Results tagged “Injury Management”

Recovery Protocol

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After the Chicago Lakefront 50 Mile, I received quite a few requests to write a post on recovery techniques I used in the twelve days between the Tussey Mountainback 50 Mile and the Lakefront 50. To be honest, a lot of what I did was similar to what I have been doing for some time now, so I will link to a few previous blog posts that may be helpful. With that said, I do have some concrete reasons that I believe my recovery was faster than normal.

Those of you who follow my blog closely know that I have been practicing a diet that can most simply be described as high fat, low carb, and moderate protein. This type of protocol is known as Optimized Fat Metabolism (OFM). Here are a few places you can learn more about this:

When I started this protocol, I noticed benefits nearly right away. Things like better sleep, less inflammation, faster recovery, more consistent energy levels (no midday crash). However, if you research becoming “fat adapted,” you will find that individuals who lived a high carbohydrate diet for many years will likely take upwards to two years to fully “fat adapt.” Because I began OFM protocol in early 2011, I am just shy of my two-year anniversary, and I believe my body is now beginning to be fully adapted. And not only because of my recovery: I've also felt a lot more consistent during 50-mile races, even when I consume carbohydrates as fuel during the race itself.

My personalized OFM approach can be characterized as macronutrient cycling. While my protein intake fluctuates little (typically 100 to 150 grams per day), my carbohydrate intake can be anywhere from 5 percent of my total calories to 50 percent, depending on where I am in my training cycle. When I am in full recovery mode after a race, I drop my carbohydrate intake as low as possible. On the other hand, my carbohydrate intake is around 20-30 percent of my total calories when my training is ramping up in volume and intensity, and in the final 36 hours before a race I allow it to climb to 50 percent at most.

All carbohydrates are not created equal. I don’t eat grains; I think the way grains have been engineered in the past several decades has made them hard on digestion and the likely cause of many of our broken guts. I also stay away from lactose, simply because my body doesn't seem to digest it very well. Commercial dairy producers have removed the enzymes in dairy that help our bodies break down lactose. Since our bodies cannot produce these enzymes on their own, this results in bloating and indigestion. I will drink raw milk if it's available, but I don't go out of my way to get it.

My primary source of carbohydrates is vegetables. I usually opt for non-starchy vegetables, but when I am looking to raise my carbohydrate intake I do eat carbohydrates from starchy sources, such as potatoes, sweet potatoes, or rice. Another source of carbohydrates I use is fruit. I try to focus on melons and berries, as they are less apt to spike insulin, but I do eat things like apples, pears, and peaches from time to time.

After protein and carbohydrates, the rest of my calories, of course, come from fat—often more than half my daily calories. Just as with protein and carbohydrates, I pay close attention to the types of fats I consume. I take in approximately 50 percent of my fat as saturated fat. In recent decades, saturated fat has gotten a bad rap—but it is shameful science that has led to that. I don’t feel the need to defend saturated fat here, because many respected scientists who are much wiser than I have debunked this myth many times. If you're interested in learning from them, check out the resources list at the end of this post. The remaining 50 percent I try to make mostly monounsaturated fat, with very little coming from polyunsaturated fat sources. The polyunsaturated fat sources are a recipe for inflammation, especially when a diet is low in omega-3 fatty acids, so I avoid them for the exception of the occasional snack of mixed nuts or nut butters. A few go-to fat sources I enjoy include: coconut milk, coconut oil, butter, animal fat, avocado, extra virgin olive oil, and cheeses (full fat, to avoid lactose).

One of my favorite dishes to eat is a mix of vegetables (mostly greens) with fresh calf liver, bacon, and sour cream. I sprinkle Himalayan sea salt, pepper, turmeric, and macca root powder on top. This dish provides a perfect blend of animal fat, animal protein, and organ meat, a combination that has shown promising benefits in recovery. I definitely ate my fair share of this dish during recovery between Tussey and Lakefront.

My diet, along with strategic use of NOW Foods, Xendurance, and Vespa Power Products, has allowed me to better recoup after a really hard effort at the ultra distance.

NOW Foods is a nutritional supplement company with countless offerings. My favorites include: spirulina, Fruit and Green PhytoFoods mix, CoQ10, yucca root, and vitamin D3/K2. These help with things like an improved micronutrient profile in my diet, sharper brain function, reduced inflammation, and better bone health. I believe a healthy lifestyle allows you to get the nutrition you need from your diet, but with training volumes exceeding 25 hours a week at times, supplementation allows me to better meet the demands I put on my body—and help with recovery.

Xendurance is a supplement that buffers lactic acid up to 15 percent (supported in double-blind, third-party studies). Vespa helps force my body to more efficiently utilize fat as fuel, sparing muscle damage. It does this with unique blend of wasp extract and amino acids (visit Vespa's website to explore science behind this). I take three Xendurance tablets every morning and every evening, and I usually take a few extra on the nights leading into a race, as well as the morning of. Also on the morning of a race, I take a Vespa Concentrate when I wake up, and then a Vespa Junior at the start line. During the race, I usually take a Vespa Junior every 90 minutes or a Vespa Concentrate every two hours. Typically, I use more Vespa Junior if the race is quicker in pace.

When I have my diet dialed in really close, supplement intelligently, and get adequate sleep, my recovery pretty much takes care of itself. I just listen to my body for muscle soreness and tendon tightness, and when the soreness and tightness is gone, I get back to training.

Resources

Yeo WK, Carey AL, Burke L, Spriet LL, Hawley JA. Fat adaptation in well-trained athletes: effects on cell metabolism. Appl Physiol Nutr Metab. 2011 Feb; 36(1):12-22.

Volek, J, Phinney S. The Art and Science of Low Carbohydrate Performance. Beyond Obesity LLC. 2012 April.

Masterjohn, Christopher. "Beyond Good and Evil - Weston A Price Foundation." Beyond Good and Evil - Weston A Price Foundation. The Western A. Price Foundation, 10 Dec. 2012. Web. 15 Nov. 2013.

Attia, Peter. "My Personal Nutrition Journey." The Eating Academy. N.p., n.d. Web. 15 Nov. 2013.

Trumping Tendonitis

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After completing the Kettle 100k, I had a pretty nasty flare-up of tendonitis on the back of my right knee. Like most runners, I have had experience with tendonitis in the past. In fact, when I was a sophomore at UW–Stevens Point, I had a particularly bad case of tendonitis that sidelined me for all of both indoor and outdoor track and field (15 weeks total of no running). The case of tendonitis that I carried into Kettle 100k and that really flared up the days after the race was probably as bad as, if not worse than, the case I had back in college (judging by pain level and joint mobility around the affected area), but this time I only had to give up running for eight days. This got me really thinking.

What made my tendonitis heal so much faster this time? I know tendonitis is very case by case—sometimes it just needs some stretching, other times a day or two off, and at worst multiple weeks off from running. But 8 days versus 15 weeks for a similar injury is no small difference. This time around, I realized, I was armed with a much better rehabilitation protocol than I had back in college. And because tendonitis is such a common ailment for runners, I thought it'd be valuable to document exactly what I do to get back on the road when I encounter tendonitis.

What finally helped shake the tendonitis I got back in college was the yucca root supplement from NOW Foods. Since then, I have always kept a bottle of yucca root on hand in case of any minor flare-ups or general inflammation.

Before the Kettle 100k, I had a few flare-ups my knee, but I was able to manage them with a few days of rest and a lot of yucca root. Afterwards, though, the yucca and rest alone were not working quite as fast as I would have liked. (Possibly something to do with running 100 kilometers in one day?) Bent on getting back to training, I pulled out all the stops, which included four main procedures:

First, the most obvious remedies were stretching and rest. Research showed that lots of times tendonitis behind the knee can be fixed much quicker by stretching out some of the major muscle groups in the legs. With this in mind, I stopped running and began stretching out my quads, hamstrings, gluts, and calves. I used a series of both dynamic and static stretches, as well as some foam rolling.

Second, I attacked the inflammation with vegetation. I continued with the yucca root supplement from NOW Foods that has helped me in the past. I like yucca root because it is one of nature's most potent anti-inflammatory, and it differs from ibuprofen in that it does not block the inflammatory properties that help with the healing of the injury. It also does not mask the pain, so there's no risk of a false sense of healing. I upped my typical routine of yucca capsules and bought a liquid concentrate of curcumin extract. Curcumin is the part of turmeric that also has the similar anti-inflammatory properties of yucca root. The stuff tastes horrific, but as my tendon began to heal, I couldn’t argue with it.

Third, I focused on the micronutrient magnesium. This was yet another way to help with the inflammation that was lingering in my right leg. The route I took was a warm epsom salt bath nightly (thanks Peter Defty for this piece of advice), as well as a topical magnesium spray (before bed and in the morning). I think the epsom salt bath was probably the thing that provided the biggest improvement. In the days after Kettle 100k, my right leg was so inflamed that, when looking at both legs in the mirror, it didn’t even look like they belonged to the same person. The inflammation was gradually reducing, but on the first morning after the first epsom salt bath was the most noticeable amount of reduction in inflammation.

Fourth, I upped my typical intake of bone broth. I like making my own bone broth at home. I do this mainly for all the awesome micronutrients that can be extracted from bones if slow cooked for 20+ hours. I started taking this once or twice a day. If you slow cook the bones along with the connective tissue still intact, you can get some of the gelatin included in your mixture. The gelatin is what I was after, as it is valuable in healing and strengthening tendons (you can buy gelatin or collagen too, but I buy enough meat with the bones that it makes more sense for me to make my own).

With all said and done, I took eight complete days off from running, which was nowhere near to the 15 weeks I had to take off last time. What a relief! I will definitely keep the procedure of stretch, yucca, turmeric (or curcumin extract), magnesium, and bone broth in mind next time I battle with inflammation.

Running Roller Coaster

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The last 10 days of running have brought both ups and downs. More specifically, a series of blissful days full of miles followed by days of no miles and tightness in the back of my right leg. What makes the title of this post even more fitting was the 100 kilometers of trail at the Kettle 100 this past weekend, which presented numerous changes in conditions throughout the morning and early afternoon.

After I finished the Ice Age Trail 50 Mile, I began to bounce back pretty quickly. In fact, a little over a week after IA50 I started toying with the idea of jumping into the Kettle 100k. I’m hoping to do a 100-miler at some point this summer, and thought a nice 100-kilometer morning/afternoon on the trails would be excellent prep. With this in mind, I set out one morning for a 24-mile long run.

Unfortunately, the tendon behind my right knee began to tighten up after I finished. By the next morning it was difficult to even put weight on my right leg. This being one week out from the Kettle 100k, I pretty much chalked the race weekend up to a loss. However, after two days of rest, my leg felt great! I was skeptical, but I managed to head out for an easy 9-miler with no ill effects. I was pumped! So naturally, I jumped onto the Kettle 100 website and signed up for the 100k. In the back of mind I probably should have better, but in the moment I thought I had dodged a bullet. The next day I scheduled a two-a-day (13mi a.m., 7.5mi p.m.). The running did not aggravate my tendon at all, which was very satisfying.

However, as I often do a couple times a week, I visited the weight room to do some stretching and strength training. It was in the weight room where I was likely a bit too aggressive. I did two sets of Russian deadlifts, and my tendon immediately re-tightened. When I woke up the next morning, the tightness was still there. With three days before Kettle 100k, I thought if I had any chance of competing in the event, I would need to shut it down until Saturday morning.

Throughout the three days of rest, my tendon progressed quickly. As I had done the first time, I pounded NOW yucca root. I love the stuff for tendonitis because it helps with the nasty inflammation without killing the pain like ibuprofen does. This is important because inflammation often sticks around after an injury is healed (when the pain goes away). Getting rid of lingering inflammation is fine, but if you mask the pain with ibuprofen you won't know if the injury is actually healed, and you'll risk further injury. I have had a lot of luck with this protocol with previous tendonitis symptoms.

After about a day I felt no pain walking around. This time I knew better than to test my luck, so I refrained from any exercising that used my legs. On Saturday morning I toed the line at Kettle 100k, fully prepared to drop out if my tendon tightened up too much. It was an interesting day. I could feel my tendon there from the get go, but it was barely noticeable. To be honest there was a general feeling of stiffness from general lack of running the past three days. After about a mile all the stiffness dissipated, and the tendon didn’t worsen.

Before I continue with how the day progressed a bit about the event. The Kettle 100k is an out and back. The course is much like IA50 in topography. However, because of the timing of the event, weather is usually quite different. It was a muggy 78 degrees with scattered clouds by early morning. The prairie sections were quite warm from the sun and humidity, but there was a fairly strong wind, which felt nice at the hottest points of the day. Along with this mixture of conditions were some very sloppy puddles throughout the prairie sections. My feet got soaked in the muck and water, and as soon as they dried enough to feel normal again I'd come across another muddy session. Overall, I'd describe the conditions as tough and varied.

As the race progressed beyond the first mile, I had a chance to run with some great guys: Jason Borst and Jake Hegge, from La Crosse, WI, for the first 35 kilometers or so. I felt pretty relaxed and casual heading into the 50k turnaround at approximately 4 hours, 4 minutes. I knew that despite feeling relaxed for the first 50k, it probably wasn’t in my best interest to continue at that pace. My goal was to get a solid effort in without creating the need for an extended recovery period. I backed off a bit on the return to Emma Carlin (midway point of the return).

Despite backing off, I hit a bit of a rough patch with about 22-23 miles left. I am pretty certain it was due to neglecting proper fueling. I didn’t really focus too much on this on the way out. I grabbed stuff from a few aid stations and tried to stay hydrated on the way out, but that was basically the extent of my fueling plan other than taking a Vespa Ultra Concentrate every couple hours.

It was during this rough patch that my tendon started to tighten up a bit. Possibly some cramping from the poor fueling caused the tendon to act up too? Either way; on the return to Emma Carlin (16mi to go) I was about ready to drop out. I didn’t want my tendon to get worse, and with 47 miles completed I would have been happy with the day as a quality training session for a summer 100-miler.

Before officially deciding whether to drop out or not, I took in a lot of calories at Emma Carlin. I immediately felt great, and thought I would test out my legs for at least a couple more miles. Miraculously, the tendon pain went away completely. In fact, it felt the best it had all day. Even better than at the start (this is why I hypothesized it may have cramped up due to poor fueling). At this point I decided to hit all the aid stations hard for the rest of the way back and, if my tendon felt good, finish out the race. It was an enjoyable final 16 miles for the most part. I stopped a couple times when a good view allowed me to admire some of the prairie sections from a higher vantage point (only a couple times). The Ice Age Trail really does have a lot to offer in terms of beauty. The last three miles included some pretty nasty rolling hills, and mentally I was ready to be done with them, so despite feeling good I was quite happy to be done with a first-place finishing time of 8:39, a course record.

Photo courtesy of Kristen Westlake Photography
I was happy with the quality workout, which will hopefully benefit me later on this summer. As I anticipated, my tendon was pretty sore the following morning. A couple days of rest and another aggressive cycle of yucca root will hopefully get me back on the run.

A huge thanks to all the volunteers, as well as race directors Tim (Timo) Yanacheck and Jason Dorgan. It never ceases to amaze me how much work goes into the planning of an ultra event. It truly is awesome how we can sign up and run these distances without worrying about all the things the volunteers and directors take care of for us.

Products Used

Ultra Speed

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I took a pretty good chunk of time away from blogging at the end of summer in order to get myself ready for the upcoming school year.

However, the break from blogging certainly did not mean a break from running. I changed a few things in training post-Western States (WS100) to prepare for the faster 50-milers I will be doing this Fall. I plan to race Tussey Mountain Back 50 Mile U.S. Road Championships and JFK 50 Mile. Both courses are relatively fast in comparison to other well-known 50 mile races.

Once I picked up training at full capacity after WS100, something ironic happened. After running in California for two weeks on the most technical terrain I ever experienced, I managed to return to Wisconsin unscathed. Then, within days of being back on the flat dirt trails of Wisconsin, I tripped and managed to roll my ankle.

Post-icing the morning after I rolled my ankle

I thought it was much worse than it actually ended up being. Fortunately, the folks at Aurora Bay Care Sports Medicine set me up with some good advice that resulted in only 7 days off running, and I before I knew it I was back in business.

Once my ankle felt good I spent about a month building up my base with very minimal amounts of intense sessions. I wanted to ease into intensity training, while gradually backing away from higher miles. As Tussey and JFK come closer I will need a bit more speed in my legs. In August and September I have scaled down to 100-150 miles (averaging around 120-130) and started adding more intensity. My hope is to raise my threshold, making the faster average paces at Tussey and JFK seem easier. Here are a few of the workouts I have enjoyed doing.

The 20 40

Peter Defty, of Vespa Power Products turned me on to this workout, and I have incorporated variations of it into my training. After a nice, long warm-up (40-60 minutes), I break each minute into an interval/recovery block. That's a 20-second sprint followed by a 40 second jog, on repeat. Some days I do this 10 times, other days up to 40. I plan to get to 60 minutes before race day. I also use it as a warm-up for a tempo run (typically I’ll only do 10 in this case).

Road Repeats

I love this one because it mimics repeats on the track, but you don’t have to go to the track to do it. Here's how it works: I get a nice long warm-up in before I start, typically lasting 30-60 minutes. I then break my workout into 3-minute blocks. The first minute is run at a high intensity—5k pace or a bit faster. The next two minutes are recovery jogging. Currently I do about 10 repeats of this during my workouts, but hope to be closer to 20 before JFK.

5K Repeats

This workout is really intriguing to me. I learned about it from Phil Richert, a former UW-Stevens Point teammate of mine. Basically, it is just what it sounds like. You get on a track or a marked section of road and do 5-kilometer repeats. Right now I have only done this workout with two repeats, but I will do a set of 3 before Tussey. The idea, like in any other interval workout, is to pick a goal pace and try to hit it on however many 5k repeats you decide to do. Recovery between intervals should be active; I aim for a 600-meter jog.

Tempo

Tempo runs are very broad in nature. The race you are training for will dictate the pace and distance of your tempo run. Since I’m training for a 50-mile race, my tempo miles usually climb up into the double digits. I aim for a pace between 5:30 and 6:00 minutes per mile. Currently I have reached 10 miles at 5:45/mile for this training block. I hope to get up to at least 15 miles at this pace before JFK.

I am really excited about this Fall's race offerings because I haven’t done this much intensity work leading up to an ultra since my first 50-miler back in 2010. I hope to see some positive effects from an improved running economy as a result of this training.

If you have any interesting intensity workouts, please post! I’d love to hear how you get your fast pace fix.

Coaching

Of course I am more than happy to answer any general questions that you might have. But if you or someone you know is interested in a really in-depth analysis of your training and nutrition, please visit my coaching website or just ask me about individual and group coaching rates.