Monday, September 17, 2012

Passing the mantle: Death Race 2012

For the first time in four years I did not attend the Canadian Death Race, although we did still make a substantial donation to our Race Against Death Charity. After two full years of rehab I can say the torn adductors in my right groin have healed to the point of rarely bothering me.

That problem has been replaced by another far more vexing and persistent problem of bilateral calf tightness and cramping/fasciculations. The verdict is, this is a form of compartment syndrome that happens when I run. The biomechanics of my lower leg are apparently so off that I develop inflammation and swelling of the intra muscular compartments within a few moments/miles of starting to run. The swelling then cuts off the blood supply and causes local focal muscle pain in various areas of my calves, which becomes debilitating. There appears to be no cure for it except discontinuing the activity indefinitely, e.g. no running for me.

Sadly, the diagnosis does not explain the vexing and recurrent agonizing calf and adductor cramps that occur more or less independent of activity, hydration or electrolyte status. Neither does the slew of normal lab values, including thyroid and adrenal evaluations. My guess is it's neurogenic but there is no real way to prove it.

So I am out of action possibly for good, but the news is not all bad! My sister Cathy has been inspired by my earlier successes and has taken up the mantle of ultra runner. At the very least I can coach her well, especially on what not to do!!!

She has completed her first 50k in a good time and with no injuries, so with a little luck she will carry the flag for us at next year’s “race against death”, the Canadian Death Race!

Tuesday, July 26, 2011

This year’s Death Race- a walk in the park?

After 3 years of Death Racing and a cumulative total of 150 miles of running, plus numerous more in training in and around Grande Cache, my body has told me I need to take a break.

And this time I have actually listened! Last year’s race was marked by the worst cramps I have ever had and a time out at the end of stage 3 which, unbeknownst to me, was extended by 3 km. I can vividly remember trying to finish that stage and thinking I had 2 km to go and 12 minutes left when a car appeared on the trail. That was strange and something I had never seen but I pretty much knew something was amiss. “You may as well take it easy you’re not going to finish on time!” My reply was I had just over a km to go. Nope, the stage is now longer than last year by a few km. OOOPS!

I spent the next 45 minutes at a very slow walk to the end of the stage. Heavy of heart!

Honestly I am not sure how much left I would have had for stage 4 at that point but I would have loved to try. After all the kids in the IM Able foundation struggle just to get out of the house!

I really do hate having to quit! But I decided to try to take care of all the things that were causing my body to shut down on Stage 2 and cramp to the point of complete immobility with requisite giant losses of time. Little did I know that a year later I would still be struggling with many of the same issues and some new ones- all part of the immense neurologic and postural retraining I have to do to have a chance at a decent run.

I remember someone quoting Steve Prefontaine as saying attempts to change his gait and running style “didn’t work”. I think he gave it about 3 weeks before he realized he would get much worse before he got better and decided it was not worth it.

I have learned a lot about kinesiology and of course running itself in the process of trying to get the perfect gait.

Did it work for me? Well not yet. My guess - we’ll have to wait until next year!
In the meantime Pagoda Pacers president Tom Chobot will be flying the flag for Dr Dave’s Best and TheRaceAgainstDeath.org.
And we’ll have a charity drive soon after this year’s CDR. But for me this year’s race will be a walk in the park. One very big, steep, beautiful park. I’ll have some pics for you for sure!

Best,
Dr Dave

Monday, December 27, 2010

Beyond the shadow of a doubt - Gait retraining and other fun stuff


No one can say I am not committed to my charity! If you could see the stuff I am going through right now to retrain my biomechanics, you would never doubt me again if you ever did.

Let’s set the stage by a little recap.

In April I tore two adductors and my rectus abdominus off the pelvic attachment points on the pubic bone. Ouch. Now the MRI did not comment on whether these were full thickness tears but I don’t think they could have been or I would never have been able to train as soon as I did.

It took about a month before I could walk without pain again and in typical last minute fashion I managed to get some long distance runs in before August’s Canadian Death Race.

Unfortunately, the loss of the adductors and another very hot day took their toll in the second and most grueling stage of the race and I cramped up badly… stretching literally every 1 to 2 minutes for as much time allowed me to finish the stage. Unfortunately, it took 7 hours and I had only budgeted 6.

With a 3-hour run looming ahead and only 2 hours to finish, I vowed “they will have to make me quit before I do!”.

In what was as close to a “heroic” run as I could ever manage, I covered half the distance (or so I thought) in exactly 1 hour. Buoyed by the hope of actually squeaking under the impending cut off, I ran my heart out and was within about 2km of finishing (again, or so I thought) with about 12 minutes to go.

Certainly doable. Then a car came down the trail and the people inside said, “you may as well not kill yourself; you’ll never make it!” What I could do was 1.2 km (just over a mile for you metrically challenged) in 12 minutes.

Sorry, pal; you are 5k from the finish. Turns out this year’s race was lengthened in this stage and shortened in the next -- two facts I was unaware of!

So basically it really was an impossible task. I slowed down to a comfortable walk and settled in for the longest 5k of my life, taking about another hour to finish.

So 40 some miles into the race (11 miles farther than last year and 38 miles less than 2008) I was forced to quit.

The culprit? Agonizing bilateral sartorius muscle cramps slowing me to a crawl in Stage 2. Once again, or so I thought. Turns out all of the adductors come together on the inside of the leg just above the knee in what is known as the “adductor hiatus”. This was the area that went nuts and knotted up.

The usual suspects? Yep, poor biomechanics, overuse (secondary to poor biomechanics) and of course heat and dehydration.

I have never one to be proud of failure but in this case, as the weeks passed by I became proud of myself for not quitting even though it was hopeless.

After a month or so of no running, I began in September to try to run again. I took it slow and easy and as I was doing it, sought out the help of some real biomechanical experts to help me fix what was wrong with my gait. This includes a real rehab of my adductors and, as we’ll see, other hip muscles as well and pretty much a complete postural makeover.

Not surprisingly I suppose, the further I got into the rehab the less I was able to run, with more and more things pulling cramping and aching than ever before. Somewhere around the end of October I gave up completely when, after a 7 mile trail run, I had agonizing adductor cramps again the night after. But what a beautiful last run it was. Warm and at night, I enjoyed running down the trails with 300 other runners, lights blazing the way, lighting up the mountain trails for hundreds of yards in either direction. If this was my last race, I could not have asked for anything more beautiful!

As much of a leap of faith as it is to accept “you are going to get worse before you get better,” I really have no choice if I ever want to run again even shorter distances. I am aware beyond the shadow of a doubt that I could not continue the way I was going.

In truth, I may have to do what most runners wind up doing when they can’t run any more: bike.

But I am committed to the process and I am learning a ton about human movement, mostly by observing and understanding how screwed up mine is! LOL.

The blessing in disguise is that I probably am saving myself from a hip replacement. I have the CDR to thank for that as well. That race allowed me to see what my body would be like if it were 90 years old and allowed me to start working on the fix now in my 50’s instead of waiting for what might have happened if I had not brought out these problems with an extraordinary task.

A few quick observations that may help you in your ultra training…

While cramps can certainly be due to biomechanical and overuse issues, dehydration plays a big role as well as electrolyte balance. Duh!!! Right? Well here is even more DUH! I am a doctor and should know better. The problem is that the first and last sign of dehydration I get is cramps when I run, and fasciculations (like a bunch of worms crawling in the muscle) when I don’t. I do not get anything resembling thirst or hunger or any other warning -- just WHAM! Cramps. In addition, I have found the amount of water you have to drink to avoid dehydration (especially on a hot day, carrying 15 to 20 pounds of gear as one does in the Death Race) is almost ridiculous.

“Normal” body water for me is 61 to 62%. I am almost never there during training, even at the start of a run. I cramp mercilessly at 57%.

So drink, drink, drink, drink and keep your electrolytes up as well on those long difficult runs.

Ok what is next for me and the charity?

My goals for this year are far less lofty. I would like to run just 2 stages totaling around 40 miles. Stage 3, which has become my nemesis, is not all that hard by Death Race standards. Stage 4, Mount Hamel, is a big challenge.

I will let others who are more fleet or feet than I handle the rest.

But, if I am successful and can do it without major trauma and actually succeed in fixing the bulk of what is wrong with me, I will challenge the Death Race solo in 2012.

If I fail, there is always the bike and I have a nice one!

I’ll keep you posted. In the meantime, check out DrDavesBest youtube channel for some interesting things I have learned!

Dr Dave

Tuesday, July 13, 2010

“This year’s model”

Well it’s been a long, long time so I will try to keep it succinct.

Back in late March, when I had the luxury of writing about sneakers and strength training, I was doing very well with my training indeed!

I had gotten to marathon distance on the trails and was on a perfect schedule.

But like every April before this one, this April became my nemesis.

To recap, in April of 2008, I was put out of action for 4 weeks with rip-roaring bilateral Achilles and bilabials anterior tendonitis.

In other words both the front and back of my lower legs were -unctional.

Bad biomechanics!

I got past that just in time to run and finish 2008’s Canadian Death Race as you see on the pictures here on the site of me crossing the line just over 24 hours after the start.

Last April I got either Pertussis or swine flu, no one is sure but I had respiratory problems for months past the race. Race day 2009 was a disaster, which I won’t recap but suffice it to say I had no business being there and had to quit at 30 miles.

OK, now in 2010 I’m doing great, right!?

Well I instructed at Greta Blackburn’s Fitcamp in Cancun in late April.

Greta, for those of you who don’t know, is the originator of the Fitness Boot Camp concept and has been doing them for 25+ years -- long before most of the current crop of instructors were even out of grade school!

This one was special and you can read about it at Fitcamp.com but the theme was anti-aging and fitness and we had top people there including yours truly, Dr Joe Mercola, Phil Campbell the godfather of modern sprint and interval training, Bill Andrews discoverer of the human telomerase (longevity gene) and Marjorie Brook AIS guru to name just some of the presenters.

Greta is also one of my co-authors of our upcoming book, “The Immortality Edge” due out in January 2011, published by Wiley and Sons.

Anyway, I did what I always do, led a pack of fit younger people on some very cool but tough “fun runs”. Only 3 miles but chock full of sprints, band work, body weight exercises; these are monster workouts and everyone loves them including me!

But it had been a while since I had done this much speed work in such a short period of time.

Superimposed on top of my distance training it led to a devastating injury in the last 10 yards of the last sprint on the last day of the camp.

It felt like I actually slipped on something with my right foot and it seemed like the right leg went far out behind me.

The ensuing pop, pop, pop in both groins and below my belly button and the immediate seizing up of my movement told me immediately I had done some serious damage.

The words are “sports hernia” but it’s not a hernia at all. As a matter of fact, it has nothing to do with the inguinal canal or the gut like a real hernia does.

My MRI said it best: torn adductors from the right hip to the pubic bone, torn rectus abdominis off the symphysis pubis (the top of the pubic bone) and more of the same on the left side.

Grade 1 is the simple groin pull.

Grade 2, which I had, is fluid inflammation and partial tears: minimum 4 weeks to heal and often months.

Grade 3 is a complete tear and surgery is usually required.

I did see a surgeon but no one in my area was interested in even coming close to operating on this as much due to their own inexperience with the problems as the actual protocol for taking care of it.

I very quickly became aware of the absolute lack of information and consistency of what was available. Everyone had different opinions on how long it would take to get better and how to treat it. I can never pick anything simple!

So I rested, hit the Airdyne, stretched and strengthened.

Long story short, I did a 40 mile run in late June and had a great CDR prep camp last week.

So in spite of my nasty injury and some residual pain I am off to Grande Cache in 2 weeks to run my third Canadian Death Race.

Wish me luck!!

P.S. Greta will be hosting another monster fitness and longevity event in November at her home base in Malibu California and again in Cancun at the beautiful Ceiba del Mar on the Mayan Riviera. I plan on being at both of them so come see us and let us teach you how not to get hurt, how to live long and healthy and to be in top shape! Fitcamp.com

Friday, March 12, 2010

The strange reason I strength train

Before I get too deep into this, let me say that I was shocked and surprised by the numerous and mostly helpful responses I got to my shoe woes blog and will follow up with another one as soon as I have had a chance to test a few more shoe types out. Now onward to today’s blog.

I have a pretty long history of strength training, one that predates my ultra running “career” by decades.

The best shape I was ever in my life was when I combined intervals with an occasional 5 or 6 mile run, lots of plyo and regular weight lifting and body weight training.

I had it all--speed, reasonable endurance, explosive and absolute strength all in a good proportion.

The demands of an ultra race at altitude are far different than the “general training” I was doing and of course when you specialize you always lose some generalization.

I do almost no traditional lower body strength training at this juncture although I will most probably start doing some one legged stuff soon for the weeks that I am not putting in the bigger mileage.

I have a steady repetitive upper body program that mixes in abs and core along with some specific functional hip flexors stuff, again one legged, and kettle bell.

My upper body program is pretty old fashioned. Some would recognize the term “classic 5’s” which refers to the near maximum lifting toned down just a bit in to a 5-3-2 rep patter with brief rests in between for 3 to 4 sets of 10.

This program will make you bigger but it is primarily designed to add steady strength to your program and for me personally it works like a charm. Just today I hit the very interesting phase of the training that adds significant weight (12 lbs. to my overhead pressing and 22 to my bench) literally from just a few sessions, sometimes several pounds per session.

Of course when your run long or run fast your weights go down but this program will make you much stronger in a relatively short period of time and as I said put on some nice lean mass.

I would not advise it to someone who is new to strength training, however. In that case just pick up one of those awful “strength training for runners” books that shows a very broad based general strength training program and use it for 2 months before you try any of the above.

OK, so why do I care about mass? I am in a happy stable relationship, not in prison or a street gang so I don’t need to be “intimidating”, don’t need to impress anyone and have long since passed the 18-25 year old testosterone driven male syndrome (I can hardly stand to look at “ Men’s Health”! LOL).

Well in spite of the fact that I rail against the “muscle burns fat” articles as misleading because it take months to put on natural muscle and it adds at best 100 calories per day per 10 pounds of muscle mass gained. The average no drugger person will take a year to put on 10 pounds of lean muscle and of course runners will take far longer!

But there is a point where having extra muscle actually helps you lean out and if you work to maintain it while you are increasing your mileage you will lose more fat and even a few more pounds. You’ll look a lot better too.

But that still is not the strange reason I work to add muscle before a big race. The real reason is that I noticed that most of the “everyday” runners that did well were stockier and beefier than your typical marathon runners.

Again, people, understand we are talking average athletes here--not world class winners!

I started to realize that the starvation reflex does indeed happen in races where you are out there for hours on end and thus muscle becomes your fuel and fat stores are (relatively) conserved. So I train to build muscle so I have some to feed to my heart, lungs and legs while I am out there long after the glycogen is gone and the fat has gone underground to try to save itself from impending doom! Now I am not saying you don’t burn fat in these races. YOU DO and lots of it. The actual physiologic full blown starvation reflex does not take that long to start working though as we see signs of it with a simple overnight fast, which we then break (breakfast!).

So for those of you who are just trying to survive these long runs like me, take my advice--put on some size in your upper body at least. Most of us can leave the lower body to Mother Nature and the trail as long as we stretch!

'Til next time train hard!

Doc

P.S. some of you have asked about my book on ultra running. It’s taken a back seat to “The Immortality Edge”, a book I am co-writing with Mike Fossel MD PhD and Greta Blackburn that shows you how to lengthen your telomeres to live longer and healthier. NO, ultra running is not part of the routines!!!

Wednesday, March 3, 2010

Shoe woes

Normally, and in the future, I promise you a more positive blog but I gotta get something off my chest.

Two years ago when I first discovered that shoes were one of the most critical components of a successful Ultra, I went through a painful (literally and figuratively) period of trial and error.

I found the following:
1) A shoe that was good for a comfortable ride for 5 or 10 miles might lead to tendonitis because of lack of support at 20 or 30 miles.

2) Your feet do swell when you run long.

3) For a long haul over rough terrain most shoes won’t cut it because they are not real trail runners: they’re road shoes, prettied up (or actually usually uglied up) to look like trail runners but they don’t have it where it counts.

4) Gore-Tex, while waterproof, is not all that good for trail runners because no one blends it with all the other elements. I tried some Inov-8's and some other Gore-Tex shoes and found them way way too flexible and light weight for the type of running and my lousy feet.

So I eventually found my beloved favorite, the Montrail 2008 Hardrock, in 13 EE and bought a bunch of them. They were like Mack trucks with almost no flexibility, tremendous support, motion control and cushioning all wrapped up in one.

But they were not indestructible and even though I had 6 pairs they eventually wore out and got to the point where no amount of repair would make them serviceable again.

So merrily I thought I would just lateralize into the “Mountain Masochist” Montrial’s replacement for the Hardrock.

What a mistake!!! The MM is lightweight and flexes if you sneeze. It’s a totally different shoe and the other old model Montrial’s just never cut it. Of course they still make them!!!

I suppose the proper response would be to be grateful that Montrail made a great shoe, thank them for it and move on. But it’s a royal PIA and so I think I am actually angrier at them for D/Cing the Hardrock, replacing it with a completely bogus shoe and leaving me in the same boat I was to spend probably thousands until I find the right shoe again

Do you hear me Montrail, you idiots? What is wrong with you!!!! You were at least making a real trail runner that everyone raved about and loved. They were always in short supply so you can’t tell me they did not sell.

Such is the way of shoe manufactures--they always have to change things and make them worse!

None of the brand names work either.

The New Balance 910 is OK but it’s got too much motion in the toe box.

The Aetrex can’t make a size that fits--the 12 is too small--the 13 is too big and there's nothing in between.

The Brooks Beast is not right for me. My favorite road running shoe, the Triax Structure, is to narrow in the toe box and flexes like a newspaper in the wind--clearly a runner masquerading as a trail runner.

So I am at the same point again: Bad feet, lousy biomechanics, a big wide size needed to accommodate the armor plated orthotics and no place to go!

While this may seem funny and was intended to stir a laugh or two, it is truly a serious problem for anyone who needs their shoes to actually be dedicated trail runners. I understand the marketing value and the need to not invest in a small segment of the running world but to call your shoes "trail runners" when I can bend them in half with no effort is plain bogus. No on, no one, NO ONE who runs on real trails-- no matter how perfect their feet and biomechanics are, no matter how much or how little pronation, suppination, etc, etc they have-- benefits from a wimpy shoe.

So, manufactures, especially you MONTRAIL, who abandoned me... listen up: don’t fix what ain’t broke!

On the plus side I called them (Montrail), something I rarely do but probably need to do more of, and spoke to “Chris” who recommended the AT+ and the not-yet-available Sabino, so I will try them. As a matter of fact, I am wearing the AT+ as we speak and I can tell you it does not feel anything like the Hardrock in terms of overall cushioning. BUT…

Here’s hoping because nothing is more elemental than what is on your foot.

Oh Yeah, I guess I should comment on the current craze of barefoot running based on the Massai and other running tribes. First off, if you have any kind of below-the-knee tendon problems, do not run or even walk far in any of the rocker bottom shoes without going into it slowly. They're hard on the Achilles unless you have perfect biomechanics.

As far as barefoot running I am aware that certain Mexican and African tribes do it. But when I start seeing people at my local races, which are on the very rough rocky (sharp, nasty rocks) trails of Eastern PA, I will guarantee you that fad will last one race--or more like one block. When your feet are shreded to ribbons, don’t cry on my shoulder! LOL, MORONS!!!

And people look at ME funny for using poles! Until next time: keep training.

Dr Dave

Tuesday, June 30, 2009

My favorite training tool

I wanted to share my favorite training tool with you because it has helped me immensely with my running and with all aspects of fitness.

It is non-traumatic, non-weight-bearing, totally user dependent in terms of intensity and very friendly on joints, time constraints, etc.

My favorite training tool is the old fashioned Schwinn Airdyne bike that has been around in various forms for decades.

The big thing that makes it so useful is the very thing that makes it different from spin bikes and other stationary bikes: the arm action.

I have found that at 50 years old I need to get my heart rate up to about 170 beats a minute and keep it there for a few moments in order to get the benefit of interval training. Interval training is absolutely critical for anyone who wants to run faster and better. These days it has experienced a renaissance because of some savvy internet marketers and of course for its superior fat burning capabilities. All of that, including my specific routine, will be in my upcoming books but for now just be aware of these facts.

1) Interval training has been around forever. There is nothing revolutionary about it and you can call it aftershock or turbulent or any other term you want to call it but the basics are the same as what high school coaches have been telling their pupils for decades in the form of wind sprints.

2) Interval training will burn more fat than any other kind of training with less trauma.

3) Interval training will not feel good at first but as you improve your fitness levels (about 6 sessions) you will come to love it so hang in there!

4) I love the Airdyne because the arm action allows more calories, more intensity and more load on my body without a whole lot of increased perceived exertion. Much like pole running you burn more calories but you don't "feel" it.

5) This type of training, especially with the Airdyne, allows you to crank up your heart rate without the local lactate accumulations you'd get from things like a studio cycle or Versa Climber, both of which, while phenomenal, limit your actually heart rate due to this local accumulation of lactate.

Now if you read between the lines you can see how local lactate accumulation would also be a great way to train. You can always use the Airdyne for this by locking the arms in the stationary position and using just the cycling portion for short super intense intervals as well as longer "burn" type of lactate thresholds.

The other thing is, when you are injured, the low impact of this tool allows you to stay fit cardiopulmonary wise without aggravating injuries… or causing them for that matter.

These days the Airdyne runs about $550 new but you can find older versions on eBay for less, although shipping is usually a consideration.

There are few tools so versatile for the runner or any athlete for that matter.

If you need to train for high level (not high latitude, mind you) sports but do not tolerate a lot of pounding, the Airdyne is the way to go!