lindstedt et al).

What’s important to remember is that it doesn’t matter how long you’ve been running or how much experience you have, if you’re new to a specific type of training, or you haven’t done that type of training in a while, progress slowly. If you’re training for a hilly trail race, don’t run down the side of a mountain the first time out.

Armed with this information, we can train with a better understanding of why running hurts, and what we need to do to reduce the effect eccentric contractions have on our body.


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“The Listening Foot”

“The Listening Foot”

The foot is the best piece of running equipment there is.
– Percy Cerutty

Ah, our lowly feet: shunned like lepers by some, abused by others, forgotten by the rest. If they’re not being squeezed into suffocating containers for hours each day, then they’re bound, writhing and naked, onto rigid slabs, the heels lifted provocatively, the toes crushed mercilessly, their contorted suffering visible to all. Our feet are the playthings of the fashion gods, and subjecting them to stylish tortures seems to be a price many pay all too willingly. If what we’re doing to our feet wasn’t so pernicious, it might be funny; can we blame them for being the source of so much discontent?

But what we wear on our feet is only part of the problem. For many of us, the feet are so removed from our everyday awareness they seem to exist only in the imagination, perhaps occupying a dusty corner of our consciousness as some barely-remembered, far-off land we once visited. Yet despite their physical and emotional remoteness, the feet are vital to both yoga and running, and we rely on them to guide and support us as they connect us energetically and mechanically to the ground. Our emotional and physical stability is dependent in large part on our ability to create connection through our legs, particularly through the feet.

That our culture acknowledges the significant role of the feet in creating a life of purpose is evident by the many commonly used foot-based metaphors: standing on our own two feet (independence); having both feet on the ground (stability, rootedness); knowing where you stand (confidence, decisiveness); getting off on the right foot (making a strong start, moving in the right direction); putting one foot in front of the other (moving forward with deliberation); putting your foot down (establishing boundaries). The list goes on, but these symbolic references all imply the necessity of using the feet to create a strong foundation for a meaningful and grounded life.

Even as our language shows the value, if mostly only symbolic, we place on our feet, history is full of examples that illustrate how ambivalent our relationship with the feet really is. They are the basis of the near mythological status attained by Ethiopian runner Abebe Bikila, who ran barefoot through the streets of Rome to win the 1960 Olympic marathon. Devout yogis prostrate before “the lotus feet of the guru,” believing those feet to be the repository of divine energy and a “terminal of magical and spiritual power and grace.” But for many centuries in Japan, women cultivated tightly bound, mutilated “lotus feet” in a belief that small feet were beautiful, even erotic. Some of us decorate and proudly display our feet; others see them as fonts of unsightly afflictions and a source of embarrassment, if not shame. In the Hindu social structure feet are symbolically “dirty”, and the servile or “Shudra” class is typically assigned to the lowest limb of the Cosmic Man to denote their low status. But just as the feet are vital to a fully functioning human being, so the Shudra class is important to the wellbeing of society. And so it goes . . . contradiction follows contradiction.

Given this bi-polar relationship, it shouldn’t be a surprise that runners obsess over nothing as much as their footwear. They believe that the right pair of shoes will save them from injury, protect them from the elements, elevate their status, shave minutes from their race times, and cushion them as they traverse rough terrain. But in yet another foot-related contradiction, a fringe group known as minimalists preaches that society’s accepted idea of footwear is absurd, that overbuilt and over-cushioned shoes are the source of misery and suffering for runners. Minimalists believe first and foremost in the architectural wonder and beauty of the foot, and in the foot’s ability, when used correctly, to absorb the punishment of running as it goes about its job of support and locomotion.

The foot/ankle complex is a focus of attention in this course because, as yoga teacher Tias Little tells us, “the foot is the foundation to the temple of the body.” But the feet are more than a foundation, they are the starting point of the body’s kinetic chain and the only point where the body interacts with the ground. Feedback from plantar sensors on the sole of the foot plays a central role in safe and effective locomotion, in stabilizing our pelvis, and in maintaining balance. The ankle is the first significant joint in the body, and as such it forms a crucial starting point for the “joint-by-joint approach”, a way of looking at the alternating mobility and stability needs of our body.  As we will see, dysfunction in the foot or ankle initiates a biomechanical wave that flows through the body, usually with negative consequences. And because kinetic forces in the body are magnified significantly when we run, the opportunity for dysfunction is magnified as well.

The Listening Foot

Conceived by physical therapist and movement specialist Joanne Elphinston, the “listening foot” concept asks us to look beyond our limited ideas of the foot’s purpose and capacities. As runners, we typically think of our feet in mechanical terms: do the feet pronate or supinate? But our pre-occupation with the foot’s mechanical workings can prevent us from seeing the bigger picture, that of the foot as sense organ with a significant sensory and motor representation in the brain (only the hands and face have more representation by the sensory and motor homunculus of the brain). Elphinston wants runners to understand and appreciate the subtle but powerful dynamics of the feet, and the importance of the information the feet draw from their connection to the ground. It’s only then that we begin to understand the vast capabilities of the feet, which far surpass the somewhat mundane mechanistic viewpoint held by most runners. Looked at this way, the foot transcends its role as support and locomotion and morphs into a highly sensitive piece of running equipment.

 

Find Relief For Your Chronically Tight Hamstrings

Find Relief For Your Chronically Tight Hamstrings

Ask runners about their hamstrings and you might hear sad stories about chronically tight and painful muscles. No matter how much stretching they do or how many hot yoga classes they attend, some never seem to get relief from the unrelenting tension that plagues their hamstrings and makes their running less than enjoyable. Does this sound familiar?

 

What’s important to understand is that many factors affect the tension of the hamstrings, and of these running may be the least influential. There are two likely culprits when it comes to the creation of tight and painful “hams”: the position of the pelvis and dormant or weak Gluteus Maximus (GM) muscles.

 

The Pelvis

 

First, a bit of anatomy: the hamstrings are three large, strong, bi-lateral muscles that begin or “originate” on each side and at the very bottom of the pelvis. From there they run down the back of the thighs, then via tendons cross over the back of the knee and attach high up to the bones of the lower leg. They play a crucial role in stabilizing our knees and, of course, in running, where one of their jobs is to assist with hip extension. (This just means they help bring the hip and leg behind us as we run.)

 

Because the hamstrings originate primarily on the pelvis (one half of one of the hamstrings, the biceps femoris, originates on the back of the femur), the position of the pelvis plays a key role in determining the amount of “pull” that is exerted on the hamstrings. From its ideal “neutral” orientation, the pelvis can be moved into many different positions, acted on by dozens of soft tissue attachments. If the pelvis is in “anterior rotation” (tipped forward) then the leverage will cause the hamstrings (attached to the bottom of the pelvis) to be pulled more taut. Presto, you’ve got tight hamstrings.

 

Is it really that simple? Well, yes and no. Now we have to figure out why the pelvis is tipped forward. The usual (but not only) reason is that the hip flexor muscles, especially those that originate on the anterior (front) of the pelvis, exert considerable influence on pelvic position. And because the hip flexors are usually very tight, they can create a strong forward pull. Voila, there’s your anterior tilt. So by stretching the hip flexors you’ll reduce the grip they have on the front of the pelvis, and this, everything else being equal, will help return the pelvis to a neutral position. Got it? Well . . . maybe.

 

Let’s figure out why the hip flexors are tight to begin with, and from there we can determine if we really need to stretch, or if some other remedy is called for. Your hip flexors may be tight simply because of the activities of daily living, in particular too much sitting. If this is the case then they will respond well to stretching. But what if your hip flexors are like your hamstrings, chronically tight and seemingly immune to the effects of a regular stretching program? Then there’s a possibility that your core or low back is unstable, and in their search for stability the back and core recruit, and overload, the hip flexors. As a result they become overworked and, predictably, very tight.

 


This nationally ranked U.S. marathoner displays a nasty anterior pelvic tilt

 

If you’ve been stretching the hip flexors doggedly without the slightest improvement, stop, and do side and forearm planks instead. Stretching will do you no good until the core/spine is stabilized. If you find that hip flexor stretches actually offer relief, then continue with them.

 

The Gluteus Maximus

 

A second possible cause of your hamstring woes is the Gluteus Maximus, or buttock, muscles. A wide assortment of muscles play important roles in running, but the GM is preeminent among them. Quite simply, the “glute max” is the mother of running muscles, and if it’s not working properly it is far more likely that some malfunction will occur.

 

More anatomy: the bilateral GM muscles sit prominently on the posterior (back) of the pelvis. The GM muscles are the main muscles or “prime movers” when it comes to hip extension in running. When I said earlier that one of the jobs of the hamstrings is to assist hip extension, what I meant specifically is that they’re assisting the GM.

 

The problems begin when the GM is either “dormant” or weak, and for many runners it is definitely in poor shape. If the GM is not functioning optimally, then the hamstrings (and the adductors as well: chronic groin strains anyone?) must take over the role vacated by the GM. This is a role the hamstrings were not designed for or intended to fulfill, and because of this added burden they become overworked and yes, you guessed it, very tight. This is precisely the same scenario we saw with the hip flexors, but now it’s the hamstrings that are being asked to pick up the slack for a deficit in strength or stability.

 

But why does the GM get weak or dormant to begin with? That’s a bit beyond the scope of this article, but briefly: the GM is a phasic muscle. This means, in part, that it can react to problems elsewhere by becoming weak and/or inhibited. Those problems can include reciprocal inhibition or injury to muscles or joints in the leg (the ankle in particular).

 

Poor GM development is something I see commonly in runners; more accurately I see flat bums and prominent hamstrings. If you’ll excuse my rude humor, this is ass backwards, a classic sign that the “hams” are doing too much of the work and the “glutes” too little or none at all. Effective remedies for lazy or weak glutes can include deep squats, supine bridges, lunges, and one-legged postures.

 

If you can restore the pelvis to its proper, “neutral” position and activate and strengthen your Gluteus Maximus muscles, then you’ll have taken huge steps toward restoring your body’s functional motor pattern and proper biomechanical alignment. You’ll feel relief in the hamstrings (and likely other areas as well), and your running will feel fun again.

 

Did this article excite you beyond belief? If yes, then consider attending my runner’s yoga certificate course happening in November over the Remembrance Day long-weekend. There’ll be three days (15 hours) worth of lectures full of fantastic information and runner’s yoga practice for attendees. No experience is necessary in either running or yoga.

 


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