A blog about nothing.

Friday, May 23, 2014

(NOT SO) TENDER LOVING CARE

When your muscles feel tight, what’s the most natural thing to do? If you said stretch, you’re right, and also wrong. Paradoxically, stretching an already tight muscle can cause reactive tension as the muscle tries to protect itself, and since taut muscles already put pressure on their attachments, stretching can actually damage the tendon and joint. What is needed is to identify the real cause of muscle irritation and treat it properly.

You’ve probably heard of trigger points. The term was coined by Dr. Janet Travell, M.D. to describe small contraction knots in muscle and surrounding tissue (collectively termed myofascia). Trigger points can feel like a partly cooked piece of macaroni buried deep beneath the skin. They are often caused by overuse and/or overexertion, as in the case of the athlete attempting to run farther or faster, and who among us doesn’t fit that description? As you can guess, myofascial irritation is astoundingly common, implicated to some degree in iliotibial band syndrome, plantar fasciitis, and other running-related conditions. What’s more, trigger points are notorious for referring pain to distant body parts - for example, pain in the quadriceps muscles often radiates to the knee – which can make them very difficult to treat. That is, unless you know where to look. Use the following head-to-toe guide, and with your own fingers and perhaps a trusty massage tool or two, you’ll find myofascial release to be fun and satisfying. Prepare to be pain free!

Foot Pain/Plantar Fasciitis
Together the two muscles of the calf (soleus and gastrocnemius) have the power to lift the entire weight of your body, which certainly comes in handy when  hurdling rocks, climbing hills, and controlling descents. But these dense muscles, if irritated, can do as much harm as good. Signs of calf trouble are felt in the feet, specifically in the long arch of the foot. The plantar fascia, as this area is called, is actually the tendon formed by the union of the two muscles. Massage these muscles with your opposite knee or with a tool like The Stick. Use deep, stroking massage rather than static pressure, massaging with short, repeated strokes in one direction.

Runner’s Knee
While arthritis and tendonitis are common diagnoses in the setting of knee pain, often it is the muscles of the thigh that require attention. Runner’s knee, or pain around or behind the kneecap, is most commonly caused by the oval bulge of muscle on the inside of the thigh just above the knee, known as the vastus medialis, one of the four quadriceps muscles. For this muscle, paired thumbs work well for massage. Be sure to give attention to the other quadriceps muscles running along your thigh between your knee and your hip, as you will likely find other hot spots as well.

Hip Pain
Pain and other symptoms of the hip are likely due to the combined effects of more than one muscle. A big culprit is the piriformis, the largest of six short hip rotator muscles located between your tailbone and thigh bone. A shortened piriformis can compress the sciatic nerve and radiate pain down the back of your leg and into the sole of the foot. To locate the piriformis, feel it contract as you rotate your leg outward while lying on your opposite side, and search the area between the top of your hip bone (greater trochanter) and your sit bone (ischial tuberosity). Massage the piriformis with a tennis ball or a lacrosse ball, either on the floor or against the wall.

Lower Back
Back pain always has a myofascial component. What’s surprising is that if you look for muscle tension in your lower back, you may never find the real cause of pain. It is actually the gluteus medius which heads the list of the many muscles associated with low back pain. One of the three buttocks muscles, the gluteus medius primarily functions as a pelvis stabilizer. Each time you lift your leg to take a step, the muscle on the opposite side contracts to keep your hip from sagging. Dead butt syndrome commonly affects runners and is a sign of weak glutes. You can feel the gluteus medius just above your greater trochanter and slightly to the rear. Try a lacrosse ball against a wall and use short, rolling strokes.

Head and Neck
Most of the time neck pain is referred from trigger points in the upper back and shoulders rather than in the neck itself.  Pay careful attention to the trapezius, the flat, four-cornered “shrug” muscle located along your upper back, since the traps are the most common musculoskeletal cause of headaches and neck pains. Leaning against a ball on the wall is especially effective for massaging this area. Come back to problem areas three to six times per day.

Be aware that longstanding trigger points often lead to irritation in adjacent muscles, so don’t limit your massage efforts to focal points: spread out. You’ll know you’ve found a “hot spot” because trigger points are always painful when pressed. Oddly enough, pain level depends more on the degree of trigger point irritability than on the size of the muscle, as trigger points in some of the tiniest muscles can be downright debilitating. The pain that comes from massaging a trigger point should be of the pleasant variety, the kind you can relax into, but not so tender as to put you to sleep. Aim for a pain level of seven on a scale of one to ten, and limit massage to roughly ten strokes per trigger point. If you get no relief from massage, you may be working the wrong spot.

Of course, not all cases of pain have muscle irritation as the main cause. If sore muscles are accompanied by redness, swelling, or joint deformity, pay a visit to a sports medicine physician. And for a more comprehensive list of muscles and their pain patterns, pick up a copy of Clair Davies’ The Trigger Point Therapy Workbook.

Thursday, May 22, 2014

FRUIT AS FUEL

There I was, among 700 other athletes getting set to tackle the eight-mile ascent of Mt. Baldy, in the annual Run to the Top trail race last September. It was about five minutes before the start when it hit me, that all too familiar feeling. It began with the sound of a missile going off in my belly, which was followed by a stifled burp, and then the inexorable urge to find the nearest toilet. I scanned the surroundings and about 100 feet away I espied three porta potties - with about 30 panicked runners waiting to use them. Clearly I was not the only one experiencing, shall we say, intestinal urgency. I plastered a grin on my face, excused myself from my fellow competitors, and managed that tell-tale splint-legged, butt-clenching speed walk to the closest and largest tree, disappeared behind it, and…you can probably guess the rest. Thank goodness there were leaves.

Gastrointestinal symptoms are so common among runners that they even have their own cute little nickname: the trots. A blanket term used to describe a wide array of symptoms including diarrhea, gas, bloat, reflux, side aches, nausea, belching, and sloshy stomach contents, runner’s trots have nearly as many possible causes. Often they are blamed on pre-race jitters or the act of running itself, which shunts oxygen away from the gut and disrupts the digestive process. And of course foods are also implicated, with food sensitivities and high-fiber favorites like bran cereal and whole grains heading the list.

But in the discussions about how best to avoid the trots, amid the calculations of precise ratios of macronutrients and how much water, salt, and other electrolytes the pre-run meal should contain, what often gets ignored is the effect of food combination. In other words, a given meal can provide all the right ingredients - a little protein to speed muscle recovery, slow-digesting carbs for prolonged energy, maybe some vitamins and minerals - but if you cannot absorb it rapidly or if it causes GI distress, the nutritional benefits are largely cancelled out. Worse, improperly combined foods could lead to an embarrassing pit stop before or during a race, or the ever-dreadful DNF.

So what do you eat before a run? Oatmeal and raisins? Bagel with peanut butter? Maybe a couple gels washed down with a sports drink? If the answer is yes, and if you are plagued by trotitis, your pre-race meal could use a make-over, as did mine.

First, for most foods, if it’s in a package, be wary. Manufacturers have evolved subtle and sly methods for sneaking not-so-healthy ingredients into their products. Consider that maltodextrin, a common sweetener found in sports gels, if not derived from wheat (a no-no for those with gluten sensitivities) is usually derived from genetically-modified corn. According to the Institute of Responsible Technology, GMOs pose many potential health risks. Rats fed these Frankenfoods develop stomach bleeding and immunological dysfunction in addition to a whole host of other problems. It is preferable whenever possible to avoid labels altogether and enjoy real food, and many coaches and elites are beginning to stress the importance of whole foods over gels, bars, and other packaged products.

But even if you make minimally-processed foods your staple, it is important to pay attention to how those foods are combined. Your body handles protein, carbs, and fats differently. For example, protein requires an acidic medium, while carbohydrates and fats require an alkaline environment. Pairing foods high in protein with foods high in carbohydrates can stall the digestive process and give rise to that sloshy feeling which can make running so unpleasant. This means avoiding common combos such as granola with yogurt, or cereal and milk. High fat foods, like nut butters, slow the digestive process and remain unabsorbed in the gut, the concentrated energy they contain being of no immediate use to the exercising athlete. And your body cannot absorb the complex carbohydrates in bread or cereal without first breaking them down to simple sugars, which takes time, and could add precious minutes to your finish time. Moreover, grains, whether whole or refined, are very dry foods, which can lead to dehydration if not consumed with enough water.

So what then should you eat? Because exercise burns a lot of sugar (in the form of glucose), your first priority should be to stock and replenish glucose as quickly as possible, which means ingesting it in its simplest form. For this, fruit would seem to be ideal. Fruit is naturally packed with a perfect mixture of water and fiber – melons typically are 95 percent water by weight - and the simple carbohydrates fruit contains, in the form of fructose and glucose, are quickly absorbed into your bloodstream to provide immediate energy to exercising muscles. In fact, fruit sugar is more readily usable than even the sugar in sports drinks, which is usually sucrose, a two-molecule pair that requires enzymatic activity before it can be absorbed and used. While some may argue that the fiber in fruit is a main culprit in the setting of stomach upset and bloat, the opposite is actually true: fiber is the preferred energy source for colonocytes (the cells of your colon), meaning it aids digestion. And the fiber in fruit helps keep blood sugar levels steady, while slowing colonic emptying and preventing intestinal urgency and diarrhea. The stomach upset resulting from eating high fiber foods usually results from improper food combination. The human digestive system evolved eating one food at a time, whatever was to be found, be it a field of greens or a felled beast, and our digestive anatomy hasn’t changed from the time of our prehistoric ancestors, so it is best to keep it simple. If you want to avoid hidden ingredients and gastrointestinal distress, choose real food, and focus on fruit. Blend several oranges into a homemade juice with the pulp. Mix a cup of your favorite berries with a frozen banana or two and a little water. Or try my personal favorite: salted dates. Avoid paring fruit with other foods, since its absorption is impaired by the presence of too much protein or fat, and choose fresh or frozen varieties over dried fruits like raisins and prunes, which can be harder to digest. And since fruit is lower in calories relative to other foods, you may need to make your pre-run meal a bit bigger. Don’t worry: The added bulk is mainly in the form of water, which will keep you hydrated without weighing you down. Make fruit your friend.

Wednesday, May 21, 2014

SAY "CHEESE"

I had just finished running my third marathon, and in what has become customary I looked up the winner and went through his race photographs. In studying elite athletes, I examine things like stride, body habitus, and facial expression. In short, I wanted to see how much Kevin Havel had suffered to run a blistering 2:23, which was almost 30 minutes faster than my personal best time of 2:51. I had gone over my own photos, and in many of them I had the look of anguish one associates with getting one’s nails ripped out with pliers. Would Kevin’s face advertise similar agony? To my surprise, the guy was smiling. Okay, so maybe he was posing for photographers, but it got me thinking about the power of the smile. Septuagenarian ultrarunner Eldrith Gosney has said that smiling is her secret weapon. “They say that if you smile, things aren’t as bad as you might think they are – somehow, smiling just makes things better.” I looked at the research, and it turns out that cracking a grin - even when you’re not in good spirits – can improve your mood and reduce stress.

This seems counterintuitive, does it not? It is customary to place cause before effect. If A, then B. The seed comes before the tree. This is the scientific (and Western) approach. But Osho, a Hindu mystic described by the Sunday Times as one of the 1000 makers of the twentieth century, says that it is wise to place greater emphasis on the effect. The seed may give rise to the tree, he says, but it is the tree that is needed to bear more seeds.

People say, “If only I had x, I’d be happy,” where x is more money, a better job, a wonderful spouse, a trip to Hawaii, etc. Instead, focus on the effect. Be happy, and often you will attract the cause, be it vacation, mate, or raise. And in the quest to be happier, what better place to start than with a smile, which is the most convincing physical indicator of well-being. Because if you smile, even when you are down, you may convince yourself that you are happy, and others will be convinced as well. And what’s more, your mood may be contagious.

“Smile and the world smiles with you,” as they say.

Tuesday, May 20, 2014

CHASING THE SPACE BETWEEN

Recently I was invited to meditate with friends Deepak and Oprah on a journey towards passion and abundance. They suggested I extend the invitation to all my loved ones and that together we embark on a 21-day, all-new, life-changing, authentic (and much-hyphenated) experience. Yeah, me and millions of others. It was a mass email.

It is not to brag when I say I am no neophyte when it comes to meditation. I’ve been to India several times, meditated long enough to stare unblinkingly at a candle light for entire red-eyed minutes – in fact, I once had the opportunity to sit in the lotus posture (read: cross-legged) at the very place and beneath the very tree where Buddha was purported to have reached enlightenment. I’ve been initiated into the mysteries. I’ve read books on the subject by guys with lots of vowels in their names, like Aurobindo, Yogananda, Ramana Maharshi, and one of my personal favorites, Nisargadatta Maharaj. I might even consider myself an expert on the Art of Om, as meditation has been called. Not to say I’m very good at it, even after all these years of practice. Rare is the time I can make it through a 30-minute session without nodding off. Still, I like what Deepak stands for, and who doesn’t appreciate Oprah (except maybe the beef industry, and who would want those guys as friends anyway), so I checked out the website.

Deepak has a lot to say on the subject of meditation, whose true purpose, according to the self-help guru, is to tune in, find peace, and get in touch with it all. I wasn’t alive in the 60’s, but these aims sound suspiciously sixties-ish. Which is cool. I can dig it. I’m sure my parents and my friend’s parents and all the other baby boomers can too, which explains at least in part the man’s overwhelming popularity. Meditation is a way, Chopra continues, to get in the space between your thoughts. (Or just the space between, as Dave Matthews has sung, and he’s more of a 90’s guy. So we’re almost caught up with the present.) A field of infinite possibilities, infinite creativity. And it gets better, or at least, longer: Meditation, Chopra writes, is a place “where there is something called the observer effect, or the power of intention, which means intention is very powerful when brought to this space and it orchestrates its own fulfillment – what people call the law of attraction – so those are wonderful qualities of your own spirit.” I’m not quite sure I fully comprehend the syntax of that sentence, but intention, attraction, etc. all sound like good things to me. I’m in so far.

But as for other particulars, such as where to meditate, when, body position … well this is where me and the Hindu MD disagree.

Regarding how to meditate, Chopra advises going to a safe and secluded place where you will not be disturbed, preferably in the early morning or evening hours, then close your eyes and get comfortable. He prefers that you sit up straight on the floor or on a chair, hands relaxed on your lap, palms up or “any way that you feel most open.” Sitting as opposed to lying helps “cultivate alertness,” notes the great master, since reclining may cause you to fall asleep, which is like meditation, only you’re unconscious. (So that’s what I’d been doing wrong all those years!)

It is not uncommon while meditating for one’s thoughts to drift and dance around the mind, which Dr. Chopra says is normal, and he advises budding meditators to let those thoughts be. If you find yourself repeatedly straying mentally, it helps to repeat a mantra (to chant the primal sound Om, for example) or to focus your awareness on your breathing, which should be unforced and natural. Chopra promises that in as little as 15 minutes a day you can reap the benefits of regular retreating and rejuvenating into that cherished space between, although extending your sessions to as long as 30 minutes twice daily as other experienced practitioners recommend may help evolve your practice.

A practice which can be summed up as follows: sit still to still the mind.

I take issue with the sitting part, and I’d like to propose an alternative to this physician’s prescription, one that I’ve evolved out of the practice of seated meditation, one that involves getting off standing up and moving around. And why? The average person spends about 16 hours seated or lying down each day, making it America’s favorite pastime. In a sedentary society more time spent on one’s backside is not what is required. In fact, sitting is now being called the new smoking. Sitting for just 20 minutes causes blood to pool in your lower extremities, reducing the flow to your brain of important chemicals, including those involved in mood. Sitting also turns off an important gene that prevents blood clotting and inflammation. What's more, the static position - hips and knees flexed - is a postural nightmare that puts excessive stress on many major muscle groups, including your hip flexors, and causes muscle imbalances in the glutes, hamstrings, and iliotibial band. Sitting is so detrimental that even vigorous exercise is not able to fully compensate for the health risks associated with prolonged time on your rump. And health risks aside, after all that time sitting in traffic, at your desk, at the table, on the couch, etc., is an additional 15 to 30 minutes of physical inactivity, even if it involves the cherished notion of mental inactivity, really all that appealing?

A better alternative is through movement to achieve mental stillness. Like Chopra’s version, this method of meditation involves a quiet place, but not necessarily private, and it must be much larger than a room. A track would be best, preferably outdoors, somewhere green, perhaps a dirt trail or stretch of road or grass of measurable distance. You’ll also need a good pair of running shoes, though barefoot is also fine. And be sure to wear a watch. This form of meditation is what for years in the runner’s community has been known as the tempo run, or (lactate) threshold pace. This is the speed at which lactic acid starts to accumulate in your blood, making your muscles burn. It is anywhere between 65 and 85 percent of maximal heart rate. In other words a pace you could be expected to maintain for between 3 and 6 miles (5 to 10 kilometers). Then, choose the length of time you wish to “get in touch with it all,” as Chopra says. For a 15-minute meditation, experienced runners will aim for 2.5 to 3 miles (10-12 times around a track), while the slower set will try for 1.5 to 2 miles. A thirty-minute session would be twice the distance (4-6 miles), and this can be done twice daily or for a full sixty minutes. But as with traditional seated meditation, novices should work up to longer periods.

What does running fast have in common with sitting still? More than you might think. If you run fast enough, with your attention focused on time, your mind cannot race ahead, or your legs will lag behind. If you find your thoughts drifting to what’s for dinner or which errands need finishing, run faster. You should not be able to carry on a conversation (not that you’d want to), and you should not be able to maintain such a brisk pace for much longer than the prescribed length of time. Meditating while still has its benefits, meditating in motion provides the added perk of calorie burn, and who doesn’t like to, as they say, “kill two birds”? Consider that for even a newbie runner, meditation in motion, or “medimoting” for short, for just 30 minutes can burn up to 500 calories and take the edges off that heavy lunch (literally, if you had pizza).

Recreational runners may argue that one of the most sought-after benefits of running is that it often makes it easier to solve challenges and come up with fresh ideas, and this can only be accomplished at a leisurely pace. Run too fast, and the only thought a person has is “please let this be over.” But remember, the point of meditation is not to think, but to go beyond mind. Sure, an easy few miles, like letting your mind wander, has its place. And you should designate your easy runs as your thinking runs. But to clear the mind, it is necessary to reach the place of thoughtlessness that comes after that last, “let this be over” thought, which is really more of an emotion or sensation than a product of the mind. Once you are comfortable there, once you can stay in that space, live in that space, you will have achieved what Chopra and all the many-voweled men who came before agree is meditation’s true purpose.

Chopra lists five things that may happen during meditation. You can experience thoughts. You can mentally repeat the mantra. You can have thoughts and repeat the mantra at the same time. Your thoughts and the mantra can cancel each other out as you slip into that place of stillness between your thoughts. Or, you can fall asleep.

Save sleep for when you’re lying down, and meditate in motion. Burn through your thoughts as your burn off your lunch. That’s meditation for the new millennium. A very modern approach.