Onward and Upward

Today I had a celebration of sorts.  A little personal victory party.  After spending the latter half of 2016 dealing with a stress reaction in my foot, I can comfortably say I am not injured anymore!  As a physio, I often advise my patients to mindfully avoid falling into a long term "disability mentality" when they are injured.  There comes a point when your body is healed, but it's easy to still think of yourself as "damaged," and remain fearful of moving normally, living normally.  Although it's still healthy and wise to be cautious post injury, consciously leaving that "injured runner" mentality behind is necessary and so liberating!

Today I completed my first 4 week training block after coming out of my boot.  I started slowly, so slowly, painfully slowly.  First I started replacing some of my bike time with walking on the treadmill.  Then I started moving into run:walk intervals, and then finally short steady runs.  Once I was able to run 4 miles with no walk breaks I moved outside, because I was then moving enough not to freeze to death!  My mileage has slowly increased and I'm feeling the need to hold back to stay in zone 1, which is a great sign. Finally.

All along the way, I gave my body small tests I strongly felt that I could pass. I was not interested in self-sabotaging this whole process and wasting all that valuable healing time I had spent resting. This is the criteria I give my patients, and I made sure to apply it to myself each and every day.

Before Running:
Pain-free walking before running. My personal test was 60 min on the treadmill.

During Running:
1) No obsessing about your injury. If you are aware of your problem with each step and you can't relax and forget about it for whatever reason, that's a sign that maybe you shouldn't be running that day.
2) No limping or altered gait allowed.  I constantly monitored my gait with the metrics from my Garmin, which meant wearing my HRM for all runs.  If my ground contact time R/L balance spread by more than 2% over the course of a run (L 51% R 49%) then I knew I needed to adjust my plan for the next few days.

After Running:
1) No lasting discomfort > 2 hours.
2) No increased morning stiffness or discomfort the next day.
3) Overall healing trend - each week is better than the last.

I just had a 3D Gait Running Assessment completed where I work at The Running & Gait Centre.  I can happily say there is nothing  biomechanically precluding me from running - no red flags.  In fact, my gait is better than it was last year! I'd highly recommend any recovered runner consider having one of our assessments done before starting to increase mileage, if for nothing else than peace of mind.  I'd be lying if I said that I am 100% pain free, but the vast majority of the time I am and each week is better than the last.

So it's time to leave that injured runner mindset behind and move on towards my next race goal.  I am finally confident enough to say that I'll still be toeing the line at the Zion 100 in April.  Very excited. Onward and Upward!

VO2 Max and Lactate Threshold Testing

Last week I had my first VO2 max and blood lactate testing done at the Pan Am Clinic where I work.  I was so excited. Despite being able to do field tests and now having a ridiculously complex and expensive Garmin that predicts such numbers from heart rate and running data, blood lactate testing and actual VO2 max testing is still considered more accurate and the gold standard of measure for aerobic fitness. So I booked myself in!

I have some big goals for 2016 and although it's getting late in the season to be having such testing done, I really wanted a snapshot of my current aerobic fitness profile in order to train more specifically throughout the rest of the year.

What is VO2 max?  It is a value given to the maximal rate at which oxygen can be taken in, transported and utilized by working muscle.  The higher your VO2 max, the better is your ability to use oxygen during muscular work.  It is often expressed in the relative score (ml/kg/min).  This is important for athletes that must move their bodies against the force of gravity (runner, X-C skiers) and for comparing individuals of different body sizes.  The absolute (L/min) value is important for sports where body weight is supported (cycling, rowing) and is a value that is only meaningful to the individual - there is no point comparing this number to others.

Here is one example of a normative data chart.  There are many and they all vary slightly.

Here is another one:

Elite runners and athletes are reported to have VO2 max values in the 70s and 80s.  The world record is reportedly held by a cyclist from Noway named Oskar Svendsen (97.5).  There is debate as to how relevant VO2 max really is in predicting performance, as athletes with lesser scores can beat those with higher scores.  Hence the whole mind over matter debate...which is best saved for another post.


Lactate threshold (LT) is used to signify your anaerobic threshold which is the shift from the energy supply primarily from aerobic to anaerobic.  Blood lactate is a measure of the lactic acid that appears in the blood as a result of anaerobic metabolism when oxygen delivery to the tissues is insufficient to support normal metabolic demands. LT is indicated by the sudden rise in the lactate when the anaerobic energy system (without oxygen) becomes the primary contributor to exercise.
Athletes all want to stay out of the anaerobic zone as much as possible and having a high LT enables them to perform to a higher level without those dreaded burnings legs. Here is a great article on LT.

Here are some pictures of my testing:

Nose clamped, breathing into a tube, heart rate monitor on

It was hard to see where I was on the treadmill with all that gear - I kept bumping into the front

This is how the test worked: After I had changed and put on the heart rate monitor, I warmed up on the treadmill at a very easy pace for 15 min.  This allowed my heart rate to stabilize, as it spikes all over the place during the first 10-15 min of any run.  Then I put on the head gear, clamped my nose shut, sealed my lips around the mouth piece, and hopped back on the treadmill.  Dean pricked my finger and took a blood sample (in the same way as a diabetic will do a blood sugar test) to determine my baseline blood lactate.  Then I started running on the treadmill.  Every 3 minutes I hopped to the side to allow Dean to take another blood sample.  Then Richard bumped the speed up by 0.5 mph and I ran for another 3 min.  We repeated this cycle several times, while Dean monitored all sorts of information on his computer and reported the blood lactate levels to Richard.  We started at 5.5 mph and by the time we reached 8.0 mph I was starting to wonder when this test would be over.  After running at 8.5 mph for 3 min, my blood lactate finally jumped from the low 3 mmol/L to 4.8 mmol/L (if my memory is correct).  At this point, we had our LT reading, but I still needed my VO2 max scores.  Richard then started to increase the incline on the treadmill by 2% grade every minute, while I was still running at 8.5mph.  It didn't take me long, and after 2 min I called it quits at 4% grade. I'm not sure if I could have gone more, but I thought I was maxed at the time.

Richard and Dean

The whole test took about 45 min on the treadmill, and I had my results within another 15 min.  Dean and Richard were amazing and very good at explaining the whole process and interpreting my results.  I have debated as to whether I should share my results publicly, but I'm no elite athlete and this is a form of journal for me, so I will use my real numbers to help explain what it all means.

Absolute VO2 max: 3.4 L/min
Relative VO2 max: 53.1 ml/kg/min
Maximum heart rate: 184 bpm
Lactate threshold: 3.1 L/min
HR at LT: 172 bpm
LT as a % of VO2 max: 91%

Interestingly, Dean asked me what I thought my LT was before he told me.  He said that people who regularly monitor their HR can usually tell when they reach it just by the burn in their legs.  I told him 170-173 bpm.  I was bang on.  So what do these numbers mean to me?  Having a high LT as a % of VO2 max means that I can run almost to my max before my body shifts to anaerobic metabolism.  It could be better though, and my coach, Sarah Seads, suggests that I work on bringing my LT up to 95% of my VO2 max before I try to up my VO2 max.  How is all this done?  By using these numbers to determine your five training zones, which can done with online calculators, or by an experienced coach or exercise physiologist (Dean gave me my zones during my session).  Knowing your specific heart rate zones can help you train more intelligently and keep your easy runs truly easy, and your tempo or speed workouts truly effective.

Now, we'll see if all this knowledge pays off for me. Ultimately, it's up to me now to apply this information to my training.  Thanks Dean and Richard for a great testing experience!

Running Strong and Injury-Free: Using the Off Season to Your Advantage

The race season is over.  There are no more race goals, no more training plans on the fridge.  The holiday season has arrived and it’s easy to lose focus and start running inconsistently, setting yourself up for a potential injury. Conversely, maybe you’ve been battling an injury all season and are hoping it will start to heal over the holidays.

The off-season is the prime time to check in with your body.  It’s an opportunity to be proactive rather than reactive.  

Some primary causes of running injuries are:

• Training errors: This includes too much too soon, poor planning and periodization, and overtraining.
• Sub-optimal biomechanics: This leads to less ability to absorb training errors.
• Poor body alignment: Sometimes you can change this, sometime you can’t.
• Muscle Imbalances: Imbalances in strength and muscle length can lead to an asymmetrical gait pattern which is a big predicator of injury in runners.
• Lack of variety:  Running involves highly repetitive movement patterns that can lead to overuse of key muscles if each footstep lands on the ground in the same way.
• Incorrect or worn out shoes: This is less of a factor if you have addressed biomechanical, alignment and muscular factors, but should be considered.

Here are my top five suggestions for setting yourself up to be injury free in the new year.

• Slow down and do a self assessment.  Pay attention to those niggles and pains that you’ve been ignoring all season.
• Identify and correct the risk factors you can on your own.  If your gut is telling you something needs to be changed, follow your instinct.  Make changes slowly and gradually.
• Cross train.  When the weather precludes you from getting outside as much as you’d like, the off-season can present the perfect opportunity to add variety to your training through cross-training.  Consider activities like spinning, cross-country skiing, skating, weight training and yoga.
• Make a plan.  Take the time to develop a training plan for the next season or race.  Hiring a coach can provide invaluable guidance, but there are many good training plans available online.  This will help you train smart by increasing your mileage gradually and intelligently, and balancing hard training days with recovery and rest days. Recovery is as much a part of training as running hard, and it’s important to build rest into your plan.
• Get professional help in areas you can’t correct yourself.  Attempting to make changes to your biomechanics, alignment and strength are best done in the off-season, not at the peak of your training cycle when your body cannot absorb those changes well.  Having professional guidance can help you focus your efforts in the areas you need to address most.

If you are a runner who has been dealing with an injury for a long time with no resolution, or a runner who wants to prevent future injuries from occurring as you reach for your next big goal, you might want to consider visiting the Running and Gait Centre at the Pan Am Clinic for a 3D Biomechanical Gait Analysis.  The centre is the only clinic in Manitoba to offer this highly advanced assessment in a clinical setting.

3D Gait Analysis

During the assessment you will have 16 sensors attached to your joints, and five sensor clusters attached to your legs and pelvis. As you run, six cameras measure your gait pattern.  A report is generated with 16 gait variables, comparing you to a database of thousands of runners.  This data is combined with a very thorough physical assessment that seeks to correlate your gait report with your measures of alignment and muscle strength and length.

You will then return to the centre for a second visit where you will be presented with a comprehensive report and plan for addressing your individual risk factors and weaknesses.  Specific strengthening, stretching, shoe and orthotic recommendations, and targeted physiotherapy treatment will all result in improved running form and efficiency. Research has shown this method to be very effective in helping runners perform pain-free, and to their peak potential.

The Running and Gait Centre is currently accepting bookings for January 2016.  For more information, visit our website or call 204-805-1912.Kim Sénéchal is the lead physiotherapist at the Running & Gait Centre: Foundation Rehabilitation Services at the Pan Am Clinic.  She is also an ultra marathon runner and run coach.

NB: This article was written for the Manitoba Runner's Association newsletter, Dec 2015.