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Prehab for Running

By Vivian Law BPHE, Registered Traditional Chinese Medicine Acupuncture 

Spring is here so many of us are eager to enjoy the warmer weather and perhaps pick up running again. Running outdoors is an awesome activity that many enjoy, which also comes with an increasing incidence of injury as we age. I love running and received an injury before the age of 20, which limits my running to shorter distances. How do we minimize the risk of injury with running? Some will suggest not running at all, which is the case when a person’s body no longer allows the process with an injury. Another option is to run within your current limits and to run smarter. 

I have needed to rehabilitate myself from injury a few times and it is just fine to combine running and walking. In fact, I completed my first and only 10km race a couple years ago in under an hour by walking a minute every 10 minutes I ran. If you are new to running or starting up again, running 1 minute and walking 1 minute is a great place to start. It is better to run a little for a long time, meaning being able to run until older age than run a lot and break down. If it is not possible for you to run for long, consider running shorter distances faster, such as sprints. I’m a bit faster than a giant tortoise, but I practice running 100m, 200m and 400m sprints, with the 400m being my arch nemesis. An additional benefit of sprints is our fast twitch muscle fibres are lost first with aging, so doing some hard work such as sprints, helps us maintain our muscles and abilities longer.

Running is a complex biomechanical process that requires a significant amount of weight bearing load and shock absorption. As we age, our bodies ‘wear out’ in different spots and become more susceptible to injury due to the way our body is used. We can prevent and manage aches, pains and injuries by becoming more aware of how our body is being used and areas where we can improve our strength, stability and mobility. 

Here are some tips on how to better prepare yourself for your next run. You may be accustomed to just lacing up and going, however, should you have any potential injury sites or any concerns, you will benefit greatly from preparing yourself for the run, by doing some prehabilitation work that is specific to your needs. How do you know what prehab is needed? Working with a trainer, coach, or clinic professional such as yours truly, can help you better assess your situation and how you can improve. Here are some tips so you can get started on running smarter right away: 

-Be sure you have optimal range of motion in your toes, especially the big toe joint. Having your toes move easily improves the mechanics of your feet as shock absorbers 

-Work on the mobility of your ankles, especially in terms of dorsiflexion, so this typically means stretching your calves. There are very few people who are particularly mobile this way and mobility in the ankle joint does not naturally improve with age

-Assess and improve the mobility of your hips, especially in relation with being able to extend your hip backwards. Many of us are lacking in this range from our time sitting, so even a few standing hip extensions just before your run can help activate the muscles needed for improved hip extension. 

-Strengthen your core, which includes the hips. Core exercise is hugely beneficial to improving your posture and stability through your pelvis, which contributes to force being efficiently coordinated and distributed through your muscles and joints. 

-Improve your ability squat, so you are able to squat with your feet flat, keep a long spine and get your butt close to the ground. This is the basic test of mobility in the ankles, knees and hips- something that we can always work at improving. The more we can squat as smoothly as an Olympic weightlifter with no weight for us regular humans, the better our hips, knees and ankles are functioning.

-Work on your breathing. Being able to breathe through your nose most of the time, including while running is beneficial to your general health, as your nose filters and warms the air before it enters your lungs. Of course, once you reach a certain intensity, breathing through both the nose and mouth become a necessity. The goal is to breathe through your nose for as high an intensity as possible for you. Practicing a more ideal breathing pattern also helps your posture, which indirectly helps with the load bearing of running. Try this stretch on a regular basis before and/or after a run to encourage deep diaphragmatic breathing: http://www.vivianlaw.ca/relax-and-improve-your-posture/

There are 6 areas mentioned above to consider, so choose 1-3 areas where you know you could improve and pick a quick exercise to do before a run. It could be a bit of stretching, mobility work or a strength exercise. For example, I use a mini acu ball and roll through my feet, do calf raises and stretch my calves before I go for a run, as my ankles are a limiting factor for me. Every runner will have unique needs. If you could use some guidance, we are always here to support you at the Adelaide Health Clinic, 100 King St W, First Canadian Place, Toronto  

Eat, Move and Sleep with the Seasons

I love tropical fruit and strawberries. My good friend Emily suggested I eat fruits more in season back when we were in school for Phys Ed. I took her advice to heart and have made an effort since then to choose fruits and vegetables in season, although I do admit to buying berries year round if available.

Practicing and studying Traditional Chinese Medicine, I have learned that it is ideal to eat more cooked, warm foods in the winter and cool, raw foods are best in the summer. This makes it easier for the body to digest the food we eat, as we work harder to stay warm in the winter and could use a little help to stay cool in the summer.

The amount of sunlight changes with the seasons and our sleep patterns can go along with that. Sleep a bit more in the winter and a bit less in the summer.

When I first studied psychology, we did a short questionnaire to determine how much of a morning or evening person we were and I was surprised to learn I was in the middle. This appears to be genetic to an extent. Here is a questionnaire to take and find out your type:

https://www.cet-surveys.com/index.php?sid=61524

Be sure to scroll down after you get your results, as the questionnaire will list your estimated peak time of melatonin production and your ideal bedtime. Provided that you are able to answer the questions based on your true ideals(you must know them somehow), it is ideal for you to keep a sleep schedule based on the bedtime listed. I have known since the start of university that I am not a morning person, and this has not changed at all!

Exercise in the winter is different, as the weather makes it difficult to go for a bike ride or run, walks are possible, although not the same. Winter activities like skating, snowshoeing, cross country skiing, downhill skiing, and snowboarding are great when available. Ordinarily, one could exercise at the gym, which are unfortunately closed at this time. That leaves us with home workouts for now. No better time then winter to get into more mindful movement like yoga and tai chi, which fulfills the need for movement in a mindful way.

How Does Acupuncture work?

Sometimes things work backwards. I would never have agreed to become a yoga teacher 10 years ago, so yin yoga was even more of a stretch. It is not my thing to sit still, and it remains more natural for me to not sit for more than 20 minutes, since it is my tendency to move. I believe it is a natural inclination to fidget or not and apparently it burns more calories.

I started to study Traditional Chinese medicine over 4 years ago with interest in herbs first, then it became a goal to become a Traditional Chinese Medicine Practitioner of herbs and acupuncture. I had no plan to be a registered acupuncturist, and here I am practicing Traditional Chinese Medicine Acupuncture. Needles still scare me and I have learned to peacefully coexist with them. I take great care to be gentle inserting needles during an acupuncture treatment, treating patients as I would like to be treated. Having practiced on quite a few willing subjects in the past 4 years, I can say I am becoming more and more of a believer in acupuncture, seeing the benefit and difference people feel after receiving a few needles.

You may wonder- how does acupuncture work? On the simplest level, acupuncture works by providing the body with a stimulus (fine needle) to elicit change. How does that change happen in 10-20min with needles retained or within seconds with Japanese style contact needling? The change happens within the body- insertion of the needle affects the nervous system, which transmits (energy)signals within the body. Ideally the treatment calms the nervous system and the specific selection of points provides stimulus for healing or bringing balance to the body. Key concept is all change starts on an energetic level first, then it becomes physical.

Various health professionals can perform acupuncture and it really matters WHO gives you the needles. The more the practitioner knows about the human body/mind and the potential impact of the needles the better. My dad persistently calls needles ‘noodles’ and I do not correct him, since it makes a scary word seem harmless, plus it is funny! Allow me to make an analogy with ‘noodles’ here, imagine an acupuncture treatment as a session where you and the professional are working together to cook ‘noodles’ to the perfect consistency (al dente). You and the acupuncturist are working together to help you feel ‘just right’ (more like yourself- refreshed), so ideally the needles are inserted in the right places for you.

How do we find the right points for insertion of needles? This is a skill with a major variance between practitioners. There is approximately 20 square feet of skin on a human body, 600 muscles and over 360 acupuncture points. We are looking for impact with an acupuncture treatment, a little can go a long way, especially as a form of preventative medicine. In my experience so far, acupuncture is highly effective for regulating energy in the body. For example, heartburn and nausea can be relieved with acupuncture and this is accomplished by encouraging the body movement of the contents of the stomach downwards, which is ‘normal’. All processes in the body have an orderly movement and is more likely to stay that way when a person lives a healthy lifestyle, keeping everything moving as best we can. Acupuncture encourages this ideal circulation.

It is a process to understand traditional chinese medicine and acupuncture, simultaenously simple and complex, so I will keep writing on this topic to offer explanation.

Wishing you all the best for 2021!

What to look for in a health and wellness professional

At this uncertain time in the world maintaining our health is more important than ever and in some ways it has become increasingly difficult to sort through the limitless amount of information coming through at our fingertips. One can use the internet to learn about almost any topic. When it comes to health, is internet research the best course of action? The short answer is no, it is not a good idea play Dr Google and become an overnight expert on your own condition. There is a lot of individuality in health and we all need guidance.

We all need good health and wellness professionals to help us take care of ourselves. Some of us are more privileged and can invest more in these services. In Canada, we have universal health care and it remains important to advocate for ourselves. We can better advocate for our own health and empower ourselves with knowledge by developing good relationships with health professionals.

Having been in the field of health and wellness for over 20 years, here are my recommendations on what to look for when you are seeking professional health related services:

Client/patient centred care: The professional prioritizes your needs and is dedicated to serving to your best interests. If a professional comes recommended by a friend, ask them about their experience with that professional. There are new professionals that are amazing right off the bat, so a long history in practice is not necessary. It is always about your comfort level with the professional.

Education: There are many forms of ‘alternative/natural’ health service offerings where the professional is trained with courses, certifications, degrees, diplomas and seminars of varying standards. More formal education for a professional in the field of health, shows a commitment to learning, which promotes improvement in practice. In an ideal world, we would have more integrated health care- a professional with education in science can help you receive the best of care in alternative health and conventional medicine. Most health services have a price range for that field, and generally speaking, the slightly higher investment in the more educated professional is an excellent value for the level of expertise they bring.

Communication and relational skills: The professional is an excellent listener, is able to understand your needs and concerns AND educate you on best practices to improve your condition. You need to feel comfortable with the professional and how they relate with you. A sense of humour always helps!

Integrity: Does this professional practice what they preach and lead by example? Adhering to ethical standards shows integrity- how does the professional handle various situations and potential conflicts of interest?

Empowerment and motivation: A great health and wellness professional is able to educate and advise you so that you gain an understanding on how to improve your health and feel motivated to do so for your own well being. Having been in the field of fitness for so long, I have heard many times, a trainer needs to look the part. I have never fully embraced this concept, as health cannot be judged by appearances alone. While there may be some short term motivation in seeing an ideal you wish to become, remember that our bodies are always changing. Learning ways to manage your own well being at any stage in life are lasting life skills, while looking great for a few months (especially if it involves a diet) is quite transient.

These are guidelines I have used myself in choosing various health professionals to work with to my great satisfaction, as I have worked with some wonderful people. As you may know, I have been studying Traditional Chinese Medicine the past 4 years and have recently started practicing acupuncture. Choosing a professional to give you acupuncture needs further guidance-although it may be a bit biased coming from me, since I am very sensitive to and afraid of needles! Acupuncture is a form of therapy where needles are inserted into specific sites to elicit some form of change in the body. Yes, a needle (hopefully fine and gently inserted) goes into your body(!) To me, this is a big deal, so I have been very picky about allowing needles to be inserted into my body. I have experienced a few mishaps with being needled and it took some time along with great beneficial effects before I became a believer in acupuncture. I actually went from being quite skeptical of acupuncture to being a believer, which amazes me. Many classmates learning of my aversion to needles asked why are you even studying acupuncture? I was interested in traditional chinese medicine first and foremost, herbs were the priority and acupuncture was part of the program. A young lady who is also afraid of needles mentioned acupuncture was recommended for her and she decided she needed to seek out a practitioner that specialized in giving acupuncture, which is an excellent plan in general and especially if you are nervous. Quite a few licensed health professionals are free to give acupuncture after weekend courses for training. This goes back to my recommendation above for education. Someone who has studied acupuncture for 4 years is different than someone who studied for 3 weeks. Feel free to ask questions. Your body is being ‘punctured’, so feeling comfortable with a practitioner takes on even more importance. If you are at all nervous or afraid of needles, it is imperative that the practitioner is empathetic and helps you feel comfortable. If you get the feeling they don’t really care about your concerns- run fast!

At this time of high stress, we really need to take care of our physical, mental and emotional health. There is a health and wellness professional around you that can help you feel better.

Cheers to your journey towards making life good with maintaining your optimal health

https://www.mahayaforesthill.com/vivian-law/