There is no shortage of people who want to discourage you from running. “It’s bad for your knees!” they knowingly proclaim. Worryingly, some of these people are Medical and Health Professionals. Aren’t we supposed to be encouraging Australians to be more active? So what’s with this?
Is there evidence to link running and knee injury?
Well yes and no. If you take a group of runners and monitor them over the course of a year, some will get injured- and the most likely part of the body that will sustain the injury is the knees. There are a few studies that have looked at this, and the numbers vary from study to study but the consistent themes are; running comes with injury risk; and the knee is the most likely spot you’ll feel it.
But does this justify the blanket rule that running is bad for your knees? If so, we would also have to conclude the golf is bad for your back, swimming is bad for your shoulders and cycling is bad for your neck. Should we also avoid these forms of physical activity?
Why do some runner’s knees get injured?
There is no single answer to this, and the reality is that injuries that develop over time generally do so because of the convergence of a number of factors. Here is a case study that can illustrate this point:
Steve is 45 and works long hours as a Chartered Accountant. He spends extended stretches of time at his computer, occasionally getting up to make another coffee. He often skips lunch, but when he can sneak out he usually grabs whatever is quick and easy from the Bakery across the road. After work he drops in to his local for a quick beer or two with a couple of mates, before getting home in time for dinner with the family. When the kids are off to bed, the feet are up and he spends more time than he should watching Netflix. His sleep is short and poor in quality as a result.
Steve sees his Doctor who informs him his blood pressure, blood glucose and waist circumference are all trending towards the red-zone, and that he needs to start doing some exercise immediately to turn things around. Steve heeds the warning, so early Saturday morning he laces up his ten year old sneakers he usually wears to mow the lawn, chucks on a t-shirt and shorts and gets out to his local Park-Run 5km. Steve starts out confidently but after about 500m starts to puff and pant. By 2km his knees and lower back are getting sore but he is a determined bugger, so he drags himself across the next 3km with a slow, loping stride. ‘This will only get easier’ he tells himself, and to his credit he repeats this torture for the next 3 weeks.
By Sunday after week 4, his knees are swollen, sore and hot to the touch. He sees his Doctor again the following day and fills him in. “Well you shouldn’t have started running, don’t you know running is bad for your knees?! You should walk, or maybe ride a bike instead”.
Was running the problem here? Or what is that Steve, although well-intentioned, just plunged himself into a task he was completely under-prepared for and hurt himself as a consequence?
Steve’s current lifestyle needs a dramatic overhaul- his overall health could benefit greatly from making some improvements to his diet, reducing his sedentary time, reducing his alcohol frequency and making sleep a greater priority.
Steve could get some advice on footwear by someone who knows what they are talking about. He could also invest some time and money speaking to an expert on how to build his body and his running form so that when he does run he has the strength and the technique to do so more efficiently.
This sounds like an awful lot. But the reality is that running is hard on your body but that is why it can impact our health in such profound, positive way. Our body adapts and evolves to physical stress if it is dosed out appropriately. It is worth making the health changes to equip your body to not only meet the demands of running, but to thrive on them.
Running is not inherently bad for your knees. Running does put your overall health under the microscope, and penalises you for what you neglect. Rather than discouraging people from running, we as Health Professionals should be encouraging our clients to audit and refine how they take care of themselves.
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How hard should I work out?
There is a common misconception within the health industry that to see results, you need to go balls to the wall every single session.
That a sign of muscle soreness is the sign of a good workout.
That being on your haunches and vomiting all over the place is somehow a good thing.
Which (in my personal opinion) is a load of absolute rubbish.
Now, before you start screaming for my head, let me clarify.
I am not saying you should never train hard.
Honestly, that would be absurd.
In fact, having a few really intense training sessions every couple of weeks is a great way to promote extra progress, keep yourself motivated, and test yourself both physically and mentally.
These sessions are important, because they essentially provide some insight into your progress, while also driving adaption.
In short, you need to train with some serious intensity sometimes.
But you shouldn’t be getting smashed every single session.
Here’s the kicker. To see progress, you also need to allow yourself time to recover from your training.
As a general rule of thumb, the more intense your training sessions is, the longer you need to take to recover from that session.
You know that debilitating pain in your bum you get after completing a heavy lower body session? That’s a sign of muscle damage (good muscle damage, I should add). This is a surefire way to tell that you need to pull back and allow a couple of days for your legs to recover.
Now, if you ignore this pain and keep training those legs hard and heavy, you will eventually reach a point where recovery stops completely. As a result, you will cease to see any progress, and may even get injured.
This would be silly (read: stupid).
However, I’m not saying that during this period of recovery you don’t train at all. It just means that you either pull back a bit, or go hard on other areas of your body, which would obviously give your legs a bit of a break.
And the same can obviously be said for any other mode of exercise.
If you have a really solid run one day, then don’t repeat that same run the next day. Take a couple of days to train in the gym (preferably with more upper body dominant movements). Or maybe go for a light swim or bike ride.
Pretty simple really.
Just make sure that you allow the fatigue to dissipate and your body to adapt before putting it through another brutal session.
How Hard Should I Work Out?
With all this in mind, to see consistent progress there is a bit of a balance that needs to be managed closely.
You need to know when to push hard, and when to pull back.
As a result, if you are training on a regular basis, most of your training sessions will fall somewhere right in the middle of ‘barely working up a sweat’ and ‘near exhaustion’.
Which is actually a very good thing.
This middle ground is where you simply put in the work. You come into the gym, and develop your technical proficiency. You stress your body enough to elicit a response, but not so much that you need to take a few days off training completely.
In doing so, you guarantee consistent progress across your training journey, without falling apart or getting injured.
Which in my mind, is a pretty good way to go about it.
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Did you know that 99.9% of all new years resolutions fail within the first 9 days?
OK, so I made that up.
I don’t know the exact statistic, and I really couldn’t be bothered trawling through the ABS website trying to find it, but I don’t doubt that this number is too far from the truth.
An incredible number of people make new years resolutions come the turn of January, every single year.
They swear they will finally start eating better, finally lose those 10kgs, and finally get ready to run that marathon – and they start like a bull out of a gate.
Until it simply just peters out.
They run out of steam.
Their five runs a week quickly turn into three, and then one, and then they just stop completely.
All that healthy meal prep becomes too much of a hassle, and boy oh boy does that Zambrero’s look damn good right now.
But there is always next year, right?
Cant wait to fail all over again…
Why your resolutions fail?
So, why do most new years resolutions fail?
In my humble opinion, those people who fail simply bite off more than they can chew.
They essentially try and turn their entire life around the space of a few days.
Really, is it any wonder that it all falls apart?
Building healthy habits take a unique combination of time and willpower – both of which are, in my personal opinion, finite resources.
As soon as you exhaust your supply of either one, well, you can say adios to your resolution.
What can you do about it?
The key to making your new years resolution actually stick comes down to making simple lifestyle changes that are not only easy to implement (and therefore require minimal willpower), but also offer a whole lot of bang for your buck.
Target the low hanging fruit, if you will.
For example, if your goal does happen to be something weight loss related, then its probably not in your best interest to try and completely overhaul your entire diet.
Because, ultimately, you will fail.
A much better approach would be to focus on those areas where you constantly fall down, and then aim to correct them.
If you often snack on sweets after dinner, throw out your sweets (willpower is no longer an issue).
If you struggle eat enough protein, have a protein shake before dinner (easy and effective).
And if you find yourself without the time required to prepare your food during the week? Prepare your meals in advance (zero effort during the week).
Each of these with have a very large impact on your diet, and honestly do not require all that much effort or willpower.
From an exercise perspective, what if you find that you want to actually start an exercise program and work towards a training goal? Then make sure to start small.
Don’t try and go for a run every day, because again, you will fail.
Try commencing you new routine with one session per week. Adhere to this for a month, and then slowly add in a second.
Make it habitual, and make it easy.
One run per week for an entire year is going to have much more impact than getting in five runs in a single week once per year.
Makes sense, right?
Of course, if you are after any help (or even some simple ideas) drop us a comment and we will endeavor to get back to you as quickly as possible so that we can give you hand.
Stuff your resolution, and decide to make some real change.
About the Author
It would be rhetorical to say: that your body is special. And you would only want the best to be guiding you through your health and well-being safely. And yet, one can still be suggestible- picking up dodgy anecdotal tips from ‘that guy’ on the lat-pull-down machine.
I have personally experienced the exercise benefits, being safely loaded, and moving with confidence with one of my colleagues. Leaving my body and surrendering to an expert has given myself a deeper appreciation of the importance of finding an expert in human movement. I have always been on the other side to what I have been accustomed too- and as bias as it sounds: my colleagues here at iNform health really know how to manage and care for their clients.
Here are three reasons why you should be exercising with an expert.
1. Your tissues need time to adapt to load.
Your tissues, all the way down to the extracellular matrix- are for ever adapting to stressors and making proteins. Prescribing appropriate load- will ensure ones tissues will safely adapt; which will add a host of benefits to ones neuromuscular system. Reduced risk of tendonopathies, appropriate motor learning and myonuclei growth (muscle hypertrophy). On the contrary, excessive loading that exceeds the capacity of the neuromuscular system can induce the contra effects to the aforementioned. Tendon pathology, disorganised motor learning due to inappropriate load and systemic inflammation (abnormal prostaglandin levels) due to poor tissue healing.
2. Assessing the capacity of the neuromuscular system before undertaking load is paramount- and if neglected, your ‘health professional’ is going in blind.
If there is a muscle inhibition due to de-conditioned tissues, or a previous pathology that was poorly rehabilitated, would you feel safe to be loaded? Or if you were unable to co-contract your gluteus maximums, or have adequate lumbo-pelvic control? And yet, you may still be subjected to axial loading in your first session…! A thorough musculoskeletal assessment can identify any red flags and give your health professional valuable subjective/objective information to prescribe appropriate exercise correctives. This will then ensure more complex movements are performed safely.
3. Co-care is so important in addressing the whole individual.
Here at iNform, our clients are closely monitored by a wonderful internal/external team of allied health professionals; ranging from: GP’s, physio’s, osteo’s, chiros, pod’s and psychologist (without exhausting). All working and communicating together for the greater good of your physical and mental health. Co-care leads to better clinical outcomes, a proper working diagnosis, and the right form of treatments that benefit you the individual.
So, next time you are wanting to move with confidence. Be interrogative with your research. Find an evidence based approach that doesn’t involve a lecture from ‘that guy’ wearing a weight belt with a skimpy muscle singlet (stereotyping much?).
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The holiday season is fast approaching, organized sports are coming to a halt, work is winding up and many of us are embarking upon holidays. The Christmas break is a time where we are often given the opportunity to reconnect with friends and family while having a break from a regular schedule. While this opportunity to recharge may be necessary, it can also be to the detriment of any fitness progress and goals you have achieved throughout the passing year. Fitness loss is commonplace, not only during the Christmas holidays but during any extended period of reduced physical activity and we often refer to this effect as detraining.
Detraining and the Residual Training Effect:
Lets talk about detraining, you may have heard about it somewhere along the grapevine or maybe you have had first-hand experience with it, most likely the latter. The relationship between detraining and the residual training effect revolves around the idea that after cessation of training or an acute reduction in volume the body begins physiological processes which slowly untie any positive adaptations to training we may have made (detraining/deconditioning). It is these physiological characteristics that when grouped together make up what we call fitness components. These components include speed, maximal strength, aerobic endurance, strength endurance and anaerobic endurance. Now, while these may not all relate to you, there are most likely one or two which are inclusive in your fitness goals (no matter how basic or specific they are).
However, it may not be all doom and gloom. It is important to know that not all of these characteristics deteriorate at the same rate, some are much more resilient to detraining than others.
The table below gives an outline of how long the physiological adaptations are maintained during a period of detraining.
The Residual Training Effect
What effects the residual training effect?
- Duration of training before reduction or cessation
- Training age and physical experience
- Intensity used during the detraining period (moderate to high-intensity exercise reduces rate)
You may be asking “how does this relate to me?”
As shown in the table above we can see that speed is the most susceptible to change (2-8 days), whereas maximal strength and aerobic endurance are the most resilient (25-35 days). If your goals are to maintain speed and strength endurance it would be counterproductive to completely stop training, these components would best be maintained with a few short sprint and full body hypertrophy sessions during the break. Whereas if your goals are to maintain maximum strength and aerobic endurance; While it would not be ideal to completely stop training, the reduction in training volume would not have such a detrimental effect as the components mentioned previously.
So what should you take out of this?
- Try to integrate some moderate to high-intensity training into your break to slow down these detraining effects.
- Short sessions with a focus on the components that are most susceptible to change or relate closest to goals are recommended.
- Sports where repeated sprint ability (RSA) is critical to performance (AFL, Soccer, Basketball), should focus training on sport-specific needs for the athlete and include short sprint sessions. There is not a great need to prescribe or complete long aerobic/anaerobic endurance sessions during the break where time is often scarce.
- Reflect on your current and previous goals and how this concept relates to you if you are planning on taking a break.
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With Christmas around the corner, we are entering a period of overwhelming enjoyment.
Days off work, weekends that are filled with staff shows and family functions, and of course lunches and dinners with friends.
How good is it?
But, as always, there is a small negative associated.
Namely the fact that we have a tendency to go absolutely crazy across the entire Christmas period, throwing caution to the wind, and eating our weight in goodies.
Now don’t get me wrong – I am a firm believer that a bad meal isn’t going to derail your progress.
A single piece of fruit isn’t going to make you skinny, and a single donut isn’t going to make you fat. As we all know, it is the accumulation of good habits that keeps us healthy, while alternatively, its the accumulation of not so good habits that makes us unhealthy.
However, despite knowing this full well, we as humans seem to love a good blowout.
I’ll use myself as an example.
The Cadbury Effect
I am a sucker for chocolate.
I have a ridiculous sweet tooth, and to be completely honest, chocolate is my proverbial kryptonite.
Interestingly, my wife and I could have an unopened block of chocolate in the fridge for the better part of a year, and I wont touch the thing. However, if we were to open it, I can guarantee that it will be gone within the hour.
Now, I realize that this doesn’t really make sense, but the reason I do this is to get rid of it.
Somewhere in the depth of my subconscious, I think to myself: ‘stuff it, I’ve already blown it, I might as well eat the whole thing‘.
We know it doesn’t make sense, but we still do it every damn time.
Not just for chocolate either (which is still not great) – we as humans have a tendency to do it for absolutely everything.
Even things that last for days or weeks at a time…
The Christmas Blowout
When it comes to Christmas, things can go downhill pretty fast.
A bad afternoon can easily turn into a very bad weekend. And that weekend can very easily roll into an extremely bad week.
All of which comes down to that same mindset.
“Welp, Ive blown it – ill get back on track after new years…”
Extremely common, and extremely stupid.
All in all I completely understand where we are coming from, but that doesn’t make this mindset any less flawed.
We know that one single afternoon of eating and drinking isn’t going to derail a years worth of progress.
Hell, outside of a little bit of bloating and a potential stomach ache, the likelihood of this single night doing any lasting damage is pretty slim.
But two weeks of eating, drinking, and being merry?
That’s when the damage starts to accumulate.
Diet Damage Control
So in my mind, diet damage control over Christmas comes down to mindset.
Take a step back and realize that a single meal isn’t going to derail all of your hard work and progress.
Enjoy that meal as much as humanly possible. Be social, drink, and be happy.
But don’t let it become a two week binge.
Keep physically active (as normal) over the Christmas period.
Eat as you normally would outside of those key social situations.
And enjoy the time off!
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