Finding your "WHY" as a runner

Running takes a lot out of you.

You wouldn’t be human if you didn’t at least once in a while think to yourself, why am I doing this again?

As the months and years tick by, running can become tiresome and less rewarding, as our bodies grow older and recovery takes a lot longer.

The initial spark that got us into running in the first place - such as athletic achievements and achieving personal best times - are not sustainable in the long run.

Rather than throwing lots of cheesy quotes to motivate you, how about we go back to your why.

For many runners, going back to rediscover their WHY can open a new portal to enjoy running for so many others reasons than just getting a new personal best.

When you have four or five reasons (or more) to keep you inspired, you are much more likely to stick with your running for the long haul.

STEP 1.

Please read through the following and tick 3-5 main reasons you choose to run:

• General fitness

• To improve physical health 

• To improve mental health 

• Set a challenge and achieve a goal 

• Socialising 

• Stress relief 

• Endorphin buzz

• Want to beat a friend / relative 

• To be able to eat more freely

• I just love running 

• To keep the knee joints healthy 

• Get some time to yourself 

• Improved vitality 

• To test my physical and mental abilities

• To get time to listen to music or podcasts

• To reduce stress from work/family 

• To improve self-esteem

• To improve my mood and find a moment of joy in my day 

• To achieve the flow state

• To explore a new region / part of the world

• Weight control 

• Get out in nature

Step 2. 

Now please arrange, in order of importance the reasons you run

I’d love to know in the comments - what’s your reason(s) for running?

Hamstring Tightness in Runners

Hamstring tightness is common in runners and often can persist for many months / years.

Stretching the hamstrings before or after a run seems to give some temporary relief at the time.

But the tightness, fatigue and pain often show up again the following day, and the day after that….with great frustration involved!

With research better informing our practice in the last few years, we now know stretching may actually be doing more harm than good for chronic hamstring tightness.  

Some of the reasons why stretching your hamstrings might be harmful:

• stretching has been shown to decrease a muscles capacity, making it more likely to cause a ‘spike in load’ during a training session. When it gets overloaded it get develop knots, trigger points and scar tissue

• stretching more than about 20% intensity triggers off the bodies sympathetic nervous system (fight or flight mechanism) that causes the muscle to ‘protect itself’ through tightness and immobility

• stretching leads to a compression and irritation of the hamstring tendon insertion - underneath the back of your hip (known as the ischial tuberosity or sit bone)

• stretching too aggressively can irritate the sciatic nerve and increase the chance of developing lower back pain

• stretching too aggressively can cause instability of the SIJ (Sacro-iliac Joint)

The bigger picture

If we zoom out and look at the bigger picture, that feeling of tightness / fatigue in the hamstrings is more of a protective response, a warning, that there is an imbalance in DEMAND relative to the hamstrings CAPACITY.  

The only way to truly get over hamstring issues is to address this imbalance by firstly identifying and then modifying your high hamstring load/demand activities.

At the same time, begin a progressive strengthening program, to build the capacity of the hamstrings (see below for more detail).

Rather than doubling down on stretching, take it as a cue to reflect on how you are balancing your activities that relate to hamstring capacity.

How to decrease load on the hamstrings:

How to increase the capacity of the hamstrings:

When we assess runners local hamstring capacity, it can often be quite surprising to see how quickly it fatigues, even in elite athletes.

Working on gradually building eccentric hamstring strength is the preferred way to meet the demands of running.  

The hamstring curl on the Swiss ball is my favourite exercise to achieve this.  

This exercise will help strengthen AND lengthen the hamstrings, providing the capacity for increased performance and reduced injury risk.

A few tips:

• Keep the hips high

• Slowly lower the feet away 

• Continue reps until you feel fatigue reach an 8/10 fatigue level (approx 5-15 reps)

• Don’t push to 10/10 fatigue as this will be too much and risk further stressing the hamstrings

• Perform AFTER a run 1-2 x per week instead of stretching

• Expect some soreness in the hamstrings 1-2 days after doing this (a good sign and will progressively get less as your capacity builds)

In clinical practice, if someone presents with chronic hamstring tightness, we would normally recommend 3-4 sessions of deep tissue massage release (and dry needling if required) to reset the muscles.

This allows us to ‘prepare the soil’ for the progressive strengthening program to have the best chance of growing capacity.

If you have any questions or comments, please feel free to leave below. 

Disclaimer: This blog contains general information for educational purposes.  Please check with your health care provider for specific advice for your situation.

Hip Stability For Runners

The more stable your hips and pelvis are when you run, the less chance you have of getting injured

Here a four essential hip stability exercises for every runner (best performed straight after you run x2 per week)

1. Crab walks. Knees extended fully, feet pointed straight and pelvis tucked gently activating core. Slow steps work best 💥
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2. Single leg bridge. Try and keep your hips level as you extend one leg straight. Remember to keep breathing!
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3. Single leg squat with theraloop. Sit back into your hip (like you’re going to sit down & then straighten up, tucking your pelvis under and squeezing the glutes
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4. Monster walks. Maintain pelvis tucked under with core activation and push back and diagonally
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Please tag any runners you think might benefit from this workout & please let me know if you have any questions at all.
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Happy running 😎

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Other Blogs To Help You Move and Feel Your Best:

5 Things Everyone With A Disc Issue Needs To Know

The story:

You’re at home and reach down to pick something up and feel a twinge.

Ouch!

But you don’t think much of it.

Until the next morning when you are unable to get out of bed because of severe pain and muscle spasms.

You’ve never felt anything quite like it - even sitting on the toilet is just about impossible.

You ring your doctor and they order an MRI - you somehow you manage to stumble into the radiology centre (lying down for the scan isn’t all that much fun).

The next day you get the results - and it shows a disc in your back has been injured.

You jump on Google and are suddenly confronted with all sorts of pictures showing discs pushing on nerves. Every website you read says that you may need surgery and you should be avoiding heavy lifting, bending and twisting.

Sound familiar?

When you have been diagnosed with a disc issue, you have two problems to deal with:

1. The physical side of the pain that can be overwhelming in the early stages and

2. The mental side, that can be equally as bad. It can very hard to think clearly when your life comes to a complete halt..(who knew back pain could stop you in your tracks so suddenly and cruelly?!)

All sorts of things can go through your head when you are lying in bed, unable to move due to pain.

That you might develop chronic pain. That you might need surgery. That you can’t go through daily life with the same care-free attitude about how you move your body as before. That life as you know it is over and you will be living in fear of recurrence.

But there are some problems with the above scenario.

Some assumptions and beliefs that need some clarifying.

A lot of clarifying.

Be careful who you take your advice from.

There are a lot of unhelpful beliefs out there and you need to avoid catching a 'thought-virus’ that can derail your recovery and unknowingly put you on a path of ongoing pain and dysfunction.

When you have injured your back, it’s amazing how all of a sudden you start receiving all sorts of (unsolicited) advice from every Tom, Dick and Harry on the street.

Everyone has their approach that works for them.

But because there is so much conflicting advice, the uncertainly can make you feel even more confused and scared…what do I do? and who do I see to help?

Recently on a facebook post, a local Adelaide media identify asked, “How do I fix my disc?”

There were around 1,300 comments and I counted at least 50 different types of treatment.

The main thing to ask yourself when hearing advice is,

• Are they using an evidence-based science approach?

If you stop and really think about this, unfortunately many well meaning people (including health care professionals) are simply giving out terribly outdated advice that creates a huge amount of unnecessary fear in people with disc issues.

This blog post is an attempt to clarify some unhelpful beliefs about disc related back pain.

There are 5 things everyone with a disc issue needs to know:

• Scans are often misleading (most people have some disc bulging but have no pain)

• Disc issues generally have a favourable outcome (and like a good wine improve with age)

• The bigger the bulge, the better

• Slumping might actually help you recover faster

• Running is very beneficial for the disc

Essentially discs are one of the most stable and resilient structures in our body.

As always the following information is general and please use in conjunction with your trusted health care professional.

If you have any questions or concerns, please reach out to dan@kinfolkwellness.com.au

Let’s explore each of these statements a little more closely…

1. Scans can be misleading…you can have a disc problem and not even know about it

It must be understood that in the normal pain-free population, there is a high prevalence of abnormal findings on MRI scans (see table below).

Brinjikji et al 2014

This systematic review by Brinjiki and colleagues in 2014 studied closely the MRI’s of asymptomatic people i.e. they had NO current back pain (or any history of back symptoms).

They found that all the people in the study showed some level of disc problems.

For example, 30% of all 20 year olds had a disc bulge and no pain.

This percentage increased with age, with over 60% of 50 year olds having a disc bulge, (and these are people who had no symptoms whatsoever).

This indicates that many of these features—particularly when found incidentally — should not be considered pathological and instead be regarded as normal age-related changes.

This makes it difficult sometimes to find what it truly driving the pain experience.

Many doctors and health care professionals (knowingly or unknowingly) contribute to a heightened pain state and increase risk of catastrophization by doing a poor job of communicating scan results.

Once a fear has been created, adrenaline can surge continually through the body, creating anxiety and fear of movement.

Having an experienced clinician explain your scan findings is an absolutely critical part of your recovery.

Evidence shows that rushing too quickly into an MRI imaging for a back strain results in a poorer prognosis, (with an increased chance of surgery).

After an injury or episode of pain, the body will heal (often over 2-3 month period).

But sometimes the pain can persist because the person feels frightened and intimidated by the diagnosis and there is subsequent ongoing protective muscle spasm (see below).

Some of the muscles that can tighten up after a disc injury and stay locked up, causing ongoing tightness and pain

2. Disc issues generally improve as you age 

Although they can be extremely painful in the initial phase, the natural history of disc issues is favourable and the majority of disc prolapses resolve with time.

Many people assume because they have had a few bad episodes of back pain that they will continue to deteriorate over time. Some people even fear they will end up in a wheelchair.

If you have had these thoughts, I would like to tell you…after 25 years of studying/working as a Physiotherapist, I have never once seen someone’s back pain progress to the point of requiring a wheelchair to get around.

Interestingly, studies (such as above) have shown that as you age, the degree of degeneration in the discs increases when scanned, but that does not correlate with pain, disability or clinical symptoms, which tend to reduce with age.

After the age of 40, your discs actually start to stiffen up and become more stable.

This stability leads to less chance of the disc causing ongoing pain.

So the take home message is once you have had a disc issue you may always have changes on scans. They can be thought of as ‘wrinkles on the inside’ - a normal part of ageing and nothing at all to be concerned about.

3. The bigger the bulge, the better

Some studies indicate that about 85% of lumbar and 90% cervical acute disc herniation will get better in an average of 6 weeks, (but sometimes take up to 3 months for symptoms to settle).

In 2014, Chiu and colleagues conducted a systematic review to determine the probability of a spontaneous disc regression.

The aim of the systematic review was to investigate the probability of disc herniation regression and complete resolution.

The different types of disc issues and severity can be seen in the picture below.

The study showed the probability of a spontaneous regression was:

• 96% for disc sequestrations

• 70% for disc extrusions

• 41% for focal protrusions

• 13% for disc bulges

Essentially, the study offers some very encouraging statistics to tell us that the larger or more severe disc herniations often have a higher chance of spontaneous recovery.

Lumbar disc herniation can regress or disappear spontaneously without surgical intervention.

4. Slumping might actually be good for you

A study done by Pape (2018) showed slouched sitting can rehydrate the lumbar discs and essentially ease the pressure off the discs.

This study showed slumped postures can provide a valuable alternative to upright sitting and “may be recommended for recovering spinal height in the working environment following periods of loading”.

A simple way to think about this is if you were to clench your fist as hard as you can for 60 seconds.

Pretty soon the muscles in your arm start to fatigue and eventually, if you held it for long enough, you’d start to feel some pain from the constant contraction.

Exactly the same thing can happen with the muscles in your spine.

After you’ve had an episode of back pain, you may start to worry about your back, and a well meaning health care professional has told you to “be really be careful with your posture and never slump!”.

Sometimes people can take this literally, always trying to sit up straight and never giving the muscles in the spine a chance to actually relax.

This can lead to the ongoing muscle tightness and tension that we mentioned earlier.

With back pain, there is no perfect position.

You don’t have to sit up straight forever - in fact doing this trying to protect your back may overload the muscles and give you more pain.

The people who don’t get pain and the ones who explore a wide variety of movement and change positions frequently. “You’re best posture is your next posture”.

5. Running significantly benefits the human intervertebral discs

A study recently that showed people who run have stronger and more resilient discs than those that don’t run.

The study showed that long distance runners and joggers had better hydration and glycosaminoglycan levels than non-athletic individuals.

“We expect that tissues will adapt to loads placed upon them,” says lead author Daniel Belavy (Burwood, Australia).

Just like your muscles and bones need stress to grow stronger, your discs also respond and adapt in the same way.

This is great news if you are a runner, as previously it was thought that the impact of running was potentially aggravating to the discs.

Now we know that runners have healthier discs, if you are considering getting back into running I would encourage you to work closely with a Physiotherapist who can help guide you back safely.

Interestingly this study showed a long distance runners using a walk / run pattern seemed to be the best for the disc, as opposed to just walking or always running fast.

This suggest that knowing your ‘easy’ running pace and sticking to it during your recovery phase may be an important part of keeping your spine healthy.

If you would like to find out your easy pace, based on your current fitness levels, please use our free online running calculator.

To be very clear…

Disc issues can be extremely painful and limiting in the first days/weeks and you need to take care of yourself by visiting a Physiotherapist who you know and trust.

Realistically, disc issues can take some time to fully settle down - sometimes up to 3 months.

Disc issues CAN be serious 1-2% of the time.

It will really only start to cause you grief if it starts to contact and compress the nerve root.

If it gets to this point, you may have pins and needles, numbness, weakness of the area supplied by the nerve that is affected.

Some of the signs you may need to consult with a doctor include:

• constant numbness / pain in the leg

• extreme constant pain and not able to get any sleep at all

• bladder or bowel incontinence

But that leaves 98% of disc issues that can be well managed with a personalised Physiotherapy program.

Some people are more susceptible to disc problems than others.

Risk factors include:

• obesity

• lack of fitness

• lack of regular exercise

• cigarette smoking

• history of anxiety or depression

How Physio can help

We are experts in treating people with disc pain and can help you in two main ways:

• designing an exercise program designed to improve strength, flexibility and fitness

• provide short-term relief with massage, spinal mobilisation or manual therapy to reduce pain and get you moving well again

If you would like to find out more information or start your healing journey right away, please use our easy online booking system to find a time that suits you.

Dan O'Grady is a results driven qualified Physiotherapist and member of the Australian Physiotherapy Association.  Dan has a special interest in treating lower back pain.  He has been working in private practice for 15 years. He is passionate about helping people to move better, feel better and get back to doing what they love.

Research Links

Ma D, Liang Y, Wang D, et al. Trend of the incidence of lumbar disc herniation: decreasing with aging in the elderly. Clin Interv Aging. 2013;8:1047-1050. doi:10.2147/CIA.S49698

Martínez-Quiñones JV, Aso-Escario J, Consolini F, Arregui-Calvo R. Regresión espontánea de hernias discales intervertebrales. A propósito de una serie de 37 casos [Spontaneous regression from intervertebral disc herniation. Propos of a series of 37 cases]. Neurocirugia (Astur). 2010;21(2):108-117.

Kim ES, Oladunjoye AO, Li JA, Kim KD. Spontaneous regression of herniated lumbar discs. J Clin Neurosci. 2014;21(6):909-913. doi:10.1016/j.jocn.2013.10.008

Chiu CC, Chuang TY, Chang KH, Wu CH, Lin PW, Hsu WY. The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clin Rehabil. 2015;29(2):184-195. doi:10.1177/0269215514540919

Pape JL, Brismée JM, Sizer PS, et al. Increased spinal height using propped slouched sitting postures: Innovative ways to rehydrate intervertebral discs. Appl Ergon. 2018;66:9-17. doi:10.1016/j.apergo.2017.07.016

Belavý DL, Quittner MJ, Ridgers N, Ling Y, Connell D, Rantalainen T. Running exercise strengthens the intervertebral disc. Sci Rep. 2017;7:45975. Published 2017 Apr 19. doi:10.1038/srep45975

Are you low in Vitamin D?

Vitamin D deficiency is a common, serious medical condition that significantly affects the health and well-being of those affected.

It is estimated 30-40% of Australians are Vitamin D deficient.

Vitamin D deficiency is commonly misdiagnosed as fibromyalgia, chronic fatigue syndrome or depression.

Role of Vitamin D:

Vitamin D is extremely important for strong and healthy bones, as it help our bodies to absorb calcium.

Some research shows low levels of vitamin D may increase risk for sports injuries, including stress fractures because the nutrient is so vital for bone health.

Vitamin D also plays a key role in:

• Muscle contraction– vitamin D is required for the activation of certain enzymes involved in muscle stimulation

• Nerve stimulation– vitamin D is necessary for the nerves to carry messages between the brain and other parts of the body

• Immune system– vitamin D helps activate and mediate the body’s immune function

Causes of Vitamin D deficiency include:

• low UV exposure

• inadequate nutrition

• dark skin pigmentation

• malabsorption disorders

• people who spend a long time indoors

• elderly

• people who are obese with a body mass index greater than 30 

Symptoms of Vitamin D deficiency:

Vitamin D deficiency has been linked to various health problems, including cognitive decline, depression, osteoporosis, cardiovascular disease, hypertension, diabetes, and cancer.

The symptoms of vitamin D deficiency are often subtle, so many people don’t know they are deficient.

Some of the symptoms include:

• Fatigue or tiredness

• Bone pain

• Joint pain

• Muscle weakness, muscle aches, or muscle cramps

• Increased muscle sensitivity to pain

• More frequent illness

• Anxiety

• Irritability

• Weight gain

• Hair loss

Tips to for adequate Vitamin D intake:

Ultraviolet (UV) radiation from the sun is necessary for the production of vitamin D in the skin and is the best natural source of vitamin D.

Sunlight and Vitamin D:

Getting 10-15 minutes of full body of sun exposure to arms, legs, abdomen and back, two to three times a week is ideal for Vitamin D production.

You may need less direct exposure in summer and more in winter. Be sure to always wear sunscreen if you out in the sun for extended periods (more than 15 minutes).

UV radiation from the sun is also the main cause of skin cancer, so striking the optimal balance of sun exposure is critical (see graph below).

Finding the sweet spot for sun exposure

Vitamin D and exercise:

This study showed people who performed three or more hours a week of vigorous exercise—such as running, jogging, or playing basketball or soccer— have higher levels of vitamin D as well as higher levels of HDL (good) cholesterol.

Another reason to go out and exercise in nature.

Foods that contain vitamin D:

• Fatty fish like salmon, tuna, herring or sardines

• Cheese

• Milk

• Egg yolks

• Mushrooms

Other processed foods with added vitamin D usually say “fortified with vitamin D” on the package. These products include dairy products, orange juice and cereal.

Summary

Vitamin D deficiency is a commonly undiagnosed condition that can have serious impact on your wellbeing.

If you want to find out more and get yourself checked, please discuss with your GP.

References:

Ultraviolet radiation and health: friend and foe

Vigorous exercise linked to higher vitamin D levels, lower heart disease risk

The Role of Vitamin D in the Aging Adult