Sprinting Downhill and Labor Day Adventures

I hope everyone had a wonderful Labor Day weekend. I went camping near Yakima and went white water rafting on the Tieton River. This was us ;) just kidding

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But the whole experience was extremely fun. The Tieton River is only open to white water rafting in September due to irrigation needs farther down the river (they open up a dam). At this time, this river is considered a class III/IV. No one fell out, everyone survived and we all had a blast.

After river rafting we took a hike to Twin Sisters Lake. This hike is relatively flat and a pretty short hike, but the lakes are beautiful. The only bummer was it was over an hour drive from our camp site, but we still enjoyed the scenery.

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I recently heard someone mention that to increase speed you should sprint downhill. Has anyone heard of this? Sprinting uphill helps with muscular and cardiovascular strength, but what can running downhill do? So naturally, I looked it up…

As we all know, whether we are sprinting or running long distance, running requires strength, but running also requires coordination and balance. When we walk, we are going from being on 2 feet to 1 foot. Being on 1 foot requires balance. If you have ever worked with people who have had a stroke or decrease strength/proprioception in 1 leg, you would see how important balance is during walking. Running is jumping from 1 foot to the next with air time in between foot strikes. This requires a lot of coordination and balance.

My studies have taught me that walking (or running) downhill requires increase eccentric control. If you think about it, when you walk down a hill or stairs, you are breaking your movement. Well, this requires more strength from your muscles than walking up stairs (or a hill). Think about a time you were really sore. What was harder? Walking up the stairs or down the stairs?  You should have answered down the stairs because you are slowing yourself down.

Upon further research, sprinting downhill as fast as you can for approximately 40m helps increase your coordination, balance and strength and allows you to run faster. According to Livestrong.com (which did back up this article with legitimate sources) "Sprinting downhill develops your coordination by forcing your legs to learn how to handle high speed travel. At first you'll have difficulty keeping your balance, but over time your coordination will improve in response to the increased stride rate."

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So go out there and run hill repeats, both down and up a hill. But remember, like with any exercise, ease into it.

Seawheeze Half Marathon and Compression Socks

On Saturday my running partner (in crime)/mother and I ran the Seawheeze Half Marathon in Vancouver BC. It was a wonderful race. Here is a little re-cap.

My mom and I headed up to Vancouver on Friday afternoon (my mom worked a half day and I currently am studying for my boards/applying for jobs). There was a lot of traffic in the afternoon, but what else do you expect.

We checked into the Delta Suites Vancouver (which I highly suggest staying in) around 5pm and proceeded immediately to pick up our race packets. Our hotel was in walking distance to the convention center (and race start), so picking up our packet was easy. The race did not give out bibs, but instead gave us bracelets with our information on them. I like that because 1.) I am so short that the bib takes up my entire torso and 2.) the bibs are just kind of annoying, especially during a long race. The rest of the night consisted of eating a carb filled dinner (maybe a glass of wine) and going to bed early.

My Mom and I selfie

The view of the water in Vancouver

The next morning was pre-race ritual as normal. Woke up, had my bagel and headed down to the race.

The race was spectacular. The start was done in waves, so I started approximately 25 mins after 7am. The views were wonderful and there was plenty of water and cheering support. This race is relatively flat with a few minor hills, so if you are looking to PR, this is a good one. I did not PR (or come close). The 1st 10 miles felt great. I was keeping up a decent pace. But right at mile 10.1 my body decided to be done. I knew this was going to happen because although I did train with long runs, I did not run enough through out the week to add up my mileage. That is okay though, I still had a wonderful time. I will be doing this race again next year!

Here are some pictures during the race. Photo source: Seawheese FB page

The start of the race

Cheer stations…Probably the best one

My mom after the race wearing the medal and the shorts you get with this race!

During the race I noticed a lot of people wearing compression socks. I have had people tell me that I should wear them and I have had people ask me what they are good for. Hey, just because I am a doctor now doesn't mean I know everything! But I do know how to look things up…so I did.

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Performance manufactures claim that compression socks improve power, endurance and aid in recovery after high intensity activities.

One study found that the compression gear did not increase maximum jump height, but did help maintain a higher repetitive jump height compared to not wearing the compression gear. This means, the socks do not make you jump higher, but you will be able to sustain a higher jump height when jump over and over again. This study also reported that people reported lower rate of perceived exertion (RPE) when wearing compression gear than without compression gear. (Rugg)

Another study found that anaerobic and aerobic thresholds were more favorable with compression socks and that speed was significantly higher with compression socks than without. This article did not find a difference in HR or O2 max. (Kemmier)

Both articles suggested that compression socks have positive effects on venous hemodynamics, arterial perfusion, deeper tissue oxygenation and muscle oscillation (which means that you are getting better blood flow and more oxygen to your muscles and blood back to your heart), along with decreased muscle breakdown, fatigue, soreness with the use of compression socks. Both articles are not 100% sure how compression socks work, but they feel that there is a proprioceptive input (proprioception means knowing where your body is in space) to your muscles making them more efficient.

The second article stated that there was only at most a 2% difference in their findings, so if you are a high end athlete, this could make all the difference with winning gold or silver, but will only help you a little if you are just average Joe or Jane. But hey, anything to shave off a minute or two when I am running.

I think I will give these socks a try!

Does anyone use compression socks and what are your thoughts on how they work?

References:
1. Rugg S, Sternlicht E. The effects of graduated compression tights, compared with running shorts, on counter movement jump performance before and after submaximal running. Journal of Strength and Conditioning Research. 2014: 28;1067-1073.

2. Kemmier W, Stengel SV, Kockritz C, Mayhew H, Wassermann A, Jurgen Z. Effect of compression stockings on running perforance in men runners. Journal of Strength and Conditioning Research. 2009: 23(1); 101-105.

The Benefits of Yoga

As many of you know, I love yoga! I have been practicing some sort of yoga for over 10 years and yoga has been practiced for over 5000 years! Yoga is more than just stretching. In fact, it can be a rigorous workout. I have walked out of classes dripping in sweat and shaking.

There are a multitude of health benefits, such as flexibility and strength. But yoga is also a great exercise for mindfulness, balance, stress management and a mood booster.

Deep Breathing/mood/stress management: the practice of yoga is based on connecting movement with your breath. In fact, certain practices of yoga are just breathing exercises and you are still truly practicing yoga. Deep breathing is so good for us and has many benefits and uses. It can help you calm down, pump you up, improve focus, reduce anxiety or keep you awake (why do you think you yawn in class). Yoga emphasizes deep breathing from your belly with a breath called Ujjayi breath. It sounds like waves at the ocean. Deep breathing sends a message to your brain to relax. Try it some time if you are stressed out. When we are stressed we tend to take shallow and short breaths, this is similar to hyperventilating and in layman's term, there is a decrease in carbon dioxide in your blood and this will cause you to feel dizzy and thus anxious. So try breathing in for at least 4 counts feeling your belly rise and 4 counts out feeling your belly sink in, you will feel better instantly. Deep breathing also releases endorphins and these are the happy neurotransmitters - it is a natural high!

Agonist-Antagonist response: Okay, you are probably asking "what does this mean?" Basically it means flexing or contracting the opposing muscle simultaneously while your are stretching another. Yoga does this naturally with its postures. When you are doing warrior 1, you are contracting your butt muscles (hip extensors) while stretching your hip flexors (iliopsoas and rectus femoris - quad). When you want to stretch your hamstrings, if you long sit and flex your quads, you can typically get a deeper stretch into the back of your legs. The mechanism of action is through your brain. You have something called mechano-receptors in your muscles and tendons that when they are being stretched your brain tenses them up and prevents you from stretching further. Well if you contract the opposite muscle that you are stretching, this sends mixed messages to your brain (it kind of gets confused) and relaxes your muscles and allows you to stretch further.

Improvement of posture: Posture comes from proper length and strength of your muscles. American's spend all day sitting flexed over a computer or driving. Not only does yoga have many poses that are the exact opposite of being hunched over, they use the mechanism mentioned above to strengthen and lengthen your muscles. Studies have shown that programs that just stretch, just strengthen, or stretch then strengthen (or vies versa) don't produce permanent changes in posture. Preliminary research has shown that stretches and strengthens simultaneously does improve posture AND makes permanent changes!

Strength benefits: You have probably seen some yogis and their amazingly lean muscles and crazy tricks they can do! Well, yoga uses your body weight along with the help of gravity to increase your strength. You don't need any equipment, just clothing that can move and maybe a towel to wipe off sweat. But give the poses a try, I guarantee you will be sore the next day.

Improved balance: A major cause of death for older people is from falling. There are many reasons why people fall, but one of them is due to poor balance. Balance is a combination of many factors and yoga works addresses many of these factors. One thing you can do to improve your balance is practice. Stand on one foot and close your eyes for 30 second. Can you do it? You should be able to. Yoga has many postures where it challenges your balance and strengthens your stabilizing muscles. In fact, I would say 90% (I made that percentage up - but it is most of the poses) of the poses performed in yoga challenge your core muscles and work on balance!

Mindfulness: Although many A type personalities tend to practice yoga, picture the stereotype of your typical yogi. That is what yoga is all about. It is a practice, not perfection. You are concentrating on your breath and your movement, not what you have to do when you get home. A wonderful and successful yoga practice could be balasana (child's pose) or shavasana (corpse pose) practice the entire class. It teaches you to be in the here and now (this is not an easy thing to do and I still have not come close to mastering this). Also, yoga teaches you to listen to your body. Some days I feel like I am an expert yogi, other days I can barely touch my toes. It is important to listen to your body since every day is different and every practice is different. If something is not feeling right, don't go in to that pose, even if the person next to you can do it. And that is okay, because maybe tomorrow you'll do it, or maybe you'll never do that specific pose, but yoga teaches us that what ever your practice is, that is the best practice to have.

Even though yoga is an amazing exercise for many people, it is not for everyone. One of the reasons could be because it does not interest you. Also, it is important to practice the poses correctly because incorrect poses could cause injury. That is why it is so important to listen to your body. Right now my shoulders are so tight that I can not perform binding poses. When I try my shoulder hurt. I am okay with this and I know in the near future (when I am not studying all the time and have more time to practice yoga) I will be able to bind once again.

And always consult with your doctor when trying new exercises. Especially if you are pregnant or have  a heart condition.

I hope I have persuaded you to at least give yoga a try.

Are there any exercises that you were hesitant to try but once you did it you loved it?

Half Marathon #29 and Patellar Taping

On Sunday I did the Sandy Feet Temecula Half Marathon, thus completing my 29th half marathon. Notice the word choice "did" and not "run". Okay, I did run most of it and I did finish, but it was not pretty. I debated not running this race because of my bum knee…thus, I did not train for this race and thus the above verbiage. 

Well, I am not one to sign up for a race and not do it (hell, I ran a half last year with a bad cold), so on Saturday afternoon, I headed down to Oceanside (near San Diego) to spend the night at my friend Kelsey's (aka co-crazy runner) house. We watched girly movies and made a delicious pasta dinner. We went to bed early because we had to wake up at 5am. Luckily, 5am is when I wake up everyday for work, so it wasn't that big of a deal. We were on the road by 6am and at the race start (after a quick Starbucks stop) by 7am. The race started at 7:30. 

We were off. I will spare you the gory details, but the course was mostly loose pack dirt and large steep hills. My legs (and knee) felt great for the first 7 miles  but the last 6 miles were HELL. My knee started to hurt, then it stopped, but that is because I think my entire body went numb. I might have curse out Kelsey in my head (who picked this race and ran it significantly faster than me) during the entire twelfth mile. When it was over all I could think of was how happy I was done. 

Kelsey and I at the finish line

Did I mention that the race started and ended at a winery? Well it did, so we might have participated in some wine tasting after the race. It was just what I needed to ease the pain.

The medal

I am going to take a month off of running and concentrate on strengthening and stretching. I need to give my legs a break because on Nov 30th, I have my last half marathon of the year and I plan on it not being excruciatingly painful.

On the Physical Therapy side of things, I did try taping my knee with Leukotape.

There are a few different types of tape. The ever popular one right now is Kinesio tape. This is the tape that you see many athletes wearing. Kinesio tape actually helps move your muscle or inhibits it from working. It can also help with edema (swelling). Supposedly it creates a pull on the skin and allows for fluid to flow. It also helps restrict or help muscle movement without restricting movement in that limb. I am currently doing research on kinesio tape, so I will get back to you when I have a little more information. 

The main purpose of taping is to use as a crutch to help you heal quicker, but it should not be something that you use all the time. 

I used Leukotape. The purpose of this tape is to restrict movement in a muscle to prevent further injury or pain…I figured if it was a quad problem, this type of taping would help...

Above are the 2 methods I used during training and during the race to off load my quad to not pull on my patella (knee cap) and prevent pain. Both methods helped, but not 100% affective.

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I also considered that my patella was sitting in the wrong place. This method is moving the patella and placing it where it should be. I thought if my patella was in the right place I wouldn't have pain when I run. I only used this method during a training run and it did not help.

When taping…it is important to know where to place the tape, where and which direction the pull should be placed, and what to do if redness and swelling occurs, so make sure to consult your PT before applying tape.

Running and a Bum Knee

As I have mentioned in (a few) past post or two, I have a plan to run 30 half marathons by the end of this year. Well I am two away from completing this goal and low and behold, I am hurt :( After the trail run, a few miles into any run my knee starts to hurt, and not the good kind of hurt.

My next half is Oct 20th and I would like to train for it. But at this rate, who knows. I talked to my clinical instructor about what she thinks I should do and here was her advice…

"As a PT, you should rest, stretch your quads, strengthen your glut meds, and ice…As a runner, you can take 3 Advil before a run and then ice it afterwards. But I don't suggest doing #2."

Well, I don't have a choice. I have been trying not to run, strengthening my quads and butt muscles, but the last few days I have decided to take a few Advil, run and then ice. Bad me. Do as I say and not as I do. But I promised myself I would complete this goal and gosh darnit, I am doing it.

It is tough to know that my body is telling me to rest but that my brain is telling me to go. Well my brain is also telling me to rest because I know the consequences of what can happen if I injury myself worse. So I guess it would be my heart telling me to keep going.

What is something that you have pushed through to complete a goal?

Well That Was Tough

On Sunday I completed my 28th half marathon and this one was definitely a challenge. It was called the Mud and Chocolate Trail Run which included a 4.5 mile & 1/2 marathon trail run. I knew it was going to be 3 loops and there were going to be trails, but I was not fully aware (or did not want to admit to myself) that the whole run was on a trail. Here was the low down.

Trail running is a completely different beast from street running. The path is narrow, it is much harder to pass people (in the beginning), you use completely different muscles on trails than you do on concrete, you have to pay attention to where you are going, and finally, you have to pay attention to where your feet are being placed.

The first loop of this race, I felt like I was stuck behind people who were going at a different pace than I would have liked to run, but by the second loop, I was all by myself on the path for the majority of the time. I didn't realize how much I need the energy of other people while I am running. I would get a burst of energy when someone would pass me or when I caught up to someone else. I think the hardest part of this race was having to be mentally on the entire time. I almost rolled my ankle a couple of times and you can't zone out in the end (which I like to do) because you have to make sure you don't trip. To top it off, since I didn't train on trails, my hip flexors were screaming at me around mile 6 because I was lifting my legs higher than I normally do to avoid branches and rocks.

I sound like I am complaining. I am not, I was just not as prepared as I should have been. Luckily my running experience got me through, but I highly suggest training on dirt and trails before completing this endeavor. I thoroughly enjoyed myself. This was definitely a new challenge and I must admit I felt pretty hardcore.

The end of the race was sweet…Literally. I ended with a chocolate medal and a buffet of chocolate goodies.

And this race definitely lived up to its name…Mud and Chocolate

My chocolate medal, chocolate cupcake and muddy legs

I don't think I will be participating in another half marathon trail run anytime soon, but I can see myself running in shorter distances of 6 miles or less.

On Tuesday I was rewarded with an amazing 2 hour massage. The massage was a 30th birthday present, but it was definitely needed after this race. I felt sore in muscles I have never felt before.

So do as I say and not as I do, and if you are planning on running a "normal" road race, train mostly on concrete. If you are planning on running a trail run, train mostly on dirt. It is important to "teach" our body's tissue to work on what ever surface it needs to work on. That being said, if you think you have bad knees, don't run mostly on the grass and dirt and then complete a long race on concrete, your body will not be trained to work on that surface. And vice versa, running on concrete did not harden my joints and muscles up for this trail run, I was probably less stable because my muscles were not use to stabilizing me on such uneven/unsteady ground. I would have benefitted from running on more uneven surfaces before this race and then I might not have been as sore as I was.

Has anyone completed a challenge that they were not prepared for?

Lack of Motivation

One month left of the 1st trimester of grad school and my motivation to study is slowly declining. It doesn't help that I have been fighting an illness for the past week (I will NOT get sick), my brain is too active to sleep and since I am tired and don't feel well, I can't work out. I literally dream about anatomy and physiology. How boring!

The stack of index cards of muscle that I have to know intimately (the pile recently got bigger too)

After our Anatomy Lab Midterm, one of my classmates, Jen, made delicious femur and skull cookies. At least I get some rewards for all my hard work!

Last week I did get a special treat! A few friends from out of town flew into LA to celebrate our friend Em's birthday. 

Sarah (out of town guest), Em (the birthday girl), me, Jeslyn and Gia(out of town guest) at a bar in Eagle Rock

I had an amazing time. We started the night at a sushi place in Downtown LA (I believe it was Zencu Sushi and Grill in Little Tokyo) that was amazing. I was sufficiently full and slightly drunk for $25. Plus it was awesome to hang out with old friends! We partied at a bar in Eagle Rock and then ended the night at a taco truck right down the street from the bar. It was the perfect night.

Since then I studied for an anatomy quiz, I am currently studying for a general medicine quiz (which is in two days) and excited to return to rainy Seattle for Thanksgiving.  I lead such an exciting life right now. Seriously, that is all I have done. So sad.

Here is something interesting that I learned.

Hamstring Stretching

Below are two ways you can get a good hamstring stretch. One way also stretches your nerve:
1.) When lying on your back (supine) to stretch your hamstring, if your leg is straight and you pull your toes towards your nose (into dorsiflexion) while in your stretch you are also stretching your nerve (tibial nerve to be exact). This is perfectly okay, but you will not get as deep of a hamstring stretch if that is your goal.

Hamstring and nerve stretch

Here is an example of just a hamstring stretch. If you are not as flexible, you can wrap a towel or a belt around your ankle or calf and it is perfectly okay to bend your knee. You will still get a good hamstring stretch.

Just a hamstring stretch

Next time you are stretching your hamstrings, you can pull your leg closer to your body if you keep your foot relaxed or even pointed. This is a great way to impress people with your flexibility. This also applies if you are sitting up with your legs straight out in front of you. But remember to always warm up first.

A Much Need Break...

Before my mental breakdown from studying on Monday. Which also happened to be Halloween. After an Anatomy test last Monday, a Lab midterm on Friday and a Physiology midterm on Monday (which means I have been studying nonstop since last summer), I felt that I deserved the night off from using my brain. So I dressed up as a beer maid and drank some bier (which is German for beer) with some of my fellow classmates.

Some of the ladies in the DPT class of 2014

Charmin Bear

Beetle Juice!

Poor homeless man

Some of the fellows in the DPT class of 2014

Max the Sheriff Dog

Tuesday morning was a little rough, but Halloween was very fun and definitely worth it.

I know I have complained about how much studying I have been doing and how it has taken over my life and that I feel like my brain hurts, BUT...I really do like the information. And I have been finding fun ways to learn it. I feel that arts and crafts are a great way to really understand something and truly learn it:

Lumbar and Sacral Plexus

The ever daunting brachial plexus

Peripheral nerve innerations

Intrinsic hand muscles

Intrinsic hand muscles as art

Right smack in the middle of completing my pre-reqs for this program, my knee hurt every time that I ran. Wouldn't you know it...I went to see a Physical Terrorist Therapist for the first time EVER. His diagnosis was that I had a weak gluteus medius (which is a muscle that is weak on almost everybody in the world - slight exaggeration). My PT showed me some exercises to strengthen my weak muscles, but I didn't really know why having a weak butt muscle would make my knee hurt when I ran. Well, now I know why. Exciting huh?

Do you want to know? Well sure, I'll tell you.

Your Gluteus Medius abducts your thigh at your hip joint, which means that when your legs are together, this muscle allows you to lift your thigh away from your body sideways

Thigh Abduction

Now, when you are running or walking, the action of this muscle is a little different. Instead of abducting (you learned a new word!) your thigh, you are stabilizing or drawing your opposite hip up when you are standing on one leg (which is typical of running or walking).

a weak glut med will cause this action:

A) is a normal or strong Gluteus Medius B) Shows a weak muscle that can not stabilize your hip

Thus another muscle will compensate to keep you from falling over, such as one of your quads. This is not their primary job and when muscles have to work overtime, they punish you by causing you pain. Just kidding.  But since this is not the quads normal job, it will become tight and pull on your patella and cause knee pain. Who knew the body was so complicated?

Well there you have it. Fascinating huh? 

I hope you had a fabulous halloween!