May 12, 2022

THIS WEEK: Should kids run marathons? The latest on running and arthritis. “Soft” shoes may reduce injuries. How much should you eat while tapering? New treatments for plantar fasciitis. You only need 7 hours of sleep. Careful with sprained ankles. Masters women know how to train smart. Soft drinks and dental health. More

Should 6 yr olds run marathons?

When a running story reaches national TV and People magazine, you know it has risen above 99.9 percent of other running stories. That’s what happened when a family of 8, including a 6 yr old, ran the recent Flying Pig Marathon. Few think this is a great activity for 6 yr olds, but evidence of harm is lacking, and evidence of low injury rates has been confirmed several times. This includes a newly published paper (on middle school and high school marathoners from the Students Run L.A. program.) They appear to incur “a lower injury rate than adults during marathon training.” The father of the Flying Pig marathoning family raised a robust defense here.


I think it would be good if we could seek some middle ground on this emotional debate. Many marathons simply won’t register runners under 18. That’s a bit strict. Perhaps we could move to something like “Runners under 18 only permitted with appropriate training and racing history, which must be submitted with entry.”


The latest on running and knee arthritis

I hope you’re already a believer that running doesn’t ruin the knees, because it doesn’t. Here are the newest studies. When researchers did a systematic review of studies of only runners over age 55, where you’d most expect an arthritis problem, they concluded: “Middle aged runners did not present greater imaging or clinical signs of OA compared with non runner controls.” This applied to both recreational and elite runners. Another study from the same team compared arthritis among those doing different sports. Conclusion: Certain sports, such as soccer, handball, ice-hockey, and rugby are more likely to be associated with premature knee and hip OA. “Conversely, runners and ballet dancers do not evidence significant increase in OA.” More at Sports Medicine & Arthroscopy Review (runners), and other sports.


Keep those quads strong for knee health

Sticking to the knee arthritis theme, here’s a report showing that quadriceps strength can help protect against cartilage and meniscus issues surrounding the knee. Also, if you do develop knee problems, it’s likely that appropriate exercise, probably including quad strengthening, is your best approach. Conclusion: “Exercise therapy ranked as the best treatment for knee osteoarthritis pain, followed by NSAIDs and opioids.” More at The J of Orthopedic & Sports Physical Therapy.


Soft shoes may reduce injuries, though reasons unclear

Deconstructing the relationships between shoe design, foot-stride, leg mechanics, and injuries is no easy task. Recent papers have indicated that “soft” shoes may reduce injuries by up to 50 percent, but mainly in lighter runners. These shoes don’t necessarily work as expected, however--through peak impact forces (lower in “stiff” shoes) or peak loading rate (about the same in both designs.) A crack research team believes that stiff shoes produce “increased mechanical burden for the musculoskeletal system, especially around the ankle joint.” Alex Hutchinson explores the stiff/soft findings behind an Outside Online paywall. The newest paper is here.


How much should you eat during a marathon taper?

I don’t usually look for disagreements with experts smarter than me, but this one has me thinking. It’s about an interesting topic: How should you eat during your several week marathon (or Ironman) taper period, when you’re probably decreasing your training by 30% to 50%? Here, the nutritionist who helped Shalane Flanagan with her 6 marathons/6 weeks last fall recommends that you continue eating as you did during peak training. She doesn’t cite any evidence, so that makes me a little bolder. I think it might be smarter to maintain the energy balance you observed in training rather than upsetting that balance. That would mean fewer calories with fewer miles. Of course, you still need to carbo load pre-race. More at Run Tri Mag. 


Two new treatments for plantar fasciitis

Simple saline injections have often been used as the “placebo” condition in trials of varied PF injection treatments. Turns out the saline is better than that. It’s a positive, active agent, according to a meta analysis and systematic review of RCTs. In this analysis that included 379 subjects with PF, “Normal saline injections showed a therapeutic effect with statistically and clinically meaningful improvement.” More at Foot & Ankle Surgery. Or you could simply walk backward down a steep slope, which “was confirmed to be helpful in terms of pain relief” according to a different paper.


Sleep: You don’t need 8 hours, only 7

New recommendations often advise seemingly impossible goals like all those fruits and veggies we’re supposed to eat every day. Is it 7 servings or 9, or what? However, sleep, our most important recovery tool, seems to be trending the other way. We all grew up hearing that we needed 8 hours a night. Newer reviews have dropped that number to 7. (Though hard training regimens probably increase your need for sleep.) Here, a news story, a link to the research, and a dissenting view. More at CNN.


Most women masters runners are training smart. Way to go!

This paper looked only at women runners over age 45. They were asked 31 questions about their training, their injuries, and their reasons for running. Most ran between 10-20 miles a week, divided into three sessions. About 10 percent ran more than 30 miles/week. Ninety-seven percent ! also did cross-training. They ran for: mental health, personal challenge, and competition. Leading injury issues were: hip/glutes, foot, knee. Conclusion: “This cohort of runners trained in a relatively smart manner.” More at Int J of Sports Physical Therapy.


Kathy Martin returns with new wins and records

Continuing on the same theme, women masters, Kathy Martin just returned from 5 years of no serious racing, and picked up where she left off. Now 70, Martin won several events at the USATF Masters Indoor Championships. And she has definitely made some smart changes: more strength training, more yoga, and a training “week” that extends over 9 or 10 days to improve recovery. More behind paywall at Outside Online.


Sprained ankles should be taken seriously, and rehabbed

When my college-rugby-playing granddaughter lost some playing time this spring to a sprained ankle, I cautioned her not to take the injury lightly. The NYT running newsletter agrees, noting  that “for an estimated 40 percent of people, a sprained ankle can lead to chronic ankle instability.” The Times also suggests some strengthening and balancing exercises recommended by experts. More at New York Times.


Sports drinks unlikely to have significant bad effect on dental health

The mass media likes to publish articles about how sports drinks (the various “ades”) are destroying your teeth, because it seems ironic that fitness-motivated athletes would gulp down something that’s bad for their health. And the stories are worrisome, because we know that ades contain sugar, and no one wants any more visits to the dentist. But when Mr. Sweat Science, Alex Hutchinson, surveyed the best and most relevant research, he did not discern “a convincing case that endurance athletes are at heightened risk of tooth problems.” More at Outside Online.


SHORT STUFF you don’t want to miss

>>> Self selected music best for running motivation and performance boost

>>> Get your calcium from foods, not supplements

>>> “Laughter yoga” good for body weight and mental health


GREAT QUOTES make great training partners

“It doesn’t matter how slowly you go as long as you do not stop.”--Confucius


That’s it for now. Thanks for reading. Stay well, and see you next week. Amby