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Dehydration doesn't discriminate. It can happen to elite athletes, weekend warriors, and the general inactive population alike. Symptoms can be mild to severe, and in some cases fatal.
Most people associate dehydration with being thirsty. While this is one sign that your body may be starting to 'dry out' like a grape in the sun, there are other things to be aware of that may help you stave off dehydration.
What's more, dehydration can be classified as either acute or chronic. In this article, we will discuss the differences between the two, what to look out for, how to prevent dehydration, and how to treat it if it happens to you.
Jump Ahead:
How to Prevent Acute and Chronic Dehydration
The Best Ways to Stay Hydrated
What factors contribute to dehydration?
How to Determine Your Fluid Requirements
What are Hyperhydration and Hyponatremia?
Supplements that Keep You Hydrated
According to the American College of Sports Medicine (ACSM), dehydration simply refers to the loss of body water. However, it is a lot more complicated than that. We need to narrow our focus on exercise-induced dehydration. We're athletes after all.
Exercise-induced dehydration refers to:
When athletes lose two percent or more bodyweight via sweating, bad things can happen. These include:
Did that last bullet point catch your attention? I hope so because dehydration is a high stakes poker game with some serious consequences if you roll the dice wrong.
Now it's time to get down to brass tacks and discuss the different types of dehydration. Acute and chronic
Acute dehydration, as the name implies, happens in the short term and occurs when you lose more fluid than you take in. It can be summed up like this:
Fluid out > Fluid in
Acute dehydration affects the way the body functions and can inhibit athletic performance. The good news is acute dehydration is easy to spot and highly preventable
The tests for acute hydration are simple and straightforward and do not require any invasive techniques. These are:
Treating acute dehydration is fairly simple.
Generally speaking, acute dehydration can be resolved in 30-60 minutes once fluid is consumed in adequate amounts and absorbed by the body.
Unlike short-term, acute dehydration, chronic dehydration occurs when dehydration recurs over longer periods of time. For example, not drinking enough water on a daily basis (over the course of a month) to replace fluids lost through bodily functions, activities of daily living, and exercise.
If left untreated, chronic dehydration can have disastrous consequences and will require immediate medical attention.
The causes of chronic dehydration are similar to those of acute dehydration. Also included are:
There are two ways to test for chronic dehydration:
Unfortunately, just "drinking enough water" is not a cure for chronic dehydration. More than likely you will need to drink electrolyte beverages to restore fluid balance and help your body hold on to more of the fluids you are drinking.
Additionally, you may be put on a drinking schedule where fluid is measured out and consumed throughout the days at certain points.
In the most extreme cases, an IV may be needed to directly deliver fluid into your bloodstream.
Last but not least you may need to cut back on habits that caused the extreme fluid loss. This includes decreasing alcohol and caffeine consumption and cutting back on any diuretic medications you may be on.
The time it takes to recover really depends on why it happened in the first place and how long you have been chronically dehydrated. Simply put, there is not an exact number of days and will depend on an individual's circumstances.
Your doctor may perform the tests listed above over the course of 60 days to determine when you are back in a euhydrated (normal body water content) state.
The following guidelines suggested by the International Society Of Sports Nutrition should leave athletes in a hydrated state throughout the day and during exercise.
There are a lot of opinions on the best way to hydrate during exercise to prevent dehydration.
However, the two most common and research-backed methods of staying hydrated are drinking on a schedule and drinking to thirst.
We'll briefly cover them here. For a more detailed explanation on each go here (drinking on a schedule) and here (drinking to thirst).
Drinking on a schedule is exactly what it sounds like. An athlete consumes fluid at specific points during racing or training.
For example, taking sips of sports drink every 10-15 minutes that usually equates to 16-32 ounces of fluid per hour.
While this method is tried and true, some athletes experience GI distress from drinking too much and other times it is not practical to drink on a schedule (i.e. during a mountain bike race on rocky singletrack.
Again, this is exactly what it sounds like. It can be summed up by:
Drink when you are thirsty and don't when you are not.
The research has demonstrated that this method is just as effective as drinking on a schedule when it comes to preventing dehydration or the 2% body weight loss from sweating.
The short answer to this is no. Besides, it is very difficult to replace every drop of fluid you lose through sweat during exercise. And that's OK!
Even if you drink on a schedule or drink to thirst, more than likely you will still lose body weight through sweat. This shouldn't have a negative impact on performance if you are following the hydration strategies outlined above.
There are a lot of variables that can determine how quickly an athlete can become dehydrated. These are discussed below.
Use the following formula to get an idea of your hourly sweat rate:
16 x [(your starting weight in-lbs) – (weight in-lbs after 1-hour of exercise)] + [fluids consumed during exercise in oz] = sweat loss in oz/hour.
Say for example I weigh 161 pounds before exercise and 160 pounds when I finish my workout. The calculation would look like this:
16 x [(161 lbs) – (160)] + [8] = sweat loss in ounces per hour.
16 x 1 = 16
16 + 8 = sweat loss of 24 ounces per hour
Therefore, I would try to drink 24 ounces of fluid an hour to offset the fluid I am losing through sweat.
What a morbid question. The norm is 10 days after absolutely no fluid is consumed.
More of something isn't always better and this can be the case when an athlete drinks WAY TOO MUCH fluid before and during exercise. Especially if it is water, as this can cause hyponatremia.
Hyponatremia happens when an individual drinks too much water which throws the body's electrolyte balance out of whack. Mild hyponatremia can lead to headaches, nausea, confusion, and fatigue while severe hyponatremia can cause comas, seizures, and death.
To avoid hyponatremia athletes should NEVER over hydrate while also consuming salty (i.e. electrolytes) foods and beverages during exercise.
So far we have discussed several conventional methods to prevent dehydration. While proper hydration and nutrition will always be your best bet to battle dehydration, there are a few supplements that may also help.
Most people think electrolytes prevent cramping. While this may be the case in rare circumstances, electrolytes play a bigger role when it comes to dehydration because they can:
Creatine isn't just for the gym bros to get big and strong. It can help with hydration! When creatine is taken it promotes water uptake in the muscles. Properly hydrated muscles = happy muscles that perform well! 2-3 grams daily is the dose here.
Betaine helps with water retention in the cell (osmolyte) and thus protects the cell from hydration. 2.5 up to 6 grams daily.
Glycerol acts like creatine in that it helps the cells to uptake more water. 1.2 grams per kilogram body weight and 26 milliliters per kilogram bodyweight of fluid, 60 minutes prior to exercise.
Both acute and chronic dehydration can derail your athletic performance AND have a negative impact on your health.
By following the advice given above, an athlete will remain in a euhydrated (adequately hydrated) state throughout the day and before, during, and after exercise.
About The Author Matt Mosman - Spearfish, South Dakota
Matt Mosman (MS, CISSN, CSCS) is a research scientist, endurance athlete, and the founder and Chief Endurance Officer at EndurElite. Matt holds his B.S. in Exercise Science from Creighton University and his M.S. in Exercise Physiology from the University of California. Matt and his family reside in Spearfish South Dakota where they enjoy running, mountain biking, camping, and all the outdoor adventures Spearfish has to offer.
EndurElite products can do amazing things for cyclists. It's the real deal.
But here's the skinny: the stuff isn't magic, and it can't fix everything—especially when it comes to knee pain.
Knee pain is a huge issue for cyclists, with 23% of elite cyclists reporting knee pain in the last year. And anything that keeps nearly a quarter of cyclists off their bikes is a problem worth fixing from our perspective. Luckily, under normal circumstances, it's totally preventable.
While it is true that riding a bike is objectively good for you, and is easier on your body than a sport like football or hockey, that doesn't mean cyclists don't deal with overuse injuries.
One of the best ways to prevent injury is to recognize discomfort early on, before it becomes a debilitating or chronic issue.
If you're experiencing knee pain, try a little self diagnosis using these bike fit rules of thumb.
Anterior knee pain is common, and occurs around your patella or just below the front of your knee. Anterior knee pain usually occurs when your saddle is too low or too far forward.
This forces your quads and/or the fibrous tissue that runs alongside the outer leg (commonly called the IT band), to pull on the patella in an odd way, which can lead to painful tendonitis.
Ideally, you should have a very light bend at your knee during the lowest point of a pedal stroke. Anterior knee pain is also associated with mashing big gears, making single speeders particularly susceptible.
If your saddle height is set correctly and you're still experiencing anterior knee pain, try riding in a smaller gear with a higher cadence for a month.
Pain behind the knee is almost always associated with overextension.
If you have to dip your toes or rock your hips to complete a pedal stroke, you're likely over extending your knees, as well. Try lowering your seat.
By the way, if you're rocking your hips back and forth, you might experience some lower back pain, too.
Lateral and medial pain occur when stress is placed on the ligaments on either side of your knee. Both lateral and medial pain generally occur from misaligned cleats.
If a cleat wasn't placed in the right position from the start, or if it shifted over time, it can put extra stress on the inside of your knee (specifically, on the collateral ligament).
If you recently purchased new shoes or pedals, cleat placement is likely the cause of your pain.
Cleats can also move with time. Check to make sure your cleats haven't "walked" to the inside or outside of your shoes or twisted at an odd angle (the angle of your cleats is called "float").
Ideally, your cleats should help keep your knees pedaling on a vertical plane, with very little or no lateral movement.
All pro riders get bike fits. Lots of amateurs don't bother. They assume that the bike fits them just fine or that they don't ride enough to notice.
Then, when they start challenging themselves with harder, longer rides, they end up in a lot of pain. Sometimes they even suffer completely avoidable injuries.
The deal is, bike fits are for everybody. Pros, enthusiasts, weekend warriors, and fresh faces all deserve a comfortable ride. And most fits are affordable (especially when you consider the cost of an injury).
Do your knees a favor and ask your local shop, sports medicine doc, or physical therapist about a professional fit.
Ride without pain!]]>
If an awesome workout and a great time for you involves a combination of Olympic lifting, an assault bike, and more burpees than you knew you had in you, then chances are you are one of the millions of individuals who participate in CrossFit.
"CrossFit is unique in endurance sports because CrossFit requires an individual not only have excellent stamina and speed but also strength, power, and focus"
Unlike running where the athlete can zone out as long as they keep their legs churning, lacking any single physical attribute can mean the difference between the fittest on the planet and getting a DNF.
Although proper training and nutrition have the most pronounced role in predicting performance, using the correct supplements at proper doses will give you an advantage over those not supplementing.
This article will take an unbiased, in-depth look at three supplements and discuss how they can help you in the next CrossFit games. At least that's what the science says!
What does beetroot do for CrossFitters:
Maintains High-Level Power Output
Reduces Fatigue
Decreases the Energy & Oxygen Cost of Exercise
Increases Blood Flow
Improves Efficiency
Effective Dose: 500mg of nitrates (~1600mg of beetroot powder) 30-120 minutes before exercise
How will taking beetroot powder help you during your next WOD?
The nitrates found in beetroot powder enhance metabolic efficiency at the cellular level. ATP is the cellular energy currency.
After taking beetroot, the ATP cost of every muscle contraction is reduced.
Saving ATP is an incredible advantage for CrossFit athletes doing multiple reps of exercises and running between sets, as such activities do not permit time to fully recover before you need to put the hammer down again!
This has been verified to increase VO2Max and exercise efficiency.
When translated to tangible performance.
Beetroot supplementation improves time to exhaustion by 20%!
If you're a research-savvy individual, you know that time to exhaustion is not the same test posed by the CrossFit games. The demands of AMRAP are not the same as ASAP.
The best part is, these results improve with time!
Daily supplementation with beetroot for at least one week produces greater improvements in performance!
Beetroot pairs extremely well with caffeine (which we'll talk about next!), and supplements that increase ATP production, like ElevATP. Combining the increased efficiency of beetroot with the increased capacity for energy production of ElevATP is a match made in heaven.
How does caffeine help CrossFitters:
Improves Pain Tolerance
Delays Fatigue
Enhances Focus
Positively Affects Aerobic and Anaerobic Endurance
Mobilizes Fatty Acids
Effective Dose: 3-9mg per kg body weight 30-60 minutes before exercise
There are hundreds of published research studies demonstrating that pre workout caffeine enhances endurance exercise performance by 5-15%.
If that's not enough, caffeine also improves reaction time, pain tolerance, and attention, each of which comes in pretty handy during long workouts and competitions.
How does caffeine work, you ask?
A review of the literature on caffeine and more in-depth discussion on the genetics of caffeine can be found on our caffeine encyclopedia page.
Another brief statement on digestion kinetics. For about 40-50% of people, caffeine has a half-life of about 5-7 hours.
In slow metabolizers, this is more like 9-12 hours, and in really fast metabolizers (~40%) it could be as short as 3 hours.
This depends on the type of caffeine. Natural caffeine, such as in coffee or tea, peaks in the blood about 30-60 minutes after consumption and quickly returns to baseline.
Caffeine anhydrous (supplemental caffeine) that is found in pre-workout, soda, and energy drinks peaks after 1-2 hours and more slowly returns to baseline.
That's why we drink several cups of coffee per day, but one scoop of pre-workout or one energy drink usually keeps us happier. Novel caffeine sources, like infinergy or PurEnergy, extend the half-life of caffeine by ~2-3 hours.
How Beta-Alanine improves CrossFit performance:
Buffers Lactic Acid
Enhances Endurance
Prolongs Time Until Exhaustion
Sustains Power Output
Increases Strength
Effective Dose: 3.2 grams per day
I, for one, like the tingles. This is a harmless side effect known as paresthesia.
The effect is due to the sensitivity of a certain class of neurons only found in the skin. It is NOT because of any sort of allergic response, irritation, or inflammation.
The gene coding for these specialized neurons is called MAS-related G-Protein Receptor Family Member D, or MrgprD. Say it with me… Murghhh Purrrd. For those with highly expressed MrgprD genes, you may just want to enjoy the tingles for the performance-enhancing effects of beta-alanine.
Lactic acid is generated when we're exercising at high intensities. During less intense exercise, lactic acid is either not generated because glucose can be completely metabolized while we do not need extreme amounts of energy or the little bit of lactic acid that is generated can be managed in the lactic acid cycle.
During CrossFit, we're exercising at high intensities frequently, so we are very familiar with lactic acid.
"Training is one way to increase the ability to clear acidity, but the next most effective way to reduce acidosis is to increase intracellular carnosine by beta-alanine supplementation."
You may be surprised to hear, carnosine supplementation is useless. This is because carnosine is broken down by the liver before it can get to the muscles.
Beta-alanine is the rate-limiting precursor to beta-alanine, and beta-alanine supplementation increases carnosine concentrations more than carnosine supplementation.
After carnosine accumulates, it binds free hydrogen ions to maintain pH and reduce the onset of that burning feeling.
Some think that lactate is a necessary fuel for the heart, and while it is true that the heart can use lactate, it is not needed. It's also very important to note that beta-alanine doesn't reduce lactate generation, but increases the point at which exercise intensity causes a great accumulation of lactate.
In other words, lactate is still formed, but we are more capable of dealing with it.
"Supplementation with at least 3.2 grams of beta-alanine per day greatly enhances high-intensity performance and repeated bouts of high-intensity performance lasting up to 240 seconds."
This translates into a few more reps before requiring rest and greater power generation on ergometers.
Beta-alanine does not need to be cycled, and it works best when used over prolonged periods of time.
Supplementing beta-alanine daily makes sure that intracellular carnosine concentrations remain elevated.
Again, I have to stress that supplementation is #4 on the list of things you can do to help your performance.
The first three are:
For each of those, get enough, but not too much. The same rule applies to supplements. Each of the three on the list is conveniently found and appropriately dosed in PerformElite - The Endurance Athletes's Pre Workout alongside 7 other great ingredients like Taurine, PeakO2, Choline, ActiGin, Huperzine, ElevATP, and PurEnergy.
PerformElite was specially engineered to improve performance, particularly endurance and strength endurance without any frivolous BS. Give it a try to find out for yourself!
Anderson, D.E. (2013). Caffeine. In A.E. Smith-Ryan & J.A. Antonio (Eds.), Sports nutrition & performance enhancing supplements (pp. 201-223). Ronkonkoma, NY: Linus Learning.
Goldstein, E. R., Ziegenfuss, T., Kalman, D., Kreider, R., Campbell, B., Wilborn, C., . . . Antonio, J. (2010). International society of sports nutrition position stand: caffeine and performance. J Int Soc Sports Nutr, 7(1), 5. doi: 10.1186/1550-2783-7-5
Graham, T. E. (2001). Caffeine and exercise: metabolism, endurance and performance. Sports Med, 31(11), 785-807.
Hord, N. G., Tang, Y., & Bryan, N. S. (2009). Food sources of nitrates and nitrites: the physiologic context for potential health benefits. The American journal of clinical nutrition, 90(1), 1-10.
Hobson, R. M., Saunders, B., Ball, G., Harris, R. C., & Sale, C. (2012). Effects of β-alanine supplementation on exercise performance: a meta-analysis. Amino acids, 43(1), 25-37.
Coles, L. T., & Clifton, P. M. (2012). Effect of beetroot juice on lowering blood pressure in free-living, disease-free adults: a randomized, placebo-controlled trial. Nutrition journal, 11(1), 106.
Lansley, K. E., Winyard, P. G., Fulford, J., Vanhatalo, A., Bailey, S. J., Blackwell, J. R., ... & Jones, A. M. (2011). Dietary nitrate supplementation reduces the O 2 cost of walking and running: a placebo-controlled study. Journal of applied physiology, 110(3), 591-600.
Bailey, S. J., Fulford, J., Vanhatalo, A., Winyard, P. G., Blackwell, J. R., DiMenna, F. J., ... & Jones, A. M. (2010). Dietary nitrate supplementation enhances muscle contractile efficiency during knee-extensor exercise in humans. Journal of applied physiology, 109(1), 135-148.
Lansley, K. E., Winyard, P. G., Bailey, S. J., Vanhatalo, A., Wilkerson, D. P., Blackwell, J. R., ... & Jones, A. M. (2011). Acute dietary nitrate supplementation improves cycling time trial performance. Medicine & Science in Sports & Exercise, 43(6), 1125-1131.
Wilkerson, D. P., Hayward, G. M., Bailey, S. J., Vanhatalo, A., Blackwell, J. R., & Jones, A. M. (2012). Influence of acute dietary nitrate supplementation on 50 mile time trial performance in well-trained cyclists. European journal of applied physiology, 112(12), 4127-4134.
Liu, Q., Sikand, P., Ma, C., Tang, Z., Han, L., Li, Z., ... & Dong, X. (2012). Mechanisms of itch evoked by β-alanine. Journal of Neuroscience, 32(42), 14532-14537.
Trexler, E. T., Smith-Ryan, A. E., Stout, J. R., Hoffman, J. R., Wilborn, C. D., Sale, C., ... & Campbell, B. (2015). International society of sports nutrition position stand: Beta-Alanine. Journal of the International Society of Sports Nutrition, 12(1), 30.
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This article will discuss what lactate threshold is, how to test it, how to improve it, and sample workouts.
In endurance events, the best competitor among athletes with similar VO2 Max values is typically the individual who can sustain aerobic energy production at the highest percentage of his or her VO2 Max without accumulating large amounts of lactic acid in the muscle and blood.
Although numerous terms have been used to describe this phenomenon, lactate threshold is the one most commonly used.
Lactate threshold is the speed of movement or percentage of VO2 Max at which a specific blood lactate concentration is observed or the point at which blood lactate concentration begins to increase above resting levels.
Several studies have shown that an athlete's lactate threshold appears to be a better indicator of his or her aerobic endurance performance that VO2 Max.
In most endurance athletes lactate threshold occurs at 78-85% of maximum heart rate, with values of 88-90% maximum heart rate seen in elite endurance athletes.
What is clear from the information above is that endurance athletes must improve their lactate threshold if they want to become faster, more competitive, or develop a greater aerobic capacity.
This requires the endurance athlete to conduct some training at elevated levels of blood and muscle lactate to maximize training improvements.
Although much of the research examining the role of lactate threshold in predicting endurance performance has centered around distance running, the same principles apply to predicting performance in endurance cycling, swimming, and cross-country skiing.
The only accurate way of getting your lactate threshold reading is to go to a lab and be tested. If you don't have access to a lab a less accurate field test can be conducted
This test protocol to determine lactate threshold:
The time-trial method of determining lactate threshold pace and heart rate can be done on a treadmill set at a 1 percent grade, on a running track, or on any other flat, smooth surface that's conducive to fast running.
It also requires some means of measuring the time elapsed and distance covered as well as heart rate. Be sure to conduct this test on a day when you are not fatigued from recent hard training.
A 2005 study by scientists at East Carolina University found that this method of determining LT heart rate and pace is very accurate. Its downside is that it's hard—equivalent to running a half-hour race.
Now that we know what lactate threshold is and how to test it; what is the best way to improve it?
The short answer is through pace/tempo training one to two times a week.
Pace/tempo training uses an intensity at or slightly higher than race competition intensity.
This intensity corresponds to the lactate threshold; therefore, this type of training is often called threshold training. There are two ways to conduct pace/tempo training: steady and intermittent.
Steady pace/tempo training is continuous training conducted at an intensity equal to lactate threshold for durations of ~20-30 minutes.
Intermittent Tempo Training
Intermittent pace/tempo training is done at the same intensity as a steady-state workout, but the training session consists of a series of shorter intervals with brief recovery periods between work intervals.
The primary objective of pace/tempo training is to increase lactate threshold while also developing a sense of race pace and enhance the body's ability to sustain endurance exercise at that pace.
Nothing Fancy here but here are some options that will get the job done:
Whether you are a beginner, novice, or pro; every endurance athlete has one thing in common. They all want to improve performance.
Performance for some may entail making their daily runs or rides feel easier while for others it may mean setting new PRs.
We all know that doing endurance exercise at an easy pace more frequently or for longer will lead to huge improvements in a relatively short amount of time, but at some point, a plateau will occur.
When this happens, going into the pain cave one to three times a week will be necessary to improve endurance performance further.
This is especially true as it relates to further improving VO2 Max; arguably one of the most important physiological variables that best predicts success for endurance athletes.
This article will discuss what VO2 Max is, how to test it, how to improve it, and sample workouts.
Almost every endurance athlete has heard the term VO2 Max, but very few know what it means beyond knowing that the higher you get it, the faster you will become.
By strict definition, VO2 Max (maximal oxygen uptake) is the greatest amount of oxygen that can be used at the cellular level for the entire body.
It has been found to correlate well with the degree of physical conditioning and is recognized as the most widely accepted measure of endurance fitness. The capacity to use oxygen is related primarily to the ability of the heart and circulatory system to transport oxygen and the ability of body tissues to use it.
Say what? In more basic terms VO2 Max is how efficiently oxygen you breath in gets to your working muscles to use it
VO2 Max values in normal, healthy individuals range from 25 to 80 ml/kg/min and depend on a variety of physiological parameters, including age and conditioning levels.
Values in elite endurance athletes can go even higher.
The highest VO2 max ever recorded is that of Bjorn Daehlie, a cross-country skier from Norway who won eight gold and four silver medals in three Olympic Games from 1992 to 1998.
His VO2 max when he was competing has been reported to be an astounding 93 to 95 ml/kg/min.
The chart below illustrates the VO2 norms and rank for men and women based on age. Please remember though these values can be significantly higher in trained endurance athletes.
There are many ways to test or predict your VO2 Max. One requires going to the lab; the other has you doing specific workouts, while the last method predicts it off a current race time.
The absolute best way to get an accurate VO2 Max is to find a lab who tests it and hooks you up to this contraption:
That, my endurance friends, is called a metabolic cart. It can be used while running on a treadmill or while using a stationary trainer.
VO2 max is calculated from measures of ventilation and the oxygen and carbon dioxide in the expired air, and the maximal level is determined at or near test completion.
There are various protocols used to measure VO2 Max when using a metabolic cart but most go like this.
Expect to spend anywhere from $100 - $250 to have a VO2 Max test conducted in the lab. If there's a University where you live check to see if they have an exercise science department. Chances are they are looking for guinea pigs to do some testing on at no cost to you.
What if you don't have access to a lab?
Remember these next methods of testing will only provide predictions of VO2 Max. More than likely they will not be as accurate as a lab test, but they should give you a fairly good idea of where you stand.
How to Perform the Test:
VO2 Max = (35.97 * distance you covered in 12-minutes in miles) – 11.29
For example, if I covered 2 miles in 12 minutes the equation would look like this:
VO2 Max = (35.97 x 2) – 11.29
VO2 Max = 71.94 – 11.29
VO2 max = 60.65 ml/kg/min
How to Perform The Test:
This way of predicting VO2 is based on the chart below and only applies to runners.
It was developed by the running coach Jack Daniels and taken from his book Daniel's Running Formula, which I highly recommend. In this chart VDOT and VO2 Max are one in the same:
Now that we know what VO2 Max is and how to test it; what is the best way to improve it?
The short answer is through interval training one to two times a week.
Interval training involves endurance exercise at an intensity close to VO2 Max or ~90-100% of maximum heart rate (220 – age will give you an estimate of your maximum heart rate) depending on the length of the interval.
Interval training permits the endurance athlete to train at intensities close to VO2 Max for a greater amount of time than would be possible in a single exercise session at a continuous high intensity.
Interval training should not be performed until a firm base of aerobic endurance training has been attained.
Interval training is very stressful on the endurance athlete and should be used sparingly (1-2 times a week).
The benefits derived from interval training include:
Below are sample workouts to improve VO2 Max. One for those who run and the other for individuals who cycle.
It is best to use a heart rate monitor for these workouts but if one is not available make sure the effort level is an 8-9 on a scale of 10.
Improving VO2 Max should be a top priority of every endurance athlete from beginner to pro and is one of the best predictors of success.
An increased VO2 can:
First and foremost, you should test your VO2 max to establish a baseline and retest every 4-6 weeks to measure improvements.
Intervals should be performed 1-2 times a week after sufficient base training and should last anywhere from 3-5 minutes at 90-100% maximum heart rate and use a 1:1 work to rest ratio.
While VO2 Max is very important as it relates to endurance training, there is one other thing endurance athletes should focus on improving for maximal performance. Part 2 of this article will discuss this.
Plantar-fasciitis. A term that strikes fear into athletes everywhere. It's a painful injury that can sideline an individual for 6 weeks or longer and make activities of daily living difficult.
In this article, we will discuss what plantar fasciitis is, what causes it, symptoms, and treatment.
There is that term again, "itis". It shows up in almost every diagnosis involving something wrong with the human body.
"Itis" denotes to inflammation and is often associated with a disease. As discussed previously, many musculoskeletal issues have been labeled with the term "itis".
In recent years, research and the advanced understanding of human performance have revealed that the pathology of these conditions is more involved than just an inflammatory process.
So why the name involving "itis?
Well, it seems that initially tissue structures become inflamed under increased stress and demands but by the time the symptoms become present, the condition has progressed underway to the true dysfunction.
Plantar fasciitis is the term utilized more commonly now to reflect the degeneration nature of the condition.
Fascia is basically a connective tissue that runs throughout the entire human body.
It is everywhere. It looks like a cobweb and is extremely thin in certain places. If you are a meat-eater, you will notice a thin white material that lies between the layers of meat. That is fascia.
Fascia acts to hold everything together so basically your muscles and organs don't bounce around and move excessively.
Think of it as a more pliable and compliant form of saran wrap. In places like the bottom of your foot, it is very thick, mostly for protective purposes from environmental elements.
Also, this region of the human body experiences a lot of daily stress considering the forces acted upon it during weight-bearing activities such as walking, standing and running.
The plantar fascia doesn't actually contract in the same way, for example, your bicep does.
It tends to act almost like a sponge or mattress as it contracts to absorb impact forces and then releases while maintaining the appropriate tension to then distribute force.
Problems occur in the plantar fascia when the tissue is not moving the way it should be.
Some signs that you may have plantar fasciitis are:
If a therapist presses their finger hard enough into the affected spot, pain can be reproduced but this is a very forceful and localized pressure that is being administered.
The pain in the heel actually results from the pull of the plantar fascia on its origin site at the calcaneus. This is usually the pain that a person reports.
If you notice in the above X-ray image, the heel spur almost appears to hook-like.
This results in the direction of the calcification moving towards the direction of the force, which is towards the toes.
The plantar fascia originates at the heel and inserts into the toes so when it contracts the pressure results in increased stress onto the bone. It actually pulls at the heel and results in what appears in the image.
Plantar fasciitis occurs when the tissue is not contracting properly due to dysfunction in the tissue integrity.
Just like the other conditions discussed in previous articles, the integrity of the tissue is abnormal, resulting in microscopic degeneration and subsequent thickening.
This can result from the overloading of the tissue commonly occurring from running or excessive volume training.
Just like Achilles tendinopathy, the plantar fascia is susceptible to injury from:
This image is demonstrating the aggravation of the plantar fascia with the presence of a heel spur.
Achilles involvement is also noted with a Haglund's deformity, which is a localized lesion of dysfunctional tissue in the Achilles tendon. It is not uncommon for both conditions to be hand in hand.
Plantar fascia issues can also result from lifestyle changes such as a person taking up a more sedentary lifestyle involving more time at the desk or behind the wheel for work.
The increased sitting time can result in tightening overtime of the tissue from limited neuromuscular input and use.
Even if the person engages in exercise throughout the week, the sedentary time outweighing the active time can cause issues.
Studies have revealed that individuals with deficits in foot plantar flexor muscle performance contribute to plantar fascia issues. Deficits in plantar flexor and toe flexor muscle groups can contribute towards longer recovery times with longer courses of therapy.
MRI images have also shown that individuals with plantar fascia involvement have smaller volumes in these muscle groups.
Interestingly, studies have noted that a single-leg heel raise will demonstrate insufficient results as it may result in limited execution of the movement due to pain and Achilles strain from the position of a flexed foot and toes.
Basically testing the strength of the plantar flexors in a heel rise position won't conclude true findings in the patient's actual strength.
Other positions will have to be used when evaluating deficits involving plantar fascia issues.
It has also been found that women are 50% more likely to experience plantar fascia due to having increased arch laxity compared to men.
Women tend to be more reliant on both intrinsic and dynamic stabilizers of the foot including the plantar fascia.
Pregnancy has also been found to alter the structure and function of the foot, contributing to an increase in joint laxity, foot length and decreased arch height.
Treatment for plantar fasciitis consists of:
Orthoses can provide longer-term relief but many studies have been investigating the use and reliance on orthoses for extended periods of time and its effects on muscle function.
It has not been completely concluded but some studies have found that increased time in orthoses can be a contributing factor towards deficient muscle function in ankle and foot stabilizers.
Further investigation is needed into the type of foot orthoses and supports used and their exact relationship towards limiting muscle function.
The most promising treatment and prevention techniques for plantar fascia issues are neuromuscular training techniques of the ankle and foot stabilizers.
Physical therapy can be beneficial in teaching individuals how to activate and properly utilize the muscles in their foot and ankle while translating it over into functional activity.
Although considered passive methods, stretching and soft tissue mobilization is an important part of the rehabilitation process as well.
Combined with manual interventions by a therapist, restoring the normal tissue properties is important to ensure proper function during movement retraining.
Many foot specialists recommend using the towel stretch, as it tends to target the plantar fascia the best.
They also advise avoiding the heel off the edge of the step stretch as that can actually aggravate the plantar fascia even more.
Although this position may seem similar to the eccentric loading principle for Achilles tendinopathy, the eccentric loading movement is different than holding a static stretch in this position.
This type of eccentric loading for Achilles treatment would also be avoided if the patient were having plantar fascia issues at the same time.
Common and effective self soft tissue exercise of rolling the fascia on a lacrosse ball. Lacrosse balls work best due to the density and firmness.
The old method of a frozen water bottle is less commonly used as the ice has no effect and the water bottle does not penetrate deep enough into the tissue.
Neuromuscular re-education exercises with "toe yoga" where a patient learns how to active their toe flexors and extensors.
Heel raise with a ball squeeze where the patient is learning to control heel and forefoot synergy, thus activating the posterior tibialis muscle. This helps to retrain control of the arch.
Regular heel raises are good but most athletes are not standing around just pushing up onto their toes.
Once control is demonstrated with a bilateral and unilateral heel raise, especially under loads, such as weighted heel raises, progression is then appropriate.
Introducing functional movements and exercises that speak the language of the person's sport will translate best over into performance.
Introducing single leg progressions and lunge specific movements while incorporating a heel raise are examples of good exercise options.
This will help train the plantar flexors with the rest of the lower extremity kinetic chain for the optimal function of the lower limb.
Plantar fascia issues are extremely common and have been noted by multiple studies to account for close to one million outpatient visits a year to podiatrists and physical therapists.
Although that number is extremely high, surprisingly, studies have also shown that the vast majority of people still are not seeking treatment for the condition.
This is partly attributed to the increasing inaccessibility of information and knowledge through the Internet. People tend to take treatment into their own hands.
Plantar fasciitis is a common occurring injury in many athletes, including runners and obstacle course racers so it would be no surprise that the condition is searched often online.
Although basic exercises can help, the research has shown that patients who received manual therapy interventions from a physical therapist vs. just standard passive treatments, resulted in fewer therapy sessions, faster resolution of symptoms and quicker return to function.
Barriers to treatment have been found to be the cost of healthcare in terms of price for physical therapy visits. Despite having insurance coverage, co-pay amounts can still be a financial strain.
Travel distance to clinics, accessibility to licensed physical therapists and dedication to rehab time are also limiting factors. This can be said for any condition in regards to seeking formal physical therapy but most importantly the knowledge base is the most essential.
Ensuring patients understand the condition and the importance of the treatment techniques will ensure compliance.
Knowledge is key.
Despite the vast amounts of information available through various sources, the majority of people still lack a full understanding of the condition.
Time commitment, finances, travel, and accessibility, as well as stubbornness, are all barriers towards athletes and non-athletes alike in avoiding seeking proper treatment.
There is no price on your health and fitness.
About The Author
Michael St. George, PT, DPT (@icore_stgeorge on Instagram) is a physical therapist who works for Excel Physical Therapy and Fitness which is a private practice that is based around the greater Philadelphia region and suburbs. He is FMS, SFMA, Y Balance and Motor Control Test Certified with 8 years of experience in outpatient orthopedics and sports medicine. His training consists of experience working with physicians and surgeons from the Rothman Institute and therapists in his field specializing in various manual techniques and advanced treatment procedures
Caffeine is the most popular drug in the world.
That's right, it's a drug, and we're (almost) all dope-heads. In fact, I'm doping right now, and I'm willing to bet my left foot that some of you are as well.
This isn't necessarily a bad thing, drugs (medicine) are what has permitted the human race to climb to the top of the food chain. For better or for worse. But does the form in which you consume caffeine matter?
The simple, TL;DR answer to the headline question is NO. The caffeine found in coffee and supplemental caffeine (caffeine anhydrous) are not different.
Caffeine anhydrous might be a scary word, but it literally translates to without (an-) water (-hydrous), which is all it is – dehydrated caffeine!
In most cases, caffeine anhydrous is simply isolated and dried out from plant sources. Just not coffee beans – those are too precious!
If you strictly want to know about caffeine and only caffeine, there isn't really a long answer. Caffeine = caffeine.
However, coffee does have other bioactive ingredients. Therefore, if you were to drink a cup of coffee, you would have more helpful little compounds diffusing into your system than if you had caffeine anhydrous. One of the most obvious being water!
But there aren't very many ways you could consume caffeine anhydrous in isolation other than taking a caffeine pill without fluid to wash it down.
If you're consuming caffeine for enhancing your performance, that is where the crux of this argument lies: coffee (and its other ingredients) vs. caffeine (and other ingredients).
Most often, caffeine anhydrous is found in energy drinks and pre-workouts that contain some amount of water and, usually, other ingredients.
Caffeine anhydrous works by competing with a molecule called adenosine for the adenosine receptor. When adenosine binds to the receptor, you feel tired or out of energy.
When caffeine binds to the receptor you feel energetic, awake, and feel less pain.
When dosed properly the benefits are:
The best way to take anhydrous caffeine is 3-6 milligram per kilogram bodyweight 30-60 minutes before exercise.
Generally speaking, yes! According to organizations like the NAS, Health Canada, and the European Association of Food Safety, the upper safe limit is 400 milligrams a day for a healthy adult.
Individuals who are sensitive to caffeine and those who consume too much caffeine can experience:
Coffee also contains proven good-guys chlorogenic and caffeic acid, theobromine (a polyphenol), and the diterpenes, kahweol and cafestol.
Each of those ingredients would require a full blog article to discuss at the length they deserve, so we'll suffice to say that these bioactive ingredients of coffee have antioxidant, antihypertensive, anticarcinogenic, and antihyperlipidemic properties.
In other words, coffee is anti-bad stuff, and coffee drinkers have been found to live longer than nondrinkers. However, there aren't really any performance-enhancing ingredients in coffee other than caffeine.
Energy drinks contain caffeine and some other ingredients, but typically they are not dosed in a quantity that will have any meaningful effects. Therefore if you're looking to improve your speed, endurance, power output, strength, or any other athletic component, chances are you're going to find that supplements will help more than coffee.
Of course, not all supplements are made equal (5 dirty secrets of the supplement industry).
That's why we, EndurElite, exist in the first place – to bring you supplements that actually work! In our honest, albeit biased, opinion, PerformElite blows coffee (and other pre workouts) out of the water. Otherwise, why would we make it?
A detailed explanation of PerformElite can be found here, but briefly, PerformElite contains about as much caffeine as 2 cups of coffee.
That's not all, it also features extended release caffeine that prevents late afternoon lethargy and allows you to sprint to the finish instead of just crossing the line.
The 1,670mg of beet root extract is the equivalent of about 600g of fresh beets. Beets are amazing, but I can't eat 600g of them before running a race. Then there are 7 more clinically-validated ingredients with known benefits to endurance performance.
There you have it.
Caffeine, no matter the source, is caffeine, and supplemental caffeine is exactly the same as caffeine from coffee.
If you're an athlete that wants to perform your best, caffeine will certainly help, but so can other supplements.
Coffee is delicious, though, and I for one will continue to drink it on my off days and while writing blog articles after my morning training sessions.
Please leave us a comment if you have any questions or counterpoints!]]>
Written by Michelle Stampe
Watch riders hop off their bike after a long day in the saddle, and it's pretty clear they won't sprint off for a beer and a taco too quick. It's more of a belabored waddle. After most endurance riders cross the finish line, the first thing they do is put their hands on their back and stretch while making that face that says, "I will NOT get back on that torture device."
Considering the hunched position riders are in, it isn't unusual to experience some discomfort after a long or strenuous ride.
To find out just how prevalent lower back pain is in bikers, one research team interviewed 109 elite road cyclists to find out what injuries they suffered from in the last year.
A whopping 45% of injuries were in the lower back. What's more, 58% of all participants had experienced lower back pain in the previous 12 months.However, just because some discomfort is normal, that doesn't mean that pain is acceptable. And if a rider is otherwise healthy, they shouldn't assume they have to endure back pain every time they ride.
As a cyclist, think about your normal routine. You get up, head to work, and likely sit most of the day. Then you leave work and sit on your bike for a ride. Then you sit down for dinner and sit in a recliner to relax before bed.
Because cyclist's sport of choice is already in a seated position, it means that most of us spend way too much time on our butts. You probably don't have great posture while doing all that sitting, either.
There are other factors as well, like poor bike fit, poor posture on the bike, and riding style. Below is some practical advice for pain-free rides.
Core strength is critical to avoid lower back pain. Basically, your core muscles help stabilize your spine, and because of that, any back rehabilitation program includes some core strengthening exercises.
Try integrating a quick, 10-minute core workout 2 times a week that includes exercises like planking.
If you're not into working out alone, pilates, yoga, or CrossFit classes include a lot of core strength.
Injury rehabilitation specialist Paul Argent points out that a lot of discomfort comes from bending at your spine instead of at your hips. When you're seated on your bike, you have two points on your body that allow you to bend over the bars: your lower back and your hips.
Research shows that cyclists with lower back pain usually have a significant bend in their lumbar spine.
Ever done "cat-cow" in yoga?
If you're doing "cat" all day, you're putting a lot of stress on your spine. Next time you ride, focus on keeping a straight back and bending at your hips.
For a few exercises to help with body position related back pain, check out this resource.
Crushing big gears hard for extended periods of time fatigues the muscles in your back. When those muscles get tired, your body relies on other structures, like bones and ligaments, to keep you upright. Without support from muscles, those structures are stressed.
You can reduce the overall amount of fatigue on your back muscles by doing two things:
1. Ride at a higher cadence
If you usually ride in the 60-80 rpm range, try downshifting to ride at 90 RPMs or faster. If you don't have a cadence sensor, simply try riding your usual route in an easier gear. It might take a while for your muscles to adjust to this style of riding.
Try standing up during short, punchy climbs to give your back a break. Lot's of us learn to climb seated because it's more efficient and overall a little easier. However, when you start increasing intensity and duration, all that seated climbing can really fatigue your back. By standing up to climb you'll lose a bit of efficiency, but may be able to stave off back pain.
As riders venture out for longer and longer rides, their backpacks get heavier and heavier. Which, as physiotherapist Phil Mack points out, this might be the most obvious problem with the most obvious solution to back pain.
Most hydration packs and riding packs center all their weight on your lower back. Try switching to a hip or fanny pack or carry your bottles on your bike. There are lots of bike bags available that hold your entire tool kit on the frame of your bike. Even if you don't have any pain, it's worth the investment to ride unimpeded by a sweaty back.
Remember, discomfort on long, hard rides is to be expected, but pain can be avoided. If you're still struggling with back pain, consider investing in a bike fit or the advice of a sports medicine professional.]]>
Good morning, family of fast. Matt Mossman, the Chief Endurance Officer over at EndurElite. Today, we're gonna cover, kind of, a hot debatable topic, and this is if minimalist/barefoot running is better than traditional running shoes when it comes to things like improving running economy, preventing injuries, and increasing running performance.
Now, this whole minimalist barefoot running boom started probably about 10 to 15 years ago, and really got started up with the "Born to Run" book by Chris McDougall, I believe, who went down and ran with the Tarahumara Indians and saw how awesome they ran, and it spurred this whole minimalist barefoot movement.
And then you saw shoe companies, kind of, hopping on board with this, like, with first the Nike Free, and then you had those freaky, little, Vibram FiveFinger toe shoes, and you've just seen other companies over the years adopt more of a minimalist type/mimic barefoot running shoe.
Now, traditional running shoes something like here like this Brooks glycerin is very, very built up. It's very cushioned.
It has a pretty large heel-to-toe drop.
So this is what you think of when you think of more of a traditional shoe.
Now, a minimalist running shoe and this is probably a pretty poor example, but you kind of get the point.
It's a lot less cushioned and then the drop from heel to toe is slightly less, or it's more even across the bottom from heel to toe.
And this, kind of, puts you in a similar, but not exactly positioned to if you were running barefoot.
Now, full disclaimer. I've ran in the Nike Frees when they first came out, you know, I ended up getting hurt in them, but that's beside the point. I probably went a little too fast to join the minimalist movement, and since then, I really haven't run in a minimalist shoe. You know, I found something that really works for me and I stick with that.
But, with that being said, you know, I really don't have a strong stance on if minimalist shoes are the way to go, compared to a traditional running shoe, and this is basically because of how conflicted the research is.
So I'm not gonna sit here and just give you my opinions on if minimalist running shoes are better than traditional running shoes.
We're actually gonna look into the research today and we're gonna see if minimalist running shoes improve running economy and prevent injuries, compared to traditional running shoes.
So grab your popcorn and grab a drink because this is gonna be one of the longer videos.
But I hope you'll be able to walk away with some good information after watching this video, and make the decision if trying a minimalist running shoe or running barefoot is right for you.
Now, throughout this video I'm gonna be throwing up some slides too, so you guys can kind of see the information right in front of your face.
Sometimes it's just, kind of, easier to read and digest that information, as opposed to just listening to me the whole time.
So, let's get started first with what people claim that are in favor of barefoot running and minimalist running shoes.
So a lot of times, you're gonna hear people say that running barefoot or in a minimalist shoe, it basically, causes people to run with a more plantarflexed ankle at initial contact, adopt a four-foot footfall pattern, which we know from previous information this may help decrease rates of shin splints and other injuries.
This is going to:
Now, let's look at the other side. Those against barefoot minimalist running say:
So, instead of like taking all these claims and opinions, let's actually look at the research behind barefoot/minimalist shoes compared to traditional running shoes.
First, we're gonna look at if these types of shoes improve running economy or running performance, and then we'll look at if they decrease rates of injury.
So, let's hop right to the slides here again. I feel like I'm a college professor all over again throwing up these PowerPoint slides.
So, does minimalist footwear improve running performance? So, we're gonna cite three studies here.
Study number one, examined if running economy differs in minimal shoes versus standard running shoes, and in forefoot versus rearfoot strike gaits.
The subjects in this study were 52 collegiate cross country runners, so lots of experience running if they're competing that level.
And what the researchers have the subjects do is run on the treadmill at three meters a second and to, kind of, get rid of some variables that could be argued that shoe mass and stride frequency were controlled, so they didn't play a factor in that.
Now, what was measured?
So, the important part here, what were the results?
The researchers found that runners were 2.41% more economical in the minimal shoe condition when forefoot striking, and 3.32% more economical in the minimal shoe condition when rearfoot striking compared to the traditional running shoe group.
Then they basically concluded that running in a minimal running shoe was more economical than a traditional running shoe and they thought this was due to because of the buildup of elastic energy and then the release of it.
So, you may be looking at this study and saying, "You know, 2% to 3% running economy improvements isn't really that much."
But over the course of like, you know, half marathon to a marathon, that adds up to a lot of distance compared to running in a traditional running shoe.
So, so far so good. It looks like, you know, these minimalist running shoes are the way to go because it's improving running economy. But let's, kind of go on to the second study.
The second study evaluated the effects of four weeks familiarization to simulated barefoot running on running economy compared to traditional running shoes.
Subjects in this one were 15 trained male runners, and just hang tight with me here.
So, the researchers had these runners complete two running economy test 24 hours apart, in both the barefoot condition and then in traditional running shoes at 11 kilometers an hour and 13 kilometers an hour.
Subjects then completed a four-week familiarization period of simulated barefoot running before repeating the two running economy test.
So the pre-test, they just had them do barefoot running and then running in the traditional running shoes.
There is no, like, adaptation period to the minimalist shoes at all which is important, which I'll tell you here in a second.
What was measured:
Now, what were the results?
Now, pre-test, there was no difference in running economy compared to the minimalist group and the traditional running shoe group.
But after the familiarization of the minimalist running shoes, so training them for four weeks, there was an improvement of 6.9% in running economy compared to the traditional running shoe group when post-testing was done.
So, the conclusion here, running economy improved in the simulated barefoot running condition only after familiarization, not before, when if you were to just barefoot and have that tested right away, then immediately after running in a traditional running shoe, you probably wouldn't see much difference.
But if you have a familiarization period with the minimalist/barefoot running, you will see improvements in running the economy as demonstrated by this study.
Let's go on to study number three, and this one is kind of a big one.
This was a meta-analysis, which means the researchers took a look at a bunch of different research that looked at how minimalist running shoes and traditional running shoes did in terms of running economy and performance.
So, like the study said, this meta-analysis investigated the effect of footwear running performance in running the economy, and distance runners reviewed controlled trials that compared different footwear conditions or compared footwear with barefoot.
So basically, they're just looking for studies that compared minimalist shoes to traditional shoes and seeing if that made any improvements in performance or running economy.
We won't look at the methods right here, but yeah, like before, they were just looking for studies that compared that thing.
And what they found after they did the meta-analysis, I think they reviewed over 1,000 different articles and they ended up with 19 studies that identified the things they were looking for.
And what they found is:
All this means is, there are benefits across the board, but maybe more so in the minimalist shoe group when it came to running economy.
It also found significant small beneficial effects on running economy for light shoes, and barefoot compared with heavy shoes, and for minimalist shoes compared with conventional shoes.
So basically, they're saying that lighter shoes are more economical, which makes sense because that's less weight your foot has to move.
And then lastly, a significant positive association between shoe mass and metabolic cost of running was identified.
So the metabolic cost of running, just again, like things like oxygen, transport, and stride, rate and efficiency and things like that were identified.
Again, more than likely because the minimalist shoe was a little bit lighter. And their conclusions are very, very vague and very, very simple.
They said, "Certain models of footwear and footwork characteristics can improve running economy." Well, no shit, sheer luck. Thanks for that information.
So, those are three studies right there, and all of them seem, you know, pretty positive as far as, you know, minimalist shoes/barefoot running improving running economy. So you might be saying, "
At this point, wham, there's really no downside to going the, you know, the minimalist route." But I'm gonna play devil's advocate here and now, we're gonna look at does minimalist footwear reduce the risk of injury?
So again, we're not gonna rely on bro-science. We're gonna go to real science.
So, study number one examined the effects of progressive increases in footwear minimalism on injury, incidence, and pain perception in recreational runners.
So when they're talking about progressive increases in footwear minimalism, they're talking about using shoes that have something like a 10-millimeter drop, a 6-millimeter drop, and then a 0-millimeter drop.
Subjects in this were 103 runners with neutral or mild overpronation, and they were assigned to receive 1 of 3 shoes
And the researchers wanted to measure a few different things.
They would say, "Hey, did running in those shoes was hurt? If so, how bad? Zero being nothing, 10 being the worst."
So what were the results?
In this one, neutral shoes reported the fewest injuries, which was four, and the partial minimalist shoes, so the Nike Free reported the most, of 12.
And basically, runners in the minimalist shoes reported greater shin and calf pain too, compared to the more cushion neutral shoe, or the Nike Pegasus.
So, what the researchers concluded here, and this may get your blood boiling if you're on the minimalist shoe movement is, running in minimalist footwear appears to increase the likelihood of experiencing an injury and increasing pain at the shin and calf.
So that's study number one. Let's go on to study number two.
And this one examined whether the drop of a standard cushion running shoe influenced running injury risk.
So again, we're looking at the heel-to-toe drop of various shoes. And this one was a pretty big study.
There was 553 recreational runners that were classified as either occasion runners, meaning they've been running for six months or less, or regular runners, meaning they ran for six months or more.
And they were randomly assigned to receive a shoe of a 10-millimeter drop, a 6-millimeter drop, or a 0-millimeter drop, and they were instructed to run in these shoes for 6 months.
And what was measured here is they just wanted to see overall injury risk. So here are the results.
Of the 553 runners, 136 total were injured across the board.
So, their conclusions, statistically, injury risk was not modified by the drop of the shoe.
But here's the one caveat, regular runners who ran in the minimalist shoes, so the runners that have six or more months of experience running, had more injuries in the minimalist shoe group compared to the group that had been running less than six months.
And the researchers really didn't have a very good explanation for why this was, but interesting to know.
Let's go on to the last study.
Study number 3, this one examined bone marrow swelling in the foot before and after a 10-week period of transitioning from traditional to minimalist running shoes.
And this study had 36 total runners. Here's what happened, here's the kind of, what the methods.
Seventeen subjects ran in traditional shoes over the 10-week period, while 19 transitioned from traditional running shoes to minimalist running shoes over the 10-week period.
So, essentially, 17 runners stayed in their traditional running shoes for 10 weeks, while 19 started in the traditional running shoes, but, kind of, slowly converted to the minimalist shoes over the 10-week period.
And what was measured here both pre and post-test was bone marrow swelling in the foot measured by MRI. And here's where it gets interesting.
The results showed that post-training MRI scores showed more subjects in the minimalist group showed increases in bone marrow swelling compared to the traditional running shoe group.
Meaning there was more swelling in the bone marrow in the minimalist shoe group compared to the traditional running shoe group.
But the researchers warn all hating on minimalist shoe groups here because they basically said in the conclusions, "Runners interested in making the transition to minimalist shoes should transition slowly and gradually to avoid potential stress injury."
So basically, what they're saying is 10 weeks may not be enough time to make their transition from a traditional to a minimalist running shoe. Maybe more need to be more slow and gradual to prevent that bone marrow swelling.
Now, you see the kind of, the pros, the key...of minimalist running shoes improving running economy, and then maybe some of the cons of causing injuries.
But when it comes to injuries, I gotta be fair too because there are other studies out there that show running in minimalist shoes can actually prevent injuries from happening more often.
So at this point, you're probably throwing your hands up in the air and being like,
"What the hell is going on? Is minimalist shoes the way to go, or is it not?" And my answer to you is I don't think anybody knows at this point, and I need to make a really important point here.
All these scientific studies done on, you know, minimalist shoes, barefoot shoes, and compared to traditional running shoes, they don't prove anything.
Science doesn't aim to prove anything. science basically wants to demonstrate things.
So a scientist does a study. He gets a certain result. That study should be replicated again, and again, and again, and again, till we get closer to an answer on anything when we're studying science.
So, the case with, you know, barefoot running shoes. If there's one study that shows it improves running economy, that experiment should be replicated over, and over again till we get to a better answer.
And again, none of this proves anything. It just demonstrates certain things.
The point being, at this point in time, I think a lot more research needs to be done on minimalist running shoes and barefoot running shoes compared to traditional running shoes, so we can make maybe a stronger argument for each...or the other one, as time goes on.
But here's my personal opinion right here. Again, I haven't really run in minimalist shoes, but on the same token too, I really don't have a problem with minimalist shoes.
Like, if you like them and they're working for you and you're noticing fewer injuries and you're running faster, so be it. Stick with the minimalist running shoes.
On the other hand, if you try them and try them over again and it's just not your thing, and you really like your traditional running shoe, you know, definitely stick with that.
At the end of the day, you know, science only demonstrates so much, but then you also have to consider field experience too, or personal experience.
We're all so different, you know, biomechanically and physiologically that there's not gonna be a right answer for everyone.
So let's just end with this. We're gonna do a couple more slides and we're just gonna look at the potential benefits of barefoot running and the potential negative outcomes of barefoot running.
Again, this is all based on the research, and take this with a grain of salt. You know, not my intention here to piss anybody off with any of this, it's just kind of keeping an open mind when it comes to this stuff.
So, the potential benefits of barefoot running are:
Now, the potential negatives of minimalist barefoot running. You know, I think if you go this route you have to be really careful about slowly transitioning, and I don't think you just want to go 0 to 100 going from a traditional running shoe to a minimalist running shoe.
It might be a little bit of a shock to the system.
If I were to do it, I would start slowly and gradually. Maybe run in a minimalist shoe, you know, one or two times a week and slowly build up from there.
Point number two, I mean, if you're having any...you know, existing issues or pain, do you really need to make this switch? Why do you wanna make the switch to a minimalist shoe?
That's really a question you have to answer. If you think it's gonna, you know, provide performance benefits, hey, give it a try.
But if nothing hurts, I'm under the mindset of, you know, nothing hurts, you're running good, maybe nothing needs to be fixed.
Minimalist running shoes offer less protection, you know, on rocks or if you were to step on glass or things like that. I don't know.
You know, it may cause, again, stress to the foot like, you know, plantar fasciitis.
But again, this may just be because if you go from 0 to 100 hoopling in from the minimalist shoe...or hopping from the traditional shoe to the minimalist shoe, you know, you may have a higher rated injury just because you're trying to do it so, so fast.
And then the last point, potential negative. This is more specifically for running barefoot, you're gonna get blisters, you're gonna step on shit. You might get your toes cut up and tear your foot calluses up.
So, that is the long and drawn out video on minimalist running shoes versus traditional running shoes, and if they improve running economy, if they prevent injury, and things like that.
Again, my stance on this is simple. If you like the minimalist barefoot running shoe movement, stick with it. If you don't, don't do it. At the end of the day, it's a personal preference, and whatever works best for you is probably what you should stick with.
So, I hope you enjoyed your popcorn and your soft drink for that extended video. If you have a friend who runs in a minimalist shoe or argues with you all the time about minimalist shoes, share this video with them. If you want other videos on endurance training, nutrition, and supplementation, subscribe to the EndurElite YouTube channel, or head on over to the EndurElite blog at www.endurelite.com. Get social with us on Instagram, in our EndurElite Facebook Training & Nutrition Club, and until next time, my endurance friends, stay fueled, stay focused, and stay fast.
Video Transcription:
Good morning family of fast. Matt Mosman, the Chief Endurance Officer over at EndurElite.
Today, we're gonna answer one of life's great questions. And that is, beer before liquor or liquor before beer?
Now, on one end, you might never ever be sicker. On the other hand, you might be in the clear.
And I really started to test this hypothesis back at a frat party when I was presented with a Budweiser and a bottle of whiskey.
Okay, so we're not gonna answer that great question today. We're gonna actually answer the other great question of life.
And that is, should you do endurance exercise before or after you strength train?
Now, in the event, you don't have time to watch this whole video, here is what you need to know.
Now, I know that's not reasonable for some people, especially like OCR athletes that do both exercises modalities on certain days.
So let's just kind of get in more of the nuts and bolts of this video as far as which one you should do first.
Now, usually, the arguments that you're gonna hear are:
And, again, I'll go back to a point I made in the first part of this video.
If gaining strength and size is your main goal, you definitely want to weight train before you do your endurance exercise.
And here's why basically.
If you're doing cardio before you weight train
So on one hand, strength training signals more of an anabolic response. It makes you stronger, bigger, muscle fibers wanna grow and get stronger.
On the other hand, doing cardio beforehand sends a different signal that basically says, "We're gonna make these muscle fibers more fatigue resistant and smaller."
So the signaling really interferes with one another. So again, if strength and size is your main goal, you're gonna wanna do it before your endurance exercise.
And there are some cool studies behind this.
One, in particular, took a group of... basically 3 groups of 10 men, and these researchers split them up.
So again, take-home point here is, if you're wanna get stronger, you're gonna wanna do weight lifting before endurance exercise.
But if you're a hardcore endurance athlete who is more concerned about running great in your marathon, or a track race, or a mountain bike event, and that's your main goal, you're gonna wanna do the endurance exercise before the weight training.
Because again, you're just training for different adaptations. And whichever one is more important to you, honestly, is the one that you wanna do first.
So what's really the take-home point? I'm gonna repeat it again.
But both actually, at the end of the day, are very important. Each kind of gives you unique benefits that both play together really well in terms of making you a better endurance athlete, especially for like you, OCR types, that do like the TMX or the Spartan Stadium sprints.
That cardiovascular fitness and that raw power and strength all play together really, really, really good.
So in those cases, you definitely wanna incorporate both.
But again, the take-home point is, if you can separate the two exercises by six hours or more or if you can do them on different days, the adaptations of each exercise modality isn't gonna interfere with one another quite as much.
So that is all I have for today, my endurance friends. I hope that just itched that scratch that was burning your mind if you should do endurance exercise or strength training first. If you have a buddy that's also questioning this, please share this video with them. If you want other content on endurance training, nutrition, and supplementation, and everything in between, subscribe to the EndurElite YouTube channel or head on over to the EndurElite blog at www.endurelite.com. Get social with us on Instagram and our Facebook training and nutrition club page. And until next time my endurance friends, stay fueled, stay focused, and stay fast.
Have you ever worn a dark colored hat enough that it collects a white line along the bottom edge or brim?
This is physical representation of why endurance athletes need electrolytes – they're lost in sweat, and if I know anything about endurance sports, I know that they're a sweaty endeavor!
Those white stains that show up when sweaty clothes dry are salt stains, and they can become much more serious than just a cosmetic faux pas.
Some people are saltier sweaters than others, but at some race distance, replacing electrolytes – particularly sodium – becomes an essential part of any race fueling strategy.
This is because excessive sodium loss will induce hyponatremia, which translates to low (hypo) blood (emia) sodium (Na).
Hyponatremia can be caused by excessive sodium loss or plain water consumption.
Sweating a lot and only drinking plain water is a double-edged sword that significantly increases risk of hyponatremia.
Symptoms of hyponatremia include:
Brace yourself for a frightening statistic; 30% of runners finish ultramarathons in a hyponatremic state.
Those with hyponatremia also have ~50% more muscle damage and 30 minute slower completion times than runners adequately replacing sodium during a 161 km race.
Electrolyte supplements and drinks or foods containing a good amount of sodium are required to prevent hyponatremia during long endurance events.
Beverages containing sodium are often the best choice, as they help replace sodium and fluids simultaneously.
This is a particularly tough question to answer as it depends so much on factors that vary from person to person.
Some people are very salty sweaters, while others are not at all.
To put how dramatic this difference is in context, athletes can require anywhere from 100 to 2,500 milligrams of sodium per hour!
An athlete's sodium needs depend on:
The best way to figure out how best to replace sodium on your own is achieved with a personalized hydration plan.
Unless you are sure you're a salty sweater, assume that you are losing about the average amount of sodium per pound of sweat.
Calculate your sweat rate by taking a baseline bodyweight before you go out for a 1 hour run, ride, or swim at race pace. When you're done, dry off, and weigh yourself again. The amount of weight lost during your workout is equal to the amount of fluid you've lost as sweat in one hour.
For example, if you've lost 3 pounds during that time, your sweat rate is 3 pounds (1.4 kg or 1.4 liters) per hour.
Now factor in the amount of sodium per pound of sweat. If it is 500 mg per pound than hourly sodium loss is equal to 1,500 mg.
For your race, you will take your hourly sweat and sodium loss rate and break it up into manageable quantities within a 15 minute time frame based on your MIN and MAX fluid needs.
Using the same example as above for an athlete with 60kg bodyweight, average sodium per pound of sweat, and an estimated 3 hour marathon time, we make the following calculations:
Therefore, in this example, fluid needs are 0.25 – 0.35 L per 15 minutes, and each liter should contain 227 mg of sodium. Modify the example according to your personal needs.
Although sodium is the primary electrolyte lost in sweat, other electrolyte minerals are lost as well.
These other electrolytes are:
Complications are not as serious as death, but a total electrolyte replacement strategy will contain the other minerals.
For every 100 mg of sodium in sweat, there is also:
Many of these, and other, minerals are lost during intense exercise at increased rates as well.
Iron, for example, already tends to be low in endurance athletes, particularly runners (over 50% are deficient).
During an hour of running, iron loss may be increased 4-fold normal rates. Thus, just one hour of running increases iron needs by at least 10% per day.
Compounded over time and with a healthy diet low in iron-packed red meat and high in vegetables that reduce iron absorption yields the iron deficiency problem often observed with runners.
This is pretty important, as low iron status significantly reduces endurance exercise performance.
But a word of caution, toxic effects of iron begin at a dose of 10 mg iron per kg bodyweight, so don't go overboard!
Likewise, magnesium needs are 10-20% greater, potassium (often already under-consumed – we need 4.7 grams per day!) needs another ~200 mg per hour, and calcium an additional ~100mg per day due to systemic loss as a result of exercise – not just the minerals lost in sweat.
Endurance exercise is a demanding task, and the body minerals take a hit!
For every product EndurElite makes, we do a competitor analysis to see where we can make meaningful improvements for endurance athletes.
Of all the other electrolyte tablets on the market, only 3 meet the criteria of the two most important factors for electrolyte supplements – having enough sodium and not containing ingredients with a tendency to upset the stomach.
What's worse is 2 don't even contain much sodium, which honestly is a little scary considering that sodium is cheaper than dirt and that's the #1 reason an electrolyte supplement should exist in the first place.
Anyhow… ElectroElite contains over 300mg of sodium per serving.
Dextrose, the naturally-occurring form of glucose, is the carbohydrate source used to help hold the tablet together – no sugar alcohols or other gut irritants.
Great, we've checked the two major boxes along with 3 other electrolyte supplements.
In common with 2 out of 3, ElectroElite also contains a full profile of other electrolyte minerals, potassium, calcium, and magnesium.
Now, here's what makes ElectroElite unique!
By providing 2 smaller tablets instead of 1 large tablet, the athlete has greater control over their dosing. Thus, endurance athletes can be even more precise at obtaining their electrolyte needs.
Everything you need, nothing you don't.
If you're thinking, "well I'll just take extra to be safe," think again. Going a little over may not be a problem, but if by mistake you double up when your initial estimation was adequate, this can lead to unnecessary complications such as GI distress and side stitches.
Finally, and we think this has the potential to be a HUGE deal, ElectroElite is the FIRST to contain iron.
Why has nobody done this before? We don't know – we think it's an obviously perfect opportunity to make sure endurance athletes are meeting their iron needs.
Oh, and did we mention, we are also the FIRST to use Himalayan pink salt as a major source of sodium, which in addition to being a natural source of sodium, contains small quantities of other minerals like zinc and iodine to support a healthy metabolism?
Better ingredients. Better athletes!
You've heard it and seen it here first.
Soon, you will see the copycat market filled with iron-fortified electrolyte supplements and natural salts.
Keep in mind that EndurElite was honest with you from the jump while others have tried to keep you in the dark.
With ElectroElite, you get everything you need to keep the body functioning strong from the start of the race all the way to the finish:
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Hoffman, M. D., Stuempfle, K. J., Rogers, I. R., Weschler, L. B., & Hew-Butler, T. (2012). Hyponatremia in the 2009 161-km western states endurance run. International journal of sports physiology and performance, 7(1), 6-10.
Hunding, A., Jordal, R., & Paulev, P. E. (1981). Runner's anemia and iron deficiency. Acta Medica Scandinavica, 209(1‐6), 315-318.
Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. (1997). Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. National Academies Press (US).
Jawadwala, R. (2012). The role of supplementary calcium in submaximal exercise and endurance performance (Doctoral dissertation, University of Central Lancashire).
Klesges, R. C., Ward, K. D., Shelton, M. L., Applegate, W. B., Cantler, E. D., Palmieri, G. M., ... & Davis, J. (1996). Changes in bone mineral content in male athletes: mechanisms of action and intervention effects. Jama, 276(3), 226-230.
Lukaski, H. C. (2000). Magnesium, zinc, and chromium nutriture and physical activity–. The American journal of clinical nutrition, 72(2), 585S-593S.
Lukaski, H. C., & Nielsen, F. H. (2002). Dietary magnesium depletion affects metabolic responses during submaximal exercise in postmenopausal women. The Journal of nutrition, 132(5), 930-935.
Ottomano, C., & Franchini, M. (2012). Sports anaemia: facts or fiction?. Blood Transfusion, 10(3), 252.
Rehrer, N. J. (2001). Fluid and electrolyte balance in ultra-endurance sport. Sports Medicine, 31(10), 701-715.
Rude, R. K. (1993). Magnesium metabolism and deficiency. Endocrinology and metabolism clinics of North America, 22(2), 377-395.
Shang, G., Collins, M., & Schwellnus, M. P. (2011). Factors associated with a self-reported history of exercise-associated muscle cramps in Ironman triathletes: a case–control study. Clinical Journal of Sport Medicine, 21(3), 204-210.
Sims, S. T., Rehrer, N. J., Bell, M. L., & Cotter, J. D. (2007). Preexercise sodium loading aids fluid balance and endurance for women exercising in the heat. Journal of Applied Physiology, 103(2), 534-541.
Tai, C. Y., Joy, J. M., Falcone, P. H., Carson, L. R., Mosman, M. M., Straight, J. L., ... & Moon, J. R. (2014). An amino acid-electrolyte beverage may increase cellular rehydration relative to carbohydrate-electrolyte and flavored water beverages. Nutrition journal, 13(1), 47.
Twerenbold, R., Knechtle, B., Kakebeeke, T. H., Eser, P., Müller, G., Von Arx, P., & Knecht, H. (2003). Effects of different sodium concentrations in replacement fluids during prolonged exercise in women. British journal of sports medicine, 37(4), 300-303.
Von Duvillard, S. P., Braun, W. A., Markofski, M., Beneke, R., & Leithäuser, R. (2004). Fluids and hydration in prolonged endurance performance. Nutrition, 20(7), 651-656.]]>
In recent years, the strong polarized opinions over cannabis and derivatives have become more neutral, and it is becoming more widely regarded as a medicine or herb than an illicit drug.
Of course, many already felt this way, and there are others who will cling to old ways. However, it sure seems clear that, sooner or later, cannabis, CBD, and/or THC will be used therapeutically.
There are a range of benefits associated with CBD and, in some cases, with THC as well.
Of those most relevant to endurance athletes, CBD may help with inflammation and pain.
But first, a couple of the basics.
There are distinct differences between plants used as a source of the extracts as well as the extracts themselves.
CBD, or cannabidiol, is a NON-psychoactive extract of marijuana and/or hemp, whereas THC, tetrahydrocannabinol, is the psychoactive compound that produces the well-known high.
As plants, some strains contain more or less CBD while others contain more or less THC.
With CBD on the rise, most plants being used are high-CBD, low-THC strains of marijuana, as the amount of THC permissible (by law, where applicable) is very low – less than 0.3% – while CBD content is often around 4% (though some claim up to 15%).
Marijuana is used most often, but it is not permitted in many states.
Thus, hemp-derived CBD may be used as well. However, much more hemp is required, as CBD concentrations are low, which leads to a lower quality product.
There is no one-size-fits-all answer for this question in the United States.
At the federal level, it's a no go, but depending on your state laws, it may be okay.
Check first, but I'm yet to see any headlines about someone getting in trouble for CBD oil – it doesn't mean you won't, though.
CBD/THC works by interacting with receptors in the endocannaboid system, namely CB1 and CB2 receptors.
It's actually not as straightforward as you may think, though.
THC is a CB receptor agonist. It "activates" these receptors to produce psychotropic effects in the brain, via CB1, and immunomodulatory effects in peripheral tissues, via CB2.
However, CBD is an antagonist of CB1 and CB2 receptors – it is actually capable of suppressing some of the psychotropic effects of THC.
CBD actually works via other receptors. Specifically, serotonin, PPARs, vanilloid, and orphan receptors. Here's a snapshot of how this all works together:
Keep in mind, each listed effect may be increased or decreased by CBD. The fact it is on the list only serves to identify that the receptor has an effect on that outcome.
Joint pain is one the biggest complaints amongst endurance athletes. So, can CBD help with joint pain?
So far, the research suggests that it can.
We say suggests here because no research has specifically examined CBD in runners with joint pain – we just aren't that high up on the priorities of funded research, so we'll draw off of conclusions made in arthritis and neuropathy studies.
One recent study found that CBD was able to reduce osteoarthritis progression when administered as a prophylactic and reduce acute joint inflammation after insult.
At least 3 other studies on the same topic confirm or otherwise support those results.
Anecdotal reports around the internet and personal accounts disclosed to us at EndurElite confirm the results as well.
Results include a disappearance or near disappearance of ankle and knee pain after a few days of treatment, while others have said a few days of topical CBD has cleared up fasciitis (administration routes are oral, inhalation, and topical).
For endurance athletes, CBD may also help improve sleep, reduce anxiety, and stimulate appetite to help fuel exercise.
It will be interesting to see how, or more appropriately when, the legalities surrounding the topic of CBD will more completely soften in the US, as they have in other countries.
From a scientific perspective, there is a clear potential for viability and efficacy with only mild side effects from over-consumption, misuse, or adverse reaction.
In all likelihood, there is greater concern between political-pharmaceutical navigation than there is over the compound itself, at least with the compound, CBD.]]>
While we all know exercise does a body good, it also has the tendency to beat us up pretty good from time to time…..with the majority of the abuse happening to our joints from high impact activities like running.
Your body is like a machine with many moving parts. Unfortunately, both break down from time to time. When proper recovery through rest days and nutrition isn't enough it may be time to consider supplements that can reduce joint pain and soreness, improve mobility, and maintain cartilage health.
In this article, we will take a deep dive into the 9 best joint supplements for athletes. We will discuss what they are, how they work, the benefits of supplementation, how much of each you should take, and the research demonstrating the effectiveness of each.
Chondroitin is one of the most popular over the counter supplements joint health supplements. It is made from chains of glycosaminoglycans with uronic acid and D-N-aceytyl-galactosamine molecules.
Chondroitin works well for individuals who put a lot of "wear and tear" on their joints through activities of daily living, those who regularly participate in activities like running where large compression forces are put on joints, or for people who have joint diseases like osteoarthritis.
Chondroitin should be dosed at 1000-1200mg/daily. This dose can be taken all at once or divided into two to three doses. Chondroitin should be taken with food. Chondroitin also pairs well with the supplement glucosamine.
A 1999 study conducted by Leffler et. al discovered that 100 patients with knee osteoarthritis who supplemented with chondroitin were able to decrease joint pain and degeneration while also improving joint function.
As a whole, chondroitin is a very safe supplement. There have been a few reports that it can cause mild stomach pain and nausea in some individuals.
Glucosamine sulfate is a sugar molecule with nitrogen that comes from shellfish and also naturally occurs in the body. It is highly concentrated in joints and cartilage and is a component of keratin (a fibrous protein found in hair). Glucosamine is commonly paired with chondroitin.
Glucosamine sulfate should be taken by athletes who participate in high impact sports like running where tremendous stress occurs in the joints. It should also be taken by individuals who want to slow the progression of osteoarthritis.
Glucosamine sulfate should be dosed at 900-1500mg/daily. This dose should be split up into 3 equal doses (500mg three times a day). Glucosamine sulfate should be taken with food.
A 3 year, randomized, placebo-controlled, double-blind study conducted by Pavelka et. al discovered subjects who supplemented with 1500mg of glucosamine sulfate daily were able to slow the progression of osteoarthritis and experience reductions in pain compared to placebo.
Like chondroitin, glucosamine sulfate is a very safe supplement. The most common, harmless side-effect is flatulence.
Cissus Quadrangularis is one of the few joint supplements that has been researched in athletic populations. It comes from a plant that contains several compounds with the main one being triterpenoids. Cissus quadrangularis may also promote bone growth.
Cissus Quadrangularis should be taken by any athlete who puts excessive wear and tear on their joints either through high impact activities or sports where repetitive movements are made. It may also be useful to individuals who are in the healing stages of a stress fracture.
Cissus Quadrangularis should be dosed at 300-600mg/daily. Higher amounts up to 3200mg daily may be more beneficial for athletes. It is important to note that this dose should be standardized to 2.5% ketosteroids.
A 2013 study conducted by Bloomer et. al discovered that exercise-trained men who supplemented with 3200mg of cissus quadrangularis daily for 8 weeks were able to reduce joint pain by 31% relative to baseline.
No adverse side effects have been observed in studies where 300mg of cissus quadrangularis was used. Overall, cissus quadrangularis can be considered a safe and effective joint supplements.
MSM is a sulfur-containing compound that is most commonly supplemented for its anti-inflammatory benefits. It naturally occurs in some vegetables and other food products but appears to be most effective in supplemental form due to the dosages needed to provide benefits.
MSM should be taken by both active individuals and those with joint diseases to help maintain joint mobility and possibly reduce joint and muscle pain.
MSM should be dosed at 3000mg/daily. The research is conflicted if taking more than this will provide additional joint and cartilage benefits.
In multiple studies, MSM supplementation has been demonstrated to significantly reduce pain and the degeneration of cartilage in joints. It has also been shown to improve joint mobility.
Side effects observed occasionally in humans include GI upset, allergy, and skin rashes.
FruiteX-B is a patented ingredient made by the company Futureceuticals. It consists of the compound calcium fructoborate. FruiteX-B is identical to the borate complex found in fruits, vegetables, and legumes. Its use for joint health is supported by over a decade of research showing significant improvements in joint comfort.
FruiteX-B should be taken by any individual with acute or chronic joint issues. It also appears to work synergistically with chondroitin and glucosamine.
FruiteX-B should be dosed at 215mg/daily and taken as one dose with food.
A 2014 study conducted by Zbigniew et. al discovered subject who supplemented with 220mg of FruiteX-B daily for 14 days were able to significantly improve joint discomfort and flexibility compared to placebo.
No known side effects at this time.
Type-II Collagen is a collagen in humans that is a peptide and a component of cartilage. It is commonly sold as shark gelatin, gelatin, chicken sternum, or bovine cartilage. This type of collagen should be taken in its hydrolyzed (broken down) form for increased absorption.
Type-II Collagen should be taken by individuals who are experiencing unwanted symptoms of osteoarthritis and rheumatism. Athletes may also want to try Type-II Collagen for long-term joint health although no research has been conducted on active or exercise-trained populations.
Type-II Collagen should be dosed at 10 grams daily in hydrolyzed form. It should not be taken in higher amounts as a protein source due to its poor amino acid profile.
A 24-week study conducted by Clark et. al discovered that Type-II Collagen supplementation appears to benefit joint inflammation, secondary mobility (76% improvement) and other tertiary effects (62% improvement). It also significantly reduced pain (reduced 88%) and led to a normalizing of Saliva pH levels which is often indicative of a reduction in inflammation.
No known side effects at this time.
Curcumin is a yellow, bioactive polyphenol found in turmeric. It has several anti-inflammatory properties and can increase the production of certain antioxidants in the body. Due to curcumin's poor absorption, it is prudent to pair it with piperine when taken in supplemental form.
Curcumin should be taken by any individual experiencing either acute or chronic joint problems. It can also be supplemented for overall health and by the elderly to reduce cognitive decline.
Curcumin should be dosed at 500-1500mg/daily using the following guidelines:
A 2014 study conducted by Drobnic et. al discovered that subjects who supplemented with curcumin (Meriva) experienced improvement in clinical and biochemical end-points associated with joint health compared to placebo. The study also found curcumin supplementation helped minimize delayed onset muscle soreness (DOMS) and pain intensity.
In healthy subjects, curcumin supplementation can sometimes lead to nausea, minor flatulence, and yellow stools (from the pigments found in curcumin). These harmless side effects stop when supplementation ceases.
Boswellia Serrata is a phytopharmaceutical herb that is extracted from the gum resin of the tree. Its active compound, boswellic acid possesses many anti-inflammatory effects that can be beneficial for joint health.
A majority of the research demonstrates that individuals with joint disorders will benefit most from Boswellia serrata supplementation.
Boswellia Serrata should be dosed at 2400-2600mg/daily and split into three equal doses when using the resin. When taken brand name Boswellia like ApresFLEX take one daily dose of 100-250mg.
For all forms of Boswellia serrata, start on the lower end of the dosage range for 2-3 months and afterward increase the dose. If you do not see greater benefits with higher doses then continue supplementation at the lower dose.
A 2011 study conducted by Gupta et. al demonstrated significant improvements in joint comfort, function, and mobility when subjects supplemented with Boswellia Serrata. Several objective blood markers of systemic activity were significantly improved as well.
In healthy subjects, the most common side effect appears to be allergic reactions. Standard oral doses that have been subjected to toxicology testing appear to be safe and nongenotoxic.
Fish oil is the combination of the two omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). These fats are found in fish, animal products, and phytoplankton. As a supplement, fish oil is recommended as the cheapest and most efficacious source of these omega-3 fatty acids.
In short...EVERYONE! Fish oil confers multiple benefits as it relates to joint and overall health. Additionally, the majority of individuals do not consume enough omega-3 fatty acids through their diet on a daily basis.
Fish oil should be dosed at 250mg to 6 grams daily. Lower doses should be taken for general health while higher doses should be taken to reduce soreness and joint pain.
A 2009 study conducted by Tartibian et. al discovered subjects who supplemented with 1.8 grams of fish oil daily for 27 days were able to minimize soreness and pain in joint and muscles.
The most common, harmless side effect of fish oil supplementation is the "fish burps." To avoid these, keep your fish oil supplement in the freezer.
Some concerns about Mercury levels should be raised in lower quality fish oil supplements. Pregnant women should consult with their doctor before supplementing with fish oil due to this.
As an athlete, it is inevitable that your daily training routine will produce a significant amount of wear and tear on your joints and cartilage. Proper recovery and strength training should be your top priorities when it comes to maintaining the health of your joints. In the event that still isn't doing the trick, consider taking a joint supplement with some or all of the ingredients listed above.
A handful of these ingredients can be found in EndurElite JointElite - The Endurance Athlete's Joint Formula. Each ingredient is clinically validated and dosed to improve joint comfort and health.
About The Author Matt Mosman - Spearfish, South Dakota
Matt Mosman (MS, CISSN, CSCS) is a research scientist, endurance athlete, and the founder and Chief Endurance Officer at EndurElite. Matt holds his B.S. in Exercise Science from Creighton University and his M.S. in Exercise Physiology from the University of California. Matt and his family reside in Spearfish South Dakota where they enjoy running, mountain biking, camping, and all the outdoor adventures Spearfish has to offer.
Eastern medicine uses at least 272 different species of mushrooms [13] for purposes such as treating cancer, diabetes, HIV/AIDS, the common cold, hypertension, heart disease, infection, obesity, and many more illnesses and diseases.
Those fortunate enough also used mushrooms recreationally – and not just the magical ones!
While even psilocybin (the active ingredient in magic 'shrooms) can be used below pharmaceutical levels for improved cognition, several other species confer physiological benefits.
A special blend of mushrooms contained in PerformElite, called Peak O2, contains 6 different types of mushrooms with known physiological benefits for athletes.
Let's see how these medicinal mushrooms can improve your endurance performance
Peak O2 is a supplement that is a combination of six different mushroom strains which act as potent adaptogens.
Adaptogens help athletes overcome mental and physical stressors during exercise and activities of daily living.
Peak O2 also contains high levels of L-Ergothioneine and beta-glucans. These two compounds are powerful anti-oxidants that combat oxidative stress.
Research has demonstrated that Peak O2 can:
Peak O2 should be dosed at 1-4 grams daily. It is important to note Peak O2 should be taken every day as it works better when you load it.
Peak O2 should be taken 30 - 60 minutes before exercise. Additional doses (above 1 gram) can be taken throughout the day if needed to reach 4 grams daily.
Cordyceps Militaris is the primary mushroom in the Peak O2 blend found in PerformElite.
There are two popular types of cordyceps mushrooms
The two are not equals, however.
Cordyceps Militaris is far superior to Cordyceps Sinensis.
In fact, in 2007, taxonomists reclassified Sinensis into an entirely different family of mushrooms. This is to say that, as far as biologists are concerned, Sinensis is more like a second cousin of Militaris than it is a brother or sister, and their differences are pretty pronounced.
First of all, Militaris contains significantly more bioactive nutrients than Sinensis [16]. The existing data on Sinensis have found no benefit to endurance [22] or high-intensity exercise [7, 24].
Militaris has demonstrated several effects that improve performance including, but not limited to, increasing vasodilation and blood flow to increase nutrient delivery and metabolite clearance, enhancing oxygen utilization, and improving metabolic efficiency [4, 9, 20, 27, 28].
A recently published study in the Journal of Dietary Supplements found Cordyceps Militaris to increase VO2Max, lactate threshold, and time to exhaustion [11].
In this study, participants were tested after 1 and 3 weeks of supplementation and compared to placebo. Even after 1 week, Cordyceps Militaris improved time to exhaustion by 28 seconds. However, at 3 weeks, performance was improved by 70 seconds!
This is one reason why it is suggested to use PerformElite regularly.
Otherwise known as Reishi or the "supernatural" mushroom, Ganoderma Lucidum is one of the most popular mushrooms worldwide.
Reishi mushrooms are well-known for their antioxidant activity [3].
It is so robust that it can protect DNA [19], improve mitochondrial function [3, 25], and increase ATP production [17]. Each of these points are invaluable to athletes because nothing can be achieved without DNA, the mitochondria are the sites where ATP is produced, and ATP is the body's major energy source!
If that impresses you, take a deep breath.
Supplementation with a Reishi mushroom extract improved swimming time to exhaustion by an astounding 10 minutes!
Even more stunning is that it occurred with a simultaneously reduced reliance on muscle and liver glycogen, resulting in lower lactate levels, and increased reliance on fat as fuel [26]!
Pleurotus Eryngii's easy name is King Trumpet.
King Trumpet mushrooms have high concentrations of the antioxidant L-ergothioneine [6].
L-ergothioneine is an interesting antioxidant, as the body does not produce any on its own. However, it still has dedicated cellular transporters, which suggests it has significant biological relevance [10].
It appears that L-ergothioneine is particularly important during periods of high stress [2], such as exercise.
Have you ever become sick following a really tough workout or a few days of hard workouts? One negative aspect of exercise is it can hamper the immune system.
King Trumpet can completely block the negative effects of exercise on the immune system.
Supplementation with an extract of King Trumpet mushrooms prevented a 28% decrease in immune function in elite athletes [1].
This is especially important because elite athletes are going to have the greatest adaptation to exercise and be the most resistant to compromised immunity.
Otherwise known as Shiitake, this mushroom is the second most common mushroom in the world.
It shares a few functions with King Trumpet as an immune booster and antioxidant.
Shiitake mushrooms have also been heavily researched as an anti-cancer food [8].
While King Trumpet improves immune function, Shiitake mushrooms actually act as anti-microbial [5] and anti-viral [23], preventing illnesses at the source.
Perfect for endurance athletes that are outside running in the elements and bumping shoulders with herds at the starting line!
The Lion's Mane mushroom. It actually looks like a Lion's mane!
The ancient Greeks and Romans used to eat lion hearts for courage – this is kind of the same thing. Kind of.
Lion's mane is a supplement that primarily improves the functioning of the nervous system.
One phytochemical found in Lion's Mane mushrooms, amycenone, is a nootropic [12].
Nootropics are a class of supplements that improve cognitive function. This is a wide range of categories including reaction time, processing speed, memory, and more.
Stimulating the release of nerve growth factor is another function of Lion's Mane [18], and that means greater protection of nerves from damage (such as with injury, even smaller ones), improvement of motor skills, and perhaps recovery from injury.
Or more simply, Turkey Tail.
Despite looking like a stability ball, turkeys can actually get going pretty fast at 25 mph, so any crazy Roman magic is welcome here too.
This mushroom gets the name Versicolor due to varying color patterns. The most common of which looks just like a turkey tail.
The mushroom contains two active carbohydrate components, called polysaccharide Kurcha and polysaccharide-protein complex.
These two nutrients increase white blood cell and immunoglobulin count [21] and reduce levels of inflammatory cytokines [14].
To date, no research or adverse events have been reported from the consumption of Peak O2.
Peak O2 is a researched supplement that can improve the maximum volume of O2 athletes can utilize over time while also helping them to use it more efficiently.
Ever wonder how athletes battle mental fatigue over days and hundreds of miles?
You might not be a professional, or self-identify as one, but I bet you invest a lot into your sport and your health.
You exercise almost daily, take care of your body (minus those post-workout beers), and set big goals.
In a word, you're dedicated.
You're willing to spend all that time training your body. You're willing to invest all that money into a sweet bike or a personal trainer or a gym membership.
How much are you willing to invest in your mind?
What if I told you that your mind is as trainable as your body, but with bigger benefits?
"Goldenshred" by Laura Heisinger
There is a certain quality in top ultra-endurance athletes. From freakishly unstoppable runners like Courtney Dauwalter to relentless cyclists like Lael Wilcox to fearless swimmers like Gertrude Ederle, if you listen closely, you can pick out similarities between these superhumans. (All of whom have held records outright in their respective sports.)
Gerturde Ederle swins the English Channel. Wiki Commons
It's this perfect balance of complete irreverence toward what is "hard" and what is "impossible," paired with a total reverence for what the human mind can convince the body to do.
In a conversation with Tracy Petervary, (ultra-endurance cyclist and co-director of JayP's Fat Pursuit bike race) I saw that she relished tough situations.
I could tell she loved pushing herself so far past the point of exhaustion and fatigue that a person just sort of runs on brain power.
At the time, she wasn't the one racing. Instead, she was giving advice. I was deciding whether to walk out the door and consequently, into a blizzard and at least 8 more hours of cold and exhaustion. Eight hours seemed like a very, very long time to me.
She said, "I know it seems easy to quit now, but I see so many people quit, and you know what they tell me the next day? They say, 'I had more in me, I wish I went on.'
What are you going to tell yourself tomorrow if you don't finish?" The subtext was that my only ailment was fatigue, and so I had no justification to quit.
A person's mind—not their body—gets to choose when it's time to give up.
When it comes to mind over matter, Courtney Dauwalter (record setter at the Moab 240 Endurance Run, among others) may be one of the best examples of an athlete taking it to the extreme.
She's suffered temporary blindness and has become delusional to the point of auditory and visual hallucinations. She reportedly deals with the stress of racing with cheesy jokes. Her husband will often pace her (around mile 50) and spout out a stream of anecdotes that would make any dad proud.
In a 2016 interview, Lael Wilcox sums up her mindset in races (and I suspect in life, too), which may help explain why she has been called one of the greatest ultra-endurance cyclists in the world (see: 2016 Trans AM race results).
Her statement isn't necessarily profound, but in it is a simple truth that might be.
When asked about her biggest struggles, she admits that route finding has always been a barrier.
She continues, "Everybody has something that holds them back, or that they're scared of. You're just going to have to get out there and deal with it."
The idea that ultra-endurance athletes just "deal with it" comes up again, and again, and again during interviews.
So HOW can the rest of us learn to deal with it? How can we train our brains?
Photo by asoggetti
Every time you leave your front door to train is an opportunity to train your mind. Maybe it's an extra rep or set, maybe it's an extra hill climb, maybe it's a spontaneous extra five miles. It could be forcing yourself to train in the rain or the cold or it could be sticking to your routine on days when you just want to sit on the couch.
Neuroscientists have known for a long time that repetitive behavior builds and strengthens neural circuitry around that behavior.
When it comes to mental fortitude, that means that every time you push yourself when you don't want to, or you take one more step when you don't think you can take another, that circuit becomes stronger. The stronger the circuit, the easier it is to perform the task.
This works both ways. Every time you think, "I can skip out today" you build circuitry around that belief, making it more likely to activate in the future.
What's more, your brain has a nearly infinite capacity to build and wire circuitry. While there is a finite limit to what your physical body can achieve, your brain and all 100 billion neurons inside of it can do just about anything your train it to do.
What I love about endurance events is that mentally everyone gets to a place where they try to justify stopping.
Do you have a plan for what you'll say to yourself at hour 15 of a 24-hour foot race? How about at mile 350 of a 450-mile bikepacking trip?
When fatigue sets in, your ability to make rational decisions suffers. At the hardest hour of an ultra-endurance event athletes are usually in physical discomfort and are a complete emotional wreck. That can snowball into a 'Did Not Finish' before they're really ready.
In the same thread, that delirium causes some athletes to fail to recognize when they are in trouble. Some athletes push through the pain to the point of self-harm.
So how do you know when to quit, and when to push through?
That's such a difficult question to answer because we're all so different. And in a physically demanding situation, you're really the only person who knows what's going on in your body.
Personally, I battle the decision-making stage with a series of questions.
Photo by Emma Simpson
If you have a big endurance event coming up, you can use your workouts as a time to think about a set of questions to ask when all you want is a hot shower and a cheeseburger.
Imagine what you'll be feeling at that moment and consider what might motivate you.
Maybe question #6 is, "Why am I out here in the first place?" Ultra-endurance events are loosely classified as an event over 6 hours. For some events, that time looks like weeks or months.
That translates into a lot of wasted time if you aren't enjoying yourself while you're out there. Most of us won't see a podium or set a new record—so that means we are out there for a different reason.
In my mind, it's a better reason.
Maybe your reason is to explore a new destination. Perhaps you want to push yourself in a new way. Maybe you are simply wondering if you can push yourself to an extreme, and you're hoping that experience affects your daily life in a positive way.
Set yourself up to appreciate the experience. Life is too short and ultra-endurance sports are too challenging to be miserable the entire time.
Bring along items that will make you happy. For me, that means a bunch of podcasts and great music, paired with really good chocolate.
Always remember, you signed up for the event—and it's going to take a while to finish—so you may as well enjoy yourself while you're out there!]]>
Summary Of The 5 Best Supplements For Runners That Increase Endurance & Stamina
If you read nothing else know that these are the 5 best supplements for runners.
Let's Face It. Running Can Suck!
I don't know about you, but sometimes I feel like running just plain sucks! The searing lungs, the burning legs....no wonder it is used as a form of punishment in gym classes and the army.
But there are those rare days when running feels like pure bliss. It's hard to describe the feeling when fast running feels like effortless motion and you catch runners high.
Unfortunately, these types of runs are few and far between. BUT.....
Luckily for you, I know five best supplements for runners that you can take RIGHT NOW that can make fast running feel easier EVERY DAMN DAY and have an IMMEDIATE positive impact during training & racing.
So buckle up, because in this article we are going to discuss what these 5 best supplements for runners are, what they do, and how much you should take of each to create some serious speed in your legs.
Ever wonder why so many runners drink coffee before heading out the door? Besides tasting awesome, coffee has copious amounts of caffeine. However, caffeine anhydrous (in supplemental form) is more effective than the caffeine found in coffee when it comes to bolstering your stamina.
How's that you ask? Here are the three ways caffeine makes running more comfortable.
Caffeine Blunts Fatigue
When you shove some caffeine down your throat, it competes with another molecule called adenosine. Both the caffeine and adenosine get into a molecular "fistfight" over the adenosine receptor.
Because caffeine is badass, it always wins the fight for the receptor. That's good news for you as a runner because when adenosine binds to the receptor, you feel tired and fatigue.
When caffeine binds to the receptor, you get copious amounts of energy and fatigue is delayed. Score 1 for caffeine, but there is so much more it can do!
Caffeine Creates Better Muscular Contractions
Another way caffeine makes running easier is increasing the release of calcium from the sarcoplasmic reticulum. WTF is that you might ask and why is it important.
We won't bother what the sarcoplasmic reticulum is; you have to know it releases calcium which is required for muscles to contract, which is needed for your legs to move.
The more calcium that is released, the longer your legs can make efficient churn and burn contractions to help you leave your competition in the dust.
How do you like caffeine so far? I'm not done yet as caffeine has one other significant benefit for runners!
Caffeine May Spare Glycogen & Increase Fat Oxidation
Glycogen (aka stored glucose from carbs) is the body's rocket fuel. It is the most efficient burning source of energy and the only compound that can be used during anaerobic glycolysis (intense efforts that usually involve puking).
Glycogen is a precious commodity as the muscles can store only 400-1000 grams of it. As such, we want to save it for when we put the hammer down.
Caffeine can help with this. It does this by increasing rates of fat oxidation (burning fat for energy) during running and saving that glorious glycogen for when it matters most.
How Much Caffeine Should You Have Before Running?
3-6 mg per kilogram body weight 30-60 minutes before exercise. At the low end, that's about 210mg for a 70 kg runners.
Need that amount converted into pounds? Stop being lazy and do the math.
Also, more DOES NOT equal better when it comes to caffeine. Go over 6 mg per kilogram body weight, and you may be shaking like a tree in the wind, vomit over your $150 pair of running shoes, or have an anxiety attack.
Enough on caffeine. It's one of the best supplements for runners. Let's move on to supplement numero dos.
And us geeky scientists tend to agree! Beets, beetroot juice, and beetroot powder contain high concentrations of nitrates. Now, before you get your panties in a bunch, let's clear one thing up. Nitrates ARE NOT harmful to you.
They have a ton of health and performance benefits for runners. On the health side, beets/nitrates can have a positive effect on blood pressure and endothelial relaxation.
But let's talk about what you want to know. How can beets make me run farther and faster?
Beets Lower The ATP Cost Of Exercise
Geek out with me for a minute. ATP is adenosine triphosphate and can be summed up with the following equation:
ATP = Energy
Without It, You Die
ATP = Good, especially for running.
All kidding aside beets are pretty bitchin' because they make hard running easier by reducing the amount of ATP needed to power muscular contractions
This, in turn, can also increase VO2 max, running economy, and lactate threshold which, if you are a real runner you already know how vital these things are when it comes to running your best.
Is that all beets do for running? Fu#k no. They have another benefit.
Beets Create Greater Energy Efficiency
I don't know anyone who doesn't want to be more efficient with their energy during running. Beets help with this by decreasing the breakdown of something called phosphocreatine.
Why's this important? Because when ATP is burned for energy you are left with ADP. Now this poor old ADP molecule needs a friend to reform more ATP, which we know by now equates to power.
So ADP's good ole pal phosphocreatine donates a phosphate group to his buddy and whoila.....you have more energy! The more phosphocreatine that is available, the more energy that can be produced.
Pretty neat, huh? That's also why you should supplement with creatine if you're a runner. When you ingest it in the hopes of becoming a total beefcake, it's stored as phosphocreatine!
How Much Beetroot Juice Or Powder Should You Have Before Running?
0.5 liters of beetroot juice 30-60 minutes before exercise if you can stomach it.
1 - 10 grams of beetroot powder depending on nitrate content. 500mg of nitrates is the amount demonstrated by the research to power up your running game.
Also, while supplementing with beets has some pretty lovely acute, immediate effects; it works even better if you take it every day. So listen to your Mom and EAT YOUR BEETS.
On to supplement number three.
Contrary to popular belief, taurine IS NOT bull semen. Could you imagine milking a bull? Oh, the carnage!
What taurine is though is a sulfur and nitrogen-bearing compound synthetically made from the amino acids cysteine and methionine. Thank god we don't have to go around harassing bulls.
Now, you're probably familiar with taurine from all the energy drinks you see the cool kids drinking at the skate park or larping or whatever the fu#k cool kids do these days. But usually, these drinks don't have enough taurine in them to make a damn difference. Plus they contain chemicals that can make you grow a third eye.
Ok, enough rambling. In the right amount here is how the supplement taurine can help you lay down some more miles with ease.
Taurine Battles Muscle Breakdown & Lactic Acid
One word strikes fear into the hearts of runners more than others. That word is LACTIC ACID! It's that burning sensation you feel in your legs when your muscles are being bathed with acid (or hydrogen ions).
When taurine is introduced to the lactic acid party with all its badass anti-oxidant properties, it can reduce the build-up of lactic acid and clear it out of the muscles quicker. HOORAY!
Taurine Reduces Muscle Breakdown
When you run, especially for longer distances like the marathon, your legs take an epic beating. From a scientific perspective, this gross abuse of your skinny legs breaks down muscle proteins. All you need to know is this is no Bueno.
When muscle protein is broken down, you fatigue quicker and hit bonk town much sooner. Taurine can help with this by decreasing the rate of muscle breakdown.
What's more, lack of taurine (which becomes depleted during exercise) can severely compromise muscle function by 80%. That's because taurine composes over 50% of free amines in cardiac muscle.
Taurine Makes New Blood Vessels
Ok, so this benefit of taurine won't have an immediate impact on your running performance, but it's still a neat little tidbit of info.
If getting blood to muscles is essential, getting MORE blood to muscles is more importanter...wait that's not a word — my point...the more blood that can get to working, running muscles, the better.
Taurine helps with this by stimulating a process known as angiogenesis. In non-geek speak, this is the formation of new blood vessels like capillaries. This, in turn, creates more efficient blood/nutrient delivery to muscles, which equals a higher capacity for running FAST!
How Much Taurine Should You Have Before Running?
A large meta-analysis (basically a statistical summary of quality research available on a specific topic) done on Taurine suggests taking 1-3 grams thirty minutes before exercise for best results.
Like eggs? Me too. Not only are they darn tasty but they're a great source of choline; a compound that has some pretty nifty brain and muscle benefits for runners.
The bad news. You're probably choline-deficient like 90% of the population, Plus, as a runner, what you do have marinating in your body's choline pool becomes depleted pretty quickly once you start exercising.
Hint Hint.....choline supplementation is a practical solution to make sure you aren't deficient. It doesn't hurt too that it can help muscles contract more efficiently and keep you focused during a race like a fat kid focuses on ice cream.
Onto the benefits of Choline.
Choline Makes Muscles Contract More Efficiently
When you take in choline, it is converted into a neurotransmitter called acetylcholine. This bad boy signals muscles to contract. I bet you can see where this is going.
If you are already choline-deficient and your choline pool becomes even more depleted during running, those super sexy muscles in your legs won't work very well when it's time to lay down some speed.
This can be summed up with the following equation:
Reduction In Choline During Intense Endurance Exercise = Reduced Acetylcholine Release = Inefficient Muscle Contractions = Reduced Endurance & Performance
The good news for you is choline supplementation can help minimize the drop in choline levels during exercise and keep you going stronger for longer.
Choline Can Help You Stay Focused
Unless you have the mindset of a monk, I'm willing to bet a lot of you runners have a hard time staying focused when the pain starts to set in. It's understandable, it sucks being uncomfortable during a race, but staying focused can mean the difference between a W and being the first loser (2nd place).
Rejoice, choline can help! That's because as mentioned before when choline is ingested it is converted into acetylcholine. Not only does acetylcholine create better muscular contractions but it is also a key neurotransmitter for mental focus.
It does this by protecting the structural integrity of cell membranes in the brain and creating more efficient neural transmissions between synapses.
How Much Choline Should You Have Before Running?
1-2 grams is the magic number here. Take as choline bitartrate, Alpha-GPC, or CDP choline.
And now on to the last supplement that can help you run faster, easier....and it'll surprise you.
Let's get two things straight before we talk about carbs:
Now that we have that out of the way if you are a runner, you should be eating carbs before, during, and after running. EAT ALL THE CARBS.
When consumed before and during running, carbs help keep blood glucose elevated. Glucose is converted to ATP, ATP makes muscles work, AND carbs/glucose/glycogen is THE ONLY fuel source that can power anaerobic glycolysis....the energy system used when heart rate gets above ~80% of max.
I hear all you Keto people complaining. I'm sorry, but the fundamental laws of physiology cannot be debated, and the research on high-fat diets in runners pales in comparison to the research on high carb diets in runners. Plus carbs are too damn delicious to give up and going keto makes you feel like sh#t.
How Many Carbs You Ask?
Follow this scheme, and you'll be all carbed up and good as gold when you start your training session or race:
Take-home point? Carbs are pretty great for runners. If anyone else says otherwise, give them a quick kick in the ass.
And that my running friends are the 5 best supplements for runners!]]>
VO2 Max the one bit of exercise physiology that almost everyone thinks they know. But do they? Let's find out.
VO2 is a measure of how much O2 your entire body is using per minute.
It can be measured in absolute terms (liters per minute) or relative to body mass (milliliters/kilogram/minute). A straightforward example will illustrate that VO2 is NOT just a measure of aerobic muscular work.
If you are hooked up to a metabolic cart (which is what they call the bunch of equipment used to measure VO2) while lying down doing nothing, you will register a non-zero VO2.
This is the O2 cost of staying alive and involves stuff that is mostly unconscious such as the beating of your heart, the functioning of your liver and kidneys, your breathing, maintaining homeostasis of things like temperature and pH, and, most importantly, keeping your brain alive.
There are a couple of mostly interchangeable terms for the above:
They refer to the oxygen cost of keeping your body alive when it is doing nothing.
BMR is much more strictly controlled and tends to give numbers up to 10% lower than RMR. On the flip-side, RMR is a better reflection of your day-to-day life. Here is a link with more details.
The practical ramification of this is that many things other than your exercise intensity will impact your VO2.
The simplest and most common example is temperature. Standing around on a cold breezy day will cost you significantly less than standing around in the sun on a scorchingly hot and humid day.
It's akin to turning the AC on in your car: the fuel consumption goes up even when you're idling, and your fuel economy goes down the crapper.
Almost all of us when we say "VO2" or "VO2 max" is talking about what happens during physical activity.
This is simply the oxygen cost of making the muscles work, added to the RMR discussed above.
In more familiar terms, it's the amount of aerobic work being done by the working muscles.
There are two important concepts to note in that statement. The simpler one is the concept of "working muscles."
While it may seem evident that the VO2 cost of an activity is determined by which muscles are active and which are not, this fact is often overlooked.
The practical take-home consequence of this is that VO2 and VO2 Max are activity-specific.
This is a massive misconception for many people, who tend to think that the VO2 max they got on the treadmill test is their only VO2 max, kind of like their max Heart Rate. Nay-nay.
If we could put the same person through VO2 max tests while doing different things, then we'd get a different VO2 max for each one.
You'd have your Running VO2 max, your Cycling VO2 max, your Recumbent Cycling VO2 max, your Assault Bike VO2 max, your Rowing VO2 max, your Swimming VO2 max, etc.
They would each be a different value for several reasons.
The most apparent reason for the differences is the different amounts of muscle mass being used.
The second big concept is the fact we are measuring strictly aerobic energy production, and your body has other options.
Remember that there are two anaerobic energy pathways in addition to the aerobic one and that all of them are in use all of the time to various degrees.
What this means is that VO2 is NOT the maximum work output of the muscles in question, since the anaerobic systems start doing more and more of the work as the intensity increases.
In real-world scenarios, what this means is that there are valuable and effective training intensities above 100% VO2 Max.
Pretty much every world-class male marathoner can and has run well below 14 minutes for 5 km.
They didn't get to their 2:05 marathon without doing speedwork and high-intensity intervals, even though their race is almost entirely aerobic.]]>
What is the best pre-workout for athletes? Besides protein and creatine, pre-workouts are probably one of the more popular supplements taken by both strength and endurance athletes; and for good reason.
Pre-workouts can provide an acute ergogenic benefit that can help athletes run faster, push further, lift more weight, and fatigue less quickly.
But with so many pre-workouts on the market how do you know which ones are the best?
This article will discuss what a pre-workout is, how to take a pre-workout, what makes a pre-workout the best for both strength and endurance athletes, and what ingredients should be found in a good pre-workout. Let's get started.
A pre workout is any supplement or combination of supplements that are designed to enhance athletic performance. A good pre workout can provide both acute and chronic benefits when taken before exercise.
The best pre workout for strength and endurance athletes will often share similar ingredients but there are some key differences that make some better than others.
Pre workouts are best consumed 30-60 minutes before exercise or competition. This time allows the body to digest and absorb all ingredients necessary to produce peak performance.
For example, when caffeine, a common ingredient found in the best pre workouts, is consumed it takes 60 minutes to reach peak concentrations in the blood.
The answer to this question really depends on the ingredients found in the pre workout.
Generally speaking, you will notice the effects of a pre workout ~30 minutes after you consume it with the effects lasting ~2-4 hours.
Using caffeine as an example again, you will feel its effects after ~15 minutes and the energy you feel from it can last 4-6 hours.
With other ingredients found in pre workouts, it may take 20-30 days to notice the performance enhancing effects.
Creatine and Beta-Alanine are classic examples. Both of these ingredients, commonly found in the best pre workouts, require a loading phase of ~30 days for you to reap the benefits.
To be considered the best pre workout, the supplement in question should contain:
Let's briefly discuss each of these.
I would guess 95% of the ingredients found in pre workouts have no scientific research on them demonstrating they enhance performance. Additionally, some ingredients found in pre workouts only have rodent research to back their use. This is no Bueno.
The best pre workouts should have ingredients in them that have been validated by scientific research to work in humans.
Meaning clinical trials conducted in a lab setting and better yet if the testing involved athletes.
Out of the thousands of supplements on the market today, probably only 50 (we'll discuss these later) have credible scientific evidence to support their use in improving athletic performance.
Examples are creatine, beta-alanine, caffeine, protein, and choline. If ever in doubt use examine.com as a reference.
Even if a pre workout appears to contain the best ingredients, it is also important to make sure it contains the appropriate doses.
For example, 1 gram of beta-alanine will not do anything to improve athletic performance. You need at least 3.2 grams daily.
Many supplement companies will put the right ingredients in their pre workout so it looks good on the surface. They'll claim it is the best pre workout. But the correct dosages will not be used to support that claim.
Proprietary blends are a well-kept secret designed to pad the pockets of those who make the supplements and rip you off.
In the simplest sense, a prop blend is a combination of many different ingredients but there is no disclosure in regard to how much of each ingredient you are getting.
This presents a huge problem.
For example, on the supplement facts panel on a pre workout, there could be a blend called the "Intense Energy Blend." This blend might list 5-10 different ingredients and state the total amount of ingredients at 5 grams.
Here's the problem…. the first ingredient in that blend could contain 4.99 grams of all the active ingredients with the others sprinkled in.
This is perfectly legal and supplement companies take advantage of this by loading up pre workouts with the cheapest ingredients first. Here's an example of a prop blend.
Take home point. The best pre workout will not contain proprietary blends.
At minimum the best pre workout supplements for strength athletes should include:
At minimum the best pre workout for endurance athletes should include:
Truth be told, women do not need to take a different pre workout from men.
The best pre workout for women will include the ingredients listed above in the proper dosages.
While several supplements companies will lead you to believe that women need a separate pre workout, this is a blatant lie. Here's why. Most of the research done on the ingredients in the best pre workouts have included both male and female subjects.
The answer to this question is yes and no.
It cannot be stressed enough to do your research on what you are putting in your body. There have been several instances of severe illness or even death from taking a pre workout with red flagged ingredients. When in doubt use examine.com as your reference.
By now you should have your PhD in pre workouts. To sum things up the best pre workout supplements should have research-validated ingredients, in the proper doses, and have been demonstrated to enhance strength or endurance performance.]]>
When you see a runner on the side of the road, do you ever notice that some look very graceful and some look like they are really struggling?
Intensity and weather factors aside, poor running mechanics can really stick out. You don't need to be an expert to spot it. Think about how graceful and synchronized Olympic level runners look.
Sprinters seem to move like a hot knife through butter and distance runners seem to just flow along. The mechanics on an experienced runner differ drastically than on a person without experience. So why is this important?
I have seen an array of interesting things when it comes to runners over the years.
My experience and knowledge base of running stems from competitive running in high school, to currently obstacle course racing and also from treatment in my career as a physical therapist.
I find it amazing what people can make their bodies do and not always in a good way.
Some people just cannot run! They either look like they are being electrocuted or like Bambi on ice.
It can be funny to see at times but also concerning as a healthcare practitioner.
Even though running is a basic functional movement of the human body, it is incredible how the vast majority of people lack the knowledge of how to run properly.
Considering running is one of the most popular forms of activity and exercise, it is important people understand how to do it properly.
Physical therapists are an excellent example of healthcare practitioners that can help with this process. Physical therapy has progressed as a profession over the past couple of decades in that we do a lot more than just ultrasound and back massages. That is an outdated treatment philosophy.
We are movement specialists that have a complete understanding of the human body and how it operates. It is our job to help educate the population about proper movement mechanics and exercise so people can better themselves while minimizing issues.
As we study human performance and conduct more research, we are learning more about the cause of injuries and how to prevent them.
So that is why in this article I am going to discuss running mechanics, injuries related to poor mechanics, treatment techniques and also everyone's favorite, running shoes.
Ok, so running mechanics are important, but why? Why can't we just get up and go even if we look like were slipping on banana peels? Shouldn't it be that easy? The answer is yes, but this not true for everyone.
Some people require more training and education than others.
Running mechanics have become a hot topic of discussion especially as we tend to analyze and understand human performance at a higher level. Every athlete is always looking for ways to improve in terms of speed, power and strength.
Considering the foundation for most sports involves running, it is usually one of the first things analyzed with an athlete.
I mentioned that experienced runners tend to seem flawless when they move but sometimes even experienced runners can benefit from a tune-up.
Sometimes a few tweaks to form and technique can be the difference in a runner dropping seconds to even minutes in their times.
One issue is that most runners have no idea they are doing something wrong until something starts to hurt or they get injured.
Video analysis involving something as simple as an experienced practitioner just watching an athlete run and providing the visual feedback to the athlete can be a huge help.
Research studies have analyzed runners more over the years as technology has improved for providing visual data, muscle activation signals and impact force generation feedback.
In order to understand where dysfunction in running stems from, we need to understand some history first.
If humans are meant to run and have been since the earliest recorded activity of mankind, then why weren't our ancestors experiencing the high amount of injuries our most recent generations are? Were they just not recorded, ignored or maybe didn't occur at all? Let's look at what has been discovered in the research.
The first endurance runner was documented 2 million years ago as cited in a journal about the evolution of homo erectus, the first ancestral being of today's human.
Running specialist physical therapist, Irene Davis talks about this in one of her research articles. Irene is a professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. She is the founder of Spaulding National Running Center and has conducted extensive amounts of research and lectures involving lower extremity movement analysis, mechanics and running.
She notes that there is documentation in the literature about materials that were used by homo erectus to simply protect the bottom of the foot from environmental elements. This is the beginning of the shoe!
Shoes have evolved over 10,00 years but the first athletic shoe emerged in the 1800's.
Rubber soles were first applied to the bottom of shoes in 1832 to provide better durability. "Sneakers" were developed with the technology of using rubber to allow for a flexible and durable sole.
Compared to older technology of shoes, these new light and flexible shoes were quiet and allowed a person to "sneak up on someone".
The first customized running shoe was developed in 1926 and had customized spike patterns depending on sprinting vs. distance running.
1964 was when the first cushioned running shoe emerged and then over the next 40 years the process of shoes becoming more cushioned and supportive took off.
The problem is this:
Irene Davis notes in one study that she had a conversation with Jeff Johnson who worked for Nike. He helped create the name Nike and is cited in this article stating that when he was younger and still running often, injuries were less common compared to now with cushioned shoes.
There were no injuries found in the literature in the 1960s but injuries did increase leading into the 1970s in congruence with the increasing popularity of running amongst the population.
Runner's World magazine published the first few surveys of running injuries in the early 1970s and it was found that there was an increase in runners sustaining injuries, specifically involving the knee.
When training on hard surfaces, the legs adapt and increase compliance due to increased demands on the muscular system.
This is in line with bone remodeling theory, which describes how our bones are constantly breaking down and rebuilding. This is why weight-bearing exercises are important for bone health for individuals with osteoporosis.
In response to the rising injury rates, shoe companies began adding more cushioning and support to try to control impact and foot motion. You will often see the shoe types described as "cushioning, stability and motion control". This trend continued for about four decades bringing us to the present time.
The boom of implementing more cushioned shoes seemed to be a response from shoe companies to address injury rates as a quick fix solution. Instead of analyzing other factors such as running mechanics, strength and individual movement efficiency, the answer was to fix the shoe.
In 2004 the first minimal shoe emerged from Nike, the Nike Free, which was designed to mimic barefoot running.
With the popular book Born to Run being released in 2009, the barefoot running craze started. Actually, it exploded!
Everyone wanted to run barefoot style, as it was the "new thing". Vibram became very popular starting in 2005 with the famous five-finger style shoe that was originally created for yacht racers to help maintain grip upon boat launching.
Runners saw this shoe and went crazy for it as it replicated barefoot style running the best out of any shoe at the time.
The running shoe style has fluctuated in waves over the past 30 years and continues to ride the pendulum between supportive to minimal, struggling to find a landing point of the perfect balance.
The exploration of minimal style shoes and barefoot running has encouraged specialists to analyze running gait and movement mechanics more in depth in an attempt to better understand athletic performance and causes for injury.
It has been shown that traditional shoes produce a landing pattern that results in a more outstretched leg with a straight knee and flexed foot, producing more of a heel strike pattern.
This also results in more oxygen consumption due to the energy required to absorb greater impact sustained through the leg.
Running in minimal shoes has been found to reduce heel striking because of pain upon the constant striking of the heel.
This results in more of a plantarflexed foot, less knee flexion excursion, and shorter ground contact.
To fully understand these mechanics, try running barefoot on a concrete surface and see how your body will naturally want to land.
This is why it is important for your foot to be able to spread and expand upon impact for proper shock absorption. Wearing a tight shoe can limit these mechanics, causing issues.
The major question of how long it takes to transition to barefoot running style still resides.
There still is no conclusive answer for how long it takes for an individual to transition to a barefoot running technique but it is known that injuries definitely occur when the transition occurs too fast and rapid.
Jumping into a pair of barefoot-style shoes and running 50 miles of trails in one week is a sure way to be on the receiving end of multiple injuries.
Studies have indicated that basic adjustment to the barefoot technique and shoe is recommended for the safest start.
This consists of gradually progressing walking and standing time in a barefoot shoe throughout a number of weeks to months while monitoring the response.
General exercise in a barefoot shoe will also help to allow adaptation to the technique and train the muscles to respond to the new loads and forces. Along with wearing the shoe, foot and ankle strengthening programs should be implemented.
With the barefoot running technique, there is more adaptation required for the joints and muscles to build a tolerance to the demands of increased impact forces and loading.
The plantar fascia, Achilles and ankle stabilizers will all be under more stress and will require time to adapt.
Ankle mobility exercises will also be important to compliment strength exercises to maintain proper joint and tissue extensibility. Transition time is also dependent on fitness level, environmental factors, running experience and compliance to a consistent routine.
A person who was very active as a child and continued into a lifestyle of movement as they aged may have a shorter transition period than someone who just started running in their later life.
Genetic variations also require consideration as some individuals are born with foot abnormalities and anatomical changes that may cause a foot to be more rigid or excessively mobile.
Depending on individual anatomy, proper treatment and training techniques are warranted to ensure the person is receiving the proper applications.
It seems that the evolution and changes to the running shoe over the years has been a contributing factor towards altering running mechanics in the general population and also contributing to injuries.
Even if returning to a more barefoot technique is the way to go for runners, the practice of running mechanics is just as important. You cannot just fix the problem of poor movement efficiency by changing the shoe only.
For any other exercise, you would practice it routinely to improve your execution. To become better at squatting, you squat more often. To improve swimming, you practice your swimming technique. To improve your tennis or volleyball serve, you practice serving. It should be the same for running.
Research in this area has shown that most commonly, abnormal hip and knee mechanics are associated with running injuries.
Iliotibial band syndrome, tibial stress fractures, and patella femoral pain syndrome are most common.
These occur when there are aberrant forces experienced in the tissue.
Occurs when the patella is not tracking properly across the front of the knee. Stress to the tissue that surrounds the patella underneath the patella and in the patella tendon can produce pain.
Occurs when the IT band is under increased stress and contracts, causing pressure and pain where it inserts on the side of the knee.
Are a result of excessive impact forces being transmitted to an isolated part of the lower leg. They also can occur from overactivation in the muscles that attach to the tibial bone.
These conditions usually result from faulty movement mechanics. Common movement disruptions are known as valgus or varus stress.
Most commonly seen during a single leg squat, the knee either buckles inward wobbles or pivots. The pelvis on the stance side rotates while the other side tends to drop down.
This is usually seen during the single leg squat test, step down test and also can be seen when analyzing running gait.
If deviations are noted with a single leg squat on a stable surface in a controlled environment, imagine what is happening when the leg is under 3x the load and impact during running with about 100 plus cycles or more of the single leg stance phase depending on the running distance!
Strengthening is important to improve muscle integrity and response to loads and stress.
Working on single leg stability exercises that target all the gluteal and pelvic muscles is beneficial to build the isolated muscle groups but research has shown that neuromuscular re-education is more beneficial towards reducing injuries and improving movement mechanics.
This is where that term "motor control" comes back as I mentioned in previous articles.
Remember when I discussed how someone can generate a high-grade strength measurement when tested in the muscle isolated movement but then when they do a dynamic movement such as single leg squat, the deviations are noted?
This is exactly that example translated over in running. The basic muscle strength may be good but the coordination of all the muscles is deficient.
Retraining individuals to improve their single leg squat through visual and tactile feedback can produce better alignment and movement mechanics than just strengthening the muscles alone.
This philosophy has been found for running mechanics in research.
One study found that retraining proper running form on a treadmill with an audible feedback machine for proper striking timing helped to improve running efficiency and cause decreased reports of pain during running.
About The Author
Michael St. George, PT, DPT (@icore_stgeorge on Instagram) is a physical therapist who works for Excel Physical Therapy and Fitness which is a private practice that is based around the greater Philadelphia region and suburbs. He is FMS, SFMA, Y Balance and Motor Control Test Certified with 8 years of experience in outpatient orthopedics and sports medicine. His training consists of experience working with physicians and surgeons from the Rothman Institute and therapists in his field specializing in various manual techniques and advanced treatment procedures
You down with ATP (yeah, you know me)....you better be because without it you DIE!
About The Author Matt Mosman - Spearfish, South Dakota
Matt Mosman (MS, CISSN, CSCS) is a research scientist, endurance athlete, and the founder and Chief Endurance Officer at EndurElite. Matt holds his B.S. in Exercise Science from Creighton University and his M.S. in Exercise Physiology from the University of California. Matt and his family reside in Spearfish South Dakota where they enjoy running, mountain biking, camping, and all the outdoor adventures Spearfish has to offer.
For the longest time, the supplement capsaicin had been used by the gym crowd as a thermogenic fat burner but a new study suggests it may improve running performance.
About The Author Matt Mosman - Spearfish, South Dakota
Matt Mosman (MS, CISSN, CSCS) is a research scientist, endurance athlete, and the founder and Chief Endurance Officer at EndurElite. Matt holds his B.S. in Exercise Science from Creighton University and his M.S. in Exercise Physiology from the University of California. Matt and his family reside in Spearfish South Dakota where they enjoy running, mountain biking, camping, and all the outdoor adventures Spearfish has to offer.]]>
Full Video Transcription:
Ever wonder how many rest and recovery days you should take after a race? That is going to be the topic of our extended 60-Second Brain Bomb for today.
Now, let's get one thing straight before I start. When I say race, I'm not talking about your local Cola or Zombie run where you're giggling and giving high fives along the race.
Oh, no, we're talking about the kind of race that's balls to the wall, pedal to the metal, nothing left when you're done, and your body feels like it's been dipped in hot lava and ran through a meat grinder afterward. That's the type of race we're talking about.
Now, after races like this, there's a lot of things going on in your body that makes it feel like hell, such as:
Now, I don't care who you are. You're not superhuman.
It's important for your long term success as an endurance athlete, and to help you avoid overtraining and injury.
But, back to the original question. How many rest or recovery days should you take after a race? And the answer is 2 days, 6 hours, 4 minutes, and 32 seconds.
Okay, I'm just messing with you because it is absolutely asinine to give an exact answer on this, based on:
It's also going to depend on the type of activity you do, whether it's a running race or a mountain bike race, and then it will also depend on the distance of that race, too, that will determine how many rest and recovery days that you're going to want to take.
But I'm going to give you my totally unscientific answer, which is rare form for me because I rarely do this, and give you my best advice to answer this question.
My best advice is to take 1 to 30 complete rest days off after a race, again, depending on the length and intensity of the race.
Now, if it's a 5k, you know, you can take one rest day. If it's, like, 100-mile race, you may take 30 rest days, or even longer than that.
After those complete rest days, I want you to listen to your body. It's pretty smart. It will know when it's ready to resume training or hit up that next hard work out.
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This is the topic of elbow pain. Medial and Lateral Epicondylalgia to be specific, are two very plaguing issues that can occur at the elbow.
Remember we discussed Achilles tendinopathy? Well, the same type of problems can occur in all tendons, including those in the elbow.
It's safe to say that a majority of athletes implement some form of weight or resistance training into their training regimen, which can vary from the use of weights, resistance bands or body weight methods.
This may be an important part of any athlete's routine but with all training regimens, there is always a risk for injury.
Non-traumatic elbow issues occur most commonly from pulling, carrying and gripping overload.
They are commonly seen in individuals who have grip intensive occupations such as manual labor workers but also are seen in upper extremity dominant athletes including golfers, tennis players, rock climbers, gymnasts, and weight lifters.
This is where the layman's terms "Tennis elbow" and "Golfers elbow" originated.
As discussed previously, tendinopathy occurs when there is disorientation of the fibers resulting in poor integrity of the tissue.
Studies have shown a change in the collagen wherein MRI results, the affected area lights up bright white. There also are changes in the neuronal tissue and nociceptive processes.
Nociception is your sensory input for pain and a problem with this input channel means that the pain can be perceived as worse than it really is.
The area can present as very sensitive to touch with excessive pain upon force production such as generating a tight fist.
MRI Image Results
Notice in the image on the right, the white area.
Ultrasound Image Results
Notice in the image to the right, the blackened region and small area lighting up white.
Grip strength has not been shown to be affected but is rather diminished due to the response of pain, meaning someone with a high pain tolerance can generate a strong grip force and fight through the pain if they wanted to.
More importantly than raw grip strength, studies have also shown that there is a delay in the contraction and reaction time on affected sides meaning the ability to generate force through the elbow such as gripping, is slower and not as smooth.
This is a result of the disorientation of the collagen fibers and poor vascularity or blood flow in the area.
This image shows a visual representation of the tendon fibers. Although inflammation is shown, it would most likely be during an acute flare-up episode. Generally, tendon issues result in pain from poor tissue integrity, not inflammation.
Pull ups, chin ups, farmers carries, curling, Olympic lifts and holding weights during weighted leg exercises are just some examples of where the elbow is at risk for excessive strain.
A strong grip is important and has been correlated with a positive life expectancy but during training, the problem resides where there are deficits that cause the muscles of the forearms and wrist to overwork.
Studies have shown that clinical presentations of individuals with elbow pain due to tendinopathy reveal a weakness in scapula musculature and the rotator cuff.
Instability in the scapula can cause compensation at the elbows and wrists.
The wrist flexors and extensors originate at the elbow. The flexors are on the inner side of the elbow and the extensors are on the outer side. They attach to a boney prominence called the epicondyle.
Think of this as an anchor, where on the other end are the tendons that flex and extend the wrist and fingers.
If the load to the anchor is excessive, the tissue experiences excessive stress as it attempts to work hard to support the wrist and elbow.
Common movements again are pulling such as during rowing movements, curling, carrying such as a farmers carry and fast wrist extension movements such as during a backhand swing,
Olympic lifting such a snatch or clean and catching a ball such as during med ball slams and tosses.
Treating elbow tendinopathy is a constant challenge for therapists but as with anything, the earlier it can be addressed the better.
The sooner treatment and activity modification can be implemented, the better the prognosis for the individual.
Most individuals have an initial thought process of, "I need an injection" so they can receive some pain relief.
A cortisone injection or anti-inflammatory medications have usually bee administered to reduce the pain.
Recent research and clinical outcomes have proven this to actually be counterproductive as inflammation is the body's way of bringing the proper nutrients to the area to heal and repair.
Anti-inflammatory medications are generally used to control excessive inflammation or if the person is in a lot of discomforts, limiting movement and exercise efficiency.
Ice also has been used in the past but the effects of ice cannot even permeate deep enough to the tendons to have an actual effect. The numbing effect may block pain but it will not have an effect on the tissue.
Braces and taping methods are commonly used to help reduce strain onto the tissue by limiting force production in the muscle group. These are just band-aid techniques and can be implemented short term while the individual is working on the underlying mechanical deficits.
Percutaneous needling is one form of treatment that is very common practice administered by orthopedic specialists.
It is done under ultrasound where a needle is guided into the tendon and used to reorient the affected sections of fibers, cause inflammation and incite the healing process.
Following this procedure, a protocol of exercises is administered in therapy to restore proper tissue integrity and mechanics.
To start treatment, the primary focus is on the elbow.
Ensuring proper healing and restoration of normal tissue properties is important before initiating anything else such as shoulder stability exercises.
The beginning phase is very calculated and it is important patients are diligent and compliant with the protocol to ensure the best possible prognosis.
The following is an example of treatment administered in physical therapy. The exercises are for an example protocol for lateral epicondylalgia, "Tennis Elbow"
This is different than a normal soft tissue massage because its focus is different than moving blood and soft tissue around to stimulate a relaxation process.
TFM is implemented to basically dig at the tendon across the fiber orientation to aggravate it and cause inflammation.
At first, it seems counterproductive to cause more pain but this is important because it is followed up by a strict protocol of corrective exercises targeted to load and remodel the tissue while the proper nutrients to heal and repair are in the area.
Following the TFM, stretching is done immediately afterward:
Then isometrics are implemented to begin a controlled loading phase to the tissue:
A weighted ball is often used
The "lowering" phase of a movement which is where the tissue lengthens against gravity. Eccentrics are primarily used in tendinopathy treatments.
The patient starts with the wrist in the top position with weight and slowly lowers down. They then use their other hand to return the wrist to the start position to avoid the concentric (aggravating) movements.
The eccentrics are meant to be done slowly and with a good weight resistance where there is some discomfort and fatigue while ensuring the patient can still maintain good control of the weight.
A hammer is often used for this exercise. The patient starts with holding the hammer and slowly lowers down with the same concept as done for wrist extension.
Once the patient can demonstrate less pain, less fatigue and improved control with higher repetitions and resistance, they are then progressed to more functional training involving gripping, pulling, carrying, and lifting and full body exercises.
Shoulder stability exercises are also implemented once the patient can tolerate gripping forms of resistance without pain. Implementing functional exercises too soon can cause regression and flare of symptoms.
This can also cause inefficient execution of the exercise, as the patient may tend to compensate due to pain.
About The Author
Michael St. George, PT, DPT (@icore_stgeorge on Instagram) is a physical therapist who works for Excel Physical Therapy and Fitness which is a private practice that is based around the greater Philadelphia region and suburbs. He is FMS, SFMA, Y Balance and Motor Control Test Certified with 8 years of experience in outpatient orthopedics and sports medicine. His training consists of experience working with physicians and surgeons from the Rothman Institute and therapists in his field specializing in various manual techniques and advanced treatment procedures.