WHY ATHLETES CAN'T HAVE REAL JOBS
compiled by R. Dan Park
Another item whose origins are lost in the clutter of
attribution-less citations on many web sites...

Chicago Cubs outfielder Andre Dawson on being a role
model: "I wan' all dem kids to do what I do, to look up to
me. I wan' all the kids to copulate me."

New Orleans Saint RB George Rogers when asked about the
upcoming season: "I want to rush for 1,000 or 1,500 yards,
whichever comes first."

And, upon hearing Joe Jacobi of the 'Skins say "I'd run
over my own mother to win the Super Bowl," Matt Millen of the
Raiders said "To win, I'd run over Joe's Mom, too."

Torrin Polk, University of Houston receiver, on his coach,
John Jenkins: "He treats us like men. He lets us wear earrings."

Football commentator and former player Joe Theismann,
1996: "Nobody in football should be called a genius. A
genius is a guy like Norman Einstein."

Senior basketball player at the University of Pittsburgh:
"I'm going to graduate on time, no matter how long it
takes."

Bill Peterson, a Florida State football coach: "You guys
line up alphabetically by height." And, "You guys pair up
in groups of three, then line up in a circle."

Boxing promoter Dan Duva on Mike Tyson hooking up again
with promoter Don King: "Why would anyone expect him to
come out smarter? He went to prison for three years, not Princeton."

Lou Duva, veteran boxing trainer, on the Spartan training
regime of heavyweight Andrew Golota: "He's a guy who gets up
at six o'clock in the morning regardless of what time it is."

Chuck Nevitt, North Carolina State basketball player,
explaining to Coach Jim Valvano why he appeared nervous at
practice: "My sister's expecting a baby, and I don't know if I'm
going to be an uncle or an aunt."

Frank Layden, Utah Jazz president, on a former player: "I
told him, 'Son, what is it with you? Is it ignorance or
apathy?' He said, "'Coach, I don't know and I don't care.'"

Shelby Metcalf, basketball coach at Texas A&M, recounting
what he told a player who received four F's and one D:
"Son, looks to me like you're spending too much time on
one subject."

Amarillo High School and Oiler coach Bum Phillips when
asked by Bob Costas why he takes his wife on all the road
trips, Phillips responded: "Because she is too d____ ugly
to kiss good-bye".

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THE NATURAL HIGH DIET
If you want to lose weight, start by feeding your brain.

Achieving high energy, mental alertness and an optimistic outlook is the best way to gain control over your eating. A diet that makes you feel naturally high also raises your fat-burning metabolism. Did we mention that it also contributes to high self-esteem as you begin to feel and eat better? This is the advice from nutrition experts Hyla Cass, M.D., and Patrick Holford, coauthors of a new book, Natural Highs: Supplements, Nutrition and Mind/Body Techniques To Help You Feel Good All the Time (Penguin Putnam).

In it, the authors present the perfect brain-food diet based on extensive research in the areas of nutrition, psychology, and neuroscience. Statistics show that most of us are exhausted, stressed and depressed. To combat this we turn to a variety of boosters to get us through the day (and night). We gobble a muffin with coffee in the morning to get a rush, sip a soda or have a cookie to overcome the afternoon slump and wind down at night with a cocktail. This often adds up to excess calories, weight gain and feelings of hopelessness. What we are unknowingly doing, say Cass and Holford, is attempting to regulate our moods and energy with substances that work only in the short term -- but lead to caffeine lag, blood sugar drops, tiredness and an unhealthy cycle of bad foods.

Here is a highly effective weight-loss diet the experts recommend:
Eat a serving of high-quality protein three times a day. Higher quality protein is better absorbed and more efficiently utilized, so you will need to eat less of it. Adequate protein promotes good moods. However, too much protein encourages fat storage, so use moderation. Good examples of high-quality protein foods are seafood, poultry, lean red meat, soy, lowfat yogurt, rice with beans, and rice with lentils.

Eat cold-water fish three times a week. This is one of the best sources of omega-3, an essential fatty acid crucial to optimal brain function. Omega-3s are found in salmon, tuna, mackerel, sardines and cod.

Eat two eggs a week, or sprinkle lecithin granules on your cereal, salads or vegetables. These are the best sources of phospholipids, which help you metabolize fat and enhance your mood and mental performance.

Eat one serving of low Glycemic Index (low-GI) complex carbohydrates at every meal. Complex carbohydrates are long chains of sugar molecules strung together that are digested slowly and help prevent fluctuations in blood sugar levels that can cause depression as well as cravings for sugar and alcohol. Complex carbohydrates also help raise serotonin levels, which calm you down and lift your mood. Good examples of low-GI foods are whole grains, bran, beans, apples, cherries, dried apricots, plums and pears.

Eat one or two servings of antioxidant fruits and vegetables with every meal. These replenish the body and brain with oxygen, giving you energy and combating illness. Antioxidant-rich foods include prunes, berries, kale, spinach, broccoli, and alfalfa sprouts.

Have a heaping tablespoon of ground seeds a day. These provide you with the essential fat to keep your body and brain churning out maximum energy. In a blender or coffee grinder, grind half flaxseeds and half sesame, sunflower, hemp and pumpkin seeds. Keep in a sealed glass jar in refrigerator, and add to your salads, sprinkle over vegetables or cereal, or have in a shake.

From eDiets
http://www.ediets.com/news/

 

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Being fit doesn't cancel out risks of excess fat

As long as you're fit, does it matter if you're carrying around excess fat? It's the subject of ongoing debate among health experts. Now a new study says that weight matters, even if you put in time at the gym.

Regular exercise does not cancel out all the health risks of being overweight, according to study results in the TK issue of the American Journal of Epidemiology. It's the normal-weight people who are in shape who can expect to live the longest.

"It is important not to be overweight, but it also important to be fit," said study author Dr. June Stevens, a professor of nutrition and epidemiology at the University of North Carolina in Chapel Hill. "Just being slender is not enough. Just being fit is not enough. In order to enjoy the best life expectancy, you need to be both."
The new findings are based on data from 2,506 women and 2,860 men in eight U.S. cities who participated in a study that began in 1972, when their average age was about 45. At baseline, subjects had their fitness levels assessed by treadmill tests and their body mass index -- a standardized measure that takes into account height and weight - calculated.

Subjects were grouped into the following categories: fit, not fit, fat and not fat. They were followed until 1998.
In both women and men, the unfit-fat group faced the greatest risk of death. But while exercise helped boost longevity in the overweight group, it did not erase all the negative effects of the excess weight. Likewise, people who were thin but unfit also faced a shortened life span, results showed.
Compared with the fit-not fat women, the increased risk of death was 32% among the fit- fat women, 30% among the unfit-not fat women and 57% in the unfit-fat women.

Similarly, compared with the fit-not fat men, the increased risk of death was 25% among the fit-fat men, 44% in the unfit-not fat men and 49% in the unfit-fat group.
The investigators took into account age, cigarette use and other factors that may have influenced the results.
The findings underscore the importance of both maintaining a healthy weight and getting regular exercise, Stevens said. But for people who exercise regularly yet still can't seem to shed those extra pounds, don't give up. "Keep exercising," she said. "And if you can't lose weight, work hard not to gain [more] weight."
SOURCE: American Journal of Epidemiology 2002;156:832-841. © Reuters Limited

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No Harm In Nibbling? Those Calories Add Up!
By Maia Appleby

I often hear people say that, although they watch
what they eat for breakfast, lunch and dinner, they just
can't seem to lose any weight. Following this statement,
many of them add that they nibble on the things they
miss eating, figuring that just one bite won't make any
difference. When you look at the big picture, one bite
probably won't, if we're really talking about one bite.

Chronic nibblers, on the other hand, eat a lot more than
they realize, and are often in denial about it. They
consume excess calories several times each day without
even knowing it, assuming that tiny amounts of this and
that don't count. They do count, though. If you're
nodding your head with a guilty grin on your face,
you've taken the first step toward recovery.

Here are a few examples of what you're consuming when
you sample some of the most tempting items you
encounter throughout the day, and the number of
calories they typically contain. Keep in mind that most
of these are high in fat and sparse in nutrients:

One fried chicken wing: 200
One teaspoon of cookie dough: 170
One fried spring roll: 104
Mayo on your sandwich: 100
One square of cheese: 100
One tablespoon of either peanuts or peanut butter: 90
One cocktail meatball: 85
One pig in a blanket: 85
One spoonful of icing: 80
One lollipop: 50
One crab puff: 42
Five M&M's: 40
One potato chip with onion dip: 40
One potato chip plain: 32

How can this be remedied? Simply by recognizing it. Be
mindful of every bite you eat, no matter how insignificant
it seems. If it helps, keep a written log for a few days.
You'll be surprised at how these little tidbits add up.

Visit Maia's site, Inch-Aweigh at http://inch-aweigh.com
for more articles, tips, tools and a free diet center.

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Quote of the Day

Sometimes when I reflect back on all the beer I drink, I feel ashamed. Then I look into the glass and think about the workers in the brewery and all of their hopes and dreams. If I didn't drink this beer, they might be out of work and their dreams would be shattered. Then I say to myself, "It is better that I drink this beer and let their dreams come true than be selfish and worry about my liver."
- Jack Handy, Saturday Night Live

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Stress May Increase Heart Disease Risk
**************

The results of a study of more than 73,000 Japanese adults aged 40 to 79 are not surprising: high levels of daily stress are associated with an increased risk of developing heart disease. This association was especially strong for women, as those women in the study who reported high levels of mental stress were more than twice as likely to die from heart disease or a stroke as those women reporting low levels of stress. Although the associations were somewhat weaker for men, the researchers did determine that high-stress males were more likely to die of a heart attack than their less-stressed peers. These findings, which were published in the September 3, 2002 issue of Circulation: Journal of the American Heart Association, demonstrate that reducing stress may not only make you feel better, but may make you healthier as well.

- M. Ellman (emazing.com)

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How Food Becomes Body Fat
by Maia Appleby

Everyone knows that overeating leads to excess weight. This concept comes in many flavors these days, though. Some people think that carbohydrates are the culprit. Others think it's sugar. Some people think that eating lots of protein couldn't possibly make them gain weight. Hmmm...
The only way to determine the answer to this enigma is to go inside the human body and take a look at how fat gets there in the first place. Let's follow a bite of pepperoni pizza and see what happens to its sugar, fat and protein. Open wide!

The food enters your mouth:

· Saliva contains enzymes that break any starch in the food down to sugar.
· This, along with any fat and water in the food, travel to the stomach, which churns them up.
· Pepsin (an enzyme that digests protein) and hydrochloric acid further break down the food, turning it into a substance called chyme.
· The mixture enters the duodenum, (the place where the gall bladder secretes its bile).
· This bile dissolves the fat in water, thinning it out and making it easier to absorb
· Enzymes from the pancreas enter the duodenum and further break down the sugar, fat and protein.

Now everything is dissolved and is in fluid form, so it is absorbed through the lining of the small bowel. Fat, sugar and protein wave good-bye to each other and go their separate ways.

What happens to the sugar:

· It also goes directly into the blood stream, and several different organs take the sugar they need as it passes by.
· Some is stored in the liver as glycogen.
· Whatever is left is converted to fat and stored in fat cells with the excess fat above.

What happens to the fat:

· First, it goes into the blood stream and travels to the liver
· The liver burns some of the fat, converts some to other substances (one is cholesterol) and sends the rest to fat cells, where they wait until they are needed.

What happens to the protein:

· It is broken down into building blocks known as peptides.
· Then, it is further broken down and it becomes amino acids.
· The amino acids are absorbed through the small intestine's lining and enter the blood stream.
· From here, some of the amino acids build the body's protein stores.
· Excess amino acids are converted to fats and sugars and follow the paths described above.

This is such a simple concept, but many people still believe that consuming lots and lots of protein will put muscle on their bones. Don't be fooled by this notion! Even excess protein turns to fat.
Here is a picturesque illustration of the real cause of weight gain. Eating too much food! Dietary fat is obviously the substance most often stored as fat in the end, but no matter what you eat, your body takes whatever it can't use and sends it to fat cells. If you don't burn it off, it hangs around in your fat cells. It's that simple. If you want to lose weight, don't eat too much of anything -- and do exercise regularly.

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IRON AND WOMEN

Women may have a greater need for iron than do men, partly because extremely heavy menstrual flows can cause iron loss and occasionally lead to iron-deficiency anemia. When you diet and cut back on red meat, the loss in protein can affect you if your iron count is already low. Aging can also be a cause of protein loss, because elderly people tend to eat less meat and gravitate towards softer foods, which contain less protein. Remember, you need some protein to retain a good immune system and to maintain muscle fitness.

Fortunately, there are some good protein choices besides meat. For example, you can choose soybeans, lentils, nuts, whole-grain cereals and breads, cheeses, milks, and yogurts. (Don't forget to watch the fats in the dairy products.)

**************************************************************

Linoleic Acid May Reduce Stroke Risk

Regular consumption of foods containing linoleic acid may reduce your chance of having a stroke, according to a study published in the August 2002 issue of Stroke: Journal of the American Heart Association. Linoleic acid is an essential fatty acid that is found in many food products, including fish and dairy products. It is also found in many vegetable oils, such as evening primrose, sunflower, and safflower oils. For their study, researchers followed nearly 7,500 Japanese adults for a period of 6 to 14 years. They discovered that a 5% increase in consumption of linoleic acid was associated with a 28% reduction in the chance of having a stroke. While the researchers stated that further research is needed, their findings imply that linoleic acid may be an important component of a healthy diet.

- M. Ellman

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HYPONATREMIA, OVERHYDRATION,HYPERTHERMIA AND
POSTURAL HYPERTENSION

Subject: New Hydration Recommendations

THE PHYSICIAN AND SPORTSMEDICINE - VOL 31 - NO. 7 - JULY 2003

http://www.physsportsmed.com/issues/2003/0703/news0703.htm

Risk of Hyponatremia Plays a Big Role

Concerns about overhydration and hyponatremia among endurance athletes were once discussed only in sports medicine circles. In May,
USA Track & Field, the national governing body for track and field and race walking, issued new hydration recommendations1 that urge
runners to hydrate based on individual needs, rather than drinking as much as they can tolerate. Since then, the message has trickled down
to mainstream medicine and even the lay press.

Hyponatremia is a hot topic among marathon medical experts and military physicians, because the condition is one of several causes
of exertion-related collapse. Though experts agree that successful identification and treatment of hyponatremia depends on
distinguishing the condition from heat illness and other diagnoses, disagreements flare about what level of hydration is optimal for the
health and performance of athletes.

Two recent reports2,3 in the medical literature seem to confirm a trend that marathon medical experts have observed: Hyponatremia has
become more common as greater numbers of less competitive athletes participate in endurance events. A postrace blood study2 done on 481
participants who ran the 2002 Boston Marathon found that 13% experienced hyponatremia. Risk factors included female gender, slower
finishing times, and excess fluid consumption. An observational, retrospective, case-controlled study3 of medical care at the 2000
Houston Marathon found that 21 runners (0.31% of entrants) presented to the medical area with hyponatremia. Risk factors among
participants included slower race times and excess fluid consumption.

What Led to New Recommendations?
Douglas J. Casa, PhD, ATC, assistant professor in the department of kinesiology at the University of Connecticut in Storrs, Connecticut,
wrote USA Track & Field's hydration advisory. He says the organization's intent was to acknowledge hyponatremia concerns that
were expressed in a hydration advisory issued by the International Marathon Medical Directors Association (IMMDA) in 20024 and to
educate athletes about determining their own individualized fluid needs. "Athletes should understand the risks of both hyponatremia and
dehydration," Casa says. "This document gets people involved in finding a middle ground between the two."

The IMMDA advisory challenges the conventional wisdom, contained in, for example, the 1996 American College of Sports Medicine hydration
recommendations,5 that endurance athletes should drink as much as they can tolerate during exercise. Instead, the IMMDA advisory states
that blanket hydration recommendations for athletes are incorrect and unsafe, and that they should drink as needed, but not to exceed 800
mL per hour.

Casa says that some level of dehydration is inevitable in some endurance activities and that USA Track & Field advises participants
to at least replace what they are losing during activity. The USA Track & Field advisory teaches athletes how to calculate their
individual sweat rates and how to monitor their hydration status with a urine color chart. "The biggest point we want to get across is that
athletes have different sweat rates based on environment, exercise intensity, equipment, and body weight," he says.

Practical Considerations
Casa says he worries that the public may misconstrue the hydration recommendations. He points to a recent New York Times headline6 that
says "New Advice to Runners: Don't Drink the Water." He's particularly concerned about athletes in other sports getting the
wrong information about hydration. "Runners have a longer time to overhydrate. But in soccer or football, dehydration is more common,
because activity is more intense and is often performed in the summer," he says.

William O. Roberts, MD, associate professor in the Department of Family Practice and Community Health at the University of Minnesota
in St Paul, says hyponatremia is mostly a problem among slower participants in long-distance or duration events and is not usually
an issue in sports such as football, as long as players ingest adequate sodium. When patients ask about the new hydration
advisories, Roberts, medical director of the Twin Cities Marathon, emphasizes that they should learn how to calculate and replace their
sweat losses.

Roberts predicts that marathon groups will educate runners about the new hydration recommendations and that race volunteers will less
aggressively push fluids on runners. Hydration stations will likely be fewer. "The Houston Marathon dropped from 30 to 15, and I'm
pressing to go back to 12 for the Twin Cities Marathon," he says. Timothy Noakes, MB ChB, MD, professor of exercise and sport science
at the University of Cape Town and the Sports Science Institute of South Africa in Newlands, South Africa, who wrote the IMMDA
recommendations and was the first to describe exercise-related hyponatremia along with the role of fluid overload, say he advises
his patients to heed their thirst and to employ the same individualized hydration strategies in competition as they do in
training. "I think that's where some of the problems have arisen," he notes.

Future Directions, Debate
Though IMMDA and USA Track & Field's hydration recommendations have generally been well received, Roberts says that some in the sports
medicine field believe allowing thirst to guide hydration automatically puts athletes behind with fluid replacement--not
dangerously, but enough to affect peak performance. "This should make for some heated and healthy debate," Roberts says.

Noakes says confusion still remains about the real dangers of dehydration. He contends that there is no evidence showing that
dehydration levels during competition (2% to 8%) impair health or performance. "There is an urgent need to do properly controlled
trials of the effects of weight loss (dehydration) during exercise on performance during weight-bearing activities like long-distance
running," Noakes says. "Similarly, there is a need to determine what levels of dehydration carry health risks."

More research is also needed to determine the effects of convective cooling on heat balance during exercise, Noakes says, alluding to his
belief that earlier lab studies that suggested the need to drink as much as possible did not match environmental conditions that athletes
encounter during competition.

------------
http://www.usatf.org/news/showRelease.asp?article=/news/releases/2003-04-19-2.xml

..For athletes in general and especially for those completing a marathon in more than four hours, USATF recommends consuming 100
percent of fluids lost due to sweat while racing. This marks a significant change from the understanding most runners have that they
should be drinking as much as possible and following the guideline to "stay ahead of your thirst," which has been held as the standard
recommendation for many years.

Simply put, runners should be sensitive to the onset of thirst as the signal to drink, rather than staying ahead of thirst. Being guided by
their thirst, runners prevent dehydration while also lowering the risk of hyponatremia (low sodium), a potentially dangerous condition
increasingly seen as runners have erroneously been instructed to over-hydrate......

Replacing fluids and sodium
A potentially fatal condition, hyponatremia most often occurs in exercise lasting four hours or longer and results primarily from
consuming excessive fluids and is exacerbated by not replacing sodium losses. Severe cases of may involve grand mal seizures, increased
intracranial pressure, pulmonary edema (fluid in the lungs), respiratory arrest and even death......

Many scientists now view hyponatremia as just as much of a threat to runners as heat illness and dehydration, and major papers distributed
by the International Association of Athletics Federations (IAAF) and USATF have described these potential problems and how to avoid them.
(These papers are available on www.usatf.org.)

Other medical issues
As runners have learned the importance of hydration during long distance events, dehydration has become a less prevalent condition.
Medical crews at marathon finish lines now are dealing more with hyperthermia (heat illness), postural hypotension (pooling of blood
in the legs), hyponatremia, and the normal injuries that are common among marathon runners such as blisters and muscle injuries.
Hyperthermia can occur regardless of hydration levels or the distance of a race. In fact, shorter races can pose more of a threat due to
the faster pace per mile, which causes greater heat production. An adequately hydrated runner who is running too fast or pushing herself
too hard, especially in hot and humid conditions, can fall victim to hyperthermia. It is therefore important that athletes adjust their
pace to take into consideration race conditions, slowing their pace as heat and humidity rises, regardless of how much they may be
drinking.

"Postural hypotension" is experienced when a runner suddenly stops, most commonly at the finish line. With blood pooling in the legs,
there is inadequate blood supply to the rest of the body and the runner feels faint and can fall down. This had been thought of as
demonstrating dehydration, so the response from medical teams was to rehydrate these runners. Now, medical personnel can identify this
problem correctly and treat it specifically. Treatment requires raising the runner's feet above the head for 3-4 minutes for full
recovery. Runners can avoid postural hypotension by keeping the legs moving, even with light walking or moderate knee flexing when they
otherwise would stand still at or immediately after the finish or at other locations along the race course.

Jamie Carruthers
Wakefield, UK

 

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Achilles Tendonitis &
Achilles Tendon Injury

Prevention & Treatment Strategies for Achilles Injury
Part 1

Every week I get asked for information on Achilles tendon injury. So instead of constantly referring people to other sites, I thought it was time to write an article on Achilles tendon injury myself.
Achilles injuries are commonly associated with sports that require a lot of running, jumping and change of direction. Excessive twisting or turning of the ankle and foot can result in a rupture or strain. The sports that are most susceptible to Achilles injury include running, walking, cycling, football, basketball and tennis.

What is an Achilles tendon Injury?
Firstly, let's take a look at where the Achilles tendon is located and what it does.
As you can see from the diagram to the right, the Achilles tendon is located at the rear (posterior) of the bottom half of the lower leg. In the diagram it is represented by the thick band of connective fibre that runs from bottom of the Gastrocnemius muscle to the heel bone.
The Achilles tendon is used to plantar flex the foot, or point the foot downward. This allows a person the run, jump and stand on one's toes.
The Achilles tendon is the strongest tendon of the body, and able to withstand a 1000 pound force without tearing. Despite this, the Achilles ruptures more frequently than any other tendon because of the tremendous pressures placed on it during competitive sports.
There are two main types of injuries that affect the Achilles tendon; Achillis Tendonitis and Achilles Tendon Rupture.
Achilles Tendonitis is simply an inflammation of the tendon, and in most cases is caused by excessive training over an extended period of time.
Achilles Tendon Rupture, on the other hand, is a tear (or complete snapping) of the tendon, and usually occurs as the result of a sudden or unexpected force. In the case of a complete rupture, the only treatment available is to place the lower leg in a plaster cast for 6 to 8 weeks, or surgery. As both of these treatments are beyond the scope of this newsletter, we'll be focusing the rest of this article on Achilles Tendonitis.

Causes and Risk Factors
There are a number of causes and risk factors associated with Achilles Tendonitis. One of the most common causes is simply a lack of conditioning. If the tendon, and muscles that connect to the tendon, have not been trained or conditioned, this can lead to a weakness that may result in an Achilles injury.
Overtraining is also associated with Achilles Tendonitis. Doing too much, too soon places excessive strain on the Achilles tendon and doesn't allow the tendon enough time to recovery properly. Over time small tears and general degeneration result in a weakening of the tendon, which leads to inflammation and pain.
Other causes of Achilles injury include a lack of warming up and stretching. Wearing inadequate footwear, running or training on uneven ground, and simply standing on, or in something you're not meant to. Biomechanical problems such as high arched feet or flat feet can also lead to Achilles injuries.
So what are some of the things you can do to help prevent Achilles Tendonitis?
1. Warm Up properly
A thorough warm up is essential to get the body ready for any activity. A well structured warm up will prepare your heart, lungs, muscles, joints and your mind for strenuous activity. If you'd like to know more about the warm up, visit http://www.thestretchinghandbook.com/archives/warm-up.htm.
2. Plyometric Training
Plyometric drills include jumping, skipping, bounding, and hoping type activities. These explosive types of exercises help to condition and prepare the muscles, tendons and ligaments in the lower leg and ankle joint.
3. Balancing Exercises
Any activity that challenges your ability to balance, and keep your balance, will help what's called proprioception: - your body's ability to know where it's limbs are at any given time.
4. Stretch and Strengthen
I'll cover these in a lot more detail a little later on when I discuss rehabilitation and conditioning exercises.
5. Footwear
Be aware of the importance of good footwear. A good pair of shoes will help to keep your ankles stable, provide adequate cushioning, and support your foot and lower leg during the running or walking motion.
In part 2, I'll be outlining a comprehensive initial and ongoing treatment program to make recovery from Achilles Tendonitis as quick as possible.

I hope you've enjoyed this month's issue of The Stretching & Sports Injury Newsletter. If you have any comments or suggestions regarding this newsletter or any other aspect of our web site, please feel free to contact us.
© 2004, Walkerbout Health. All rights reserved.
This article may be re-published in complete form,
as long as the following paragraph and URL are included.
------------------------------------------------------------------
Article by Brad Walker. Brad is a leading stretching and
sports injury consultant with over 15 years experience
in the health and fitness industry. For more articles
on the prevention & treatment of sports injury,
subscribe to The Stretching & Sports Injury Newsletter
by visiting http://www.thestretchinghandbook.com/.
------------------------------------------------------------------

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BOOST ENDURANCE, SPEED, AND POWER

By Liz Applegate, Ph.D.

New research reveals the real secret to boosting your endurance, speed, and power I recently spent 4 days at the American College of Sports Medicine's annual meeting in Indianapolis. This is the meeting where the world's top exercise physiologists, nutritionists, and sports medicine physicians and psychologists present the latest research on anything and everything related to exercise.

This is as cutting-edge as it gets, folks. These preeminent scientists often bring their latest nutrition research straight from the laboratories where they work. And I was there to sift through their hundreds of studies, looking for the ones that directly applied to running. Here are the five most important research findings of the year, and how to use them to improve your stamina, immunity, recovery, speed, and power.

Stamina
If you've been reading my column for a while, you probably know that a high-carbohydrate diet keeps your muscle-glycogen stores well stocked, giving you more energy to burn during your long runs. But new research suggests that increasing the amount of fat in your diet may boost your endurance even more.

Exercise physiologists Ted Zderic and Ed Coyle, Ph.D., from the University of Texas in Austin, fed endurance cyclists diets composed of three different proportions of fat and carbohydrate:
" A very-high-carbohydrate, very-low-fat diet (88 percent and 2 percent of calories)
" A high-carbohydrate, low-fat diet (68 percent and 21 percent of calories)
" A moderate-carbohydrate, moderate-fat diet (57 percent and 32 percent of calories)

In all of the diets, about 10 percent of the calories came from protein.

The cyclists spent 5 days on each diet and worked out 2 hours each day. At the end of each week, the researchers extracted a tiny sample of leg muscle to measure the cyclists' levels of stored glycogen and fat. While the very-high-carbohydrate, very-low-fat diet packed glycogen stores to their maximum, it left reserves of muscle fat nearly empty. On the other hand, the high-carbohydrate, low-fat diet filled both glycogen and muscle-fat stores to optimal levels.

How important is muscle fat to your endurance running? Very. Called intra-muscular triglyceride, this muscle fat is a vital source of fuel during a marathon or some other type of endurance exercise, supplying more than 60 percent of the total fat used to power your running. Think of it as an extra tank of fuel. Without it, you drain your glycogen stores faster, and tire earlier. Previous studies have shown that over-trained marathon runners often have depleted intra-muscular triglyceride levels, and researchers suspect that low stores of muscle fat can lead to poor endurance.

What this means to you: In your zeal to prevent heart disease, don't slash fat below 20 percent of your total daily calories. Instead, focus on the heart-healthy monounsaturated and polyunsaturated fats found in nuts, avocados, olive oil, and fatty fish. Check my menu (on page 28) to find out how to consume enough of the right fats in your diet.

Immunity
If you've ever caught a bad cold after running a marathon, you're not alone. Twenty-five percent of distance runners say they get sick after an endurance event such as the marathon. That's because endurance running can suppress your immunity for as long as 3 days, leaving your body vulnerable to invading bacteria and viruses. According to research from exercise physiologist David Nieman, Dr.P.H., quaffing a sports drink during your marathon may prevent this immunity drop.

Nieman offered 50 LaSalle Bank Chicago Marathon runners either a placebo beverage or Gatorade to drink at a rate of 1 liter per hour during the race. This amounts to 60 grams of carbohydrate (or 240 calories) per hour, which is right on target with American College of Sports Medicine guidelines. Nieman took blood samples from runners before, immediately after, and 1 1/2 hours after the marathon. The runners who drank the sports drink had higher levels of certain specialized immune cells in their blood.

What this means to you: Consume a sports drink or eat a carbohydrate-rich food such as an energy bar, dried fruit, or an energy gel during any event lasting longer than 90 minutes. Aim for 100 to 125 calories every 30 minutes. After the race, minimize your exposure to people with colds or the flu, and wash your hands before touching your face or eating.

Recovery
Guzzling a carbohydrate-rich sports drink right after a tough workout or race is a great way to replenish fluids, but it may not be the best way to replenish the fuel in your muscles. That is, unless you consume some protein along with the drink.

In a study done by exercise physiologists Donovan Fogt and John Ivy, Ph.D., both from the University of Texas in Austin, endurance cyclists rode a grueling 2 hours on stationary bikes, depleting their muscle-glycogen stores. Immediately following exercise and again 2 hours later, the riders drank 12 ounces of a carbohydrate-protein beverage (53 grams of carbohydrate and 14 grams of protein) or a carbohydrate sports drink (20 grams of carbohydrate, no protein). When the researchers extracted muscle samples from the cyclists 2 hours after the exercise session, they found that the carbohydrate-protein beverage resulted in a 128 percent greater restocking of glycogen compared with the carbohydrate-only sports drink.

Why does protein help? Circulating levels of the hormone insulin, responsible for ushering carbohydrates into the muscles, were also higher when athletes consumed the carbohydrate-protein drink rather than the carbohydrate-only sports drink. The combined dose of carbohydrate and protein helps boost insulin levels, which in turn acts indirectly to stimulate glycogen rebuilding. Also, insulin aids the recovery and repair of proteins that may have been damaged during exercise.

What this means to you: Combining carbohydrate with protein may help you recover faster after tough workouts. After long or intense workouts, eat within an hour, combining carbohydrate and protein in a 3-grams-to-1 ratio. For example, try a tuna sandwich on whole-grain bread along with a peach. A protein-rich energy bar and a cup of regular sports drink also works. Then eat another carbohydrate-and-protein combination 2 hours later.

Speed
Previous studies have shown that consuming 2 cups of coffee about 1 hour before a run can boost your endurance-possibly by encouraging your body to burn more fat and less glycogen for fuel. Naturally, researchers from the University of Melbourne in Australia wondered whether caffeine might also boost shorter efforts, such as a sprint rowing session.

They gave competitive rowers a placebo or one of two doses of caffeine-one equivalent to 4 cups of coffee, the other to 6-1 hour before a timed 2000-meter rowing effort.

The higher dose of caffeine improved sprint time by about 1.5 seconds, with most of that improvement occurring during the first 500 meters of the race. Caffeine might work by stimulating the adrenal glands, which revs up the body's fight-or-flight response.

What this means to you: If you enjoy coffee or another caffeine-containing beverage and you want a faster start, give caffeine a try before a race or workout. But be aware that 4 to 6 cups of coffee may cause nervousness, increased fluid losses through urine, diarrhea, and an irregular heartbeat. If you simply want to run longer, not faster, stick with 2 cups. This amount has been shown to boost endurance.

Power
A simple sugar called ribose is one of the newest and soon-to-be hottest sports supplements on the market. Inside your cells, ribose is a component of a high-energy molecule called ATP. From muscle contractions to protein synthesis, you need ATP for most of the chemical reactions that take place in your body.

Researchers from Eastern Michigan University suspected that ingesting a ribose supplement might boost ribose levels inside your cells, which, in turn, might increase the pool of ATP. End result: more speed and power.

To test their theory, the researchers gave cyclists a placebo or four 8-gram doses of ribose over 36 hours. The cyclists then performed six 10-second sprints on stationary bikes while the researchers measured peak power output.

Ribose supplementation boosted peak power in four of the six sprint efforts. The researchers agree that more studies need to be done, but say that ribose shows promise as a sprint performance aid.

What this means to you: There's simply not enough research out there for me to recommend spending your money on ribose supplements. That said, these products are already on the market, and I know plenty of you will try them. Since ribose is a simple sugar, it doesn't pose adverse health effects beyond possible weight gain from the extra calories. So feel free to experiment.

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Burn Fat Faster

By Mark Remy

Losing flab isn't about magic potions and diet books. It's about intense effort. Here are 11 ways to get it done ... and fast Listen carefully, because we're only going to say this once: If you want to burn more fat, you have to burn more calories. And to burn more calories, you have to work at it.

Period.

In this age of miracle pills, protein diets and flavor-of-the-month fitness fads, such advice may seem overly simple, perhaps suspiciously so. But that's what it boils down to.

Some people cling to the notion that nothing burns fat like a nice, long walk. There's a grain of truth in that--but only a grain. As exercise intensifies, your body does burn less fat and more carbohydrate. That's because when oxygen is scarce, carbs burn more readily than fat.

But don't be led astray: Raw calorie burn is what it takes to shed extra pounds, and your body couldn't care less where those calories come from.

Consider this example:
A 170-pound man walking for 30 minutes at 3.5 mph might burn 155 calories--in a 60/40 blend of carbohydrates and fat. The same man running for 30 minutes--at a fairly sedate 6 mph--will burn closer to 375 calories, in a 75/25 ratio. Walking burns a higher ratio of fat calories, sure, but running burns more than twice as many total calories. And that's the kind of math that will loosen your waistband.

To that end, here are 11 exercise options guaranteed to burn calories like gangbusters. Some are outdoor workouts, some are indoor, but they all have three things in common:

They're fast. Each one takes about 40 minutes--including a 5-minute warmup and cooldown.

They're intense. We're not going to lie to you; some of these routines are tough. (Fortunately, as a runner, so are you.)

They're varied. Hey, we'd hate for you to get bored.

So what are you waiting for? Take your pick.

How we crunched the numbers
Calculating total calories and fat calories burned is slippery work. Variables such as your fitness level, weight, age and--of course--intensity conspire to skew the results. Still, we thought it would be helpful to give you ballpark figures. So we enlisted the aid of Ralph La Forge, M.Sc., an exercise physiologist and managing director of the Duke Lipid Clinic and Disease Management Preceptorship Program at Duke University Medical Center in Durham, N.C.

Our calculations are based on:

Average workout intensity of 70 percent max V02.

A healthy person who is slightly above average in aerobic fitness.

Runners come in all sizes, so rather than take a one-size-fits-all approach, we've included three sets of figures for calories burned in each exercise: The first applies to a 130-pound person; the second, 170 pounds; and the third, 210 pounds.

Note: Calorie burn for non-weight-bearing activities, such as cycling and weight training, remains about the same, regardless of your weight.

ELLIPTICAL TRAINER: The Roll Reversal

Total calories burned: 286/358/429

Fat calories burned: 107/134/160

Equipment needed: 1 elliptical trainer, a canny sense of balance

Workout time: 40 minutes

Workout: After a 5-minute warmup, go hard for 2 minutes, recover for 1 minute, then go backward for 2 minutes. "This will call different muscles into action," says Wayne Westcott, Ph.D., fitness research director at the South Shore YMCA in Quincy, Mass. Repeat six times, then end with a 5-minute cooldown.

Tip: Grip the handrails lightly, if at all. The less you rely on your arms, the more calories you'll burn.

ROWER: The Stroke of Genius
Total calories burned: 268/336/403

Fat calories burned: 98/123/147

Equipment needed: 1 rowing machine

Workout time: 40 minutes

Workout: Warm up with 5 minutes of easy rowing. Then change the cadence--going 2 minutes slow, then 2 minutes fast--for 30 minutes. End with a 5-minute cooldown.

Tip: Find a teacher. The rowing machine is deceptively tricky, so have an instructor show you how to do it right. Otherwise, you may cheat yourself out of calories burned.

STAIRCLIMBER: The Random Assortment
Total calories burned: 304/380/456

Fat calories burned: 116/145/174

Equipment needed: 1 stairclimber, 1 small towel

Workout time: 40 minutes

Workout: Simple. Choose the "random" setting, drape the towel over the display, and go nuts for 40 minutes. "The quick changes require your muscles to respond more abruptly," says Westcott. "And the novelty will keep you from growing bored." Note: If your stairclimber doesn't have "built-in" warmups and cooldowns, include 5 minutes of each in your workout.

Tip: Stand up straight! Poor posture will lower your calorie burn.

STATIONARY BIKE: The Vicious Cycle
Total calories burned: 380

Fat calories burned: 145

Equipment needed: 1 stationary bike

Workout time: 40 minutes

Workout: After spinning easily for 5 minutes, go hard for 3 minutes, then easy for 3 minutes. Keep your cadence steady throughout; the only variable should be the resistance. Do five sets. Finish with 5 more easy minutes.

Tip: Adjust your seat so that your leg is just slightly bent at the bottom of each stroke. You'll be able to use more resistance this way.

TREADMILL: The Great Pyramid
Total calories burned: 392/490/588

Fat calories burned: 144/180/216

Equipment needed: 1 treadmill

Workout time: 40 minutes

Workout: Warm up for 5 minutes at zero incline, then do 10 minutes at 5 percent, 10 minutes at 10 percent, 10 minutes at 5 percent, and the final 5 minutes at zero incline.

Tip: Stride out. "A lot of people on treadmills shorten their strides,"says Westcott. "But you'll burn more calories if you open up to a nice, full stride."

TREADMILL: The "Tune"-Up
Total calories burned: 286/358/429

Fat calories burned: 107/134/160

Equipment needed: 1 treadmill, 1 stereo tuned to a rock station

Workout time: 40 minutes

Workout: Music can be a great motivator. After a 5-minute warmup, pick up the pace for the duration of the next song you hear. Recover during the following song, or commercials, and kick it in again when the next song begins. Continue for 30 minutes, and wrap up with a 5-minute cooldown.

Tip: Watch out for "60-minute music marathons."

INLINE SKATING: Gliding Lite
Total calories burned: 268/336/403

Fat calories burned: 98/123/147

Equipment needed: 1 pair of inline skates, 1 stretch of smooth road or bike path

Workout time: About 40 minutes

Workout: After a 5-minute warmup, just skate. Inline skating provides a great low-impact workout, says Ed Burke, Ph.D., author of Optimal Muscle Recovery. If you choose a hilly course, the workout will practically take care of itself. "Really push it on the uphills and recover on the downhills," advises Burke. Cool down for 5 minutes.

Tip: To maximize power, glide as far as you can with the stroke of each skate.

MOUNTAIN BIKING: The Wheel Deal
Total calories burned: 380 to 403

Fat calories burned: 156

Equipment needed: 1 mountain bike, 1 off-road course

Workout time: 40 minutes

Workout: Head for the hills. In general, mountain biking burns more calories than road biking (sorry, but "mountain biking" around the block doesn't count). "On a hilly course, it's a total body workout," says Burke. "You're varying your cadence a lot and using your upper body to pull on the handlebars."

Tip: Spinning the pedals smoothly and quickly--rather than grinding along in a high gear--will spare your knees.

RUNNING (ROAD OR TRAIL): The Vertical Challenge
Total calories burned: 295/369/442

Fat calories burned: 112/140/168

Equipment needed: 200 meters or more of uphill asphalt

Workout time: About 40 minutes

Workout: After a 10-minute warmup, sprint about 200 meters uphill, then recover on the way down. Repeat six to eight times, then cool down.

Tip: Try to keep a consistent pace through each of your repeats.

The Buddy System
Total calories burned: 286/358/429

Fat calories burned: 98/123/147

Equipment needed: 1 stretch of road, 1 buddy

Workout time: 40 minutes

Workout: You're strapped into a Hurt Machine . . . and your sadistic buddy is at the controls. Here's how it works: You and your training partner warm up with a 5-minute jog, then take turns calling the shots for 30 minute's worth of intervals. You won't know when the next one's coming, or how long it will last, until your partner tells you. After a brief recovery, it's your turn. End with a 5-minute cooldown.

Tip: Pick a partner who's about as fit as you are--and as competitive.

SNOWSHOEING: The Arctic Blast
Total calories burned: 268/336/403

Fat calories burned: 98/123/147

Equipment needed: 1 pair of snowshoes, open field (snow optional; see below)

Workout time: About 40 minutes

Workout: Wearing your snowshoes, jog on level ground for 5 minutes to warm up; then do four half-mile repeats interspersed with 2 to 3 minutes of recovery. Cool down with 5 more minutes of jogging. (Variation: Do 10 to 12 repeats up a short hill.) "If you don't mind attracting stares, you don't even need snow for these," says Runner's World senior editor Eileen Portz-Shovlin, who has trained in warm weather for snowshoe races. "Because you're lifting your legs so high, snowshoeing feels like running uphill--even on level ground," Portz-Shovlin says.

Tip: Pick running snowshoes rather than trekking snowshoes. Running models are lighter and smaller for an easier stride.

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Soul Food

Some foods have the power to calm your body and mind. Here are the best ones to try
When times get tough and tensions run high, some people bite their fingernails. The rest of us bite into Sara Lee's chocolate-chip cheesecake. But rest assured: Eating in response to stressful situations is normal, even for health-conscious runners. Research shows that there are biological reasons why we reach for certain comfort foods to help lift our spirits and ease feelings of stress, anxiety, and depression.

Still, comfort eating can get out of hand and lead to unhealthy habits (such as mindlessly eating a pint of Ben & Jerry's at the end of every tough day). So here's the latest on how food and mood are connected, plus some strategies to help you maintain your sanity and your waistline.

THE FOOD-MOOD CONNECTION
Growing up, I always got a sugary treat from my mom when I was upset. I used to think this was just a mom-made distraction. Now research suggests that this type of eating may actually calm the brain and body. Studies with both animals and people show that eating certain foods can alter hormone levels in the body and chemical levels in the brain. All of this can affect mood. Here are some well-known food-mood pairs, and the research behind them.

Calming carbohydrates. Many people instinctively turn to carbohydrate-rich foods for a mood fix. Some research has shown that eating these foods can boost insulin levels in the body, which, in turn, allows an amino acid called tryptophan to enter the brain. Once in the brain, tryptophan is converted into a brain chemical called serotonin, which has a calming effect.

But it's important to note that other studies don't wholly support this research. Alternative research suggests that individuals respond differently to carbohydrate-rich foods, and that only those with a tendency toward depression may be calmed by carbohydrates.

Soothing sugar. Sugar, a specific type of carbohydrate, has been found to do a lot more than satisfy a sweet tooth. Studies with animals suggest that consuming sugar can alter levels of cortisol, a stress-related hormone. In one study, laboratory rats were forced to swim in cold water (a very stressful situation, even for a rat) while consuming sugar water or plain water. The rats that drank sugar water had lower levels of cortisol in their systems than the rats that drank plain water.

Invigorating chocolate. Anything that tastes as good as chocolate is bound to make you feel good, right? Sure, chocolate's pleasure-inducing effect may be due in part to its taste, but there's more to it than that. Chocolate contains small amounts of caffeine and another similarly acting stimulant called theobromine. Both give the brain a wake-up call and can improve mood. Another compound in chocolate, called phenylethylamine (PEA), has been shown to boost mood in depressed individuals.

Familiar favorites. Macaroni and cheese, apple pie, meat loaf, biscuits and gravy, and even Aunt June's green bean casserole with those little crunchy things on top are just a few other comfort foods that many people seek out during times of stress. Why? Because it's natural to gravitate toward the familiar during times of uncertainty. Since the flavors and aromas of food often elicit vivid memories, slurping up a bowl of your mom's chicken soup can certainly bring you feelings of safety and calm. For me, a steaming plate of mashed potatoes always takes me back to the simpler times of my childhood.

OF COMFORT AND CALORIES
We've all been there: One Twinkie to soothe the nerves at the end of a bad day turns into an entire box, plus a few Devil Dogs and Ho Hos thrown in for good measure. The aftermath leaves us feeling too sluggish to exercise, and, worse yet, may set off even more overeating. So, the next time you feel yourself heading down this road, back away from the Ring Dings and try one of these simple strategies.

Call a friend. Often just talking about your bad day or stressful situation can help you calm down before you turn to food.

Grab a pen. Jot down your thoughts (as in, what you really wanted to say to your boss but couldn't), or write out other feelings that may help you settle your nerves. Keeping a journal can help during particularly stressful times. This way, you get your feelings out rather than stuffing them down with food.

Run away. Going for a run or doing something else physical is often the best medicine for stress. Studies show that a single bout of exercise can boost mood. Exercise also takes you away from the "scene" of the stress, and allows you to gain perspective on the situation.

Find a distraction. Sure it's a temporary fix, but focusing on another task that requires your strict attention at least keeps you out of the cookie jar momentarily. Run an errand, repot that overgrown houseplant, or clean the fish tank. Do it quick. Chances are, this may be all you need to get beyond that desire to munch.

That said, there's no reason to completely avoid comfort foods (even the high-fat ones). By employing the following five comfort-eating strategies, you can soothe your soul without piling on the pounds.

1. Go single. Rather than buy a carton of ice cream, opt for a single-serve cup or bar and savor it slowly. This way you control the calories. And if you worry about not feeling satisfied, tell yourself you'll go back and buy more if need be. But most likely, the feeling will pass.

2. Sip or dip Mr. Hershey. When chocolate is your comfort food of choice, choose a big mug of hot chocolate made with fat-free milk. Or for a really satisfying and nutritious way to lift your mood, dip fresh fruit such as strawberries or pineapple chunks into sweetened cocoa powder.

3. Make a slight adjustment. Clearly, a rice cake is not going to cut it if your brain really craves chocolate cake. But you can substitute a slice of pumpkin pie for a piece of cheesecake, or a fruit smoothie for a milk shake. Such alternatives provide comfort along with a good dose of vitamins, minerals, and fiber.

4. Give Mom's a twist. Take your favorite comfort food that Mom used to serve and give it a makeover. My mashed potatoes (see Liz's Feel-Good Mashed Potatoes above) are creamy and delicious but low in fat, because I've eliminated the sour cream and butter that my mother always swore by (sorry, Mom). To cut back on the fat in recipes, use ingredients such as low-fat cheese in macaroni and cheese. Inject extra nutrition into old favorites such as meat loaf by adding chopped vegetables. And for sweets, simply cut back on the amount of sugar in recipes. You'll be surprised how good they'll taste.

5. Swap the salt. Some folks are soothed by salty chips and crackers, which can be hard to stop eating once you get started. Opt for salted air-popped popcorn for big calorie savings. Or mix ready-to-eat breakfast cereal with soy nuts and pumpkin seeds. Drizzle the stuff with soy sauce, then bake it in the oven. You'll end up with a salty snack loaded with protein, vitamins, and minerals.

Liz Applegate
Runners World Publication

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Fartlek Training

By David Holt

Several months ago, this column explained the many uses of Fartlek training, I'll now show you how to do your fartlek running to motivate yourself to run quality workouts.

But First a Reminder on Why Fartlek Running is so Useful:

Fartlek (Swedish for speedplay) running gets more of your muscle fibers into the running. You'll condition your entire muscle to prepare for racing.

Post Long Distance Run Recovery - After the longest run of the week, fartlek brings pep back to your legs...gently.

Quality Aerobic Conditioning - Fartlek's speedy sections bring in your reluctant fast twitch muscle fibers. Long fartlek sessions at modest pace, combined with long runs will improve the endurance of these fast twitch fibers.

Improved Range of Motion to supplement your stretching - All runners should put their muscles through a full range of motion at least twice a week to maintain good running form, while getting full use from the fast twitch muscle fibers.

Leg Strength and Anti-aging - Use fartlek to gain or maintain leg strength at all ages. Speedplay stimulates endorphin production inside your body for healing and health.

Speedplay is fun running at its best.

Fartlek Running, or Speedplay Helps You to Maintain or Develop Good Running Form:

Keep your leg speed (cadence) with 30-90 second efforts at 5K intensity. Play around with your knee lift and stride length.

Be gentle with your first few fartlek runs. Start with just one mile at speed, and add a quarter of a mile every other week to reach 7 miles by the end of the year. Just kidding. Increase the duration until you reach 10 percent of your mileage at 5K to 15K pace in one session. Then gradually decrease your recovery time between striders but keep the session fun.

Fartlek Pace:

Run anything from 15K to 5K race pace. Run between 90 and 95 percent of your maximum heart rate. Simply enjoy the fast running while working on your running form. Push off from the toes and enjoy the speed.

Run some longer efforts too, at the nice relaxed tempo of 15K pace (35 seconds per mile slower than 5K pace) for 3-7 minutes. Feel the power in your legs from your new mileage base. However, don't run all-out.

Fartlek is a controlled OR uncontrolled system to accomplish quality aerobic running and speedwork. It can be a run fast when you feel like it session, or you can have a set plan of say 20 efforts of 200 to 300 meters; another day it could be 6 efforts of roughly half a mile. Or let the trail dictate your session, as you run intensely over sections with the safest footing, or least traffic, or most mud, or enjoyable slope; then run at easy pace to recover.

Fartlek Training Improves Your Flexibility and Running Efficiency...If you Practice these points:

1. Let your ankles roll as you glide along.
2. Feet should be moving backwards when they land on the ground, ready to propel you forward.
3. Land with a slightly bent knee, as if onto eggshells. A soft footfall with flexed knee reduces the pounding.
4. Land on the outer edge of the heel or mid-foot, then roll inwards to a neutral position as you move toward push-off.
5. Push yourself forward powerfully with the calf muscles: By extending the trail leg to its full length, and pushing off from the end of your toes.
6. Run upright; run tall. Bring the hips forward.
7. Make your feet hug the buttocks as they swing through on each stride. Whip those feet through.
8. Keep your hands loose and relaxed. A clenched fist transfers its tension to the shoulders.

How can a 15 miles per week runner incorporate fartlek running?
Warm up with 10 minutes of easy running and then speed up a bit for any distance and at almost any intensity. After a fast section of running you ease to a jog or walk until you feel like going moderately hard again. However, whether you do your fartlek on asphalt, grass, dirt or mud and sand there are two key intensities to aim for:

Intensity One:
Close to your VO2 maximum, your current two mile race pace or 98 percent of your maximum heart rate by the end of each fartlek effort. Most of the benefits come at 5K pace though, or 95 percent of max heart rate, so run a 5K race to find this intensity for you and then 5 to 7 days later you can do fartlek efforts at 5K intensity. Over a series of sessions you can gradually bring your speed up to two-mile race pace, which is 15 seconds faster per mile than 5K pace. It is also harsher on your body, so take short strides to avoid overstriding. I suggest efforts of 30 to 90 seconds at these paces.

Intensity Two:
Anaerobic Threshold training improves the point at which you begin to produce lactic acid in your muscles. You'll eventually be able to run faster before producing lactic acid, and be able to run faster 5Ks. Run your fartlek effort at 30 to 40 seconds per mile slower than 5K pace. You'll be at 80 to 85 percent of your max heart rate in threshold training. The usual recommendation is to do 4 to 10 minute efforts at this intensity.

Look to do about 10 percent of your weekly mileage as fartlek. i.e. total a mere 1.5 miles at speed for the early sessions. Provided you don't sprint in these sessions, you can increase to 2 miles over about 10 weeks. The rests between fast efforts do not count toward your 2 miles. You'll need to cool down with another mile of easy running.

My 10K & 5K Running, Training & Racing book has a nice 20 miles per week training program and should see you through most sprint triathlons. You'll probably need 30 per week to handle a decent 10K though.

Here's a 5 week rotation at 15 miles per week to help you.

Week one:
Sat: Fartlek with short efforts at 5K to 2 mile race pace.
Sun: Long steady run of 6 to 7 miles.
Wed: The remainder of your weekly mileage.
Note that you have to restrain your pace on Saturday so that you can handle the long Sunday run. Run on Monday if your Sunday bike ride is really long, or bike after the Sunday run.

Week Two:
Sat: Long fartlek efforts at 35 seconds per mile slower than 5K pace.
Sun and Wed as last week.

Week Three:
Sat: 800 meter repeats or half miles at the track at 5K pace.
Sun and Wed are unchanged.

Week Four:
Sat: Mile repeats at 35 seconds per mile slower than 5K pace.
Sun and Wed unchanged.

Week Five:
Sat: Fartlek with the first half at 35 seconds slower than 5K pace. Do the second half at 5K intensity.
Sun: 4 miles easy.
Wed: 2 miles easy.

Sat: Race a 5K or short triathlon.

Your swimming and biking also need to be decreased leading into races. The next time through the 5 weeks you could add a mile to all runs to reach 18 per week the second time and 21 per week the third time through. Your speed sessions could go up to three miles after 15 weeks.

If you want to make the program harder, do 10 x 100 to 200 meter striders at 5K pace during all but the last of your Wednesday runs while thinking about an economical running form. There is no point in sprinting.

Check out www.runningbook.com or the book for more info. Or send $14.95 per book to David Holt at 3335 Richland Drive #4 Santa Barbara, CA 93105. (includes shipping and tax) Please state which books you are buying.

© All content is copyrighted TransitionTimes.com Inc. 2003

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Nutrition Simplified
Learn the Fundamentals

By Jason Gootman, MS, CSCS & Will Kirousis, BS, CSCS; USAT Certified Triathlon Coaches, Tri-Hard Sports Conditioning Systems

As coaches of endurance athletes worldwide, we are flooded with questions on nutrition. The funny thing is, behind all the 5 syllable biochemical names of nutrients, the keys to good nutrition are really very simple. Our goal in this article is to help you learn these fundamentals.

Each time you watch the evening news or read your local newspaper, you are informed of some new nutrition "discovery". In reality, what we need to know about nutrition, to optimize our health, we already know. The "new discoveries" are mostly interesting bits of science, but knowledge of these bits is not needed to optimize your health. In reality, the keys to good nutrition lie in our evolutionary history.

All too often, triathletes fall into the trap of following the latest trends in nutrition attempting to gain a boost in performance. The truth is that the principles of solid nutrition have not change in thousands of years. It is these principles that should guide you and not the conflicting 30-second soundbites you hear on the evening news.

Ok, to get right to it, lets look at what foods to eat, why to eat these foods, answers to common questions, and practical suggestions for how to gradually implement changes to your daily nutrition routine that will improve your health and performance.

What Foods to Eat
A few very straightforward guidelines will help you determine what are the best foods to eat:

· Any foods that would naturally occur in nature and that can be eaten by humans with minimal processing are good food for you to eat. These foods that naturally occur fall into one of two categories: plants and animals. Think of it this way: If you were not a modern day human with a car and a grocery store that provided hundreds of processed food choices, what would you eat? You would eat plants and you would eat animals. More specifically, you would eat foods like fruits, berries, vegetables, tubers, nuts, seeds and animals like fish, red meat (beef, venison, buffalo, etc.), birds, and eggs. Nature does not make mistakes. If you eat what is found in nature, you can rest assured of two things. First, you will be consuming everything that you need and second, you will not be consuming anything that you do not need.

· The less it goes through before it goes through you, the better the food choice. This means that just choosing naturally occurring foods is not enough. It means that you should also eat foods in as close to their whole state as possible. When a whole, natural food undergoes processing of any kind, its chemical structure is changed, thereby altering its nutritional value. Consider an apple. You could go to an apple tree, pick an apple and eat it. In this case, you consume the apple in its most whole state thus ensuring that you receive all the nutritional benefits of the apple. Then consider apple pie purchased at your local grocery store. This is what happened to the apples. First, their skin was removed. Then, they were chopped up and mixed together with many other ingredients for the pie including sugars and hydrogentated oils. Lastly, the mixture of apples and other ingredients were exposed to 350 degrees of heat for an hour. This processing alters the normal chemical structures of the apples in the pie thus dramatically reducing the nutritive power of the apples in their whole state.

Why Eat These Foods
As stated, whole, unprocessed, edible food contains all the nutrients your body needs and does not contain any substances that could harm your body. But let's take a closer look at the properties of whole, unprocessed food:

· Micronutrients: Micronutrients are vitamins and minerals. These vitamins and minerals are essential co-enzymes in the metabolic processes that occur within the body. Whole, unprocessed foods are the most nutrient-dense foods. That means that for each unit of energy you consume, you get the greatest amount of nutrients in the form of vitamins and minerals. Processed foods and refined grain products, on the other hand, are nutrient-sparse. They provide ample energy, but low amounts of vitamins and minerals. Consider the following example. Since the advent of agriculture, humans have used refined grains as an increasingly large component of their diet, replacing fruits and vegetables in the process. In 1997, an analysis of 4500 research studies was performed (1) to examine the effects of certain foods as preventative cancer agents for 18 types of cancer. Vegetables were found to have a convincing preventative effect on 5 cancers, a probable preventative effect for 4 cancers, and a possible preventative effect for 7 cancers. For fruits, the analysis revealed 4 convincing, 4 probable, and 4 possible. Yet for grains, there were zero convincing or probable effects found, one possible effect, and for cancer of the esophagus, grains were found to possibly increase the risk (1). So although grains do contain micronutrients, fruits and vegetables appear to contain greater quantities of the specific nutrients that we are designed to eat and therefore exert a much greater effect on preventing disease and maximizing health. You give yourself the best chance of attaining adequate amounts of all required micronutrients by eating a variety of fruits and vegetables.

· Fiber: People who eat fiber rich diets have lower blood cholesterol levels, a reduced risk of several cancers especially cancer of the colon (2), and they better regulate blood sugar levels (3). Whole, unprocessed plant foods like apples, pears, carrots, peas, almonds, and leafy greens are the best sources of fiber. Truly whole grains like wheat berries, quinoa, barley, millet, and other unrefined grains can also provide fiber. It is believed, however, that fiber from pre-agricultural foods is a better source of fiber because of their decreased association with phytic acid. Phytic acid, found primarily in grains, interferes with mineral (i.e. iron, zinc) absorption in the body (4).

· Essential fatty acids: Fat is not just OK to eat. Fat is not just good for you. Fat is essential! That is why dieticians term the acids derived from fats essential fatty acids. The richest source of essential fatty acids are naturally occurring plant foods like cashews, sunflower seeds, avocados, and olives as well as animal foods like coldwater fish and free range animals. Not only does eating whole, unprocessed foods provide ample quantities of essential fatty acids, but it also promotes the critical balance of two essential fats in the body, the Omega-3 fatty acids and the Omega-6 fatty acids. The Omega-3 to Omega-6 ratio should be in the range of 1:1 to 1:4 for optimal health. The standard American diet of processed foods and refined grains often balloons this ratio to as high as 1:25 in many individuals. This is because our diets are typically too high in Omega-6 fatty acids which come primarily from vegetable oils and too low in Omega-3 fatty acids which come from fish, meat (5), and many nuts and seeds. A skewed Omega-3 to Omega-6 ratio leads to the development of a myriad of health problems including cardiovascular disease (6,7,8,9). To promote the healthy balance of fatty acids in the body, make sure to eat modest amounts of naturally raised meat and fish as well as plenty of fresh fruits, vegetables, nuts, and seeds (10).

· Quality protein: Protein is a major component in the structure of each cell in your body. Nature supplies the most complete protein in the shape of all forms of animal flesh. If the animals and fish are well-raised (no growth hormone, no antibiotics, ample room to roam, natural diet, and low stress) or better yet, caught in the wild, their meat is high in quality protein, low in saturated fat, and also provides essential fatty acids in the optimal balance. Including all forms of meat and fish in your diet ensures that you consume quality protein.

· Low glycemic index foods and meals: The glycemic index is a measure of a carbohydrate food's ability to raise blood sugar levels. High glycemic carbohydrates raise blood sugar rapidly and tend to leave people hungry again just a short time later. High glycemic carbohydrates include refined foods like fruit juice, sweets, and refined flour products like bagels and pasta. Regular consumption of high glycemic carbohydrates tends to produce blood sugar fluctuations, energy fluctuations, and mood swings. Carbohydrates that are lower in glycemic index release their energy more slowly and produce a greater feeling of satiety. These are whole foods like vegetables and fruits. To promote the utilization of fat as fuel (a critical concept to triathletes and all endurance athletes), your daily diet must favor low glycemic carbohydrates and meals. The great thing is that nature takes the guesswork out of the glycemic index. There are very few high glycemic foods in nature, and when eaten in combination and in a large variety, natural foods provide a very low glycemic diet.

Common Questions
At this point, there may very well be several questions on your mind. Here are some common ones that we hear and their answers:

· Shouldn't grains make up the majority of my diet? We have been taught this for many years. As a result, you can still walk into any endurance athlete's kitchen and you will still find far to many relying on refined grains such as pasta, bagels, and cereal grains to support their training. But common sense and a little science should help show you that there is a better way. Anthropological research shows us that humans have only been eating grains of any kind since the advent of agriculture, which was about 10,000 years ago. This may sound like a long period of time, but considered in the total course of mankind, these years can be represented by 8 minutes of a 24-hour day. This means that man has simply not had enough time to genetically adapt and evolve to a grain-based diet. There is no single nutrient that can only be found in grains. All of the nutrients found in grains can be found in more robust quantities in fruits, vegetables, tubers, roots, nuts, seeds, meats and fish. Plus they can be eaten without processing thus preserving their inherent vital nutrients. Truly whole grains (bulgur, quinoa, barley, etc.) that have not been refined can be a good part of your diet, but do not have to be the majority of your diet. Refined grain products (breads, crackers, muffins, pastries) have no place in the diet of a health conscious/performance minded athlete.

· Won't I have less energy if I am eating more fat and less carbohydrates? For some reason, we have been led to believe that carbohydrates are the only source of energy in the body. This is simply not true. Fat is actually a must better energy source for fueling endurance activity if your body is capable of using it. Through proper aerobic training, we are actually teaching our bodies to utilize fat as fuel. A diet that contains healthy fats has been shown to aid in this process (11). If fat is absent and carbohydrate is the only prevalent source of fuel, your body tends to utilize this easy to access substrate in place of fat. This substrate utilization shift can lead to decreased fuel economy. Conversely, providing ample fat in your diet, together with an effective training program will promote the use of fat as a fuel substrate. Creating an efficient fat metabolism is one cornerstone for any successful endurance performance. People sometimes feel that carbohydrates have to be a superior energy source to fats since the net ATP (most simple form of energy) yield from a gram of carbohydrate is higher than that of a gram of fat. However, this outlook fails to look at the big picture, which clearly shows us that carbohydrates do not last for very long.

· What about sports bars, drinks, and gels? They seem to defy the logic of eating whole foods? This is very true. "Sports foods" are not whole foods. In fact they are often extremely refined. That being said, they are the ideal food choice when used correctly. What is correctly? That is when they are used for the purpose in which they are intended. These foods, broadly stated, are intended for use during and immediately after very vigorous (long and/or intense) exercise. Their composition is designed to take advantage of the unique hormonal states that our bodies encounter during and after vigorous exercise. A full discussion of the use of "sports foods" is beyond the scope of this article. The key is to not fall into the trap of using these foods as replacements for real foods in your daily diet.

Practical Suggestions
Here are some practical tips for successfully implementing improvements to your daily nutrition routine:

· Make slow, gradual changes. When working to make improvements in your daily diet, it is best to make gradual changes and not try to do it all at once. Say, for example, that you have decided to add more fruits to your diet and you have set a goal of eating five fruits a day. You currently eat one or two. Rather than simply trying to eat five every day from here on out, start by seeing if you can consistently eat three fruits a day. Then gradually work towards your goal of five a day.

· Think positive, not negative. Think about putting all kinds of great food into your body, and do not think about avoiding all kinds of bad food. Instead of thinking, "I can't eat this and that," try to think, "I get to eat this and that." For example, if you are trying to eat less sugary sweets, instead of harping on missing that chocolate cake, think about the great banana/strawberry/mango smoothie you are going to make.

So when it comes time to eat, just think whole, real unrefined food and you cannot go wrong!

Will Kirousis BS, CSCS and Jason Gootman MS, CSCS coach endurance athletes of all levels, write for conditioning related magazines/journals and, provide educational services for private and professional groups about optimizing endurance performance. Together they own and operate Tri-Hard Sports Conditioning Systems (Tri-Hard for short) and are certified as coaches by USA Triathlon and The National Strength and Conditioning Association. Will and Jason can be reached with questions or comments through their website, www.tri-hard.com or via email at will@tri-hard.com or jason@tri-hard.com respectively.

References
1. Worldwide Cancer Research Fund & American Institue for Cancer Research, 1997.
2. Colgan M. Your Personal Vitamin Profile. New York: Morrow, 1982.
3. Spiller, GA, Kay RP, editors. Medical Aspects of Dietary Fiber. New York: Plenium, 1980.
4. Eaton SB, Eaton SB III, Komner MJ. An evolutionary perspective enhances understanding of human nutritional requirements. Journal of Nutrition. 1996;126:1732-40.
5. Ollis TE, Meyer BJ, Howe PR. Australian food sources and intakes of omega-6 and omega-3 polyunsaturated fatty acids. Annals of Nutrient Metabolism. 1999;43(6):346-55.
6. Adams PB, Lawson S, Sanigorski A, Sinclair AJ. Arachadonic acid to eicosapentaenoic acid ratio in blood correlates positively with clinical symptoms of depression. Lipids. 31:S157-61, 1996.
7. Hibbeln JR, Salem N. Dietary polyunsaturated fatty acids and depression: when cholesterol does not satisfy. American Journal of Clinical Nutrition. 62:1-9, 1995.
8. Eaton SB, Eaton SB, Konmer MJ. Paleolithic nutrition revisited: A twelve year retrospective on its nature and implications. European Journal of Clinical Nutrition. 1997;51:207-16.
9. Simopoulos AP. Essential fatty acids in health and chronic disease. American Journal of Clinical Nutrition. 1999;70(3 Supplement):560S-569S.
10. Broadhurst CL. Balanced intakes of natural triglycerides for optimum nutrition: an evolutionary and phytochemical perspective. Medical Hypotheses. 1997;49(3):247-61.
11. Pendergast DR, Horvath PJ, Leddy JJ, Venkatraman JT. The role of dietary fat on performance, metabolism, and health. American Journal of Sports Medicine. 1996;24(6 Supplement):S53-8.

© All content is copyrighted TransitionTimes.com Inc. 2003

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Electrolyte Replenishment

By: Hammer Nutrition's Steve Born

In addition to replenishment of calories and fluids, properly fueling the body during exercise requires consistent and adequate electrolyte replenishment as well. However, unlike energy absorption and depletion rates, which remain relatively constant from athlete to athlete, electrolyte expenditure varies tremendously between individuals. Your individual and specific electrolyte requirements will not only differ from another athlete's but will also change constantly, depending on your fitness level, acclimatization level, and training duration and intensity. In fact, your electrolyte requirements may change during the course of the same workout or race, if only due to changes in the weather.
WHAT ARE ELECTROLYTES AND WHY DO I NEED THEM?
Electrolytes are chemical substances that form electrically charged particles (ions) in body fluids. Electrolytes are used to create the electrical energy necessary for many body functions, including nerve impulse transmission and muscle contractions. In simple terms, many normal bodily functions are dependent on these substances. Even if you've been fortunate enough to have never suffered the painful, debilitating effects of cramping, you still need to provide your body with a consistent and adequate supply of electrolytes. Why? Because cramping is simply your body's way of signaling that it's "on empty" in regards to electrolytes. Just as surely as you don't wait until you're dehydrated or bonking before you replenish fluids or calories, you never want to wait until you're cramping before replenishing electrolytes.
Again, normal bodily functions, the optimal performance of these important bodily functions, are dependent on an adequate supply of electrolytes. Your body's performance in workouts and races will be severely compromised if adequate levels of electrolytes are not present, especially in the heat or when exercise goes beyond two hours. Therefore, as important as the fuel you consume and the water you drink during exercise is a consistent replenishment of electrolytes.
CAN'T I JUST USE SALT TABLETS?
Salt tablets are an unacceptable choice for electrolyte replenishment for two reasons:
1.) They provide only two of the electrolytic minerals your body requires - sodium and chloride
2.) They may supply too much sodium to the body, overwhelming the body's complex mechanisms involved in supporting and maintaining proper sodium levels in the blood.
Each of these issues are important, and we'll discuss both of them. Right now, let's focus primarily on the second one.
Far too many athletes have suffered needlessly with swollen hands and feet from water retention due to ingestion of salt tablets or electrolyte products too high in sodium during prolonged exercise in the heat. The consumption of too much sodium is counterproductive because it interferes with or neutralizes the complex body mechanics involved in re-circulating and monitoring proper blood sodium levels. Sweat generates large sodium loss, which is monitored closely through hormonal receptors throughout the body. In other words, the body has very effective mechanisms to regulate and re-circulate sodium from body stores. However, rapid replacement of sodium neutralizes the body's hormonal defenses, allowing water replenishment to dilute sodium content. High sodium electrolyte supplementation contravenes natural physiological serum electrolyte control. Once the body detects an increase in sodium from exogenous sources (i.e., food, salt tablets, or products too high in sodium), the hormone aldosterone signals the kidneys to stop filtering and re-circulating sodium and instead excrete it. Once this happens, the actions of another hormone, vasopressin, becomes more predominant and causes the body to retain fluids. If you've ever finished a workout or race with swollen hands, wrists, feet, or ankles, or have excess puffiness under your eyes and around your cheeks, chances are your sodium/salt intake was too high.
The truth is that the human body needs only minute amounts of sodium to function normally. We require a mere 250 mg of sodium each day, athletes maybe 500 mg, which is easily supplied by natural, unprocessed foods. However, the average American consumes approximately 6000 to 7000 mg per day. The average athlete stores at least 8,000 mg of dietary sodium in tissues and has these stores available during exercise. In other words, you already have a vast reservoir of sodium available in your body from your diet, ready to serve you during exercise. In addition, your body has a highly complex and efficient way of monitoring and re-circulating sodium back into the blood, which it does to maintain homeostasis. Yes, you do need to replenish sodium during exercise but it has to be in amounts that cooperate with, and not override these complex body mechanisms.
The way to fulfill sodium requirements is not by indiscriminate consumption of salty foods or salt tablets, but rather with a lower-sodium approach that emphasizes a balance of essential minerals that cooperatively enhance the body's natural hormone and enzyme mechanics. A product that provides a more moderate supply of sodium goes undetected by the sensitive mechanisms that monitor and regulate sodium levels, and replenishes sodium requirements more precisely by permitting sodium to be re-circulated rather than excreted by hormone messenger activity.
DON'T I NEED TO REPLACE WHAT I SWEAT OUT?
It's easy to formulate a product that matches one of the many perspiration analysis studies, and then explain to athletes that they simply need to replace what they lose. Some products do just that. Unfortunately, there's a problem with this because individual sweat-loss differences vary greatly and the human body does not and cannot efficiently replace what it spends during exercise activity at any intensity above a walking pace. Electrolytes lost are not replaced by electrolytes consumed.
The body replaces only 35-45% of what it loses during exercise and this is true for fluids, calories, and electrolytes. If you try to replace all the fluids at once, you may end up with dilutional hyponatremia (overly diluted blood sodium levels) or water-intoxication. If you attempt to replace all the fuels that are spent, the stomach will back up in total rebellion, and refueling will grind to a halt. And, if you try to replace all the electrolytes you lose in equal amounts, a number of hormonal triggers may create all sorts of problems such as gastric stress, edema, or muscle spasms and cramping.
Endurance nutrition guru Bill Misner, Ph.D. says, "Give it [your body] 35-45%, even though it cries aloud for 110%." In regards to the amount of fluids you drink, calories you eat, and salt/electrolytes you replenish, this is an important key to remember.
SO WHAT IS THE ANSWER? HOW SHOULD I REPLENISH ELECTROLYTES?
The solution for proper electrolyte replenishment during endurance exercise is a gradual, consistent approach that provides all the required electrolytic minerals in amounts that do not override normal body mechanics. Remember, electrolyte intake needs to be below systemic detection, yet provide support to systemic depression. This simply means that you have to take in enough to support body functions while also preventing heat related issues such as cramping. It also means that electrolyte intake can't be too high as to overwhelm the body and what it can handle. Put another way, regarding electrolyte intake, it has to be accomplished in a way that falls under the "radar detection system" of the body while still providing optimal support.
ENDUROLYTES and ENDUROLYTES POWDER are full-spectrum electrolyte products, designed to fulfill the body's electrolytic mineral requirements, countering the effects of hyperthermia, optimizing specific bodily functions, and enhancing endurance performance, especially beyond the 2-hour mark. ENDUROLYTES and ENDUROLYTES POWDER are not formulated to reflect the amounts of electrolyte loss in sweat because each human being has a unique biological predisposition in terms of minerals lost via perspiration. Additionally, the differences in an athlete's size and fitness, as well as the rate of pace and during exercise, and of course the humidity and heat can mean up to a 100% difference when one athlete's sweat rate is compared to another's. A "one size fits all" formula based merely on sweat rates does not and will not work in adequately supporting your specific electrolyte requirements.
In the purest sense, the ENDUROLYTES formula is not so much an electrolyte replenishment product, but is better described as an "electrolyte stress support formula." It helps the body perform better under the demands of exercise, especially in heat, by providing a full complement of minerals in the proper balance, and without overriding normal body mechanics. ENDUROLYTES and ENDUROLYTES POWDER work with your body, not against it.
CHELATED MINERALS AND WHY ENDUROLYTES CONTAIN THEM
Chelation is the pharmaceutical process of bonding a mineral to an amino acid. This bonding makes it easier to digest and assimilate each mineral for proper utilization in the body. Chelated minerals are the form most often recommended because they provide greater absorption than their non-chelated counterparts. For example, magnesium is 87% absorbed when chelated, but only 16 % when taken in an inorganic, non-chelated form. One nutrition scientist wrote, "Estimates of normal mineral absorption average 10%; however absorption of chelated minerals may be as high as 60%"
THE ENDUROLYTES FORMULA
A MORE RATIONAL AND PRECISE APPROACH TO ELECTROLYTE REPLENISHMENT
CALCIUM is the most abundant mineral in the human body (about 2.85 pounds in the average person). A constant blood calcium level is required for a normal rhythmic heartbeat, healthy nerve transmission, and strong muscle contractions. During exercise, calcium-dependent enzymes produce energy from fatty and amino acid conversion. Because fatty acids are such an important fuel during endurance exercise (providing 60-65% of your energy needs when exercise goes beyond two hours in length), having adequate calcium available to efficiently convert them into energy is crucial. When blood calcium runs low, the body extracts it from the bones, but this may take more time than competition allows. A deficiency in blood calcium levels during endurance events may produce high blood pressure, muscle cramps and weakness. 150-300 mg/hr is an adequate dose of calcium to maintain the aforementioned proper body functions.
MAGNESIUM should accompany calcium at a ratio of 1:2. When calcium flows into working muscle cells, the muscle contracts; when calcium leaves and magnesium replaces it, the muscle relaxes. Many enzymatic reactions necessary for fuel conversion to muscular energy occur in the presence of adequate magnesium. Deficiency of magnesium contributes to muscle cramps, tremors, sleep disturbances, and in some cases, convulsive disorders. Simply put, if the body doesn't have a sufficient supply of magnesium, energy production is compromised. Though 100 mg or more is lost in sweat and used up by the muscles hourly, 75-150 mg/hr adequately replenishes magnesium without the laxative effect larger doses can produce.
POTASSIUM is the chief cation (positively charged ion) within all muscle cells, necessary for maintaining the optimal concentration and balance of sodium. Potassium deficiency symptoms are nausea, vomiting, muscle weakness, muscle spasms, cramping, and rapid heart rate. 75-150 mg/hr is an adequate replenishment amount. Even though 100-200 mg are lost in sweat alone (not counting internal muscle and cell use), if we try to replace it all at once, optimal sodium balance is altered. In addition, too much potassium is hard on the stomach and can cause severe stomach distress.
SODIUM is the chief cation (positively charged ion) outside the cell. The average American carries 8000 mg of excess sodium in extracellular tissues. During endurance events, a minimum of 3-4 hours are necessary to deplete this mineral, which may result in symptoms of abnormal heartbeat, muscle twitching, and hypoventilation. However, if sodium is replaced at the same rate as depletion, it overrides the hormonal regulating mechanisms that cause the body to conserve electrolytes. If you want to throw a wrench into your body's very intricate way of maintaining electrolyte balance, if you want to see your hands, feet, wrists, ankles and other body parts retain water and swell up, then indiscriminately dump copious amounts of sodium into your system. We highly recommend a gentler, saner approach, using 120-240 mg/hr of sodium (in the form of sodium chloride).
CHLORIDE is the relative anion (negatively charged ion) that must accompany sodium in the extracellular tissues. This mineral is absolutely necessary in maintaining the osmotic tension in both blood and extracellular fluids. It's a somewhat complicated process but to put it in the simplest terms, think of osmotic tension as being the proper balance and consistency of body fluids and electrolytes. We believe 180-360 mg/hr of chloride (as sodium chloride) adequately replenishes chloride without overriding the function of the hormone aldosterone in regulating and conserving proper electrolyte levels.
Note: "Salt: and sometimes the generalized use of the word "sodium" means sodium chloride, which is 60% sodium and 40% chloride. The numbers above for both minerals, sodium and chloride, when combined together equals 300-600 mg sodium chloride, which is our recommendation for "salt" intake.
MANGANESE is included in ENDUROLYTES as it is necessary in trace amounts for optimal muscle cell enzyme reactions for conversion of fatty acids and protein into energy. Again, fatty acids and protein are an important, even crucial part of the endurance athlete's fuel supply, so while manganese is not technically an electrolyte, its importance cannot be overstated. Research also shows that manganese deficiency plays a key role in blood sugar fluctuation, free radical build up from intense exercise, and nerve function disorders, especially in older athletes. Taking 5-10 mg./hr will help resolve all these issues, hence its inclusion in ENDUROLYTES.
PYRODOXINE HCL (vitamin B-6) is a coenzyme that performs in 60 enzymatic reactions involving metabolism of carbohydrates, fats, and protein. We include this water-soluble B vitamin in ENDUROLYTES because of its active role in maintaining sodium-potassium balance.
L-TYROSINE, included in varying amounts in both ENDUROLYTES and ENDUROLYTES POWDER, is an amino acid that has been added because blood plasma deficiency during extreme endurance events will lower thyroid and adrenal production, which hinders the proper rate of metabolism. Symptoms of l-tyrosine depletion first appear as depression, later anger, then despondency that degenerates into total despair. If any of these has ever happened to you during a long training bout or race, it may be due to low thyroid and adrenal production; it can be easily avoided by the intake of supplemental l-tyrosine at 50-100 mg/hr.
GLYCINE is an amino acid added to ENDUROLYTES POWDER to help neutralize the naturally salty/bitter taste of the minerals.
Everyone knows that consistent replenishment of fluids and calories are absolutely essential to maintaining energy levels during workouts and races. Hopefully this article has shown you that providing constant replenishment of electrolytes is an equally important component of proper fueling. While getting your fluid and caloric needs dialed in and nailed down is fairly easy to accomplish, properly fulfilling your electrolyte needs can be a bit more challenging because it's an ever-changing process, based on several variables. Using ENDUROLYTES and ENDUROLYTES POWDER will make that challenge so much easier to resolve because they contain the right minerals in the right balance, and, because they are independent of your caloric and hydration source, provide you with a tremendous amount flexibility with the dose. No matter what size athlete you are, no matter what sport you're engaged in, no matter how far or fast you go, and no matter what the weather is, you can fulfill your electrolytes needs accurately and precisely with ENDUROLYTES or ENDUROLYTES POWDER.
Steve Born is the senior technical advisor for E-CAPS with over a decade of involvement in the health food industry. He is a three-time RAAM finisher, the 1994 Furnace Creek 508 Champion and 1999 runner-up, the only cyclist ever to complete a Double Furnace Creek 508, and the holder of two ultra- marathon cycling records.
© 2003, Endurance Marketing Group. This information is copyright protected. Please feel free to distribute this information as long as the copyright notice, phone number, and/or URL are included. Content must remain unchanged and original authorship acknowledged.

www.ecaps.com

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Type-2 Diabetes

Fitness Q&A
Q: I was just diagnosed with type-2 diabetes and was hoping you had general guidelines for me to follow to make sure I implement a safe exercise program? I'm really excited to get started with your program, but I want to make sure I go about it the right way. I will be visiting my doctor again on Friday, but if you could reply and let me know your thoughts, I'd really appreciate it. Thanks so much!
http://www.global-fitness.com/fitnessconsultants/kling.html%0d%0d

http://www.global-fitness.com/fitnessconsultants/kling.html%0d%0dA: Exercise, along with diet and medication, can help those with diabetes manage their disease. Because it promotes the entry of glucose into the cells, exercise can lower your glucose levels. However, too much exercise, like too much insulin or insufficient food, may bring on an episode of hypoglycemia, or low blood sugar.

If you do experience a hypoglycemic episode, you may feel faint or excessively fatigued, lose consciousness, or have a seizure. Other symptoms include headaches, light-headedness, sweating, shakiness, butterflies in the stomach, irritability, and slurred speech. I mention this, just so you're aware.

Before beginning an exercise program, you should definitely consult with your physician about monitoring and adjusting insulin dosages and injection sites. Once you have become educated in caring for yourself in such situations, you can safely begin an exercise program. It may also be a good idea to undergo an ECG-monitored exercise test to rule out cardiovascular abnormalities before starting your program. The following precautions and recommendations should be helpful:

1. If you're on insulin, you may need to determine if you should reduce your insulin doses when beginning a regular exercise program. It is important for diabetics to work closely with their physicians to ensure appropriate dosages.
2. Cardiovascular exercise is best suited to "burn" calories, promote fat reduction, and metabolize blood glucose efficiently. Diabetics can best control their blood-sugar levels with exercise that is predictable and consistent in duration, intensity, and frequency, such as walking three days a week for 30 minutes at a heart rate of 65% of maximum heart rate.
3. Obese type-2 diabetics should follow the guidelines for nondiabetic obese exercisers, which include low-impact, low intensity cardiovascular exercise, 3-4 times per week.
4. Diabetics who use insulin should not inject it into the limbs they are about to exercise. The increased circulation in the exercised extremity may cause the insulin to be absorbed quickly enough to bring on hypoglycemia.
5. Exercising in weather extremes could affect insulin absorption. Cold weather may slow insulin absorption, and hot weather may speed up insulin absorption. Try to avoid extreme weather conditions.
6. To help avoid hypoglycemic reactions during exercise, eat a complex carbohydrate snack before exercising. If the cardiovascular exercise duration exceeds 30 minutes, eat a carbohydrate snack every 30 minutes during exercise. Juice or crackers also work well in these situations.
7. Always have easily digestible carbohydrates, juice, or candy on hand, in case you experience hypoglycemia.
8. Strength and flexibility exercises should also be included in your program, but let Dani, our Exercise Expert, customize one specifically for you - one that's both safe, realistic, and effective for YOU.
9. Be sure to maintain good foot care. Because high blood sugar levels can damage nerves and blood vessels, causing poor circulation and reduced sensation to the legs and feet, foot problems are a major complication of diabetes. Be aware of hot spots, blisters, calluses, cuts, sores, and bunions and receive proper treatment.

I really hope this helps. Please let me know what you doctor has to say and if there's anything else I can do to help! Yours in medical fitness,

Mark Kling, MD, FAAEM, CSCS
GHF's Medical Fitness Expert

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Strength Training for Runners

Courtesy of Runner's World
by Owen Anderson, Ph.D.by Walt Reynolds

Strength-training can improve power, reduce risk of injury and increase your speed. Check out this program designed especially for runners.

We've put together the 10 best strengthening exercises in a program that will specifically enhance your running performance. They can be done in a gym or at home. For two of these exercises, you'll need a piece of resistive tubing, available from pharmacies with extensive home-therapy sections or from companies that sell sports-medicine products. (Saunders Sports is one such company; call 800-770-8920 for a catalog or to order resistive tubing.)
You should be able to complete all 10 exercises in 20 to 25 minutes or less.
For maximum benefit, do them before you run. These exercises will not tire you so much that you can't run well afterward. In fact, they may "wake up" your muscular and nervous systems and lead to higher-quality training.
If you practice these 10 exercises faithfully, within a few weeks you'll notice improved coordination during running and more explosive push-offs whenever your feet strike the ground. As your muscles become more powerful, risk of injury should decrease, and your running speed will improve significantly. Best of all, you'll have some PRs to show for your efforts.
1. Hip Hikers
MUSCLES EXERCISED: Buttocks and muscles that control the hip joint
IMPORTANCE TO RUNNERS: The buttocks and hip muscles control and stabilize the pelvis and hip joint during the touchdown and takeoff phases of the running stride. Hip hikers strengthen these muscles and ultimately prevent unnecessary hip motion, improving your running economy.
TO DO THE EXERCISE: Stand sideways on a step or low bench with your weight on your left leg and your right leg unsupported over the edge of the step. Keep both knees locked so that your legs are perfectly straight throughout the exercise. Lower your right heel toward the floor by tilting your right hip down. Don't bend your left leg at the knee! Then raise or "hike" your right hip as high as it will go. Lower and raise the right hip 12 times before switching to the left hip. Perform two sets with each hip twice weekly, on nonconsecutive days.
2. Resisted Leg Swing
MUSCLES EXERCISED: Hamstrings
IMPORTANCE TO RUNNERS: The hamstrings stabilize the hip and knee joints when the foot is in contact with the ground, provide propulsive force during push-off and control the forward swing of the leg as the knee drives forward. Resisted leg swings will strengthen the hamstrings.
TO DO THE EXERCISE: Anchor one end of a piece of resistive tubing to an immovable object. For best results, the attachment point of the tubing should be at hip height. Place the other end of the tubing around your left ankle and stand about 4 feet from the attachment point (facing it) so that the tubing is stretched. Shift all of your body weight to the right leg and stand on your right foot only. Raise your left thigh so that it is parallel to the floor.

While keeping your left knee flexed, move your left leg through what feels like a normal running motion for a set of 10 repetitions. Your left foot should not touch the floor at any point during the cycle, and you should maintain full weight on the right foot. Perform two sets per leg, two days each week on nonconsecutive days.
3. Toe Presses
MUSCLES EXERCISED: Muscles of the calf and Achilles tendon
IMPORTANCE TO RUNNERS: The calf muscles absorb shock during footstrike and stabilize both the ankle and knee during the ground-contact phase of running. The calf muscles and Achilles tendon also help to rock the foot forward just prior to toe-off. Toe presses build up this whole area of the leg.
TO DO THE EXERCISE: Stand on a step or low bench with your weight on the ball of your right foot and your right heel hanging down below the edge of the step. Your left leg should be bent and unsupported. Hold onto a handrail or wall to maintain balance, and rise up on the toes of your right foot as high as you can, keeping the right leg straight. Then lower your right heel below the level of the step until you feel a stretch in your right calf. Repeat the exercise 15 times before switching to the left leg. Do two sets of toe presses per leg, three days a week on nonconsecutive days.
4. Toe Pulls
MUSCLES EXERCISED: Muscles of the feet and toes
IMPORTANCE TO RUNNERS: The muscles of the feet and toes maintain the strength and resiliency of the arch and provide a strong base of support during the ground-contact phase of running. Doing toe pulls regularly should lower the risk of plantar fasciitis and decrease your ground-contact time during footstrike, boosting your stride rate.
TO DO THE EXERCISE: Stand barefoot or in socks with your feet about 2 inches apart. Shift your weight slightly onto your left foot while flexing the toes of your left foot upward and pulling the toes of your right foot downward and back. Your right foot should slide forward 1 to 2 inches as you pull strongly with your right toes. Next, shift your weight slightly to your right foot, and flex your right toes upward while pulling down with your left toes, causing your left foot to creep forward. Starting slowly and gradually increasing the tempo of movement, repeat this right-left cycle until each foot has pulled you forward 30 times. Complete two sets of toe pulls, three times a week on nonconsecutive days.
5. Bench Sit-Ups
MUSCLES EXERCISED: Buttocks and hamstrings
IMPORTANCE TO RUNNERS: The buttocks muscles and hamstrings stabilize the hip and knee joints and help to propel the body forward during running. Performing bench step-ups intensifies this propulsive action.
TO DO THE EXERCISE: Begin from a standing position on top of a bench of about knee height, with full body weight on the left foot and weight shifted toward the heel. Let your right foot hang freely, slightly behind your body. Lower your body in a controlled manner until the toes of the right foot touch the ground, maintaining all of your weight on your left foot at all times. Return to the starting position by driving downward with the left heel and straightening the left leg. Maintain an upright posture throughout this exercise, and keep your hands at your sides. Repeat 10 times before switching to the right leg.
Do three sets with each leg twice a week on nonconsecutive days.
6. One-Leg Squats
MUSCLES EXERCISED: Quadriceps muscles, or "quads"
IMPORTANCE TO RUNNERS: The quads stabilize the knees, help to swing the leg forward during running and are especially active during hill running.
TO DO THE EXERCISE: Stand with your right foot forward and your left foot back, with your feet one shin-length apart from front to back and hip-width apart from side to side. Place the toes of the left foot on a block or step that is 6 to 8 inches high, and keep most of your weight on the heel of the right foot. Bend the right leg, and lower your body until the right knee makes an angle of 90 degrees between the thigh and lower leg. Return to the starting position, keeping your trunk upright and your hands at your sides. Repeat the exercise 10 times before switching to your left leg. Complete three sets on each leg twice weekly on nonconsecutive days. Compared to traditional two-leg squats, this exercise is much better for runners because only one leg is weight-bearing at any one timethe same as during running.
7. One-Leg Hops
MUSCLES EXERCISED: Muscles of the hip, thigh, lower part of the leg and foot
IMPORTANCE TO RUNNERS: These muscles stabilize the body and push it forward during running. Performing one-leg hops will make you a more explosive runner and increase your stride length.
TO DO THE EXERCISE: Start from the same position used for one-leg squats, with the toes of the left foot supported on a 6- to 8-inch block or step. Hop rapidly on the right foot at a rate of 2 to 3 hops per second (25 to 30 foot contacts every 10 seconds). Force the right foot to strike the ground in the midfoot region and then spring upward rapidlyas though your foot were touching a red-hot stove. The right knee should rise 4 to 6 inches as the left leg and foot remain stationary throughout the exercise, and your hips remain level and virtually motionless, with very little vertical displacement. The motion should come from your right leg. Perform 30 hops on the right leg before switching to the left. Begin with one set of hops on each leg twice a week on nonconsecutive days. After three weeks, increase to two sets per leg.
8. Abdominal Stabilizers
MUSCLES EXERCISED: Abdominal and oblique trunk muscles
IMPORTANCE TO RUNNERS: The abdominal muscles stabilize the trunk during running. Abdominal stabilizers will eliminate energy-wasteful movements of the upper body and may reduce the incidence of side stitches.
TO DO THE EXERCISE: Sit on a bench or chair with your legs extended in front of you and your knees slightly bent. Recline your upper body from the hips about 45 degrees, keeping your chest up and your shoulders back. Raise your right arm to an overhead position while lowering your left arm, and alternate back and forth until each arm has been raised 30 times. Maintain a rigid position with your upper torso and legs at all times. Only your arms should move during this exercise. Do three sets two times a week on nonconsecutive days.
9. Glute-Lumbar Stabilizers
MUSCLES EXERCISED: Lower-back and buttocks muscles
IMPORTANCE TO RUNNERS: The lower-back and buttocks muscles maintain proper trunk position during running, prevent excessive forward lean and limit unnecessary rocking movements of the trunk. Glute-lumbar stabilizers will strengthen these key muscles and make you a more efficient runner.
TO DO THE EXERCISE: Lie face down on a bench, padded table or bed. Extend your legs straight behind you and position yourself so your hip bones are at the edge of the table and your upper body extends beyond the table. Brace your feet under an immovable object or ask someone to hold your ankles while you do this exercise. With your upper body extending straight out beyond the table, raise your right arm while lowering your left arm. Alternate back and forth until you've raised each arm 30 times while keeping your legs and upper body in a rigid position. Do three sets of glute-lumbar stabilizers two to three times a week on nonconsecutive days.
10. Resisted Ankle Pulls
MUSCLES EXERCISED: Shin muscles (front of the lower leg)
IMPORTANCE TO RUNNERS: The shin muscles stabilize the lower leg, ankle and foot during both the swing and ground-contact phases of the running stride. Strengthening these muscles with resisted ankle pulls will produce a more powerful toe-off. It should also minimize the occurrence of shinsplints and decrease the risk of stress fractures in the lower part of the leg.
TO DO THE EXERCISE: Anchor one end of a piece of resistive tubing to an immovable object, and attach the other end to your left foot just above the toes. Sit with your left leg extended in front of you (on a line with the tubing) and your left foot about 4 feet away from the attachment point of the tubing. The tubing should be stretched at all times during the exercise.
Alternately flex and extend your left ankle 20 times while keeping your left leg straight. Repeat the exercise with your right leg. Do three sets of ankle pulls for each leg, three to four times a week on nonconsecutive days.
©2003 New Balance Athletic Shoe, Inc. All Rights Reserved.

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Carbo Loading For That Extra Edge

It used to be so simple. You completed an exhaustive workout and then ate minimal amounts of carbohydrate for three or four days to wipe out your muscle-glycogen stores. Then came the good part: you trained lightly and consumed biscuits, pies, pasta and potatoes in lavish quantities for three days to super-saturate your leg muscles with carbohydrate. This was the classic 'carbo-loading' strategy developed by top-level Swedish scientists in the late 1960s and early 1970s, a plan which was used by countless endurance cyclists, cross-country skiers, and runners prior to their long-distance races.

But then Dave Costill made things simpler still. In his lab at Ball State University, Costill showed that the initial, three- to four-day, low-carbohydrate 'depletion' stage was impractical and unnecessary. The famed Indiana scientist suggested that endurance athletes could stay on top of the carbohydrate game simply by reducing their training and eating increased amounts of carbohydrate during the three days before an important, long-distance competition.
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The two-hour window
It would have been nice if things stayed that uncomplicated, but scientists gradually discovered that many endurance athletes were not storing enough glycogen in their muscles during periods of vigorous training and were consequently having trouble maintaining their desired training loads. In the late 1980s, one reason for this lack of glycogen storage became apparent: research showed that muscle cells are quite temperamental about when they like to stock away glycogen. For example, muscle fibres usually have little inclination to store glycogen before a meal or during sleep, but they are most willing to pull carbohydrate out of the blood and stockpile it during a fairly brief period: the two hours immediately after a strenuous workout. It seemed that many glycogen-deficient athletes were failing to give their muscles what they needed during this critical two-hour time span.

As a result of that discovery, wise athletes began to 'fuel up' with copious quantities of sports beverages and high-carbohydrate foods, taken in shortly after their workouts had ended. The next step was to figure out exactly how much carbohydrate was actually needed during this muscle prime-time (the two hours after a workout), so that glycogen would be replaced as quickly as possible.

Fortunately, in about 1987, John Ivy, Ph.D. and his colleagues at the University of Texas discovered that eating about two-thirds of a gram of carbohydrate per pound of body weight, once right after a hard workout and a second time two hours later, helped athletes achieve super-high muscle glycogen levels in a short period of time. If you weighed 150 pounds, all you had to do to ensure that the interiors of your muscle cells were 'carbohydrate pantries' was to consume 100 grams of carbohydrate (150 x 2/3) right after your workout and 100 grams two hours later. If your regular meals were also biased toward carbohydrate, you could be fairly certain that your muscle cells would contain enough glycogen to keep you training at a high level.

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Supplanting the Ivy
But it's a changing world, and the Ivy strategy now seems almost as outdated as the old Swedish carbo-loading regimen. In recent research at Ohio State University, scientists have uncovered a scheme which quickly gets at least 20% more carbohydrate into your muscles, compared to the Ivy plan. This 20% boost in carbohydrate should help to ensure greater endurance during subsequent long workouts or races. To put it simply, you'll have a much lower risk of having your performances harmed by low muscle-glycogen levels.

In the Ohio State investigations, 10 fairly fit individuals cycled for 75 minutes at an intensity of 70% VO2max (80% of maximal heart rate) and then surged through five one-minute sprints at 100% VO2max (very close to maximal heart rate). To further reduce muscle-glycogen levels, the subjects then completed 10 sets of 10 leg extensions or flexions on a Cybex resistance-training machine.

48 hours after this rugged session, the athletes returned to the laboratory and repeated their cycling efforts (75 minutes of riding, plus five one-minute sprints). Following each of the two workouts, the 10 participants consumed carbohydrate every 15 minutes for four hours. The actual amount of carbohydrate was huge: a total of almost three grams of carbohydrate per pound of body weight, subdivided into 16 equal doses over the four-hour period. This meant that the Ohio State athletes ingested about 30 grams of carbohydrate every 15 minutes.

Although stoking in that much carbohydrate required real effort, the strategy paid off: muscle biopsies revealed that the rate of glycogen storage was at least 20% greater than the storage rate achieved with the old two-snacks-in-two-hours programme and up to 90% greater than traditional carbo-replacement plans.

The reason for the exceptionally advanced glycocen storage in the Ohio State study was simply that the carbohydrate was ingested in 15-minute intervals over four hours, not just in one or two lump sums. The 15-minute pattern insured that blood glucose and insulin levels stayed exceptionally high throughout the entire four hours after exercise. In fact, insulin, a potent booster of glycogen storage, actually increased steadily over the four-hour time period!

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An insulin digression
Before going further with this story, we should note that insulin has attracted a bit of notoriety recently. Specifically, ads for various nutritional products sold to athletes suggest that insulin is bad because it reduces the use of fat for energy. While it's true that insulin blocks the release of fat into the blood from fat cells, and it's also true that this would be a bad deal for you if you were running long distances without being able to ingest a sports drink, it's also essential to point out that insulin is a critically important hormone which aggrandises your muscles' stores of carbohydrate. This surplus carbohydrate then allows you more effectively to carry out high-quality interval workouts, long-distance training sessions, and races lasting an hour or more. The bottom line is that you want to have increased blood-insulin levels after a meal (or series of snacks), so that you can stuff as much energy as possible inside your muscle fibres.

The new four-hour strategy is particularly important if you work out more than once a day, if you're a very high-mileage trainer, or if you complete a lot of intense intervals, because these scenarios extensively deplete muscle glycogen. The strategy may also be of value if you're an athlete who carries out a lot of training on hilly terrain, because the Ohio State researchers showed that glycogen storage was reduced by 20% when the post-cycling weight-training work was eccentric in nature. Since hill running emphasises eccentric muscle contractions (actions in which muscles are stretched as they are trying to shorten), normal glycogen storage patterns may be compromised during hill training. Fortunately, the Ohio State strategy is a way to perk up muscle-carbohydrate attendance in athletes who train on rolling terrain.

Wolfing down large amounts of carbohydrate after a workout may seem a bit extreme, but it's a strategy routinely followed by some of the most successful endurance runners in the world, the élite Kenyans. At their rugged, high-altitude camp near Embu, Kenya, where the Kenyan cross country teams complete three demanding workouts per day and run about 140 miles per week, the Kenyans guzzle highly sugared cups of tea and milk almost immediately after each training session and then devour huge platefuls of high-carbohydrate food. They do a great job of preparing their muscles for their next workout, which may follow the preceding training session by just four to six hours.

However, even the world-beating Kenyans don't have the formula exactly right. The Ohio State idea is to graze for four hours or so, converting your bloodstream into a steady river of carbohydrate and insulin and forcing your muscles to work overtime stacking up that carbohydrate as glycogen.

Read the whole of this article in our Carbo Loading report.
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Interval Training at Close to your VO2 Maximum Pace

Running Coach David Holt
By David Holt
One of the many non-existent secrets to successful running is to train at close to your maximum oxygen uptake capacity on a regular basis. Runners with a high VO2 maximum absorb more oxygen per minute, so generally they can race faster.
Economic runners burn less oxygen at a given pace: being frugal with oxygen use, they too can race faster.
The best 5K and 10K performances are run by athletes with high VO2 max and good running economy.
Regular training at 2 mile & 5K race pace improves both VO2 max and running economy.
The aims of Interval Training then, are to:
1. Improve Maximum Oxygen Uptake Capacity or VO2 Max, which is the amount of oxygen you absorb into our cells in one minute while working at full capacity. It's a measure of fitness expressed in milliliters per kilogram per minute.
2. Get more efficient at utilizing the oxygen you absorbed by improving leg turnover and running economy.
Easy running improves VO2 maximum enormously, but eventually you'll have to run at close to your maximum capacity, yet much slower than your maximum speed to improve your running speed improve your running economy.
Frank Horwill, the British Athletic Federation coach says, "The best way to improve VO2 max is to run between 80 and 100 percent of VO2 max. One hundred percent equals the athlete's 3K pace; 95 % equals 5K speed; 90 % is 10K speed.
"Work physiologists believe training at 95 % VO2 max brings the best results - though one Russian physiologist of note - Karibosk, thinks 100 % (3K or two mile pace) is better because it tunes up the anaerobic pathway. Note: The 3,000 meters race is run at 60 % aerobic and 40 % anaerobic."
Months of long runs have increased your VO2 max substantially. Now it's time to make additional VO2 max and running economy gains by training at close to your maximum oxygen uptake pace. Applying this modest stress to your lungs, muscles and circulatory systems will stimulate your VO2 max to rise: you'll be able to race faster.
The Track.
Interval training is a precise and progressive form of training. You'll change one of Waldemar Gerschlers' 5 variables such as increasing pace by one second per quarter mile, once a month to:
Further stimulate your VO2 system;
Force you to run more economically;
Use all your muscle fibers - making you stronger; and,
Develop pace judgment.
These goals are best achieved on a flat surface of known distance. Running these sessions on a track creates a more reliable yardstick to assess progress.
The advantages to track sessions are:
1/ Same distances all over the world (except that a quarter mile track is a couple of yards or meters more than 400 meters.
2/ A smooth surface.
3/ You get away from traffic, dogs and pedestrians.
There are some track rules. Look before you change lanes; avoid lane one if possible; and if you think someone ahead of you is going to veer left to the inside after his interval, chances are, he will actually veer right. Assume everyone else's brain is malfunctioning, and you should stay safe. Don't expect to educate all the joggers and walkers. If you can persuade a few to stay out of the inside two lanes, you've achieved more than most runners have experienced. Many are beyond our help, so don't stress yourself out by worrying about them. Run well wide of them using a gradual change in your line of running. Overtake them on the outside.
Rest During Interval Training.
Actually, the rest period is the Interval! Generally, you should take less than 90 seconds rest during interval sessions. The greatest stimulation of heart development occurs in the first 10 seconds of the rest period. If you're running reps at the appropriate pace for you, it should only take 30 seconds for the heartrate to get below 130. The extra minute is for your mind, not your body. There is no need to wait for your H.R. to reach 90. Let it reach 110 to 120 while you maintain a decent recovery speed. Running at a respectable jog during your recoveries brings in nutrients and helps the muscles to get rid of the accumulated wastes.
You need a good base before commencing serious speed running. Never lose sight of the strength phase. Keep your long runs and the modest pace threshold sessions and hill repeats throughout the year.
Your mileage and strength base increased the number and size of your mitochondria, the organelles inside the muscle cells that make ATP (adenosine triphosphate), which fuels your muscles.
Interval Training Basics.
Do a warm-up and stretch. Flexibility determines your range of movement, your potential stride length. Muscles are 10 percent longer when warmed up. Muscles work better when they are long - exerting the same amount of force using less effort.
Don't jump straight into long sessions of intervals.
Feel as comfortable in the last 400 meters as you did in the first 400.
Run the last few reps as fast as the early ones.
But don't make the last few significantly faster.
Don't feel wasted afterwards. Feel as if you could have run another 200 meters at that pace at the end of each rep; feel as if you could have run several more reps when you've completed the session.
Whether training on your own, or in a group, here's how you can progress if doing formal VO2 max training for the first time.
* Week One: Bends & straights to get used to the surface. Stride out at 5K pace along the straight and then jog the bends at a steady pace. Run eight to twelve laps - giving you 16 to 24 striders. You should not feel exhausted. Short striders of 20-30 seconds at 5K pace require little concentration.
* Week Two: 16 x 200 meters with a 200 interval recovery. The surface may tempt you to run faster but hold at 3K pace to decrease injury potential.
* Week Three: 10 x 300 meters. Run a little slower than the 200s. Run two straights and one bend for the repetition; jog a small circle and then the bend for the recovery. Use lane 4 or 5 to reduce the strain on your ankles, knees and hips as there is a tendency to lean into the curves on lane one.
Again, pace should be no faster than 2 mile or 3K race speed...100 percent of VO2 maximum, or about 12 seconds per mile faster than your best recent 5,000 meters. Sessions at this modest pace give your leg muscles a chance at adjusting to the track surface.
* Week Four: 8 x 200 and 4 x 400 meters. You will probably need to run at 5K pace in order to keep going for the extra 100 meters on the 400s.
Use the sprinters start point when running in the middle lanes. The relay boxes are also a useful guide. Otherwise, running a whole lap in lane five adds 26.8 meters per lap if the lanes are 42 inches wide. That's an additional 5.4 seconds for the 80 seconds per 400 meter runner, and 6.7 seconds for the 100 second 400 runner.
* Week Five: 10 x 300 again. Pace judgment will improve with practice; aim to run them fairly even. If you run more than 40 miles per week, build toward at least fifteen reps.
* Week Six-: 4 x 200 and 6 x 400 meters with 200 rest. This session is hard if you run too fast. Aim to maintain good form for the entire lap...assess yourself in each hundred. Ask...is my form going? Quarters have the advantage that you start and finish each effort at almost the same place.
* Week Seven: 4 x 300, and then 3 to 4 x 600 with a 400 rest.
* Week Eight: 6 x 200, and then 3 x 800 meters.
Then alternate sessions using mostly short reps at 2 mile pace, with sessions of longer reps at 5K race pace.
This speed running helps you get the greatest possible amount of the energy from your highly trained running muscles. Use the good form such as:
Don't run with high knees. Short, fast strides are often better.
Keep your hips forward.
Think about the elements of good form. It helps you to maintain efficient form for longer periods.
As the months and years progress, you'll become less bouncy, and more efficient at running...if you practice.
Track Psych-out?
You don't have to run these sessions on a track. You can use a watch with a beeper to run a session of one or two minute efforts with a minute rest...on grass, or paths, trails and road. A track session and a hill or a fartlek session will give you two sessions of short efforts a week. Retain a tempo run or a session of long reps each week.
Tracks can help you keep interval training precise in any city; you can measure your progress, and the eventual decline as you age.
Intervals fine-tune your body; they help you get the best out of yourself. Measure the real progress in racing though. Don't just become good at interval sessions.
Practice good form, and intervals at close to VO2 max will:
Improve your flexibility and running efficiency so that you can race faster.
Recruit even more of your fast twitch fibers, more of your total fibers to shift your limbs at this pace. Which:
Improves your leg strength and therefore your stride length - allowing you to run faster.
Raises your leg turnover or cadence.
Improves overall speed and economy.
Your smoother running requires less ATP - your energy lasts longer. You can run farther at a set pace.
Your pace judgment improves.
You improve your neuromuscular coordination even if you forget to work on form.
You breathe deeper - intercostals and diaphragm muscles develop tone.
Your anaerobic buffering system is enhanced; your lactate tolerance goes up. Which means that your muscle fibers will contract despite the presence of high levels of lactic acid.
The body's ability to process oxygen improves.
Your aerobic capacity and VO2 maximum rises.
You're able to run longer before you reach oxygen debt...and you'll be better able to handle that debt...at a given speed.
You race faster.
You can even talk during the rest interval. The running becomes social.
At 2 mile pace, or the distance you can complete in about 10 minutes, the heart, lungs and entire circulatory system work at maximum capacity to maintain speed. This stimulates your VO2 maximum to increase.
Run long repeats of 3 to 5 minutes at this intensity and you'll also be forced to run economically. Gradually ease into longer repeats to spend more time in your training zone of 95 to 98 percent of max heartrate, which are 95 and 100 percent of your maximum VO2.

Adapted from 10K & 5K Running, Training & Racing, by its author David Holt. 180 pages for $17.95 ISBN 0965889718 order from high street or Internet stores.

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Intensity vs volume for ageing athletes

For many years the conventional wisdom of exercise pundits was that more was better; that long, slow workouts were much more beneficial - for health and fitness - than short bursts of intense exertion.

For some time now the tide has been turning - and Peak Performance Newsletter has been in the vanguard of opinion-formers arguing that intensity is (often) more important than volume when training for a wide range of sports and events.

And it now seems that health as well as fitness benefits most from high-intensity exertion. Walking used to be recommended as a prophylactic against heart disease, but the latest research suggests that only vigorous activity is effective in reducing heart deaths.

The high-intensity-is-best theme is given a different slant in Peak Performane's latest special issue on ageing and performance. In his lead article on how to maintain speed in the face of advancing age, John Shepherd points out that human growth hormone, which plays a crucial role in maintaining many aspects of fitness, including speed, is released in the body in direct proportion to the intensity of the exercise being performed.

Other strategies recommended by Shepherd for fending off the age-related decline in the various parameters of speed include:

o Hill training, which works to offset the typical reduction in stride length and increase in ground contact time;
o Weight training to offset the decline in fast twitch muscle fibres;
o Plyometric exercises for stride length and fast twitch maintenance;
o Creatine supplementation for enhanced muscle power.
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Ageing and distance running
Speed and power are close cousins, both relying on the ratio of fast twitch to slow twitch fibres within the muscles. As Craig Sharp points in his article on ageing and distance running in the latest issue of Peak Performance, aging muscle has been shown to contain higher proportions of slow twitch fibres, which might be good news for marathon runners, but is less so for any athlete in search of speed and power.

Sharp presents a grim catalogue of the normal manifestations of age-related deterioration, with body fat rising, lean mass declining, height falling, cardiorespiratory capacity diminishing and muscles atrophying.

Nevertheless, the extraordinary marathon performances of very elderly runners set out in an accompanying table proves that such losses are reversible to a greater or lesser extent.

His tentative conclusion is that an estimated 20-40% - or maybe even more - of the physiological deterioration associated with ageing is not inevitable but is due to a 'detraining effect' of decreased exercise, often coupled with an increase in body fat.

Never has the athlete's motto of 'use it or lose it' seemed more apt!

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Nourishment for ageing joints
Regular PP contributor Andrew Hamilton is even more upbeat in his detailed account of nutritional strategies to protect the joints from age-related degeneration.

As time goes by, he explains, joints tend to become less flexible, full-range movement more difficult and pain and stiffness ever more apparent. It is these mechanical limitations, more than anything else, that can scupper the best-laid plans of even the most determined veteran athletes.

Nutrients of particular importance for older athletes and should be well supplied in their diets are:

o Vitamin C for collagen formation;
o Omega-3 oils (from nuts, seeds, oily fish and wheat germ) for anti-inflammatory effects;
o Sulphur-containing amino acids (from some vegetables, meat, poultry, fish and dairy products) for joint cartilage health;
o Bioflavinoids (from all fruit and vegetables, and buckwheat) for anti-inflammatory effects and improved local circulation;
o Antioxidants (selenium and vitamin E) for protection against the damaging 'free radicals' that proliferate in the body with age;
o· Zinc and copper for a range of protective benefits.

Additionally, Hamilton recommends the following supplements:

o Glucosamine sulphate for reducing pain and stiffness, increasing mobility and offsetting the joint space narrowing that typically occurs in degenerative conditions;
o Chondroitin sulphate , which appears to promote cartilage water retention and elasticity;
o· S-adenosylmethionine (SAMe), which plays similar roles to those of glucosamine and may also work as a 'natural' antidepressant.

In summary, 'despite the fact that older athletes are more vulnerable to chronic joint pain and stiffness, you are not powerless to act. While it is obviously vital to get your training right and to incorporate any other rehab/injury prevention techniques deemed necessary…there is also a place for nutrition'.
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Power v endurance
This theme is taken up again in the 'What The Papers Say' section of the latest issue of Peak Performance. It comes in a report of a US study based on world record statistics, showing that ageing diminishes muscle power considerably sooner and more dramatically than endurance in both men and women.

While rowing (endurance) performance in men peaks in the twenties and declines by just 4% between 25 and 55, power-lifting records show a much steeper and earlier decline. (Fascinatingly, women's endurance performance peaks in the thirties rather than the twenties - but that's another story!)
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Fitness and the ageing brain
Meanwhile, there are heartwarming suggestions in this issue of Peak Performance that those who take care to maintain their fitness will not only hold the physical impact of ageing at bay but also protect their memories and other intellectual capacities from the ravages of age.

In a US study reported in the 'What The Papers Say' section, researchers scanning the brains of a group of 'high-functioning' over-50s observed substantial age-related deterioration in tissue densities in the frontal, parietal and temporal cortices.

That was the bad - although not particularly surprising - news. The good news was that those demonstrating aerobic fitness showed substantially reduced losses in these areas.

And the even better news was that the brain regions and tissue most obviously protected by aerobic fitness were the very ones that play central roles in successful everyday functioning and whose losses are associated with a variety of clinical syndromes, including schizophrenia and Alzheimer's disease.

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Activity and memory
Fitness is also linked with a reduced rate of memory decline in middle age, in new British research reported in the same section of Peak Performance. In this retrospective study of just under 2,000 middle-aged people born in the same week in March 1946, physical activity at age 36 was significantly associated with better memory performance at age 43 and with a slower rate of memory decline from 43 to 53 years.

There was also evidence that continuing exercise after age 36 was important, since those who became inactive did not show the same benefits as those who were still exercising at age 43 or had taken up exercise for the first time.

The suggestion is that it is never too late to benefit from exercise - and further research on this same cohort of ageing adults should confirm whether this is true.
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Yours,
Isabel Campbell
Editor
Peak Performance

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Ginseng

Panax ginseng, Panax quinquefolius, Eleutherococcus senticosus

There are actually three different herbs commonly called ginseng: Asian or Korean ginseng (Panax ginseng), American ginseng (Panax quinquefolius), and Siberian "ginseng" (Eleutherococcus senticosus). The latter herb is actually not ginseng at all, but the Russian scientists responsible for promoting it believe that it functions identically.

Asian ginseng is a perennial herb with a taproot resembling the human body. It grows in northern China, Korea, and Russia; its close relative, Panax quinquefolius, is cultivated in the United States. Because ginseng must be grown for 5 years before it is harvested, it commands a high price, with top-quality roots easily selling for more than $10,000. Dried, unprocessed ginseng root is called "white ginseng," and steamed, heat-dried root is "red ginseng." Chinese herbalists believe that each form has its own particular benefits.

Ginseng is widely regarded by the public as a stimulant, but according to everyone who uses it seriously that isn't the right description. In traditional Chinese herbology, Panax ginseng was used to strengthen the digestion and the lungs, calm the spirit, and increase overall energy. When the Russian scientist Israel I. Brekhman became interested in the herb prior to World War II, he came up with a new idea about ginseng: He decided that it was an adaptogen.

The term adaptogen refers to a hypothetical treatment described as follows: An adaptogen should help the body adapt to stresses of various kinds, whether heat, cold, exertion, trauma, sleep deprivation, toxic exposure, radiation, infection, or psychological stress. Furthermore, an adaptogen should cause no side effects, be effective in treating a wide variety of illnesses, and help return an organism toward balance no matter what may have gone wrong.

Perhaps the only indisputable example of an adaptogen is healthy lifestyle. By eating right, exercising regularly, and generally living a life of balance and moderation, you will increase your physical fitness and ability to resist illnesses of all types. Whether there are any substances that can do as much remains unclear. However, Brekhman felt certain that ginseng produced similarly universal benefits.

Interestingly, traditional Chinese medicine (where ginseng comes from) does not entirely agree. There is no one-size-fits-all in Chinese medical theory. Like any other herb, ginseng is said to be helpful for those people who need its particular effects, and neutral or harmful for others. But in Europe, Brekhman's concept has taken hold, and ginseng is widely believed to be a universal adaptogen.

In the 1940s, Brekhman decided that a much less expensive herb, Eleutherococcus senticosus, is just as good as ginseng. A thorny bush that grows much more rapidly than true ginseng, this later received the misleading name of "Siberian" or "Russian ginseng." Contrary to some reports, its chemical makeup is completely unrelated to that of Panax ginseng.

What Is Ginseng Used for Today?
If Brekhman is right, ginseng (whether Eleutherococcus or Panax) should be the right treatment for most of us. Modern life is tremendously stressful, and if an herb could help us withstand it, it would be a terrifically useful herb indeed. Ginseng is widely used for this purpose in Russia and Eastern Europe. However, the scientific basis for this use is largely limited to animal studies.

There have been a few studies of ginseng for certain more specific purposes: strengthening immunity against colds and flus and other infections (including herpes), helping to control diabetes, stimulating the mind, increasing a general sense of well-being, and improving physical performance capacity (sports performance), with some positive results.

Ginseng is also said to help prevent cancer, fight chemical dependency, and improve sexual performance, but there is as yet little direct evidence that it really works.1,2,3 Highly preliminary evidence suggests that American ginseng might help breast cancer chemotherapy drugs work better.4
However, Panax ginseng does not appear to be helpful for menopausal symptoms.5

What Is the Scientific Evidence for Ginseng?
Adaptogenic Effects
Numerous studies have evaluated the effects of oral ginseng on animals under conditions of extreme stress. The results suggest that ginseng increases physical endurance and causes physiological changes that may help the body adapt to adverse conditions.6-12 In addition, studies in mice found that consuming ginseng before exposure to a virus significantly increased the survival rate and the number of antibodies produced.13,14

Immune Stimulation
A double-blind placebo-controlled study suggests that Panax ginseng can improve immunity.15 This trial enrolled 227 participants at three medical offices in Milan, Italy. Half were given ginseng at a dosage of 100 mg daily, the other half placebo. Four weeks into the study, all participants received influenza vaccine.

The results showed a significant decline in the frequency of colds and flus in the treated group compared to the placebo group (15 versus 42 cases). Also, antibody measurements in response to the vaccination rose higher in the treated group than in the placebo group.

Two other studies found evidence that ginseng increases the number of immune cells in the blood,16,17 although a third did not.18

Diabetes
A double-blind study evaluated the effects of Panax ginseng (at dosages of 100 mg or 200 mg daily) on 36 people with adult-onset diabetes.19 The results showed improvements in blood sugar control. The authors attributed this benefit to a spontaneously increased level of physical activity in the ginseng group.
Improved blood sugar control was also seen in two small double-blind placebo-controlled trials using American ginseng (Panax quinquefolius).20,21

Mental Function
A recent study found that Panax ginseng can improve some aspects of mental function.22 Over a period of 2 months, 112 healthy, middle-aged adults were given either ginseng or placebo. The results showed that ginseng improved abstract thinking ability. However, there was no significant change in reaction time, memory, concentration, or overall subjective experience between the two groups. Another double-blind trial of 16 healthy males found favorable changes in ability to perform mental arithmetic in those given 200 mg of ginseng extract for 12 weeks.23

Herpes Infection
A 6-month double-blind trial of 93 men and women with recurrent herpes infections found that treatment with Eleutherococcus (2 g daily) reduced the frequency of infections by almost 50%.24

Sports Performance
The evidence for Panax ginseng as a sports supplement is mixed. An 8-week double-blind placebo-controlled trial evaluated the effects of Panax ginseng with and without exercise in 41 individuals.25 The participants were given either ginseng or placebo, and then underwent exercise training or remained untrained throughout the study. The results showed that ginseng improved aerobic capacity in individuals who did not exercise, but offered no benefit in those who did exercise. In a 9-week double-blind placebo-controlled trial of 30 highly trained athletes, treatment with Panax ginseng or Panax ginseng plus vitamin E produced significant improvements in aerobic capacity.26 Another double-blind placebo-controlled trial of 37 individuals also found some benefit.27

However, negative results were seen with Panax ginseng in an 8-week double-blind trial that followed 31 healthy men in their twenties.28 Negative results have been seen in other small trials of Panax ginseng as well.29-34

A double-blind study of 20 athletes over an 8-week period found that a standard Eleutherococcus formulation produced no improvement in physical performance.35

General Well-Being
The results of a double-blind study of 625 individuals suggests that Panax ginseng improves general sense of well-being.36

Preventing Cancer
A recent observational study on ginseng and cancer prevention has been widely publicized, but a close look at the data arouses some suspicions. This study was performed in South Korea and followed a total of 4,587 men and women aged 39 years and older from 1987 to 1991.37 People who regularly consumed Panax ginseng were compared with otherwise similar individuals (matched in sex, age, alcohol use, smoking, and education and economic status) who did not.
The reported results were impressive. Those who used ginseng showed a 60% decrease in risk of death from cancer. Lung cancer and gastric cancer were particularly reduced. The more ginseng consumed, the greater the effect.
However, there is something a bit fishy about this study. Use of ginseng less than three times per year caused a 54% reduction in risk. It seems difficult to believe that so occasional a use of ginseng could reduce cancer mortality by more than half!

Menopause
A double-blind placebo-controlled study of 384 postmenopausal women found no significant benefit, and no evidence of hormonal effects.38

Dosage
The typical recommended daily dosage of Panax ginseng is 1 to 2 g of raw herb, or 200 mg daily of an extract standardized to contain 4 to 7% ginsenosides. In one study of American ginseng (Panax quinquefolius) for diabetes, the dose used was 3 g.39 Eleutherococcus is taken at a dosage of 2 to 3 g whole herb or 300 to 400 mg of extract daily.
Ordinarily, a 2- to 3-week period of using ginseng is recommended, followed by a 1- to 2-week "rest" period. Russian tradition suggests that ginseng should not be used by those under 40.
Finally, because Panax ginseng is so expensive, some products actually contain very little of it. Adulteration of ginseng supplements with other herbs and even caffeine is not unusual.40,41

Safety Issues
The various forms of ginseng appear to be nontoxic, both in the short and long term, according to the results of studies in mice, rats, chickens, and dwarf pigs.42-45 Ginseng also does not seem to be carcinogenic.
Side effects are rare. Occasionally women report menstrual abnormalities and/or breast tenderness when they take ginseng. However, a large double-blind trial found no estrogen-like effects.46

Unconfirmed reports suggest that highly excessive doses of ginseng can cause insomnia, raise blood pressure, increase heart rate, and possibly cause other significant effects. Whether some of these cases were actually caused by caffeine mixed in with ginseng remains unclear. Ginseng allergy can also occur, as can allergy to any other substance.
In 1979, an article was published in the Journal of the American Medical Association claiming that people can become addicted to ginseng and develop blood pressure elevation, nervousness, sleeplessness, diarrhea, and hypersexuality.47 This report has since been thoroughly discredited and should no longer be taken seriously.48,49
However, there is some evidence that ginseng can interfere with drug metabolism, specifically drugs processed by an enzyme called "CYP 3A4."50 Ask your physician or pharmacist whether you are taking any medications of this type. There have also been specific reports of ginseng interacting with MAO inhibitor drugs51 and also with a test for digitalis,52 although again it is not clear whether it was the ginseng or a contaminant that caused the problem. There has also been one report of ginseng reducing the anticoagulant effects of Coumadin (warfarin).53
Safety in young children, pregnant or nursing women, or people with severe liver or kidney disease has not been established. Interestingly, Chinese tradition suggests that ginseng should not be used by pregnant or nursing mothers.

Interactions You Should Know About
If you are taking
" Drugs processed by an enzyme called "CYP 3A4": Ginseng might interfere. Ask your physician or pharmacist whether you are taking any medications of this type.
" MAO inhibitor drugs or digitalis: It is possible that ginseng might cause problems.
" Insulin or oral hypoglycemics: Ginseng may reduce your dosage need.
" Coumadin (warfarin): Ginseng might decrease its effect.
" influenza vaccine: Ginseng might help it work better.

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Pronation, Supination
...and choosing the right footwear

These two terms refer to a foots natural rolling movement while walking or running. This motion is sometimes called the running gait, and is described at the New Balance web site as...
"A unique set of actions and reactions that your foot performs while in motion to support, cushion and balance your body."

What is Pronation?
Pronation refers to the inward roll of the foot during normal motion and occurs as the outer edge of the heal strikes the ground and the foot rolls inward and flattens out. A moderate amount of pronation is required for the foot to function properly, however damage and injury can occur during excessive pronation. When excessive pronation does occur the foot arch flattens out and stretches the muscles, tendons and ligaments underneath the foot.
The picture on the right (used from the steenwyk.com web site) shows a view of the right foot as if looking at it from behind. As you can see in the picture the ankle is over pronating or rolling inwardly.

What is Supination?
Supination is the opposite of pronation and refers to the outward roll of the foot during normal motion. A natural amount of supination occurs during the push-off phase of the running gait as the heal lifts off the ground and the forefoot and toes are used to propel the body forward. However, excessive supination (outward rolling) places a large strain on the muscles and tendons that stabilize the ankle, and can lead to the ankle rolling completely over, resulting in an ankle sprain or total ligament rupture.
This time, in the second picture to the right (used from the steenwyk.com web site), the foot is over supinating or rolling outwardly.

Symptoms
Excessive pronation and supination can cause a number of ailments that affect the foot, ankle, knees, hips and back. Some of the more common symptoms of excessive pronation and supination are listed below.
" Arch pain
" Heel pain
" Flat feet
" Corns and calluses
" Ankle sprains
" Shin Splints
" Achilles tendonitis
" Knee pain
" Hip pain
" Back pain

Prevention & Treatment
Pronation and supination are bio-mechanical problems, and are best treated and prevented with orthotic inserts. But before you run out to buy orthotics it makes sense to get the right advice on footwear, and the best advice I can give you, is to go and see a qualified podiatrist for a complete foot-strike and running gait analysis. They will be able to tell you if there are any concerns regarding the way your running gait is functioning.
After your running gait has been analysed, have your podiatrist, or competent sports footwear sales person recommend a number of shoes that suit your requirements. Good quality footwear will go a long way in helping to prevent pronation and supination. And, if needed, invest in a pair of orthotic inserts to further prevent excessive pronation or supination.

Choosing the right footwear
That brings us to the next point. What should you be looking for when purchasing a new pair of shoes?
1. Choose a shoe that suites your running gait and foot type. Money spent at the podiatrist now, for a complete foot-strike and running gait analysis, will save you much heart-ache and discomfort later. Having a shoe that suits your foot type is the best prevention for injury and pain.
2. When having your shoes fitted have both feet measured to ensure you get the most appropriate size, and remember, your feet are three dimensional. The length of your foot is only one part of a proper fitting, measure your feet for width and depth to get a better fit.
3. When purchasing footwear make your purchase in the later half of the day. Your feet will swell during the normal course of a day, so avoid making a purchase in the morning as you may find that your new shoes are half a size too small by the afternoon.
4. When trying on new shoes always wear the socks that you will be using with your new shoes.
5. Never purchase tight fitting shoes in the hope that they will stretch or wear-in over time.

Apart from good footwear and orthotic inserts, what else can you do?
Firstly, a thorough and correct warm up will help to prepare the muscles and tendons for any activity or sport. Without a proper warm up the muscles and tendons around your feet, ankles and lower legs will be tight and stiff. There will be limited blood flow to the lower legs, which will result in a lack of oxygen and nutrients for those muscles.
Secondly, flexible muscles are extremely important in the prevention of most ankle and lower leg injuries. When muscles and tendons are flexible and supple, they are able to move and perform without being over stretched. If however, your muscles and tendons are tight and stiff, it is quite easy for those muscles and tendons to be pushed beyond their natural range of movement.
To keep your muscles and tendons flexible and supple, it is important to undertake a structured stretching routine. For a comprehensive reference of over 100 clear photographs of every possible sports related stretch, consider getting a copy of The Stretching Handbook. If you're interested in stretches for the ankles and lower legs, The Stretching Handbook has 22 different stretches you can do. Order your copy now!
And thirdly, strengthening and conditioning the muscles of the lower leg will also help to prevent ankle and lower leg injuries.
I hope you've enjoyed this month's issue of The Stretching & Sports Injury Newsletter. If you have any comments or suggestions regarding this newsletter or any other aspect of our web site, please feel free to contact us.

Article by Brad Walker. Brad is a leading stretching and
sports injury consultant with over 15 years experience
in the health and fitness industry. For more articles
on the prevention & treatment of sports injury,
subscribe to The Stretching & Sports Injury Newsletter
by visiting http://www.thestretchinghandbook.com/.

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Carbohydrates (Simple vs Complex) Absorption Rates

Carbohydrate absorption rate is dependant upon individual
biochhemistry, the carbohydrate selected, and the available intestinal
and serum sodium carriers. Each hour during exercise the maximum
consumed carbohydrates absorbed and oxidized for energy are (for most
athletes) between 240-288 calories (+/-15 calories) per hour
requiring between 300-700 mg sodium to assist brush border translation
across intestinal membranes (mostly duodenum). There are exceptions to
these numbers based on individual biochemistry. One athlete in a
research study once oxidized 432 carbohydrate calories per hour. Most
of us would gag on that much energy fuel intake. They did not record
his sodium intake. At the lower end of the scale, one athlete won a
24-hour ultramarathon on 100 mg sodium/hour (or at the rate of 0.4 mg
NA+/calorie). Based on numerous sweat composition and carbohydrate
oxidation studies, the range of sodium required to carry carbohydrates
across gut membranes is between 1.0-2.4 mg sodium (+/-0.6 mg
Na+/Calorie) per hour for most endurance athletes. Heat stress
training, low BMI, low age, low sodium nutrition, and peak fitness
each increase relative nutrient absorption & oxidation rate resulting
in less required total sodium but potentially raises carbohydrate
oxidation rate. Unfit, unacclimatized, aged, high BMI, poor quality
training exposure, may increase sodium requirements, while reducing
carbohydrate absorption and oxidation rate. All the numbers given in
this reply are relative range estimates an attempt to list what works
in the majority of endurance athletes.

Dr. Richard Kreider, Ph.D., Memphis State University, is a highly
regarded sportscience researcher whose research was financed by the
National Honey Board with definitive interest in promoting honey as an
energy gel. Honey is an inexpensive simple sugar with a lower glycemic
index than maltodextrin, but perhaps it is not as efficient from an
osmolality and caloric volume advantage as maltodextrin-based energy
gels. In my own personal experience/tests, fructose is poorly
tolerated sugar in the upper gut, especially when the pace and/or the
heat is high. Fructose elevates serum circulating triglyceride levels,
but then again, eating too much carbohydrate creates a similar
unhealthy triglyceride profile. As you can see, my personal opinion is
not favorable toward the use of any simple sugar during exercise. My
glycemic index listings also differ from Dr. Kreider's. The reported
Glycemic Index for Honey is 35 & dextrose 43 are considerably lower
than that suggested by others. One source reports the GI for honey is
above 100, another 91, another 83, another 73. Honey is a mixture of
nearly equal parts fructose slightly higher than glucose content. On
average it contains 38.38% Fructose, 30.31% Glucose, and a tincture of
Sucrose at 1.31%. Since these figures are from the National Honey
Board, calculating their glycemic index using Rick Mendosa's Glycemic
Index tables, the average sample of honey should typically yield a
glycemic index of 78.5.

Kreider compared dextrose @ 100 glycemic index (GI) to honey with a GI
of 83 utilized during exercise to another group who consumed no
carbohydrates during a 40k time trial. Dextrose compared favorably
along side of honey enhancing performance in exercising test subjects
though no performance advantage was experienced in athletes who
consumed no carbohydrate calories. Maltodextrin was not tested
comparatively in either trial honey or dextrose exercise test.

Maltodextrin presents a high glycemic index, which I have often
referred to when advising athletes to avoid during sedentary times or
up to 3-hours prior to exercise. The only time an athlete should
consume high glycemic carbohydrates is during rapid depletion or when
carbohydrates are being consumed in order to replace glycogen stores
when glycogen synthase enzyme levels are elevated 120 minutes post
endurance-exercise. Maltodextrin absorption is quite attractive
because it is absorbed at body fluid osmolality levels at much higher
rate in up to 20% solutions.

Tempering the volume is an important adjunct to maximizing absorption
while not provoking the former gastric stress mechanisms often
experienced with simple sugar intake. For most athletes their bodies
will only return 4.0-4.8 calories carbohydrate per minute (or 240-288
cal/hour)to the energy production. Once calorie intake exceeds 280
calories per hour, regardless of the source, back-up sugar calories
sit in the gut with the potential to induce absorptive halting or
gastric reaction. The likelihood of taking more than needed appears to
be higher when using sugared gels than gels formulated with long-chain
maltodextrin.

Limitations presented by simple sugar gel solutions is that they are
absorbed efficiently only in 6-8% solutions, whereas maltodextrin gels
are immediately absorbed at body fluids osmolality in 20% solutions,
infusing up to 240-276 calories per hour to working muscles. When an
athlete creates too much simple sugar intake in the gut, fluids and
electrolytes must be drawn through the gastric membranes in order for
absorption of sugar overdose to be complete. Kreider's study compared
taking 60 calories of honey or 60 calories of dextrose in efficiently
absorbed 6% solutions once every 10 miles 20-30 minutes. At a time
trial max effort, expenditures approach between 900-1000 calories per
hour. The test subjects consumed or absorbed 120-150 calories from a
6% solution at an exercise deficit of 750-880 calories per hour.

............If you had two fuel-fluid choices for a 40K TT:

[a] A 15-20% solution permits an efficient absorption of 240-276 calories

[b] A 6% solution permits an efficient absorption of 120-150 calories

............Which one would you chose?

Kindly note that Kreider's IRI tests were recorded during sedentary
state and further emphasize the need to not consume high glycemic
products when blood sugar turnover is minimal during sedentary state.
During sedentary times and 3 hours prior to exercise, it is best to
restrict high glycemic carbohydrates including our products. Any form
of carbohydrate consumed within less than 3 hours before exercise will
cause glycogen depletion at a faster rate than if the subject fasted
carbohydrates. However, during exercise when high blood sugar turnover
presents, repletion of 240-276 calories per hour in divided dose from
a 15-20% solution of maltodextrin-based energy gel or drinks is
recommended and is considered performance-enhancing. Repletion of
glycogen stores is further enhanced from total intake of up to 4
grams/kg body weight of high glycemic long chain maltodextrin- based
carbohydrates with 0.5-1 gram/kg body weight whey or soy protein in
divided dose for up to 120 minutes after finishing exercise.

Colgan pointed out, it is attractive to see carbohydrates alone or
with protein riding an insulin drive-train to muscle structures which
are rapidly in need of both macornutrient forms due to turnover rate
and depletion. Excess insulin elevation is not warranted during
sedentary meals but during exercise and immediately after exercise,
moderate levels may contribute to refueling and repleting order with
no harm to health nor inhibition of performance.

CARBOHYDRATES GLYCEMIC INDEX
Fructose-32
Lactose (milk sugars)-65
VO2 Max Energy Bar-69
Power Bar-81
Honey-83
High fructose corn syrup-89
Sucrose-92
Maltodextrin-137
Glucose-137
Maltose-150

This is a low glycemic index carbohydrate food list recommended eaten
in moderate amounts during non-workout times, sedentary meals, etc.

GI 50-59: Buckwheat, White Spaghetti, Sweet corn, All-Bran, Peas, Yam,
Potato Chips.

GI 40-49: Wholemeal Spaghetti, Sweet Potato, Navy Beans, Dried Peas,
Oranges, Sponge Cake

GI 30-39: Butterbeans, Blackeye Peas, Apples, Ice Cream, Milk, Yogurt,
Tomato Soup

GI 20-29: Kidney Beans, Lentils, Parsnips

GI 10-19: Soybeans, Peanuts

As you know, one size does not fit all, nor do reference ranges
provide the specific dose required. Permit me to exercise literary
"overkill" with further explication. At an aerobic pace, carbohydrate
is depleted from glycogen stores remarkably, but only during the first
hour. However, in the second hour carbohydrate cannibalization for
producing energy is depressed remarkably between 70-90 minutes when
the body enzymatically "senses" that the glycogen stores are running
low. This table reflects which fuels and the approximate volume
recruited to meet endurance muscle demand.

EXERCISE TIME--VO2-RATE---CALORIC SOURCE---CALORIES RANGE
60 MINUTES-----65%-75%----GLYCOGEN & CHO---360-540
60 MINUTES-----65%-75%----FATTY ACIDS------180-270
60 MINUTES-----65%-75%----AMINO ACIDS--------60-90
__________________________________________________
1ST HOUR TOTALS----------->600-900 CALORIES/HOUR

120 MINUTES----65%-75%----GLYCOGEN & CHO---180-270
120 MINUTES-----65%-75%----FATTY ACIDS-----360-540
120 MINUTES-----65%-75%----AMINO ACIDS-------60-90
__________________________________________________
2ND HOUR TOTALS --------->600-900 CALORIES/HOUR

HOURS 2-ON:Similar to hour number 2, but may decrease proportionately
to duration. The above values will vary per athlete 14-16%. The lower
values would be assigned to smaller persons or to occur at a slower pace.

POST-EXERCISE GLYCOGEN REPLACEMENT
Ivy's studies suggest that an upper limit of 225 grams carbohydrate
taken each hour, for 4 consecutive hours, after a glycogen depletion
session. Ivy reported that beyond a 4 each timed 225-gram carbohydrate
dose, there were no further glycogen loading advantages. It should be
mentioned that carbohydrates need up to 3 days to top off formerly
depleted glycogen stores. Following a glycogen-depletion workout of 2
hours or more, carbohydrates eaten find their way into muscle and
liver glycogen storehouses proportionate to the available glycogen
synthase enzyme. During the first 2 hours after a depletion workout,
glycogen synthase is plentiful, then during hours 3-4 it begins to
diminish, but there is small amounts present until the glycogen tanks
are full. This is where most of the confusion is. Small athletes have
smaller stores proportionate to muscle mass size. Some athletes
measured after a glycogen-expense workout were unable to replace the
glycogen stores until they had consumed nearly 8 grams per kilogram
bodyweight, while others were filled to the full with much less than 6
grams/kg bodyweight.

CARBOHYDRATES-MINUTES EXERCISE(total grams carbohydrates required/day)
BODYWEIGHT--------120'----240'----360'
110 lbs.----------300-----500-----700
132 lbs.----------400-----600-----800
154 lbs.----------500-----700-----900
176 lbs.----------600-----800----1000
198 lbs-----------700-----900----1100
220 lbs.----------800----1000----1200

However, this amount should not be taken all at once...But how much
and when? Glycogen synthesis from carbohydrate intake takes place most
rapidly the first 2 hours after exercise, but may occur at lessor
rates up to 4-6 hours and with lessor amounts for up to 3 days after
depletion event until glycogen stores are topped off gradually. The
expense of glycogen or carbohydrate occurs rapidly while replacement
occurs slowly.

TOTAL DAILY CARBOHYDRATE VS EXPENSE BASED ON BODY SIZE DAILY CHO
INTAKE----TYPE OF PERFORMANCE

*10-12 g/kg/day-----5-6 hours intense pace rate as in stage-racing

*7-10 g/kg/day------3-4 hours exercise/events (marathons, shorter
triathlons,longer cycling efforts)

*5-7 g/kg/day-------2-3 hours exercise/events (Half marathons, 10K
runs, shorter cycling efforts)

*3-5 g/kg/day-------1-2 hours exercise training or shorter
events
*1-2 g/kg/per hour exercised--Enhance recovery[general]

*1 g/kg/during workouts---->during 1-4 hour exercise/events (take
30-60 grams/hour)

*[PLEASE NOTE changes made in the above approximate estimate for
replacing glycogen stores. This could be challenged as one size never
fits all.

There are a number of mechanisms which may enhance the glycogen
loading process in trained athletes.[table below]

DIFFERENT DIETARY INTERVENTIONS MECHANISMS INFLUENCE MUSCLE AND LIVER
GLYCOGEN STORES:

SUBJECTS TYPE AND TIME OF DIET MUSCLE[g/kg] LIVER[g/kg]
Trained---Low Carbo Diet-----------14-------------30
Trained---High Carbo Diet----------21-------------70
Trained---24-Hour Fast-------------21-------------10
Trained---Glycogen Stripping
==========>[3 day low Carbos]-------7-------------10
Trained--->[3 day CARB-LOAD]-------36-------------90
Trained=[POST-EX 70-85% VO2 Max]----4+------------23
Trained 24 hrs post-race[high CHO]-15-------------90
Trained 48 hrs post-race[high CHO]-27-------------90
Trained 7 days post-race[high CHO]-30-------------90

Each of above figures provide an estimate for glycogen replacement
without packing on excessive dietary carbohydrates as dead weight fat.
Most endurance athletes spend between 2.5-3.75 grams [10-15 calories]
per minute during endurance exercise, repletion is rapid the first 2
hours, less rapid the next 2 hours, diminishing gradually for glycogen
store uptake in very small amounts for up to 72-hours of a
glycogen-depleting event. I observe a number endurance athletes eating
excessive carbohydrates in one sitting in stead of timing carbohydrate
intake throughout the workout in small bites of 240-280 calories per
hour, then limiting two replacement doses to between 200-225 grams
carbohydrate eaten 60 minutes and 120 minutes post-exercise.

HOW MUCH SODIUM WITH HOW MUCH CARBOHYDRATE?
Each hour during exercise the maximum consumed carbohydrates absorbed
and oxidized for energy are (for most athletes) between 240-288
calories (+/-15 calories) per hour requiring between 300-700 mg
sodium to assist brush border translation across intestinal membranes
(mostly duodenum). There are exceptions to these numbers based on
individual biochemistry. One athlete in a research study once oxidized
432 carbohydrate calories per hour. Most of us would gag on that much
energy fuel intake. They did not record his sodium intake. At the
lower end of the scale, one athlete won a 24-hour ultramarathon on 100
mg sodium/hour (or at the rate of 0.4 mg NA+/calorie). Based on
numerous sweat composition and carbohydrate oxidation studies, the
range of sodium required to carry carbohydrates across gut membranes
is between 1.0-2.4 mg sodium (+/-0.6 mg Na+/Calorie) per hour for most
endurance athletes.

If concerned over sodium (NA+) adequacy, have a physician draw blood
tests to determine serum levels immediately following an event:

ANALYTE--NORMAL REFERENCE RANGE
Sodium----------136-145 mEq/L
Potassium-------3.5-5.1 mEq/L
Chloride--------96-104 mEq/L
Magnesium-------1.2-1.9 mEq/L
Calcium---------8.6-10.0 mg/dL
Glucose---------74-106 mg/dL

If you hydrated adequately I would expect that post-race weight to be
2-3% less than at the start. If no weight loss occurred, overhydrated
with imposed dilutional hyponatremia (diluted serum sodium) occurred.
Nevertheless, I would expect all of the above analytes to be within
normal reference range, if fuel, fluids, and electrolyte intake was
sufficient during the event. Yes, this is all old information, but the
human physiology has not changed since it was written...So I am told.

Best wishes and kindest regards,

Dr. Bill Misner, Ph.D., C.S.M.T.
AAMA Board Certified Alternative Medicine Practitioner
Certification #38272409

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Chronic Fatigue Syndrome
Matching Exercise to Symptom Fluctuations
James S. Skinner, PhD

THE PHYSICIAN AND SPORTSMEDICINE - VOL 32 - NO. 2 - FEBRUARY 2004

In Brief: Physical activity decreases insulin resistance and can aid in both preventing type 2 diabetes mellitus and managing the disease. Before patients with type 2 diabetes begin an exercise program, they should undergo a preparticipatory clinical assessment and screening for micro- and macrovascular disease. Patients older than 35 and those with additional cardiovascular risk factors, peripheral vascular disease, long-standing disease, or peripheral neuropathy should have an exercise stress test. Adequate glycemic control and selection of appropriate physical activity, such as brisk walking or swimming, are essential to avoid associated complications. Patients on diabetes medications should monitor blood glucose levels and adjust their diet to minimize fluctuations in blood glucose during exercise.
The cause of chronic fatigue syndrome (CFS) remains unknown. CFS is diagnosed when patients have an unexplained onset of fatigue for more than 6 months that is severe enough to limit daily activity and not resolved by rest. In addition, patients must have at least four of the following eight symptoms to meet the established criteria: muscle pain, joint pain, sore throat, tender lymph nodes, cognitive difficulty (memory and concentration), headaches of a new pattern or severity, postexercise discomfort lasting 24 hours or more, and sleep disturbance (table 1). They may, however, have other symptoms as well (table 2). Just under 1% of the population experiences CFS. A disproportionate number of this group are women, but the reasons for the disparity are not clear.

Chronic Fatigue Syndrome and Physical Activity

CFS is difficult to study, because the population of patients is heterogeneous and the symptoms have a tendency to fluctuate. Many patients reduce their physical activity to avoid symptoms and rest longer after exercise than do healthy controls. Silver et al also found that exercise can provoke anxiety and a feeling of increased vulnerability to pain and fatigue. Vercoulen et al reported that patients with CFS were less active than healthy subjects and were more likely to avoid activities that they perceived to be fatiguing. As a result, part of their increased fatigue may be associated with or exaggerated by deconditioning. Sleep deprivation or psychological distress or both may also contribute to the higher levels of fatigue.
The hallmark of CFS is an increase in symptoms following exercise. This phenomenon is usually the result of high-intensity or prolonged exercise. For many CFS patients, very minimal exertion (ie, less than what others might consider exercise) can exacerbate symptoms from 6 hours to as long as 5 days afterward. In contrast, Clapp et al found no changes immediately after 30 minutes of light, intermittent exercise (three 10-minute bouts) or 1 week later.
Those with CFS tend to be weaker and have delayed recovery after strenuous strength training. Paul et al had participants perform 18 maximal voluntary contractions of the quadriceps. The contractions of the control group were consistently higher than those of the patients with CFS, but both groups had a similar reduction in force over the 18 contractions. While normal participants showed no change over the next day, patients with CFS had reduced strength 3 hours and 24 hours later.
Patients who have CFS perform poorly compared with healthy controls on tests of focused and sustained attention and have a greater impairment in cognitive processing immediately after exhaustive treadmill exercise and 24 hours later. Using a battery of cognitive measures, Fuentes et al found that patients with CFS were slower but not less accurate than healthy persons. However, those with CFS had greater intraindividual variability over 10 weekly sessions compared with healthy persons.

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Delayed onset muscle soreness:

After a hard workout, most people begin to experience soreness in the body parts trained within 24-48 hours. If you haven't lifted weights for a while this soreness can last for as long a week after the initial soreness begins.

This sore and stiff type of pain is called "delayed onset muscle soreness".

I'd venture to say that everyone who experiences delayed onset muscle soreness would like to find any tested and genuine methods to reduce this irritating muscle soreness.

The first thing that you would probably think about is some type of supplement. But is there a supplement or even some kind of exercise you can do to alleviate the pain?

First of all scientists aren't exactly sure what causes of delayed onset muscle soreness, but some think they have a pretty good idea.

The burn you feel during while performing an exercise (usually near the end of each set) is caused by the build-up of lactic acid, a by-product of exercise metabolism.

Initially it was thought that delayed onset muscle soreness was a result of the lactic acid staying in your muscle. But nowadays most exercise physiologists agree that the primary cause of delayed onset muscle soreness are the tiny tears that occur in the muscle as a result of high intensity resistance training (weight lifting).

Essentially when you exercise with weights you literally create little microscopic tears in the muscle fibers of the muscles you are using. In the days following your resistance workout, your muscle fibers begin to rebuild, providing enough time has been allowed to recover and you have provided your muscles with the proper amount and types of nutrients.

This rebuilding process makes your muscles bigger and stronger than before. This is essentially how the entire muscle building process takes place.

This type of pain is different than lactic acid burn discussed above and it's very different from any pain as a result of an injury. It's important that you develop the ability to differentiate between delayed onset muscle soreness and the pain of an injury.

Believe me, after you've been training for a while it's very easy to tell the difference.

Unless the delayed onset muscle soreness is so extreme that it is unbearable and prevents you from taking part in sporting events or performing everyday tasks then delayed onset muscle soreness is GOOD PAIN!

It is a sign that you had a good workout and that you've trained hard enough to break down muscle tissue in order to build up a larger and stronger muscle.

Delayed onset muscle soreness will be a lot worse in a beginner weight lifter who has never worked out before. The more your body adapts to the stress you place on it, the less soreness you will feel.

If you do the same resistance workout over and over again you'll eventually reduce delayed onset muscle soreness completely. Unfortunately, you will also cease to make any progress.

Progressive resistance is the only way you can continually strive to see improvements in strength and muscle size. We will discuss progressive resistance in detail in a future issue.

For more information please visit our website @:
http://www.womens-health-fitness.com

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Drinking Distilled Water

by Zoltan P. Rona, MD, MSc

During nearly 19 years of clinical practice I have had the opportunity to observe the health effects of drinking different types of water. Most of you would agree that drinking unfiltered tap water could be hazardous to your health because of things like parasites, chlorine, fluoride and dioxins.
Many health fanatics, however, are often surprised to hear me say that drinking distilled water on a regular, daily basis is potentially dangerous.

Paavo Airola wrote about the dangers of distilled water in the 1970's when it first became a fad with the health food crowd.

Distillation is the process in which water is boiled, evaporated and the vapour condensed. Distilled water is free of dissolved minerals and, because of this, has the special property of being able to actively absorb toxic substances from the body and eliminate them. Studies validate the benefits of drinking distilled water when one is seeking to cleanse or detoxify the system for short periods of time (a few weeks at a time). Fasting using distilled water can be dangerous because of the rapid loss of electrolytes (sodium, potassium, chloride) and trace minerals like magnesium, deficiencies of which can cause heart beat irregularities and high blood pressure. Cooking foods in distilled water pulls the minerals out of them and lowers their nutrient value.

Distilled water is an active absorber and when it comes into contact with air, it absorbs carbon dioxide, making it acidic. The more distilled water a person drinks, the higher the body acidity becomes. According to the U.S. Environmental Protection Agency, "Distilled water, being essentially mineral-free, is very aggressive, in that it tends to dissolve substances with which it is in contact. Notably, carbon dioxide from the air is rapidly absorbed, making the water acidic and even more aggressive. Many metals are dissolved by distilled water."

The most toxic commercial beverages that people consume (i.e. cola beverages and other soft drinks) are made from distilled water. Studies have consistently shown that heavy consumers of soft drinks (with or without sugar) spill huge amounts of calcium, magnesium and other trace minerals into the urine. The more mineral loss, the greater the risk for osteoporosis, osteoarthritis, hypothyroidism, coronary artery disease, high blood pressure and a long list of degenerative diseases generally associated with premature aging.

A growing number of health care practitioners and scientists from around the world have been advocating the theory that aging and disease is the direct result of the accumulation of acid waste products in the body.

There is a great deal of scientific documentation that supports such a theory. A poor diet may be partially to blame for the waste accumulation. Meats, sugar, white flour products, fried foods, soft drinks, processed foods, alcohol, dairy products and other junk foods cause the body to become more acidic. Stress, whether mental or physical can lead to acid deposits in the body.

There is a correlation between the consumption of soft water (distilled water is extremely soft) and the incidence of cardiovascular disease. Cells, tissues and organs do not like to be dipped in acid and will do anything to buffer this acidity including the removal of minerals from the skeleton and the manufacture of bicarbonate in the blood.

The longer one drinks distilled water, the more likely the development of mineral deficiencies and an acid state. I have done well over 3000 mineral evaluations using a combination of blood, urine and hair tests in my practice. Almost without exception, people who consume distilled water exclusively, eventually develop multiple mineral deficiencies.

Those who supplement their distilled water intake with trace minerals are not as deficient but still not as adequately nourished in minerals as their non-distilled water drinking counterparts even after several years of mineral supplementation.

The ideal water for the human body should be slightly alkaline and this requires the presence of minerals like calcium and magnesium.

Distilled water tends to be acidic and can only be recommended as a way of drawing poisons out of the body. Once this is accomplished, the continued drinking of distilled water is a bad idea.

Water filtered through reverse osmosis tends to be neutral and is acceptable for regular use provided minerals are supplemented.

Water filtered through a solid charcoal filter is slightly alkaline. Ozonation of this charcoal filtered water is ideal for daily drinking. Longevity is associated with the regular consumption of hard water (high in minerals). Disease and early death is more likely to be seen with the long term drinking of distilled water. Avoid it except in special circumstances.

About the Author
Dr. Rona is a leading proponent of natural, harmless, health-building alternatives to conventional medical care. He has a general practice where he has provided preventive medical counselling for seventeen years and is a past president of the Canadian Holistic Medical Association. His books The Joy of Health: A Doctor's Cuide To Nutrition, Alternative Medicine <http://www.amazon.com/exec/obidos/ASIN/0875426840/o/qid=961340501/sr=2-2/103-2662777-6929445> , Fertility Control: The Natural Approach, Return to the Joy of Health, and Childhood
Illness and the Allergy Connection <http://www.amazon.com/exec/obidos/ASIN/076150611X/o/qid=961340501/sr=2-1/103-2662777-6929445> , have been well received, as have his countless articles on natural health topics. Dr. Rona is also a consultant to the Motherisk Program of the Toronto Hospital for Sick Children Department of Pharmacology and is known for his many public lectures and media appearances.

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Gatorade Sports Science Institute Statement on New Sports Drink Research Regarding Protein During Exercise
August 2004

Jeff Zachwieja, Ph.D., FACSM
Gatorade Sports Science Institute

You may be familiar or have heard of new research published in the July issue of Medicine Science Sports and Exercise suggesting that a sports drink containing protein might provide an additional performance benefit compared to a sports drink without protein (M. J. Saunders et al. Effects of carbohydrate protein beverage on cycling endurance and muscle damage. Med. Sci. Sports Exerc. 36(7):1233-1238, 2004).

This study is sure to draw the attention of coaches, athletes and media, so we want to provide you with our point of view on this topic:

Background on Published Study and Research

While the new published study referenced above may lead some to conclude that protein should be included in sports drinks, we have several concerns about this specific study. While the researchers used Gatorade-brand powder to formulate the carbohydrate only sports drink, it was mixed to a 7.3% concentration. The package mixing instructions recommended and research indicate that Gatorade should be consumed as a 6% carbohydrate solution. Also, while the two sports drinks contained the same amount of carbohydrates, they were not calorie matched, making it impossible to tell if the effects of the carbohydrate-protein sports drink resulted from additional calories or from the protein itself. Finally, this study was not placebo controlled, making it impossible to fully understand the importance of the performance benefit.

We believe that research on the benefits of protein for performance to this point has been inconclusive. In fact, the same research group just presented a follow-up study at the 2004 American College of Sports Medicine (ACSM) meeting that showed contrasting results — no additional performance benefit of a carbohydrate-protein mixture. (B.C. Romano et al. Effect of 4:1 ratio of carbohydrate/protein beverage on endurance performance, muscle damage and recovery. Med. Sci. Sports Exerc. 36(5):S126, 2004).

Gatorade Sports Science Institute Position

At the Gatorade Sports Science Institute, we constantly evaluate potential new ingredients and research those that appear to have the greatest potential, including protein and amino acids. For example, the University of South Carolina showed several years ago that a combination of a sports drink and branched-chain amino acids (derived from protein) was no more effective than a sports drink alone at improving stop-and-go exercise performance. (J.M. Davis et al. Effects of branched-chain amino acids and carbohydrate on fatigue during intermittent, high-intensity running. Int. J. Sports Med. 20:309-314, 1999.)

It's important to understand that the primary reason for consuming a sports drink is to prevent dehydration by rapidly replacing the fluid and electrolytes lost through sweat. Preventing dehydration reduces the risk of heat illness and can avert premature muscular and mental fatigue.

At this time, we have counseled against adding protein to Gatorade for the following reasons:

· Carbohydrate, not protein, is the primary energy source for muscle and brain during exercise.

· Protein does not enhance fluid absorption and in fact may slow gastric emptying.

· Protein does not improve rehydration.

· Protein in a beverage has a "chalky" taste characteristic that can reduce acceptability and thus fluid consumption.

· The evidence of any benefit has yet to be firmly established.

That said, we do believe that ingesting protein after exercise is important for muscle recovery, and that is why high-quality protein is part of the Gatorade Nutrition Shake.

We continue to learn from emerging science and will keep a close eye on this topic. At the same time, we remain committed to making certain that the Gatorade formula stays the best on the planet for hydration and performance. We're willing to make formula changes whenever the scientific evidence justifies a change, as was the case with the Gatorade Endurance Hydration Formula, a new specialized sports rehydration drink developed for endurance athletes for their longer, more intense workouts.

For more information on protein and exercise, please review our Sports Science (SSE) Exchange on: Dietary Protein, Amino Acid Supplements and Recovery From Exercise or our SSE Roundtable on Amino Acids, Proteins and Exercise Performance or Gatorade News issue Protein: Power or Puffery.

Copyright © 2002 Gatorade Sports Science Institute - All rights reserved

 

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Heat Injuries, Heat Exhaustion and Heat Stroke

Tips for Training and Playing in the Heat

No matter where you are in the world, it's summer somewhere; and as the temperature rises, so does the occurrence of heat injuries.

Although heat injuries are one of the most common forms of sports injuries to effect athletes, they are totally preventable.

Heat injuries occur when your body temperature rises above normal, or when your body is no longer able to regulate heat loss. Heat injuries are generally defined in three stages.

* Dehydration: This is the first stage of a heat injury. It's the mildest form of heat injury in which your body simply suffers from a lack of fluid.
* Heat Exhaustion: This is the next step beyond dehydration. If not treated immediately, serious injury and even death can result.
* Heat Stroke: This is the worst stage of a heat injury. Without proper medical attention a victim can die within minutes.

What Causes Heat Injuries?
There are a number of contributing factor that increase your chances of suffering a heat injury. Some of them are obvious, like high temperatures, others are less obvious. To follow is a list of factors to be aware of when training and playing in the heat:

* High temperatures;
* High humidity;
* Sun exposure;
* Excessive activity and exertion;
* Coffee and alcohol;
* Medications, especially diuretics; and
* Illness, especially vomiting and diarrhoea.

What are the Signs & Symptoms?
There are plenty of warning signs that will notify you, and other around you, that dehydration in setting in. The major problem with the following signs and symptoms is that most people tend to ignore them until it's too late. Catch these signs early enough and you won't have any problems, but ignore them, and you'll pay dearly.

The following signs and symptoms have been arranged so as to begin with the mildest warning signs first. By the time you start to suffer the signs from half way down the list, you're in big trouble. Remember; catch heat injuries early by looking out for the warning signs at the top of the list.

* Thirst
* Headache
* Nausea
* Cramps
* Dizziness
* Weak, no energy
* Confusion
* Hot, dry skin
* Weak, but rapid heart rate
* Low blood pressure
* Rapid breathing
* Unconscious

There is one other sign that is often over looked, and I feel it's one of the best indicators of dehydration. It's simple to check and very reliable as an indicator of possible heat injury.

The color of your urine will tell you a great deal about your body's level of hydration. When your body is depleted of fluid and dehydrated, your urine becomes very dark in color. In severe cases it can be a dark brown color. However, when your body is fully hydrated, your urine is a very light color, even clear.

My recommendation; drink fluid until you pee clear. This way you'll always know that your body is fully hydrated.

How do you Prevent Heat Injuries?
As with all sports injuries, it's far better to prevent them from occurring, than to treat them after it becomes too late. Prevention is even more important with heat injuries, because if you leave it too late, you may not get a second chance. To follow is a list of things you can do, to prevent heat injuries.

* Drink, and drink often. Before, during and after any training or competing. Don't wait to become thirsty. Remember drink fluid until you pee clear. Water is usually best, however, a good quality sports drink will also help to replace salts and minerals lost through sweat. If you're looking for a good quality sports drink, give Reddrox a try.
* In Australia, they have a saying called; "Slip, Slop, Slap!" Slip on a shirt, Slop on some sunscreen, and Slap on a hat. It's good advice whenever you go out in the sun.
* Wear loose fitting clothing that doesn't restrict your movement, and also allows for a good circulation of air.
* Avoid the extreme heat of the middle of the day. If possible schedule your training and playing times around the cooler parts of the day. Maybe even opt for a workout in the pool instead of the running track.
* Avoid sunburn at all costs. Sunburn will draw fluid from all areas of your body in an effort to replenish moisture in the skin. Remember, Slip, Slop, Slap.
* Schedule plenty of rest time in cool, shaded areas, as part of your training and playing.
* If at all possible, acclimatize to your current training and playing environment.
* Avoid caffeine, alcohol and sugary drinks like soda, cola and fizzy drinks.
* Lastly, use a bit common sense and don't ignore the warning signs.

How do you Treat Heat Injuries?
Generally speaking, the treatment for dehydration, heat exhaustion and heat stroke are very similar. However, whenever dealing with a victim of heat stroke, the patient must be referred to professional medical assistance. Remember, heat stroke is life threatening, don't take any chances, call for professional medical help.

To follow are a few guidelines for treating heat injuries.

* Have the patient lie or sit down in a cool, shaded area with good air circulation.
* Elevate the feet.
* Start to replace both fluid and salt loss. Give both water and sports drink if available.
* Loosen any clothing.
* Saturate clothing in cool water. If necessary remove outer clothing and wrap patient in a wet sheet or towel.
* Use fans or other cooling devices to help reduce body temperature.
* Immerse in cool (not cold) water. (Bath, swimming pool, river, lake, etc.)

Remember; if the patient is suffering from any of the serious warning signs like confusion, a weak, rapid heart rate or becomes unconscious, seek medical help immediately.

If you enjoyed this issue of The Stretching & Sports Injury Report, please feel free to forward it to others, make it available for download from your site or post it on forums for others to read. Please make sure the following paragraph and URL are included.

-----------------------------------------------------------
Article by Brad Walker. Brad is a leading stretching and
sports injury consultant with nearly 20 years experience
in the health and fitness industry. For more articles on
stretching, flexibility and sports injury, please visit
The Stretching Institute.

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How does scar tissue affect recovery and
re-injury of pulled muscles and sports injury?

Have you ever had an injury that just won't heal? And then when you think it has healed, you go and re-injure it again. You may have a problem with scar tissue.

So you've pulled a muscle? Over-stretched it, torn it, strained it, sprained it. Call it what you want. From an injury point of view, the initial healing process is all the same.

Sprains (ligament) and strains (muscle or tendon) are the most common type of soft tissue sports injury and are often caused by activities that require the muscles to stretch and contract at the same time. A lack of conditioning, flexibility and warm up can also contribute.

While most people are well aware of the importance of applying the R.I.C.E. regime to a sprain or strain in the first 48 to 72 hours, it's after this that most people get stuck. Let's start by having a look at what happens during those first 72 hours and then move onto what's needed for a full recovery.

The First 72 Hours
Without a doubt, the most effective, initial treatment for soft tissue injury is the R.I.C.E.R. regime. This involves the application of (R) rest, (I) ice, (C) compression, (E) elevation and obtaining a (R) referral for appropriate medical treatment.

Where the R.I.C.E.R. regime has been used immediately after the occurrence of an injury, it has been shown to significantly reduce recovery time. R.I.C.E.R. forms the first, and perhaps most important stage of injury rehabilitation, providing the early base for the complete recovery of injury.

The diagram below is a comparison of the same injury treated with the R.I.C.E.R. regime and without. The top row of pictures show the effects of a soft tissue injury when the R.I.C.E.R. regime is not used. While the bottom row of pictures show the effects of a soft tissue injury when the R.I.C.E.R. regime is used.

The first diagram in the series shows a rupture in the soft tissue immediately following an injury. 24 hours later, when R.I.C.E.R. has not been used, there is a large amount of uncontrolled bleeding and swelling. However, in the bottom diagram, the application of rest, ice, compression and elevation has significantly reduced the amount of bleeding and swelling.

Picture courtesy of Dr. Barry Oakes, MB, BS, MD, F.A.S.M.F. Senior lecturer in the department of Anatomy, Monash Universtity, Victoria, Australia

Picture courtesy of Dr. Barry Oakes, MB, BS, MD, F.A.S.M.F.
Senior lecturer in the department of Anatomy, Monash University, Victoria, Australia

The Problem with Scar Tissue
When a muscle is torn, you would expect that the body would repair that tear with new muscle. In reality, this doesn't happen. The tear, or rupture, is repaired with scar tissue. As you can see with the final diagram on the right hand side, when the R.I.C.E.R. regime is used, this limits the formation of scar tissue.

Now this might not sound like a big deal, but if you have ever suffered a soft tissue injury, you'll know how annoying it is to keep re-injuring that same old injury, over and over again. Untreated scar tissue is the major cause of re-injury, usually months after you thought that injury had fully healed.

Scar tissue is made from a very brittle, inflexible fibrous material. This fibrous material binds itself to the damaged soft tissue fibers in an effort to draw the damaged fibers back together. What results is a bulky mass of fibrous scar tissue completely surrounding the injury site. In some cases it's even possible to see and feel this bulky mass under the skin.

When scar tissue forms around an injury site, it is never as strong as the tissue it replaces. It also has a tendency to contract and deform the surrounding tissues, so not only is the strength of the tissue diminished, but flexibility of the tissue is also compromised.

So what does this mean for the athlete? Firstly, it means a shortening of the soft tissues which results in a loss of flexibility. Secondly, it means a weak spot has formed within the soft tissues, which could easily result in further damage.

Lastly, the formation of scar tissue will result in a loss of strength and power. For a muscle to attain full power it must be fully stretched before contraction. Both the shortening effect and weakening of the tissues means that a full stretch and optimum contraction is not possible.

Getting rid of the Scar Tissue
To remove the unwanted scar tissue it is vital that you start a course of deep tissue sports massage. While ultrasound and heat will help the injured area, they will not remove the scar tissue. Only massage will do that.

Either find someone who can massage the effected area for you, or if the injury is accessible, massage the damaged tissues yourself. Doing this yourself has the advantage of knowing just how hard and deep you need to massage.

To start with, the area will be quite tender. Start with a light stroke and gradually increase the pressure until you're able to use deep, firm strokes. The more you massage the effected area the harder and deeper you will be able to push.

Use deep, firm strokes, moving in the direction of the muscle fibers. Concentrate your effort at the direct point of injury, and use your thumbs to get in as deep as possible to break down the scar tissue.

A few final points before finishing up. Be sure to drink plenty of fluid during your injury rehabilitation. The extra fluid will help to flush a lot of the waste products from your body.

Also, I recommend you purchase a special ointment to use for your massage called "Arnica". This special ointment is extremely effective in treating soft tissue injuries, like sprains, strains and tears. You can purchase this ointment at most health food shops and pharmacies.

If you enjoyed this month's issue of The Stretching & Sports Injury Newsletter, please feel free to forward it to others, make it available for download from your site or post it on forums for others to read. Please make sure the following paragraph and URL are included.

-----------------------------------------------------------
Article by Brad Walker. Brad is a leading stretching and
sports injury consultant with over 15 years experience
in the health and fitness industry. For more articles on
stretching, flexibility and sports injury, subscribe to
The Stretching & Sports Injury Newsletter by visiting
http://www.thestretchinghandbook.com/newsletter.htm.

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Keep from Cramping
Diet-based ideas for conquering muscle cramps

By Jackie Dikos, R.D.
As featured in the Web Only issue of Running Times Magazine

The run starts no different than the others. The groove of one leg in front of the other feels so good. Without warning you’re stopped dead in your tracks. Reacting with a grit of the teeth and reach for your calf, no relief can be found from the mind blowing intensity of such a pain. The tension that overwhelmed the whole body slowly starts to fade. A final deep breath and it’s over.

Although the violent strike of the muscle cramp has subsided, a bruised sore feeling has now taken its place. You try to resume with a light jog. Oh, but what a tenderness remains. This one wasn’t as bad as the one a few weeks ago; you’ll be able to finish this run. Why does this keep happening?

There are many contributing factors to muscle cramping. This makes it difficult to say there is one clear cut answer for a runner seeking relief from the debilitating pain. A change in training, massage, or light stretching may prove to be quite beneficial. In ruling out all potential causes, a look at dietary considerations can support modifications in the training routine and help you get back to full stride.

Hydration
Hydration, or a lack of, is one of the most common causes of muscle cramping. This may become more pronounced in those who train in the heat or consume little fluid during longer sessions. However, this can also apply for those who find it a challenge to drink enough fluids throughout the day. It’s easy to get side tracked, neglecting fluid with or between meals. Drink adequate fluids such that light colored urine is produced. This is an indicator you’re on the right track with your daily fluid requirements. As for those longer training sessions, be aware of major weight changes and sweat rate to better evaluate your fluid needs.

Eat Those Bananas
Potassium is present in many foods including the well-known source of a banana. The concern here is the contribution of electrolyte imbalances that trigger muscle cramping. Potassium is an electrolyte that when the body craves more it may respond with an uncomfortable muscle spasm. Include more potassium rich foods such as bananas, oranges, potatoes, spinach, tomatoes, and avocado into the diet. You will not only be getting the wonderful nutrients available in such foods, but you can keep your fingers crossed this will reduce your chances of muscle cramping.

Got Milk
There is no real proven evidence that a lack of calcium is the cause of muscle cramping. It is a fact that calcium plays a big part in muscle contraction. However, the body has quite a pool of calcium it can dip into and readily available from the bones. No matter the rationale, there are continued reports of unwanted muscle contraction relief with heightened calcium efforts in the diet. Who would want the body to have to pull from its bone stores in meeting muscle requirements anyway? That would only lead to inadequate calcium in the bone. It’s a good idea to drink your milk and eat your cheese in protecting the body for two reasons: to avoid muscle cramping and to maximize bone health.

Sodium
This can be conflicting to some. So much of the world preaches to a low sodium tune and for good reason. However, there is a difference for those who lead a lifestyle with high sweat losses. The combination of sodium loss in sweat and consuming a lower sodium diet can throw the body into an electrolyte imbalance leading to those unwanted cramps. Combine such a lifestyle with a long run and only water to drink and sodium levels can dip too low. Generally most diets consist of plenty of sodium, but if you struggle with cramping issues a little extra salt won’t hurt the situation. Also try packing a sports beverage for your next long training session.

Unfortunately there isn’t a specific remedy to managing the cramping blues. Adjustments in the training routine can certainly make a difference. Add a diet with plenty of fluid, your favorite high potassium and calcium rich foods, as well as have a dash of salt every now and then and you just might prevent a cramp in your stride.

Jackie Dikos, R.D., is a 2:45 marathoner and mother of two. All of her Fueling the Runner articles can be found at http://runningtimes.com/fuel.

 

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KNEE PAIN PREVENTION & TREATMENT

Adapted from: Sports Injury Bulletin

Every coach and athlete should know something about knee pain and treatment, since its among the most common of athletic injuries. This brief overview is from Sports Injury Bulletin, James Taylor, editor: www.sportinjurybulletin.com . SIB articles are compiled by a multi-disciplinary team of writers, including coaches, physicians and physical therapists.

INTRODUCTION

It would be unfair to suggest there is consensus among scientists on the design flaws of the human knee, but you can't help think­ing that if you could re-engineer this particular joint, you wouldn't start from here. Backs, necks, and shoulders all cause their share of problems, but knees just seem to be permanently problematic. It is a rarity to find a seriously active or sporting person whose knees have never given them grief.
Thanks to the dedication and professional curiosity of our editorial team of knee specialists, coaches and researchers, we get some privileged insight here into how surgical techniques are developing in astonishing ways. Indeed, the fact that surgical knee repair has been transformed in the past ten years is a cause for great cheer among all sports people.
While the horror of a single career-ending incident does still happen among elite and not-so-elite athletes, for the vast majority of us, these days, knee injuries may bring pain, disruption and frustration, but not disaster.
This piece will give you a brief education in the mysteries of the knee, glimpses of what will soon be possible in repair techniques, and of course, most importantly, self help tools to assist you in tackling your own niggling knee pain and injury. We don't cover every known sporting knee problem, but you'll find the major ones here.

CLICKING, LOCKING AND GIVING WAY

The menisci are two crescent shaped pads of cartilage present in both knees. The pad on the inner side of the knee is the medial meniscus.
The menisci improve the knee function in three ways:
• They spread the load across the joint
• They improve joint congruency or stability
• They help to circulate synovial (joint) fluid around the knee.

Menisci are made from a specialized type of fibro-cartilage, the high water content of which allows them to resist the forces they must withstand. Menisci injuries are fairly common, with the medial meniscus being more likely to suffer damage.
Typical signs of a meniscus tear will include swelling and difficulty moving through the full range. Sometimes a mobile segment of torn menisci can lodge in the joint and you may feel frequent locking of the knee or be unable to fully extend your leg. This is sometimes referred to as a bucket handle tear.
Other symptoms may include rising pain when you squat right down.
You should always get your menisci injury looked at by a specialist or orthopedic surgeon. It is best not to leave it unattended if it is causing you problems because this may result in further damage to the cushioning ends of the main leg bones at the knee. If your injury does need an operation it would be carried out in the form of keyhole surgery known as arthroscopy.
Results for meniscal repair are very good, especially when carried out alongside reconstruction of the ACL.
It is very important to undertake a post operative rehabilitation program, supervised by a physiotherapist.

PATELLAR TENDINOPATHY

Patellar tendinitis is the most common form of knee disorder found among competitive athletes. Known as "jumpers knee," it is most likely to affect you if you play high impact sports involving bursts of intense or repeated stress, notably basketball and volleyball or high jumping.
Classically patellar tendinitis has been explained as chronic in­flammation of the tendon connecting the patella to the tibia. Recent research has however changed its terminology; it is now more correct to refer to the condition as tendinosis. This reflects the understanding that the tendon pain does not come from inflammation, but rather degeneration and fibrosing of the collagen that makes up the tendon, due to the fact that microscopic damage has failed to heal over time.
Recent research has shifted focus of blame away from environmental factors and towards more individual causations. An American study of healthy competive athletes used a series of body measurements to try and detect a link between intrinsic risk factors and the development of tendinosis.
The only identifiable common risk factors were poor flexibility of the hamstrings and quadriceps muscle groups. This research shows that you may be able to reduce risk with a good stretching program Another recent U.S. study supports these findings and shows a higher incidence of tendinosis among subjects whose kneecaps naturally had a higher tilt when they did knee bends.
Likewise the greater your Q angle (this is an estimate of the alignment of the knee in relation to the angle of the thigh and lower leg) the more strain is likely on the knee.

TREATMENT

Physical therapy can stabilize the condition and this is always a preferred option compared to surgery.
Research has shown that a regimen made up of single leg declines performed 3x15 reps twice a day can make great progress.

A PROMISING NEW ACL SURGERY TECHNIQUE

The ACL (anterior cruciate ligament) is responsible for maintaining the correct anatomical relationship between the femur and tibia throughout the range of knee move­ment. Its main role is to stop the tibia from sliding forward against the femur, but it is a secondary restraint against side-to-side forces and tibial rotation. Anatomical stud­ies have shown that it is able to do both things because it is made of two separate fiber bundles, the antero-medial (AM) and postero­lateral (PL) bundles, each of which has different attachment points on the tibia and femur.
Reconstructive surgery at present focuses on replacing the AM bundles and thereby stabilizing the knee against forward slippage of the tibia.
If you have damaged several knee ligaments in the same injury you may be more susceptible to rotational instability and may there­fore also benefit from double bundle reconstruction.
Double bundle reconstruction results in two separate replacement grafts within the knee, which theoretically has several advantages in the form of added strength and support if either graft fails.
There is however little evidence to support the use of the double bundle techniqure in preference to traditional reconstruction.

ARTICULAR CARTILAGE---THE ENDS OF BONES

The ends of the body's bones are covered with articular cartilage. This highly specialized tissue is principally made up of hyaline cartilage secreted by chondrocytes. Because of the poor blood supply at the end of the bones, these cells work in a low oxygen environment and are vulnerable to injury.

CHONDRAL DAMAGE

Articular cartilage can be damaged by excessive shearing (sliding) forces, and is a common feature of sports injuries to the knee.
High impact combined with twisting can generate a shearing force at the chrondal (articular cartilage) surface, as one surface impacts against the other.
Higher energy trauma can lead to fissuring or partial thickness loss of cartilage, and full thickness injuries may result in osteochondral fractures: breaks that run through the whole thickness of cartilage to damage the underlying bone.
Knee injuries that cause tears to a meniscus or anterior cruciate ligament may well also have damaged articular cartilage.
Chrondal damage is usually graded 1 (superficial) to 5 (most serious). Arthroscopy (keyhole surgery) allows the surgeon to examine the surface of the lesion and carry out therapeutic work.
For lesions that involve the full thickness of the articular cartilage and the bone beneath it there are techniques to repair the damage. The defective loose edges are trimmed back and new repair and growth factors can be stimulated by the technique of microfactors.
Stem cell research also offers potential treatment options. One of the properties of stem cells that make them attractive is their ability to multiply almost without limit. This expansion allows potentially large areas of defects to be treated. However this treatment is still in the early stages of development.

TO SUMMARIZE

Due to the way that the kinetic chain responds to critical weaknesses both mechanically and neurologically, injuries arise that may initially seem to have little or no connection to core strength but are in fact a direct consequence of the lack of it.
It is very important to remember that your postural problems may have very little to do with your sport----as they are just as likely to emanate from poor posture when you are at work or simply relaxing at home.

SPORTS SCIENCE KNEE DISCOVERIES---­WOMEN AND ACL INJURIES

It is widely accepted that women and girls are more vulnerable to ACL injuries than men. Here are a few tips to prevent these injuries from happening.
Ensure that the coach or trainer assesses and corrects the athlete's landing technique when jumping. And in particular make sure that the athlete is positioning her hips, knees and ankles correctly when landing.
A well researched nine-week program can help female athletes prevent the problems of ACL injury.
Exercises include wall jumps, jump tucks, standing broad jumps, bounding in place, 180 turns, double leg hops, single leg lateral hops, single leg forward hops, and single leg lateral hops. Part of the reason as to why women are more prone than men to ACL injury and patello-femoral pain is thought to lie in gender difference in leg biomechanics.

SELF HELP

The key to self management of knee pain lies in listening to your body. If it feels wrong, don't do it. Don't be tempted into the "no pain no gain" ethos. Patello-femoral joint meniscal pain in the knee will respond well to self help approach.

SELF-HELP EXERCISES

Aim to do three formal blocks or sessions of exercise daily, but do what suits you best. A lot of these exercises can be incorporated into daily activities.
Two exercises are Static Quads Contraction With VMO Focus (muscles targeted---Quadriceps especially VMO [vastus medialis oblique]), and Modified Thigh Stretch (muscles targeted-Quadriceps and hip flexors).

THE KNEE AND THE KINETIC CHAIN

The kinetic chain is the term we use to describe the interdependent operation of the body's:
• Soft Tissue System (muscles, tendons, ligament, fascia)
• Nervous System
• Articular System (joints)

THE KNEE IN CONTEXT

A case history that reveals recur­rent niggling injuries over the years, especially on the same side of the body, is a big hint that core stability may be at the heart of a problem, because of poor functioning of the kinetic chain and the lumbo-pelvic hip complex (core area). How well the muscles in the kinetic chain are working together to produce force, help decelerate and maintain stabil­ity is known as the "neuromuscular efficiency" of the kinetic chain.
Neuromuscular efficiency and good core strength protect us physi­cally by allowing optimal shock absorption and permitting the body to decelerate against gravity without injury.
A number of signs to note on a patient seen together may give more clues, e.g., a hollow back, a slightly swayed-back posture, protruding abdomen and, when relaxed, feet pointed outwards slightly.
When the patient performs an overhead squat test watch to check if his feet turn out, his weak knee buckles inwards and lower back arches inwards during the squat.
This demonstrates problems in the weak leg in the form of weak calves, weak buttocks and a tight front hip. Strain may increase on the knee due to inhibited gluteal muscles (buttocks). The weak gluteal muscles may also cause overloading on the calf muscles, leading to a similar strain which can cause achilles tendinitis and plantar fasciitis.

REHAB FOR PRESENTING SYMPTOMS

It is important to improve the patient's neuromuscular efficiency and enable him to engage his gluteal muscles and keep his lower back and front hip muscles well stretched.
The following exercises could be prescribed:
• Prone Hip Extension
• Swiss Ball Bridge
• Lunge
• Step-ups
• Hamstring Stretch (Muscles targeted---Hamstrings and popliteus)
• Calf Stretch (Muscles targeted---Gastrocnemius)

SQUATS (Muscles targeted---Quadriceps and gluteals)
Progressions of the squat may be:
• increase depth
• try to make squat sport specific
• hold weights in your hand
• perform squat with arms out straight and up on your toes

LUNGES (Muscles targeted---Quadriceps and gluteals)
Progressions of the lunge may be:
• Increase depth of lunge
• hold weights by your side
• start from a standing position and step into the lunge
• make it sport specific, e.g., stepping into the lunge on an angle

STEP UPS AND STEP DOWNS (Muscles targeted---Quadriceps especially VMO).

BALLET BAR EXERCISE (Muscles targeted---Gluteals, especially gluteal medius and Quadriceps especially VMO).

FROM: TRACK COACH 184

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The Core of the Matter

Strengthen your core muscles, and you'll run smoother and faster, with fewer injuries. Bonus: a set of seriously taut abs

As runners, we tend to focus on building a stronger heart (cardiovascular system) and stronger legs, but we too often neglect the in-between areas. That's a mistake. A mechanical structure (read: your body) is only as good as its weakest link, and weak core muscles can lead to injuries and sub-par race efforts. Not to mention a not-ready-for-prime-time stomach.

In recent years, core strength training, which develops the muscles of the stomach, back, and hips, has become one of the hottest areas in the fitness field. Increasing numbers of athletes in all sports have come to realize that core training gives you more than just gorgeous, washboard abs. It also improves your performance and reduces injuries.

Take your pelvic area, for example. "When your pelvis is not aligned properly while you run, you become prone to injury," notes Mark Fidel, the director of Sports Medicine Institute International, who designed many of the exercises in this article. "You can get hamstring pulls, Achilles problems, and lower-back pain."

Which is why you need strong core muscles to keep that pesky pelvis right where it's supposed to be. A well-balanced core also improves your running economy. Result: faster times.

"The stronger your core, the more solid you are as you hit the ground," explains Jack Daniels, Ph.D., exercise physiologist for the Nike Farm Team. "That reduces your need for unnecessary stabilization, and allows you to be a more economical runner."

Each of the exercises that follows is designed to help you develop a strong and stable core. Mark Fidel suggests doing the exercises in the order shown, spending 60 seconds on each. Rest for 15 seconds before moving to the next exercise. After completing all six, take a 3- to 5-minute break, and repeat the entire series. Try to do this routine three times a week.

While doing each exercise, move slowly, and aim for total control. If you get tired and lose form, stop for the day. It's more important to maintain quality than quantity.

1. Step Downs
Lie on your back with one hand under your lower back. Lift your legs so your thighs are at a 90-degree angle with the floor, and bend both knees to a 90-degree angle. Tighten your lower back so that it doesn't move up or down, and slowly lower your right foot to within 1 inch of the floor. Keep your right knee bent at a 90-degree angle, and maintain the position of your left leg. Hold your right foot 1 inch off the floor for 2 seconds, then return it to the start position next to the left leg. Repeat the same action, but this time lower the left foot. Repeat both sequences three to five times.

2. Prone Stabilizer
Start on your stomach, and raise yourself into a modified pushup position, with all your weight balanced on your forearms and toes. Keep your back as straight as possible. Slowly raise your left leg until it lines up with your back. Hold this position for 4 seconds, then lower the left leg, and repeat for 4 seconds with the right leg. Repeat both sequences three to five times.

3. Bridge
Lie on your back with your arms beyond your head, and your feet planted on the floor directly below the knees. Press down on your feet, and lift your torso and upper legs until they form a straight line. With your weight on your shoulders and your feet, slowly extend the right leg by straightening the knee. Be sure to keep your back straight. Hold for 4 seconds, then repeat with the left leg. Repeat both sequences three to five times.

4. Side Stabilizer
Lie on your right side with your right elbow under your shoulder, and your left foot resting on your right foot. Press down with your forearm and foot until you lift your body off the ground. Keep your body as straight as possible; don't allow your hips to sag. Hold this position in a controlled fashion for 30 seconds. Repeat on your left side.

5. Fire Hydrant
Start on your hands and knees. Maintaining the 90-degree angle of your left knee, lift your left leg until the thigh is parallel with your upper body. Hold for 4 seconds, then lower. Repeat the same motion, but this time continue it by forcing the knee and thigh as far to the left as possible. Hold for 4 seconds. Repeat A and B, but this time force the knee and thigh as far as possible to the right, crossing over your body's midline. Hold for 4 seconds. Repeat with the right leg. Repeat both sequences three to five times.

6. Supine Stabilizer
Lie on your back with your legs fully extended. With your elbows under your shoulders, lift your entire body onto your forearms and heels. Keep your legs, hips, and back as straight as possible. While maintaining this position, lift your left leg 4 inches off the floor. Hold for 4 seconds, then repeat with your right leg. Repeat both sequences three to five times.

Jeff Purton
Runners World Publication

 

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