January 26, 2023

At last! An injury-prevention program that actually works

But you’ve got to be really consistent. Swedish researchers managed to enroll 433 healthy veteran runners (a good number, and almost half female) into an 18-week investigation. During that time, the runners kept training as they normally would. Half added “general strength and foam-rolling exercises twice weekly” to their efforts. The other half did nothing special or different. Both groups reported their injuries over the 18 weeks.

A comparison of the runners who “did something” vs those who “did nothing” produced no differences. Damn. However, when the researchers focused on the highly compliant runners who performed more than 90% of the exercise sessions, the results leaped off the page. For their discipline and consistency, these runners were rewarded with an 85% lower injury rate vs the control group. Indeed, only 4.6% of the highly compliant suffered any injuries at all. That’s a number the likes of which you almost never see in reports on runner injuries.

The strength exercises required about 19 minutes in total, and the foam rolling about 11 minutes. Strength: 1-leg squat, forward lunges, side-steps with elastic training band, supine abduction with elastic training band, side-plank, diagonal lifts, and foot supination with elastic training band. Foam rolling: upper leg involvement of hamstring, quadriceps, gluteal and abductor muscles; lower leg involvement of plantar fascia, calf and shin muscles.

The runners had an average age of 39, and covered an average of 13 miles a week of running, with slightly more in the high-compliant group. Forty four percent of all subjects fell into the low compliant group; only 29% managed to hit the high compliant level.

The researchers believe their study is unique in combining both neuromuscular and foam rolling components into an injury-prevention protocol. Also it is "easily performed, familiar to the majority of recreational runners and relies upon minimal equipment.” 

Conclusion: The runners who did strength training plus foam rolling had a “significantly lower risk of running-related injuries” than the control runners” and “took on average 57 days longer to sustain an injury” than the control runners. More at Scandinavian Journal of Medicine & Science in Sports (free full text). Infographic here.

Super shoes produce super training, and that could make you faster

If a pair of shoes help you run faster in training, that should improve your fitness, allowing you to also run faster when race day rolls around. And super shoes appear to do that for hard interval training. Plus, you can wear them on race day too.


Here the study team tested what would happen when 12 well trained men ran a long interval session in Nike ZoomX Vaperfly shoes “or a traditional running shoe.” The workouts were separated by 7 days, and randomized for order. (Of course, the runners presumably knew what shoes they were wearing, which introduces a placebo concern.)

Key result: “Training performance improved 2.4% in the Vaperfly shoes.” The shoes also “reduced subjective perceived muscle pain compared to regular training shoes.” Step length, contact time, and leg stiffness were higher in the Vaperflys, while flight time was lower. 

Conclusion: “Vaporfly shoes improved the long-interval training performance with similar running power, heart rate, and neuromuscular fatigue.” More at European J of Sport Science.

Laura Fleshman, body composition, and weight loss

Let me just say flat out that Lauren Fleshman’s new book, Good For a Girl, is fantastic. It’s sad, scary, riveting and unrivaled in its candor. The book is a must-read for teenage girl runners, the parents of the same, any coach (but particularly of girls/young women), and basically anyone who cares about healthy running.

The book's main topics, to simplify, are male-dominance in sports administration/coaching and eating disorders. Fleshman, a many time NCAA champion who never quite achieved her dream of making an Olympic Team, knows these subjects from deep personal experience. And she doesn’t like what she has seen and experienced. 

That said, she doesn’t proffer easy solutions. I admire her for that. She’s smart enough to recognize complex situations that aren’t easily resolved. She’s shining a big spotlight beam on the problems, and doing so in an effective, well-researched, and engaging personal narrative.

Here are a few more articles related to Fleshman’s concerns. Runner’s World reports that many colleges are concerned that eating disorders among athletes could cause mental health and physical health problems. As a result, the colleges are steering away from regular weigh-ins and body composition testing. 

That said, there are worse and better ways to lose a few pounds, and veteran sports dietitian Nancy Clark lists a number of the better choices here. These are for “athletes who have to/want to lose weight for the short-term” like boxers and wrestlers who need to hit their division weight. With the emphasis on short-term.

Beyond the small realm of elite athletics, the average weight of young American women appears to be continuing its 20-year rise. This is a different kind of health concern--one that we see all around us on a daily basis--and it’s a major public health problem.

The skinny on fruits and vegetable skins

This nutrition article from a solid source taught me things I didn’t know, so I figured I should pass it along. I almost never peel away fruit and vegetable skins because I know they are nutrient-rich. But watermelon rind? Banana skins? I had never even considered these. Now I’ll have to see if I can change old habits. Here are 11 fruit and vegetable skins loaded with fiber, antioxidants, polyphenols, and other good stuff. More at WebMd.

How to get rid of muscle knots

Some of my friends call them “knots,” some use the term “adhesions,” and you may use a different one. But chances are you’ve experienced annoying muscle knots at one time or another. I’ve often been troubled by knotty calves, as have many other runners. How to get rid of them?

I have a training partner who’s currently having some success with dry needling by a PT. There are many other approaches from stretching to foam rolling to massage and electrical stimulation. Here an exercise physiologist reviews them all so you can pick what sounds best to you and your particularly knotty problem. More at The Conversation.

Take naps like the elites to improve your mental & physical game

When you read about elite athletes and/or Kenyan distance greats, you often notice how lazy  their lifestyles appear. Sure, they rack up impressive weekly training miles, but they also seem to have time for naps nearly every day. Is napping a secret performance enhancer?

Could be. In this systematic review and meta-analysis, the authors found that naps of 30-59 minutes have a “moderate-to-high effect” on improved physical and cognitive performance during the afternoon following a normal night’s sleep. The best time for the nap was about 2 p.m, and you shouldn’t run in the first hour after waking up from the nap. Otherwise, you face the dreaded “sleep inertia.”

Other studies have suggested similar benefits after nights of “partial sleep deprivation,” but the evidence is not currently strong enough to be a “firm recommendation.” Napping may also reduce the sense of fatigue you feel after a workout, especially if you wait 4+ hours to begin training after the end of your nap. More at British J of Sports Medicine.

The beet goes on. The latest on performance boosts from beets and nitrates

The possible connection between beet consumption and improved endurance performance has been investigated in probably 100s of studies in the last decade. Most, but not all, have produced modestly positive results. Beets are called “beet root” in England, where the first papers came from. 

When there are so many papers already out there, researchers need to look for new angles. Here’s one: Beets might improve your sprint at the end of an endurance race.

In this crossover, blinded RCT, “9 recreationally active men” consumed/didn’t consume beetroot powder for a week, and just before and during a 2-hour cycling test in a lab. At the end of the 2 hours, they were asked to launch into an all-out sprint for 60 seconds. Result: The athletes on beets were able to produce more power during the final 30 seconds of the sprint effort.

Otherwise there were no differences in “any muscle oxygenation variables during moderate-intensity cycling during the 2 hour endurance cycle.” Also, the difference in that last 30 seconds of sprinting doesn’t appear to have been statistically significant. So this is a small victory for beets. More at Antioxidants. 

Another new nitrate study looked at quadriceps muscle function shortly after volunteers consumed potassium nitrate. It seemed to have an effect on muscle power, as “mean muscle torque production was approximately 7% greater during the first 18 contractions.” The results showed, for the first time, that skeletal muscle can rapidly utilize dietary nitrate, which enhances muscle contractile performance. The researchers also raised “the intriguing possibility” that nitrate supplied by a supplement or food might be more accessible than stored nitrate. More at Acta Physiologica.

Count me skeptical on mass dehydration worries

Excuse me, but I just don’t get this panic over dehydration. Here’s my logic: Body water makes up from 45 to 65% of body weight, so if anyone is chronically dehydrated, it follows that they would lose a little weight every day. But this isn’t happening. We know that more people are gaining weight than losing. So where’s the proof of massive, population-wide dehydration?

I mention this because of a sodium/dehydration paper that got a ton of press in the last several weeks, presumably because everyone (except for me) is convinced they’re dehydrated. The researchers actually measured blood sodium levels (not water levels), and found that people with higher sodium levels tended “to be biologically older, develop chronic diseases and die at younger age.” 

This seems plausible enough. We know that high sodium consumption can be unhealthy for many. And it’s also true that temporary dehydration (as in marathon running) causes a rise in plasma sodium concentration. However, that still doesn’t convince me that dehydration is a major public health problem. Maybe I’m missing something here, but Dr. Gabe Mirkin seems to agree with me when he writes: “This study does not prove that drinking more water prevents chronic disease.” He does list several of the common reasons to avoid dehydration. Here.

Here’s the original report. It “used serum sodium, as a proxy for hydration habits” and found that a high “middle age serum sodium is associated with a 39% increased risk to develop chronic diseases.” More at E Bio Medicine/The Lancet (free full text).

SHORT STUFF you don’t want to miss

>>> British runner declines trip to World XC in Australia over concerns about long air travel contributing to climate change.

>>> How to become a morning runner.

>>> In 6-year followup study, key to long-term weight loss is limiting large meals.

GREAT QUOTES make great training partners 

“Come what may, all bad fortune is to be conquered by endurance.”


That’s all for now. Thanks for reading. See you next week. Amby