To train or not to train… that is the question?

For many runners, once they are bitten by the running bug, there are suddenly a whole host of complex reasons why they run, in some cases twice a day and in many cases every day of the week. The forces that drive people to miss out on social engagements, pretend that they really like salad and wholemeal pasta dishes, go for orange juice and soda water in the pub, are powerful indeed. And sometimes the drive to improve and to succeed can become too powerful. Sometimes we are driven to train when it is certainly not the best thing to be doing.

sick-runnerSo the question is, how do you know when you should most definitely not be training and when you can safely push on through?

Actually I don’t know that there are any hard and fast rules. For me, as with so many things in running, it comes down to experience and intuition.

Listen to your body?

Runners often advise each other (and probably themselves) to ‘listen to the body’ but I think that this is too simplistic. Sometimes the body is sending messages that should be heeded, whilst at other times it should be completely – and I would suggest – aggressively ignored.

But how do you know which is which?

There are times when all runners, indeed all athletes, feel pretty low. Fatigue, over-training, a slight cold, a niggle here or there. But in many cases, the problem is not significant enough to warrant stopping training altogether. But other times a cold can become a chest infection or a pain in the knee can develop into serious tendonitis that takes months to heal.

My experience is that the longer I have been a runner, the tougher I have got. Whereas when I first started running I would heed every cough and sniffle or twinge, now I tend to get myself out to do something, even if that is not the session that I had planned. So far, touch wood, I have not had a twinge turn into anything more serious and colds have abated without morphing into pneumonia.

What advice can I offer?

I know that intuition and experience is not very useful, so here are my top tips for working out if you should HTFU and get out there, or take a rest day or two and get better first:

Illnesses
  • If you check your heart rate and it is hammering, then your body is fighting some bad-dude germs and you should give it a chance to win. My resting heart rate (that is measured as I wake up before getting out of bed) is around 42-44 BPM. I measure it once every couple of weeks. If I wake up feeling rough and my heart rate is in the 50s I give it a break.
  • If your illness is affecting your respiratory system, i.e. you’re really coughing or your lungs are sore, don’t go for a run. Breathing hard in those circumstances is a bad idea.
  • If you have diarrhea or vomiting, especially if you are dehydrated as a result, take some rest and drink electrolytes to replenish the fluids and minerals lost.
  • If you have a tickly throat or a bunged-up nose, wrap up warm and get out there, even if you only go for 20 minutes easy, you’ll often find that the run clears the symptoms of the cold.
  • Hungover? No sympathy. Get out for a run and stop feeling sorry for yourself.
Injuries – this can be a more difficult area and these are only my rules of thumb. I’m no medical expert!
  • If you have a sore spot that eases up once you’re running, it is probably tightness rather than an injury, so get your run done and remember to stretch well when you finish
  • In my opinion if you have an injury that persists or even gets worst when you’re running, stop running. If you can’t at least be pain free after 10-15 minutes running then your injury is chronic and needs to be dealt with
  • Upper limbs don’t count. I ran races – including the New York marathon – two weeks after an operation to pin a broken bone in my wrist. Provided you’re not off your head on pain-killers you will be fine. Just don’t fall over.
  • If you don’t know what your injury is, figure it out. There are some things that cannot and shouldn’t be run-through. Check out the Running Injury Oracle or a physio for diagnosis
  • Accupuncture works… fast! Nonsteroidal anti-inflammatory drugs, such as Ibuprofen work… but they don’t fix the problem so don’t abuse that route
  • Change your shoes if you have knee/ankle problems and see how you get on before you confine yourself to your bed for a week

Timing

There is something to be said about timing – if you are two or three weeks out from a key race and you pick up an injury or an illness, the most important thing of all is getting well as fast as possible. I promise you that any fitness you loose by not training in the last 14-21 days before a key race will pale into total insignificance in comparision to how you will feel and perform if you try to train through and allow whatever it is to get it’s teeth into you. Stop training, rest and rehabilitate in the most appropriate way so that you have a chance of getting to the start line in decent shape.

If you get ill or injured with a month or more to go, the trick is to assess whether you do need to rest and rehabilitate or whether you can afford to take your foot off the pedal and simply train through whatever ails you, whilst keeping some training going. This is not, however, the time to give yourself a week off because you’re tired or have a little cold. If you are in the 16 weeks-to-go zone, you really need to be training as much as possible.

Final advice

The main thing to focus on is getting well again. Remember that for most of us (and I’ll assume everyone reading this) running is a fun activity. Sure, it is wrapped up in self-worth and how we define ourselves. But you’re not a contestant in The Running Man. So be smart – if you’re just feeling a bit tired, ill and daunted by the prospect of training, do something else, but DO get out and do something.

If you are unlucky enough to end up with a proper illness or injury, deal with that first and then get back to training. You won’t loose anywhere near the amount of fitness you fear you might and if you’re clever, you’ll be back and ready to regain your former fitness and more in no time at all.

 

The storm is coming

Think back if you will, to the point before your marathon preparation cycle started. Let’s take November last year for example. Whether or not you raced last autumn, it is highly likely that last November you were not training for anything specific. Wasn’t that a lovely time? Blissful in fact. You were running, sure, but it was base building stuff – more steady runs and less sessions. Maybe even skipping a run or two if life or work got in the way.

But now, if you listen carefully, you can hear the rumble of the approaching spring marathon. Coming like a train down the tracks, ever day it is getting closer and closer…

And the training is getting harder and harder.

Welcome to the Twiglet Zone.

As I look around me at my compatriots, my training partners and the people I have contact with through this blog or through social media, the incidences of injury and tiredness are becoming more and more common.

At the track last night, people were missing. Others didn’t manage to finish the session. The recoveries between reps stretched out from 60 seconds initially to 75 seconds.

I have heard from friends who are starting to get over stretched. Little injuries are appearing. General fatigue is setting in.

I’m suffering too. As I write this I am sat on the sofa with my feet up and a cup of tea, like an old man. I felt OK after my track session last night, but a combination of a hard session, a rather restless night and possibly not eating very sensibly after the track last night, left me feeling utterly drained as I went out for my run this morning. I managed the 60 minutes and kept to the pace that I usually manage for those runs, but I felt ragged and there were several very sore spots in my legs – right calf, back of the left knee and both quads. I was in a sorry state!

But I have now got to the point where I realise this is all part of the training. If you want to be the best runner you can be, you have to manage these difficult periods. Training for a marathon involves having injuries treated or resting them for a few days. It involved making sure there is enough food in the house. It requires making sure that you create the environment that will allow you to sleep properly. And most of all, training to run the best marathon you can (or excelling in any sporting endeavor for that matter) requires you to embrace the challenges that come with training hard and the build-up of fatigue that is part and parcel of training week in, week out.

Professional athletes suffer too!

It is tempting when you see the runners at the top of their field, floating along at super-human speeds, to thing that the pros have it easy all the time, but that is far from the truth. Check out Jessica Ennis in this BBC film, at about 4min 25sec talking about the struggle of getting out of bed when the weather is horrible and she feels broken from all the training. Or consider Julia Bleasdale, who I interviewed recently, who told me that

Sometimes when I am really tired and I have a second run to do and the weather is miserable – those runs are very difficult, but of course they can also be the most beneficial.

What the pros know is that when it comes to the day of the race or event, all the hard training will pay off and succeeding will look easy. That is what we have to focus on – the end goal.

So, there is no way to sugar-coat this. If running a marathon was easy, there would be NO POINT DOING IT. We do it because it is hard and because it is a challenge. But in reality the bulk of the challenge is now, not on the day. So get that injury fixed and make sure you have the right stuff and the right environment to train hard and recover. And visualise the moment when you achieve your aim… I promise you: the pain and fatigue you feel now will pale into insignificance on the day. You didn’t really think it would be easy, did you?

Getting rubbed up the right way.

I love a massage, there is no getting away from it. In fact before I started running I used to love a massage. But now that I train and run regularly, I find that a massage has gone from almost a pleasure that I afford myself to a necessity.

But there is actually not all that much scientific research on the benefits of massage that I can find (if you have any, please post a link in the comments section!) A little like ice-baths, there seems to be more anecdotal than empirical evidence for their value. But given the range of types of massage on offer, I think that there is most certainly a market and that wouldn’t exist if there weren’t benefits, however intangible.

So what should you be doing?

I believe that if you can have a massage once a month then you should. More than that could be a bit indulgent and actually not have that much more benefit. And there is the cost factor. Once a month seems to be regular enough for ‘normal runners’ (I know that many elite athletes are on the masseurs table at least once a week and often more than that) and then you can always throw in another one if you have a niggle or something that needs working on in between your regular sessions.

As far as what to go for, I would say that you should see a sports specialist. Anyone that isn’t familiar with the rigours of regular training is unlikely to know exactly what is required and there is no value in seeing someone who is too soft, too hard or simply doesn’t know which areas to concentrate on.

I would also say that many chiropractors and osteopaths offer sports massage and their intimate and specialist knowledge of the human anatomy means that they can treat any little issues that they find as they go. I tend to also always have a look at the books that a practitioner has in their massage room or in the surgery and have yet to find one where the books are about athletes physiology and specific injury treatment or prevention, where I have not had a great treatment.

How to choose your masseur

It is also important that you choose someone you are comfortable with in an environment you are comfortable in. Lets be honest here, we are talking about a stranger (certainly to begin with) rubbing your skin with oils and, if they are doing their job right, getting into some pretty intimate muscles – glutes, anyone? If you don’t feel comfortable, you will be tense and that is not great for you or the masseur trying to loosen off your muscles.

As far as which type of massage to go for, I think that there are lots that can help. This article in Competitor Magazine describes four of the most common and is worth a read.

But for me, I tend to not worry what the massage is called. The person that I go to see, Chris Wilson at BodyLab in Islington, London, has never discussed the actual type of massage he uses, but he is a runner and triathlete and knows what needs to be done to keep me feeling supple and uninjured. I am sure it is a hybrid of all the things he has learned and I feel completely safe in his hands.

So there you have it: massage – possibly one of the best things you can invest in as a runner and if you find the right person, a great way to keep your body in great shape.

Athletes and Injuries: A journey through London 2012

Another treat from the wonderful Catherine Wilding, who in this post looks at the pattern of athletes and injuries, especially in the run-up to important championship competitions. But it really begs the question: are we all not susceptible to pushing too hard as the ‘big day’ approaches and tipping over from fit to broken…?

 

For many athletes, there is often a tale of adversity to accompany their success.  It can be overcoming hardship, battling prejudice or just proving people wrong but more often than not, it’s overcoming career threatening injuries.  The athlete’s journey is long and winding and often a lonely path filled with emotional highs and lows.  It is beset with many obstacles but it is injury that is probably the most difficult.  It takes years of dedication and determination to achieve recognition and before even making the start-line of major championships and tournaments, many athletes have endured months of painstaking re-habilitation from injuries and some just don’t even make it.

As runners, ours is a cruel sport. The longer the distance, the more likely we are to get injured and the list of injuries for long distance runners is almost as long as the races themselves.  It’s a repetitive sport which is hard on the body and it is a lucky runner who escapes injury.

The London 2012 Olympic Games were a veritable catalogue of injuries. There are countless stories of athletes from almost every nation who were either not selected owing to injury; were forced to pull out before the games began; arrived at the start line not fully fit and carrying a niggle; or were injured during competition.

Our most famous distance runner of all time and World Record Holder – Paula Radcliffe – has a heartbreaking story and one we are all too familiar with.  It’s been an eight year journey from Athens, via a stress fracture and a cruel and disappointing race in Beijing, to London 2012. But such is marathon running a challenging sport – Paula didn’t even make the start line in London.  She was forced to pull out just one week before with a recurring foot injury and so her Olympic journey ended before it had begun.

Ryan Hall was a big medal hope

Her compatriot Mara Yamauchi completed months of hard training to line up on the Mall on Sunday 5th August.  But hers was a short-lived race and not the one she had trained for.  She hadn’t quite made it to the 10K mark before she had to pull up with an injury to her heel which clearly wasn’t going to hold up.  In the women’s marathon, the gun had only just gone off when one competitor had to be carried off the course.  One of the favourites for the race – Shobhukova also pulled out with a hamstring injury.  In the men’s marathon a week later, Ryan Hall of the USA was forced out after 10 miles also with a hamstring injury.  He later said that he has never not finished a race, but felt it was something he couldn’t work through and the injury could do damage to his career. His fellow team make Abdirhman barely made it a mile further before also pulling up after feeling a “pop” in his knee.  In fact 18 of the competitors didn’t make the finish line and will forever have the misery of seeing DNF next to their name in Olympic history.

That’s just the story of the marathon.  The most remarkable injury to have been incurred during competition must be that of Manteo Mitchell the American sprinter in the men’s 4 x 400m relay.  He heard his left fibula crack whilst running the first leg in the heats.  In an extraordinary feat of mind over matter he continued running on a broken leg despite the pain.  His rationale being that he didn’t want to let the team down.   Team USA qualified for the final but Mitchell wasn’t able to help his team-mates take Silver.  The Jamaican sprinter Asafa Powell also pulled up in the 100m final after pulling a thigh muscle.  He limped across the line last but still managed to finish the race in 11.99 seconds.

Poor old Liu Xiang

Another heartbreaking story is that of China’s most famous athlete, the hurdler Liu Xiang.  After crashing out of the Olympic final in Beijing in 2008, he was again carried off the track in a wheelchair at London 2012.  An ongoing Achilles injury was to blame and after hitting the first hurdle in the 110m heats he ended yet another Olympic dream and promptly announced his retirement.

These are just a few stories from the runners.  Almost everywhere we looked we saw the tell-tale sign of injury.  KT tape (or Kineseology tape) was a ubiquitous and somewhat cult accessory at London 2012. Sported in every colour, Athletes use the tape to support injuries to shoulders, calves, hamstrings etc.  In the women’s 10K, the favourite Dibaba had thick blue tape down her hamstring, wearing it like a badge perhaps to tell us that she wasn’t quite in her best shape.

But it’s not just the runners who get injured. Some sports are more deadly than others and injuries can be crushing. For the road cyclist it can quite literally be “one false move and your dead”.  Travelling at speed is not the time to make a mistake as Fabian Cancellara the former Olympic Time Trial champion knows to his cost.  He hit a barrier in Richmond Park and suffered a debilitating injury to his collar bone which all but ended his Olympic chances.  The women’s road-race saw several crashes – none life threatening but ending medal chances for all those caught in the tangle.

The equestrian events are also no place to make mistakes.  It’s the horse that is in charge and being thrown from the saddle can not only end ones medal hopes but also put an end to riding for months or even years.   Team GB’s Nick Skelton has broken practically every bone in his body and suffered a near fatal neck injury in 2001, yet he managed to survive London 2012. After missing out on an individual medal in the show-jumping, he helped the team to ride away with Gold in the team event.  Broken bones are not confined to cycling, riding (and even running).  In the hockey, the Women’s Team GB captain played on despite suffering a broken jaw in the early rounds.  She went on to captain the team to a Bronze medal.

It's not all bad news though

Any athlete who has been injured knows that the recovery process and re-hab is fraught with difficulty – both physically and psychologically – which makes it even more remarkable that Team GB’s Alistair Brownlee – who, having suffered a tear to his Achilles as recently as February this year – was able to compete in the triathlon in Hyde Park.  Not only did he make the start line fighting fit but he ran a blistering race to take the Gold medal and a very convincing victory.

Others arrived gallantly for the competition having battled injury yet weren’t able to perform.  After weeks of speculation and controversy, Philips Idowu arrived only to crash out in the heats.  Some put on a great performance having overcome injuries but missed weeks of crucial training.  Our 1500m runner Lisa Dobriskey had a catalogue of injuries and illness, including surgery on her hip; a stress fracture in her femur, and a blood clot on her lung all in the space of a few months earlier this year.  It was an incredible achievement just to make it to the final but she was disappointed to finish in 10th place.  In the women’s triathlon, Helen Jenkins finished in 5th place despite not being fully fit having missed significant training in the preceding 10 weeks with a knee injury.

There are endless tales of disappointment and endless tears from athletes who have incurred injuries and not been able to fulfil their dreams.

We have to reflect and ask: How would the London 2012 Games have looked if Usain Bolt had not overcome his Achilles injury?  Only 95% fit, he ran away with three gold medals and a legendary status but it could all have ended quite differently.

 

 

Oh no, Paula

Always giving her all. Photo from Getty

I have spent more time than I care to reveal hoping and wishing that Paula Radcliffe would reach the start line of the marathon at the London Olympic Games, fully fit and ready to race. I am afraid that I think there are women now who are faster, stronger and more aggressive, so I didn’t really rate Paula’s chances of pulling off a golden finish to a really incredible and illustrious career, but I believed that she would be able to give it 100% and maybe, just maybe…

But today I read that she is carrying a foot injury – in fact a recurrance of a foot injury – and with six weeks until the race, there must be huge doubt that she will make it. I am a massive optimist and I love stories like that of Joan Benoit-Samuelson recovering from knee surgery to win the first women’s Olympic marathon in Los Angeles. But Paula seems so fragile. I guess we can only keep on hoping and Paula, if you ever happen to read this (not likely I know, but you never know…) I really wish you all the best and come what may, you are one of my absolute heroes.

“The only antidote to mental suffering is physical pain” Karl Marx

When I started running, pain was something that I understood would be inevitable, but assumed would be temporary and periodic. However as I progressed my training over the years increasing my mileage as well as the intensity of my sessions, I came to realise that pain could be a pretty constant companion. At the moment, as I am logging regular 65-70 mile weeks, I wake up every morning with a very tight, sore right ankle. Following my easy morning run and after an hour at my desk my right knee twinges. By lunchtime there is a pain in my lower back. And before I set out for my session in the afternoon my IT Band feels like a tensioned steel cable. These niggles are a part of being a marathoner.

The regular companionship of mild pain or discomfort has, however, made me think about what it is like for other runners and especially 100+ mile-per-week elite athletes.

Elite runner, elite pain

In Charlie Spedding’s brilliant autobiography, From Last to First, he describes how, when he was training full time, pain was something he had to deal with constantly. This was especially true for his Achilles tendon, thanks to which he almost died after a negative reaction to an operation he was having.

Ben Moreau
Scott Overall

So what about contemporary elite athletes? I had the opportunity to ask Ben Moreau, an aspiring Olympic marathoner, Scott Overall, whose 2:10:55 at Berlin in 2011 secured him the first place on the Team GB marathon team and Alyson Dixon who is also hoping for a place in the Olympic marathon for Team GB.

When I asked Ben about whether he deals with constant pain he said that, thankfully, he doesn’t. However Ben went on to tell me that he has trained through pains that have lasted for weeks and that in fact at the moment – with 13 weeks until his shot for a place on the Olympic team at the Virgin London Marathon – he has a hamstring issue that has been going on since early December (that is for around seven weeks). Ben said that this pain has meant that he has reduced intensity of training somewhat but that his volume of training has remained constant.

Scott Overall was similarly sanguine about pain when I asked him, telling me that

I think the aches and pains that athletes have are natural as I think its quite un-natural to be running over 100 miles per week, week in and week out

and he went on to say that in his experience a pain is often a sign of a problem away from the site of the discomfort. In his case calf pain was due to hip issues:

once I had a calf problem but the cause of this was because my pelvis was out of alignment and the pain was showing itself at the weakest part of the chain. No amount of stretching or icing the calf would help it because the root of the problem was with my pelvis, and it was this that needed to be corrected.

Alyson Dixon

Last weekend I was at a marathon training conference in Brighton and had the opportunity to run with Aly Dixon, who is looking to take the third and final place in the Team GB  Olympic team for the London Games. When I asked Aly about managing pain she laughed wryly, after all Aly has only recently returned from injury having run last year’s World Championship marathon in Daegu with a the double whammy of fracture to the distal phalanx (big toe) and sessamoid (ball of the foot) that she thinks started when she ran the Great South Run in 2010.

Aly is reported as saying that she was in pain during that race “but thought it was because I needed to change my shoes as they were worn out.” Aly went on to tell me that because the pain was intermittent she assumed it was a natural part of having increased her mileage and that it was something she just had to manage. In interviews Dixon described how the physios at Team GB in Korea did a great job at managing the ‘niggle’ to allow her to run after which they discovered the broken metatarsal.

Pain is inevitable. Suffering is optional (according to the Buddha)

So we have established, from some of the best runners in the UK, that with hard training comes pain and niggles. There is of course, quite a challenge in telling the difference between natural soreness or tightness and the start of an injury. So what do the experts say? Well Scott Overall told me that

Elite athletes tend to be very in tune with their bodies and would know why something is sore, it might be my calves are sore because I did a session on the track the night before, or my Achilles is sore because I’d stupidly been walking around in flip flops the previous day. A lot of the time there is a reason for the pain and you can generally narrow it down to what’s caused it.

and Ben Moreau gave me tips on how he manages the inevitable discomfort:

  1. if I feel like I’m changing my running style to accommodate it [the pain], I’m on a hiding to nothing and so will have to rest
  2. if it is getting worse constantly, that’s a bad sign, so I’ll rest
  3. assess rest vs healing and see if a reduced training amount now will impact the end goal vs possible benefits

Aly Dixon, now something of an expert in dealing with pain and recognising (or ignoring) injury, told me much the same as Ben – that she tries hard to recognise when pain is constant or worsening and affecting the way she is running and then decide whether, with a goal in mind, rest is possible and appropriate or whether she simply needs to push on and manage the issue.

How does that affect me?

To summerise, it seems that pain is an inevitable part of being a marathon runner and to avoid all pain would mean that the runner was not able to train enough to really reach his or her potential. The challenge comes when the pain is not a niggle but actually an injury. Scott Overall advises that

It’s important to nip these niggles in the bud before they get anymore serious. Keeping on top of things and getting regular physio and even massage can really help – if those things are not an option then just simply stretching or getting a foam roller to massage yourself.

One thing I have learned from talking to Ben, Scott and Aly is the importance of getting to know your body and recognise the difference between a niggle and an injury. Obviously being overly sensitive will mean that one doesn’t run enough whilst not being sensitive enough means that a serious injury could develop whilst the runner stubbornly refuses to acknowledge it.

I think that my advice would be that if you feel sore before you run, get out of the door and go for a 10 minutes warm-up. If after that the pain goes then it is fine to carry on (but get a physio to check out the area of pain anyway) but if the pain really remains or worsens, go home and immediately book an appointment with your favourite physio!

To conclude this ramble about pain, I think that my coach Nick Anderson of runningwithus, gave me some great advice this morning. We were out running together and I mentioned my sore ankle. I told Nick that the pain subsides within a couple of minutes of waking and goes completely once I have been walking or running for a minute or two. Nick said that this meant that the problem is manageable at the moment, but with three months until my ‘A’ race – the London marathon in April – I should get the ankle checked out by a physio now to avoid problems later as the volume of training continues to increase. I think that this is pretty good advice for all you marathoners out there so please let me know what you think and what you are doing to be the best runner you can be despite the pain!

 

 

The finished product

Inspiration from ‘The Perfect Distance’ by Pat Butcher

I have just finished reading Pat Butcher’s excellent book on the golden era of British middle distance running “The Perfect Distance. Ovett & Coe: the record breaking rivalry” (published by Phoenix and available here). I’ll write a specific review of the book soon, but in the mean time there was a theme running through the book that I found interesting because it spoke to me about my own current predicament.

In the closing pages of the book, Butcher writes about the Los Angeles Olympic Games 1500m final in which Seb Coe, Steve Ovett and Steve Cram all ran and which provided British athletics fans with one of the most iconic images ever; the three of them in a line at the bell (see right). The result of that race is that Seb Coe became the first man ever to successfully defend a 1500m Olympic title. But perhaps more extraordinarily, he did it despite battling with injury and illness almost his entire career. Butcher tells us that;

After almost three years of illness, half an elite athlete’s lifetime. He’d [Coe] done it [defended his Olympic 1500m title]. Against all the odds. He had done it.

Perseverance

And that is extraordinary to me in one very clear sense. How many people would have persevered through the sorts of trials and tribulations that Coe had endured? Stress fractures, crippling toxoplasmosis, sciatica and a host of other injuries? I have had a very fortunate ‘running career’ of 5 years during which time I have managed to avoid any serious illness or injury (save for a broken wrist that was the result of being knocked off my bike) whilst friends and contemporaries have suffered all sorts of set-backs. But the remarkable thing is that Coe kept coming back. He took his time, got the treatment and worked his way back to top form.

The same is true in so many walks of life – it is all too easy to see a finished product in any discipline and not realise what had been going on in the background for months, years or even decades. In terms of my interest in running, it is easy to think that sporting greats arrive on the scene as the finished product. But that is never the case. I think that arguably the greatest distance runner the world has ever seen is Haile Gebrselassie and he himself acknowledges that it was decades of running, starting with 10km a day to school and back, that set him up for his achievements in later life. One story that I love, which may or may not be true, is that of Picasso sketching a woman in a cafe;

A woman was strolling along a street in Paris when she spotted Pablo Picasso sketching at a sidewalk cafe. The woman asked Picasso if he might sketch her, and charge her accordingly. Picasso graciously obliged and in just minutes, there she was: an original Picasso.

“And what do I owe you?” she asked.
“Five Thousand Francs,” Picasso answered.
“But it only took you three minutes,” she politely reminded him.
“No,” Picasso said. “It took me all my life.”

The point of this story is obvious, but one that it is easy to forget – achieving greatness, whether that is objective greatness or simply being the best we can be, takes years or decades or even a lifetime of dedication. So how does that relate to my predicament?

The lesson learnt

For the last few months I have been struggling to train at the level that I think I need to, to achieve what I want to, especially in terms of achieving new personal bests. Now I am not suggesting for one minute that there is anything to compare between me and Sebastian Coe, but I do think there is much to be learned from his example – he rolled with the punches and dealt with the set-backs. And in my mind that is one of the things that makes an athlete great. Like all injured runners I need to stop feeling sorry for myself, find out what I need to do to get back to my best form and get there step-by-step . Thanks for the inspiration, Lord Coe!

Success and motivation

I have just watched this video on the BBC website with Paula Radcliffe talking about running and her career in athletics and the power that the games in London in 2012 are having over the decisions she is making in her life. It really made me think. Personally I think that Paula is an incredible person and an incredible athlete. Where the media and arm-chair pundits do criticise Paula, it is usually because in their minds she has under-performed at major championships – most notably the last two Olympics. But I doubt there is a serious runner in the world who doesn’t know how hard it is to arrive at the start line of a key race in perfect shape, and it is absolutely true that the closer one is to the edge, the harder it is to get the training just right and arrive without either under training or, possibly worse, over training.

I am really pleased to hear that Paula does not consider the issue of her not being in shape for the last two Olympics to be defining in her career or in any way indicative of an unfulfilled life. And at the same time I was touched by the fact that she is clearly still so affected and concerned by the opinions of the people who turn their gaze on her once every couple of years when she races a high-profile event, but in all likelihood have no concept of what it takes to do what she does. She mentions in the video that when all is said and done, running was the thing that Paula did as a hobby and I think, from the couple of times I have met her (albeit very briefly both times) and from the hours of video footage that I have seen of her, that Paula is still at heart a runner who runs because she loves it. I hope that it may always be like that for her and that she can have her dream of performing at the Olympics whilst retaining her sanity in the face of relentless pressure from the media and sponsors and the public.

So three cheers for Paula. Let’s all get behind her and the other runners who will hopefully be toeing the start line of the marathon in 2012 and aiming to be the best runners they can be on the day.

Ice, ice baby!

I have been running for around 6 years now and I have to admit that I have never been a fan of ice-baths. I suppose that in an attempt to avoid the unpleasantness of immersing myself in cold water, I imagined that they were only for elite athletes or only for injured athletes… of injured elite athletes. Basically I was too chicken!

Last year in March I went on a week long training camp to the Algarve with my coach, Nick Anderson, and a group of the runners he coaches. You can read about the week here. It was a great week of training with so many things that I would incorporate into my training if life and work didn’t get in the way so regularly – at least 8 hours sleep every night, training with a group of totally positive people, spending the day between two runs resting by the pool, hydrating and fuelling well, running off-road for most of the easy runs… the list goes on and on.
And there was something else; after every run we would arrive back at the hotel and all wade straight into the unheated outdoor pool.

Now I’ll admit that there is a world of difference between an unheated swimming pool and a proper ice-bath, but I think all of us on the camp realised the benefits of cooling our legs down immediately post-run. It is a habit that I have tried to resurrect in the last couple of weeks. But being the curious type I decided to try to understand what the benefits are and how plunging into cold water helps us as runners.

The theory

The basic theory is that by immersing oneself in cold water – ideally between 12 and 15ºC – blood vessels are constricted which reduces blood flow, swelling and tissue damage. There is also talk of an additional benefit once one gets out of the water, which is that the re-warmed muscles increase bloodflow post ice-bath and this helps “return the byproducts of cellular breakdown to the lymph system for efficient recycling by the body” (according to Nikki Kimball, a physical therapist in Bozeman, Montana, who was named USATF’s Ultrarunner of the Year in 2004, 2006, and 2007).

This is just the tip of the iceberg (I know, that was terrible… sorry) as far as cooling is concerned. The latest technology, adopted by those at the cutting edge of training methods like Alberto Salazar at Nike’s Oregon Project, is the cryosauna; an upright tube that athletes climb into and which is filled with liquid nitrogen which cools the athlete’s skin with temperatures as low as minus 170 degrees Celsius. Click here for a great interview by Steve Cram interviewing Mo Farah in a cryosauna . Quite an amazing bit of kit and dangerous if mis-used; only recently the US sprinter Justin Gatlin suffered mild frostbite from climbing into a cryosauna with wet socks on. Ouch!

The debate

There is a huge amount of debate in the running world about the potential benefits of ice-baths with many runners pointing out that there is very little, if any, scientific evidence for ice-baths delivering any advantage at all. Indeed a study published in 2007 in the British Journal of Sports Medicine concludes with this statement: “The protocol of ice-water immersion used in this study was ineffectual in minimising markers of DOMS in untrained individuals. This study challenges the wide use of this intervention as a recovery strategy by athletes. “ (Effect of cold water immersion on repeated cycling performance and limb blood flow Br. J. Sports. Med. 2011;45:825-829)

However there are other studies that take the contrary view, in particular a study by the French Ministry of Sports which concludes by stating that “Overall, the results indicated that the WBC [specific whole body cryotherapy] was effective in reducing the inflammatory process. These results may be explained by vasoconstriction at muscular level, and both the decrease in cytokines activity pro-inflammatory, and increase in cytokines anti-inflammatory.” (Time-Course of Changes in Inflammatory Response after Whole-Body Cryotherapy Multi Exposures following Severe Exercise. Source, Research Department, National Institute of Sport, Expertise and Performance (INSEP), Paris, France.)

To ice, or not to ice?

So where do we go from here? Well, I think that the scientists will continue to debate the issue for a while yet. For me, I take a slightly less scientific view. I believe that cooling my legs helps me recover from strenuous sessions and long runs more effectively. I also think that elite athletes like Mo Farah and Paula Radcliffe would not use ice-baths and cryosaunas if they didn’t have a positive effect.

But more than anything I think that it may just be that leaping into a cold bath makes us feel like serious runners who are prepared to endure discomfort for the sake of improving our results and that adds immeasurably to the psychological strength we need to go hard in those sessions or on race day. I am a strong believer in the theory that one reason for the east African dominance in middle and long distance races (though not by any means the only explanation) is the hardship that the runners there know, which makes running feel like an easy option. That may also explain the dominance of other countries in the past, where strong economies now mean that few endure the sort of hardships that were common even in the UK a generation or two ago. Who knows, but for now I’ll be maintaining my ice-bath routine and secretly hoping there is a definitive study that says they do no good!

And I will leave the last word to David Terry, M.D., an ultrarunner who has finished the Western States 100 and the Wasatch Front 100, 10 consecutive times. “Ice baths don’t only suppress inflammation, but help to flush harmful metabolic debris out of your muscles” and with his record of ultra running, if he says it, it must be true!

Looking for a needle in a haystack

Injuries can be funny things. By this I mean they can sometimes seem to come from nowhere and be resistant to all the common treatments whilst at other times their arrival can be well announced and then they respond perfectly to icing or stretching or massage or whatever else is prescribed.

However with trickier injuries it is often a lack of clear solution that results in the injury worsening and become a real season-interrupter. My first brush with a persistent injury that resisted treatment was also my first experience of acupuncture and I learned a lot from both the injury and the treatment.

The injury was diagnosed as patella tendonitis or what many runners refer to as runner’s knee or jumper’s knee. Basically this is inflammation of the patella tendon which is found at the front of the knee connecting the knee cap (or patella) to the top of the shin bone. It is a classic over-use injury which often comes on when the runner increases milage and/or intensity and possibly doesn’t increase stretching to compensate.

In my case I had stubbornly kept running even though I was acutely aware of the pain in the front of my right knee. The pain continued to worsen until it was continuous and especially painful when I was running. And then I hit my knee with a pallet-lifter…

It was the Wednesday before the Milton Keynes half marathon and I was having a particularly difficult conversation with a client on the telephone. I had decided to take my phone and continue the conversation with the client while I took a walk from my office to the factory on the ground floor (I worked for a commercial printer at the time). I was mindlessly pushing and pulling a heavy industrial pallet trolley around whilst listening to the client when WHAM! the handle came down on my right knee. I was in agony (although I managed to avoid yelping and scaring the crap out of the client). By the time I got home that night my knee had swollen up and the tendon was incredibly sore. In desperation to run the race four days later I went to see Gavin Burt at Backs and Beyond who had dealt with my previous injuries. He decided that acupuncture was the best course of action.

Despite being rather nervous, I trust Gavin and so I tried to relax on the treatment table and see what acupuncture could do for me.

According to Gavin – in his typically straightforward manner – the idea behind acupuncture is this:

“If you have a splinter in your finger your brain sees it as a foreign object which may be infected and dirty, and certainly shouldn’t be under the skin so it mounts an immune response and an inflammatory response against it, involving white blood cells and inflammatory substances to disinfect the area and to get rid of the offending splinter. exactly the same process occurs when you have an acupuncture needle in your skin, except this time it’s the damaged Achilles tendon or muscle tear that the needle is inserted into that gets all the good healing stuff that the brain sends down there. so the acupuncture needle is used as an antenna to direct the brain’s attention to damaged tissue to help it heal….. simples, no?”

My experience was that after the initial very, very mild discomfort of the needles being deployed (acupuncture needles are typically made of stainless steel wire and are very thin) there was a sensation not unlike warm water rushing down my leg and around my knee. Gavin and I then chatted for a while – it might have been 20 minutes – before he removed the needles, which was totally painless, and I hopped off the treatment table.

The result was remarkable. My knee felt instantly better and I walked out of Gavin’s practice rooms with significantly less pain than I arrived with. Gavin suggested I ice my knee and rest for a couple of days, which I did. And on the day of the race I was completely pain free – no bruising from the pallet-lifter incident and no patella tendon pain.

The cynical amongst you may well suggest that the ice and rest had the effect of reducing the swelling and resolving the patella tendonitis. I guess there could be some truth in that.

However I am absolutely sure that the acupuncture had a significant effect – not least reducing the pain immediately after the treatment in the way it did. I must admit that I can’t rationalise how acupuncture can help people stop smoking or cure baldness, but I am a convert to the type of acupuncture that Gavin uses at Backs and Beyond. I have been back to Gavin with a few injuries and on the occasions where he has used acupuncture it has worked brilliantly so I would recommend that for those of you suffering from an injury that is not responding to the treatments you are using, find a practitioner that you trust, lay back and see what a bit of ancient Chinese medicine can do for you.