Most runners, whether they’re training for a marathon or simply out to get some exercise, will stretch before they take off. It’s a ritual that verges on the sacred, strongly connected to the intuitive sense that priming the muscles is a good way to avoid injuring them during the run to come.

But researchers at George Washington University and the USA Track and Field Association (USATF) report that stretching before a run does not appear to reduce injury at all. In fact, among the more than 2,700 runners in the study, ranging from recreational runners to competitive marathoners, all of whom ran at least 10 miles a week, the scientists found similar injury rates — of about 16% — over a three-month period among those who stretched before running and those who did not.

The idea behind stretching is to lengthen the muscle fibers to increase their function and hopefully enhance performance, helping runners maintain a faster pace or run for a longer period of time. A study of British recruits in the military found that a regular stretching routine before training reduced injury rates from 6% to 1%. But other recent studies among gymnasts, football players and wrestlers have questioned the practice, suggesting that stretching does not impact performance at all.

That’s why Dr. Daniel Pereles, a runner himself, decided to look specifically at the role that stretching might play in running injuries. Most studies on the subject, including the British trial in the military, involved stretching routines that included much more than stretching running muscles; they also incorporated calisthenics and other exercises. Pereles wanted to know specifically whether stretching leg muscles — the quadriceps, hamstrings and calf muscles — would have an impact on injuries.

Through the USATF, Pereles was able to recruit enough runners of various levels to get an answer to his question. About half of the 2,729 volunteers were told to stretch their quads, hams and calf muscles for three to five minutes before running for however long they usually exercised. The remaining half were told to run without stretching.

While he found that stretching did not have any effect on injury rates among the two groups, he did find several factors that did seem to influence whether the runners hurt themselves. Heavier runners, as well as those who had recently suffered an injury, were more likely to harm themselves. Interestingly, Pereles also found that those who switched from a stretch to non-stretch or non-stretch to stretch routine for the study were more likely to get injured. Stretchers who were told not to stretch during the three-month study increased their risk of injury by 40%, while those who switched from not stretching to stretching increased their risk by 22%.

Pereles is still at a loss to explain that trend, although he suspects the change in routine accounts for most of the result. “It’s completely confounding, but by switching routines, it somehow messed them up,” he says.

That’s why his advice, as both researcher and runner, is to stick with what works for you. “If it feels good for you to stretch before you run, then continue if you have the time,” he says. “But if it doesn’t feel good, and you like to run and then stretch, or not stretch at all, then that’s fine too. I can’t tell anyone there is conclusive evidence that stretching makes a difference in injuries or performance.”

He notes that professional athletes, who often spend as much time stretching and warming up as they do training, are combining stretching with other activities for a more dynamic warm-up. Most recreational runners, however, don’t have the luxury of spending that much time exercising. Pereles himself admits to changing his running routine as well, and stretching only a little before a run. Part of the reason, he says, is because he doesn’t have the time, and but part of the reason has to do with the science, which so far suggests that it doesn’t seem to make a difference in injury rates.




Are Your Medications Harming Your Running?


By Laurel Leicht

From the September 2010 issue of Runner’s World 

Running keeps you healthy. even active people sometimes need medications—and when you do, telling your doctor you’re an athlete is key. “Exercise can affect how certain drugs work,” says Lori Mosca, M.D., director of preventive cardiology at New York-Presbyterian Hospital. “And certain drugs affect how you feel while exercising.” So before you pop a pill, do your homework.


Treat sneezing, itchy eyes, runny nose

WHY WORRY: Benadryl and Tavist can cause sluggishness and slow reaction times, says Marjorie L. Slankard, M.D., of Columbia University College of Physicians and Surgeons.

WHAT INSTEAD: Dr. Slankard recommends Claritin and Zyrtec (over-the-counter) and Clarinex and Allegra (prescription)—all have fewer side effects.


Treat high blood pressure, heart palpitations, migraines

WHY WORRY: Beta-blockers may cause fatigue. And because they lower heart rate, they can make it tough for your heart to perform at its peak, making even easy runs feel challenging. That’s why Heather Gillespie, M.D., team physician for UCLA Athletics, says she’d never put a runner on beta-blockers.

WHAT INSTEAD: Opt for calcium-channel blockers, ACE inhibitors, and angiotension receptor blockers (ARBs).


Treat bacterial infections

WHY WORRY: Research shows that taking antibiotics in this family (Cipro, Levaquin, Floxin, Noroxin) triples the risk of Achilles injuries. And your Achilles may be vulnerable for months after your prescription runs out.

WHAT INSTEAD: “If I have an active patient, I’ll give them a different antibiotic, like penicillin,” Dr. Gillespie says. NS


Treat pain relief

WHY WORRY: Nonsteroidal anti-inflammatory drugs (Advil, Aleve, Naproxen) can impair kidney function when taken in excess before or during a run, especially if the user becomes dehydrated, says David Nieman, M.D., of the North Carolina Research Center and Appalachian State University. Dr. Nieman studied participants of the 100-mile Western States Endurance Run who used ibuprofen to manage discomfort. After the race, he measured participants’ muscle soreness and found that the pill-poppers felt just as achy as those who hadn’t medicated.

WHAT INSTEAD: If you need to pop something before you hit the road, you probably need a rest day. Running through pain could lead to injury. Postrun, Dr. Gillespie recommends acetaminophen (Tylenol), which has fewer side effects.


Treat depression

WHY WORRY: Tricyclics (Endep, Sinequan) cause increased heart rate, which can make you tire faster on a run. They can also cause lightheadedness and delay electrical conduction in the heart, which can lead to an irregular heartbeat.

WHAT INSTEAD: In some cases, regular exercise can be enough of a mood-booster to reduce reliance on these drugs. If not, selective serotonin reuptake inhibitors (Prozac, Paxil, Zoloft) have fewer side effects. “They still increase heart rate a bit,” Dr. Gillespie says. “But they’re better for active people.”





Yes, it’s true: Jogging, long thought to hurt knees with all that pounding and rattling around, may actually be beneficial for the complex and critical joint. There are caveats, though, especially for people who have suffered significant knee injury or are overweight. But for the most part, researchers say, jogging for your health seems like a good idea.

David Felson, a researcher and epidemiologist at Boston University School of Medicine, says past concern about jogging and knees centered on the continuous impact of the foot to the ground and suggestion that it caused degeneration of the knee and the onset of osteoarthritis. But when researchers actually studied the impact of running on knees, he says, that’s not what they found.

"We know from many long-term studies that running doesn’t appear to cause much damage to the knees," he says. "When we look at people with knee arthritis, we don’t find much of a previous history of running, and when we look at runners and follow them over time, we don’t find that their risk of developing osteoarthritis is any more than expected." Both types of studies agree, says Felson, that recreational running doesn’t increase the risk of arthritis.

'Running Is Healthy For The Joint'

In one study, Swedish researchers found that exercise, including jogging, may even be beneficial. Felson describes how researchers took one group of people at risk of osteoarthritis and had them engage in exercise, including jogging. The other group didn’t exercise. After imaging the joints of the participants in both study groups, they found that the biochemistry of cartilage actually appeared to improve in those participants who were running. Felson says that suggests that “running is actually healthy for the joint.”

Long-term studies show that running doesn’t appear to damage knees. But researchers caution that if you’ve had knee surgery or if you’re more than 20 pounds overweight, you shouldn’t jump right into an intensive running routine.

Jonathan Chang, an orthopedic surgeon in Alhambra, Calif., says that exercise appears to stimulate cartilage to repair to minor damage. It could be that the impact of body weight when the foot hits the ground increases production of certain proteins in the cartilage that make it stronger, he says. This is similar to the way exercise, in particular weight-bearing exercise like jogging, increases bone and muscle mass.

According to Nancy Lane, director of the UC Davis Center for Healthy Aging who specializes in rheumatology and diseases related to aging, scientists are now starting to understand that there is some loss of cartilage annually after a certain age. Some doctors think cartilage loss begins after age 40.

But, according to Lane, “if you have a relatively normal knee and you’re jogging five to six times a week at a moderate pace, then there’s every reason to believe that your joints will remain healthy.”

An Indicator Of Activity

That’s great news for Paul and Lyra Rider, avid joggers who live in the Hollywood Hills in Los Angeles. Jogging on Mulholland Drive, they say, offers fantastic views — along with a relatively flat route. Paul, 46, jogs a seven- to eight-minute mile — not as fast as his younger days. Lyra jogs a bit slower. She enjoys the exercise, health benefits and simplicity of jogging. “You don’t need lots of fancy equipment, and you just feel great when you’re done,” she says.

Lane did some of the very first studies of runners and knees while she was a resident at Stanford University.

"We wanted to answer the important question of whether, if you continued to run into your 50s and 60s and even 70s, you also ran the risk of damaging the knees," she says. The answer, she says: absolutely not. And there was an extra bonus: While enthusiasm for jogging seemed to diminish as people hit their mid-60s, Lane says they were still more inclined than the non-joggers to get out and exercise.

"They were active doing other activities, like walking, yoga, water aerobics," she says. "We found that as these people aged, not only did they feel better about themselves, but their quality of life was better and they tended to actually live longer" than the non-joggers.

So, the message for joggers like the Riders, who hope to be jogging all their lives, is a hearty two thumbs up.

A Few Caveats

Lane cautions that if you have suffered a knee injury, especially one that required surgery, running can actually increase your risk of knee arthritis. So can routinely running really fast — at a five- or six-minute-mile pace — or running in a marathon. Lane’s best advice? Running in moderation, at an eight- to 10-minute mile pace, for about 40 minutes a day.

But if people are more than 20 pounds overweight, Lane says they shouldn’t start off with an intense running regimen.

"I have them walk and walk until they’re to a point where I think their body mass is reduced enough that it won’t traumatize their joints," she says. Otherwise, significantly overweight joggers run the risk of that extra weight stressing the knee to the point of inflammation, the formation of bony spurs and accelerated cartilage loss.




Follow these time-tested principles and you’ll spend more time on the roads—and less in rehab.

By Amby Burfoot (@exerscience)

From the March 2010 issue of Runner’s World

The 10 Laws of Injury Prevention

In the mid-1970s, Runner’s World medical editor George Sheehan, M.D., confirmed that he was hardly the only runner beset by injuries: A poll of the magazine’s readers revealed that 60 percent reported chronic problems. “One person in 100 is a motor genius,” who doesn’t have injuries, concluded the often-sidelined Sheehan. To describe himself and the rest of us, he turned to Ralph Waldo Emerson: “There is a crack in everything God has made.” With all the amazing advancements in sports medicine, you’d think that our rates of shinsplints and stress fractures would have dropped since Sheehan’s era. But 30 years after running’s first Big Boom, we continue to get hurt. A recent poll revealed that 66 percent of respondents had suffered an injury in 2009.

Still, I figured medical science must have uncovered lots of little-known prevention secrets. So I went searching for them. After reviewing hundreds of published papers, I was surprised to find few answers. Most of the studies are retrospective, looking back. A few are prospective, looking forward. Even then, they’re not the gold standard, which are randomized, controlled, double blind experiments. And conflicting results make it difficult to draw meaningful conclusions. I learned, for example, that running injuries can be caused by being female, being male, being old, being young, pronating too much, pronating too little, training too much, and training too little. Studies also indicate that the “wet test” doesn’t help shoe selection, old shoes don’t offer less cushioning than newer shoes, and leg-length discrepancies don’t cause injuries (but too-little sleep does). Oh, here’s good news: To get rid of blisters, you should drink less and smoke more.

Clearly, the medical studies wouldn’t offer much help. So I switched to Plan B: I interviewed nearly a dozen of the best running-injury experts in the world. They come from the fields of biomechanics, sports podiatry, and physical therapy. Like the medical studies, these experts didn’t always agree. But the more I talked with them, the more certain principles began to emerge. From these, I developed the following 10 laws of injury prevention. I can’t guarantee that these rules will prevent you from ever getting hurt. But if you incorporate these guidelines into your training, I’m confident you’ll be more likely to enjoy a long and healthy running life.



Study of Long Distance Runners Suggests It’s Sometimes OK to Push on Despite Pain.

By Charlene Laino
WebMD Health News

Nov. 29, 2010 (Chicago) — Contrary to what’s been taught, you can run through pain.

So say researchers who used a 45-ton mobile MRI unit to follow runners for two months along a 2,800-mile course to study how their bodies responded to the high-stress conditions of an ultra-long-distance race.

"The rule that ‘if there is pain, you should stop running' is not always correct,” says study leader Uwe Schutz, MD, a specialist in orthopaedics and trauma surgery at the University Hospital of Ulm in Germany.



Running 'can slow ageing process'

Running on a regular basis can slow the effects of ageing, a study by US researchers shows.

Elderly joggers were half as likely to die prematurely from conditions like cancer than non-runners.

They also enjoyed a healthier life with fewer disabilities, the Stanford University Medical Center team found.

Experts said the findings in Archives of Internal Medicine reinforced the importance that older people exercise regularly.



Double Lung Transplant Patient Completes NYC Marathon

It took Tim Sweeney almost seven hours to finish the New York City Marathon but he walked on air every step of the way.

The 33-year-old medical miracle competed in the epic race Sunday with a new set of lungs after receiving a double transplant a year ago.

"It was so much more than I expected. It was overwhelming," Sweeney said after clocking in at just under six hours and 55 minutes. "I didn’t care about time. I really wanted to finish. It meant a lot to me."

Sweeney, a personal trainer from Connecticut, suffered from cystic fibrosis, but always stayed active.

In 2007, however, he lost 80% of his lung capacity. He underwent the transplants at New York-Presbyterian Hospital Columbia last year.

If Sweeney had any doubts along the 26.2-mile course, he had his surgeon, Dr. Joshua Sonett, running with him every step of the way. “When he said he wanted to run the marathon … I didn’t know if it was the right thing. But he did it, and he did it safely,” said Sonett, a five-time marathoner.

Sweeney was one of 43,000 runners to compete Sunday in a field filled with inspirational and dramatic stories.



The Physical and Mental Benefits of Running

With all the different forms of exercise out there, why run? For me, it was a simple choice of economics, as I could save money by replacing my gym membership with a treadmill and a pair of moderately priced running shoes. Others who run, do so for different reasons.

While running is easy to learn and fairly inexpensive, it also benefits the runner’s mental outlook. Basically, what is good for the body is good for the mind, and psychologically speaking, running has a lot to offer!

You have to wonder at times what you’re doing out there. Over the years, I’ve given myself a thousand reasons to keep running, but it always comes back to where it started. It comes down to self-satisfaction and a sense of achievement. – Steve Prefontaine



Marathons, Heart Damage, MRIs, and VO2max

Three points. First, do marathons “damage” hearts? Second, are runners who train less more susceptible to damage? And third, should prospective marathoners get a VO2max test to figure out whether their heart can handle a marathon? 



Understanding the Heart Hazards of Marathon Running.