Why patience?

Think about it…if you have been sitting around for a few years…or even a few months…not really doing anything…your body has adapted to that level of activity – muscles, tendons, bones – your heart and lungs. If you decide that today you are going to get back in shape, you will have to give your body a chance to adapt to that higher level of activity. It will adapt if you give it enough time – be patient with your body – listen to it.

Research by Kenneth H. Cooper and published by him in a few books on aerobics (one book actually has the title aerobics) is given credit for kicking off the fitness craze back in the early ’70′s. In his research, he found that people who had been sedentary could be converted into endurance fanatics but…it requires time.

When I hear about these running clinics that say they will get you to running a marathon in a few months, I cringe. You may succeed in doing so but how much fun/enjoyment will you actually get out of the experience. Believe or not running can be fun. It’s a matter of your approach.

Starting out, I say just do an easy jog for 5 or 10 minutes 3 times a week. Why this? It’s to give your body time to adapt – get stronger – muscles, tendons, bone density, heart and lungs. And do this for at least 3 weeks – could be more – depending how far out of shape you are – are you carrying some extra weight? And don’t worry about speed — that will come eventually.

After a few weeks of doing this, try 5 times a week…but remember to listen to your body but keep the time to about 5 or 10 minutes.

As time goes on, you should find it easier to do – you probably have picked up the pace a bit – maybe shed a pound or two along the way.

If, after several weeks, you find that at the end of 5 or 10 minutes you feel like going for a little while longer try it but I would suggest adding a maximum of 10 minutes. Why? To give your body a chance to adapt. Doing too much too soon can lead to shin splints, aching knees and other weird aches and pains. A time or two, I forgot this. Once I had built my running back up to 40 minutes and it felt so good that I actually added another 40 minutes right then. My knees, which had been fine up to that point, developed aches. It took some rest before they recovered and it set me back by several weeks.

This was a problem that I had thought I had found a solution for more than a year ago. And this was a problem that had been with me for 10 years now. It stems from the time I blew out my knee and this was a side effect that doctors, physiotherapists, massage therapists, podiatrists and a pedorthist had been unable to resolve.

It wasn’t until I used an anatomy program and had a real close look at the lower leg that I got a real surprise. I found on the back of the leg, running from the knee down to the ankle area, 8 muscles. The ones every hears about and work on – the soleus and the gastrocnemius – plus 6 other muscles. None of these other 6 muscles were mentioned by anybody over the years.

These other 6 muscles are:

1. tibialis posterior
2. flexor halluncis longus
3. flexor digitorum longus
4. plantaris
5. peroneus brevis
6. peroneus longus

From looking at the diagrams, given the pain I was feeling, I discounted the importance of 3. flexor digitorum longus and 4. plantaris.

But the:

1. tibialis posterior
2. flexor halluncis longus
5. peroneus brevis
6. peroneus longus

muscles were very interesting.

Figure 1

The tibialis posterior (Figure 1) and the flexor hallucis longus (Figure 2) are both buried underneath the soleus and gastrocneuiius muscles with the tibialis posterior being the deepest and the flexor hallucis longus overtop that but still buried. I could see how any massage therapy would have a difficult time being effective on these muscles — even finding a stretch that would have any affect on them is problematic.

Figure 2

The black circle is the area where I had felt tightness in the past and which has now flared up again since mid-August.

I’m going to leave the peroneus brevis and peroneus longus muscles for the moment because they seem involved but in a different way.

The tibialis posterior and flexor hallucis longus muscles twist in an odd way at a point about 6 inches above the back of the heel to wrap around the inside of the foot through the instep area. The tibialis posterior muscle starts up behind the knee while the flexor hallucis longus muscle starts about a third of the way down.

When I think back to how I blew out my left knee – partially torn ACL and minicus damage – I was turning to my right to look back over my shoulder while running forward thereby twisting the left knee inward when it went – I can see how my foot could have been twisted in such a way as to overextend those muscles — and of course — overextending a muscle ain’t exactly a good thing.

The stretch I came up with is shown in Figure 3 –
bend my left knee a bit,
push up and out on the side of the big toe
hold for 30 seconds
repeat 3x in a session
often I would do this twice in one day

Figure 3

I could feel it stretch up through the area shown by the black circle in Figure 3. This is good and I have been doing it more than a year. But my running kept getting interrupted by more injuries – first a hamstring pull and then wretching that left knee again – by playing basketball. I simply had to lay off the basketball for awhile to see about rebuilding my endurance and strengthening the quads and hamstrings — once that was done maybe – just maybe – I could try basketball again.

This spring I started walking and running again – taking it very easy – starting with walking then adding the running. I started with 10 minutes of running and had the walking up to 2 hours. The lower leg was feeling fine and all the way through summer it did okay while I added more time/distance running while cutting back on the walking.

Then BANG! in mid-August the problem started up again.

When I looked at what may have caused the problem to flare up again, I looked at my running route. It was fairly flat – just some small bumps in the path through Taylor Creek Park. But I had started going a little further and going up a small hill that had a steeper slope than anything I had been doing up to that time. When I checked the left ankle flexion I found it was significantly less than the right, and I found the area involving the tibialis posterior and flexor halluncis longus muscles had tightened up again.

I have continued the Figure 3 stretch but trying various hold times to see what happens. I have noticed that when I hold it longer than 30 seconds – up to a minute and 2 minutes – I can feel the stretch through a longer part of my leg. But there was increased tenderness lower down around the back of my heel so this may be a little too much. I will back off to 30 seconds for awhile to see if that tenderness disappears and maybe try again.

But maybe more needed to be done.

Figure 4

That’s where the peroneus longus (Figure 4) and peroneus brevis (Figure 5) muscles seem involved.

Figure 5

Figure 6

In Figure 6, the red indicates the site of the pain/tenderness that I have been feeling. The soreness in this area had gone away from doing this variation of the traditional calf stretch previously and there had not been any tenderness through the summer until it flaired up again. In this variation of the calf stretch notice how my foot is turned to the outside about 45°. I have been experimenting with various angles all the way up to 90°. I can feel the pull through that red area for much of that range with the 45° being about the strongest.

Previously, I have held this stretch for 30 seconds and repeating it 3x. This seemed to work okay. These past few weeks I have tried holding it longer – 60 seconds to 2 minutes to see what would happen. It doesn’t seem to make that much difference.

Figure 7

Figure 7 shows another stretch which also gets into that red area but feels more extreme. This is something new I have been trying this time around. This is basically a squat but concentrating on having the feet turned out about 45°. When I do this stretch, I compare the pull in the left leg to the right leg in the same area. There is a strong pulling sensation in that area of the left leg shown by the red dots that is absent from the right leg, and it feels different from the calf stretch variation. It appears that I will need to try this for awhile. Since it does seem more extreme and the area is still tender, I’m leaving it for the moment until the tenderness dissipates. When I start using it, I will monitor the area for any soreness to see how much it does help.

For the moment, I have stopped running, walking as much as I can, and doing the stretches in Figure 3 and Figure 6.

As for why I would want to do this instead of doing some other aerobic activity that remains for another post but suffice to say I have tried other activities but running has remained the most enjoyable.

Eugene Ruthven

(garabaldi is a nickname I got in high school.)

But I discovered this was not set in stone.

One day I was browsing through a bookstore and came across aerobics by Kenneth H. Cooper. The book was about how to improve your physical conditioning. It said conditioning can be improved by consistently doing your endurance activity of choice.

I went through that book with a fine-toothed comb. He talked about the training effect and how it actually occurs. (You need to do an aerobic activity for at least 5 minutes continuously before it kicks in.) Cooper had access to United States army and air force personnel to do his research and to apply it over many years. He found that by consistently doing an endurance activity you could improve your endurance. He also found other health benefits from doing the right kind of exercise – particularly improved heart health. At that time, I wasn’t concerned about my heart – being only 22 – but this improved endurance and how it can impact playing other sports – that really got my attention.

I studied his charts and exercise plans. He had found that the best exercises for improving endurance where, in order of benefits:

1. running
2. swimming
3. cycling
4. walking
5. stationary running
6. handball
7. basketball
8. squash

Things like:

• isometrics
• weight lifting
• calisthenics

did not even make his list.

I was interested to see that basketball made his list of good things to do but…I would need to devote a lot more time to playing if I wanted improvement. Hey – I like playing but I wasn’t fanatic about it – it was just for fun.

But he found that running delivered the best results faster for the amount of time invested.

I had actually ridden bicycles a good part of my life up to that point but not with the consistency needed to acheive the endurance benefits Cooper had described. I had also done swimming for endurance – spent about 2 years doing that – getting up to doing a mile in 30 minutes 3x a week – good in Cooper’s book but I didn’t really feel the benefits when it came to playing basketball.

So I chose running as my endurance activity – something I actually do when playing basketball. Cooper’s research showed it was okay to start out slowly – a slow speed and a short distance was okay. The main point he made that you had to be consistent – a minimum of 3x a week – if you could do a couple of more times a week – good – but be patient – it takes time for your body to adapt to exercising. It has been a long time since then but I wouldn’t have gone for more than 20 minutes – more likely 10 or so – I did have some endurance from playing basketball – just not that great.

It was within a matter of weeks that I felt the benefits when I played basketball – it was becoming easier and I could play longer.

I did the running early in the morning so that if I got a chance to play basketball later that day I would do so.

As time went on, the running got easier and easier until at the end of 20 minutes it felt really good. So one day, I felt so good I thought what the hey – let’s run for another 10 minutes.

It was this gradual approach to running that finally saw me get up to doing an hour of running 5 or 6 times a week. It did not happen quickly – it was several months before I was able to run this long easily and actually enjoyed it – a big difference from the laps I did around the track in high school. I still played basketball a few times a week so I was getting a lot of endurance activity sessions in one week.

It did come about that I began to feel rundown and tired so I decided to change the running a bit. I changed it so that I ran 40 minutes one day and then did 80 minutes the next. Why 80? By this time I had really improved my endurnace and speed so I was doing at least 8 minute miles so that made 10 miles a nice round number with 5 miles on the short days. By making this change I was able to continue the running and play basketball to my heart’s content.

I have been consistent with this approach over the years except for those times I have been injured. If I had an injury and I was off long enough I would take a gradual approach to rebuilding my running.

When I left about 7:45am it was 9C/50F with 75% humidity. A good temperature I thought so I dressed for it – shorts and a single long-sleeved polypropylene shirt. I had considered just a simple cotton short-sleeved t-shirt as my other choice.

As soon as I stepped outside it felt a bit warmer than 9C/50F – I may have overdressed. I did find over the summer given my current conditioning that I’m sensitive to temperature/humidity combinations.

But I went anyways without changing to a lighter shirt.

I have also been fighting a bit of a bug the last few days so I still may be feeling the effects of that.

It was my intention to do 70 minutes with a possibility of tacking on an extra 10 if it went well.

Well – I got to the 40 minute mark and I was feeling loggy and my quads were starting to hurt which is my sign that I may not be able to do as much today. I stopped and walked for 10 minutes then headed back towards home.

I managed another 20 minutes before I felt too rotten and walked some more.

After another 10 minutes I was still feeling yucky but I tried to do some easy jogging but managed only another 5 minutes before packing it in for the day.

I had thought with the low temperature and the run 2 days ago that 70 minutes was well within reach today.

I was frustrated even more when I returned home to find that the temperature had climbed to 15C/60C while I was out – so my feeling that it was warmer than what I had dressed for was right. At 15C/60F, I would have gone topless because I do heat up quite a bit and sweat enormous quantities.

It would be nice to see smooth increases in running times but it does take time for the body to adapt again to what I wanted to do. I must remember patience – it will come – it has before and it will again.

Through the summer I kept adding more time as my fitness improved. But I noticed that on those days when the temperature was around 20C/68F or higher and the humidity was 80% and higher that I felt loggy – slowish. At that time I was trying to do 40 minute runs consistently but with that combination of temperature/humidity I found that I was lucky to get up to 25 minutes before I felt so yucky that I would walk. I would walk for 10 minutes and then continue running and finally get the time in.

For the past few weeks, the temperature has consistently been 10-15C/50-60F with the humidity below 80% and I have been able to run 70 minutes fairly consistently.

Then 3 days ago – this past Tuesday – the temperature got back up to 20C/68F and the humidity hit the 95% mark. When I saw this I prepared myself for a slow day – considering myself lucky if I could get a 50 minute run in. I did about 30 minutes before I felt loggy – walked 10 minutes – did another 30 minutes – walked another 10 minutes and finally ended with a slow 20 minutes – to make up an 80 minute run.

Then yesterday – Thursday – the temperature dropped down to 15C/60F and the humidity remained at 95%. Remembering what happened just 2 days earlier I prepared myself to do some walking. To my surprise the lower temperature was enough to offset a great deal of the humidity so I managed to do 70 minutes without stopping but towards the end of the run I was feeling yucky.

I am male and I have been running since the mid-70′s fairly consistently. I am now 55 years old. My running has been interrupted by various injuries. As a result of this more than 35 year experience, I do have some opinions and experiences I will share.

I am currently in Toronto, Ontario, Canada, and I have been here the last 10 years. I have run in London and Peterborough, Ontario, and Edmonton, Alberta. I have done my share of cold-weather running. I even have done a couple of runs in Salt Lake City, Utah, just before Christmas.

Generally, my runs have consisted of alternating 40 and 80 minute runs. I have pushed the time up to 100 minutes on the odd occasion.

Have I ever done a marathon? No. My running supported my basketball habit. But now that it seems that basketball doesn’t agree with me anymore – too many injuries the last little while – I’m concentrating more on running – so who knows — maybe I will give a marathon a try. But I’m not ready today to try it. I haven’t reached the point where my running feels easy yet as it has in the past.

At this point, I’m in a rebuilding phase. I have been dealing with Achilles problems which were a side effect of blowing out my knee several years ago – partially torn ACL and minicus damage.

My injuries over the years have included:

• several sprained ankles
• broken foot
• blown knee – partially torn ACL and miniscus tearing
• Achilles problems as a result of the blown knee
• back injuries – sciatic nerve mostly
• plantar fasciitis

Most of my injuries have been the result of doing other things than running – mostly playing basketball – the reason I started running in the first place.

The running injuries have been:

• a couple of sprained ankles
• plantar fasciitis twice
• a back muscle spasm
• Achilles problems as a result of the blown knee