sign in sign up
<<
Home , Aerobic exercise, Endurance training, Exercise, Jogging

GALILEO, University System of Georgia GALILEO Open Learning Materials

Nursing and Sciences Open Textbooks Nursing and Health Sciences

Spring 2018

Walking and for Fitness

Scott Flynn Georgia Highlands College, [email protected]

Lisa Jellum Georgia Highlands College, [email protected]

Jonathan Howard Georgia Highlands College, [email protected]

Althea Moser Georgia Highlands College, [email protected]

David Mathis Georgia Highlands College, [email protected]

See next page for additional authors

Follow this and additional works at: https://oer.galileo.usg.edu/health-textbooks

Recommended Citation Flynn, Scott; Jellum, Lisa; Howard, Jonathan; Moser, Althea; Mathis, David; Collins, Christin; Henderson, Sharryse; and Watjen, Connie, " and Jogging for Fitness" (2018). Nursing and Health Sciences Open Textbooks. 3. https://oer.galileo.usg.edu/health-textbooks/3

This Open Textbook is brought to you for free and open access by the Nursing and Health Sciences at GALILEO Open Learning Materials. It has been accepted for inclusion in Nursing and Health Sciences Open Textbooks by an authorized administrator of GALILEO Open Learning Materials. For more information, please contact [email protected]. Authors Scott Flynn, Lisa Jellum, Jonathan Howard, Althea Moser, David Mathis, Christin Collins, Sharryse Henderson, and Connie Watjen

This open textbook is available at GALILEO Open Learning Materials: https://oer.galileo.usg.edu/health-textbooks/3 Open Textbook Georgia Highlands College

UNIVERSITY SYSTEM OF GEORGIA

Scott Flynn, Lisa Jellum, Althea Moser, Jonathan Howard, Sharryse Henderson, Christin Collins, Amanda West, and David Mathis Walking and Jogging for Fitness Walking and Jogging for Fitness

Scott Flynn, Lisa Jellum, Althea Moser, Jonathan Howard, Sharryse Henderson, Christin Collins, Amanda West, and David Mathis

1. Benefits of Walking and Jogging for

2. Getting Started

3. Adaptations to Stress

4. Technique: The Art of Walking and Jogging

5. and Energy Requirements

6. Injuries and Injury Prevention

Appendix:

Walking and Jogging for Fitness by Scott Flynn is licensed under a Creative Commons Attribution- NonCommercial-NoDerivatives 4.0 International License.

Direct any permission requests to:[email protected] Chapter 1 The Benefits of Walking and Jogging as Exercise

The History

The benefits of and Anatomy of Melancholy, “Opposite to exercise exercise have been recognized for as long as is Idleness or want of exercise, the bane of body man has been around. Our first ancestors and minde…one of the seven deadly sinnes, and didn’t think they were exercising. For them, it sole cause of Melancholy.1 (1632) Heironymus was more like chasing their next meal to survive Mercuralis (from the 16th century) defined instead of chasing a ball to win a game or going exercise, a definition that has changed little for a leisurely stroll. Regardless, in order to since the 16th century, “exercise is the survive, they had to be actively engaged in deliberate and planned movement of the moderate levels of physical activity either human frame, accompanied by breathlessness, through hunting or gathering foods for their and undertaken for the sake of health or sustenance. In other words: no exercise, no fitness…”1 food; no food, . How’s that for a health benefit? Beyond the physical health benefits, there are affective benefits associated with The Greek physician Herodicus in fourth group games and activities. Ancient Mayans century B.C. recognized the importance of organized the first team game called the Ball exercise. He practiced gymnastic medicine, a Game. It consisted of two teams trying to get a branch of Greek medicine that relied on ball through a hoop mounted about 23 feet on vigorous exercise as a treatment.1 Hippocrates a wall. The rules were to get the ball through also agreed, “if we could give every individual the hoop using certain parts of the body. In the right amount of nourishment and exercise, some cases the captain of the losing team gave not too little and not too much, we would have himself as a human sacrifice to the winning found the safest way to health.”1 The Jewish team, an act that was believed by the Mayans philosopher Rabbi Moses ben Maimon of the to be a vital part of prosperity. 2 12th century, a physician to the Sultan of Egypt, stated, ”Anyone who lives a sedentary life and American Indians are thought to be the founder does not exercise…even he eats good and takes of the modern game of lacrosse as well as other care of himself according to proper medical stick games. In general, Lacrosse (which principles-all his days will be painful ones and received its name from French settlers) was his strength will wane.”1 Robert Burton, a perceived as a cultural event. theologian and scholar also saw the benefits of an active lifestyle and stated in his book The things like yard , house cleaning, walking the dog, or taking the steps instead of the elevator. Physical activity does not have to be done all it once. It can be accumulated through various activities throughout the day. Although typing on a phone or laptop or playing video games does require and a minimal amount of energy, the amount required isn’t sufficient to improve health.

Despite the common knowledge that physical George Catlin [Public domain], via Wikimedia Commons , activity is tremendously beneficial for health, https://commons.wikimedia.org/wiki/File%3ABall_players. rates of activity continue to be below what is jpg needed. According to the CDC, only 1 in 5 (21%) of American adults meet the recommended The game was sometimes used to settle physical activity guidelines from the Surgeon disputes between tribes, victory and choosing General. Less than 3 in 10 high school students teams was thought to be controlled get 60 minutes or more of physical activity per supernaturally, and games and equipment were day. Non-Hispanic whites (26%) are more active prepared ritualistically. 3 than their Hispanic (16%) and Black From Ancient History to Modern Times counterparts (18%) as is the case for males (54%) and females (46%). Those with more In retrospect, the perceived benefits of education and those whose household income exercise have changed very little since is higher than poverty level are more likely to Herodicus or the American Indians. Mounting be physically active. 4 research continues to support early thoughts that exercise is vital to human quality of life. Exercise, although often used interchangeably Culturally, plays a huge role in growth and with physical activity, is a sub-category of of development of youth and adults. Physically, physical activity. Exercise is a planned, there is indisputable evidence associated with structured and repetitive movement pattern the short and long-term benefits of regular intended to improve fitness. As a positive side- exercise to brain, , , muscular, and effect, it also significantly improves health as emotional health, and reductions in risk for well. Fitness improvements would be seen as chronic such as , , and the heart’s ability to pump blood, increased . muscle size and flexibility. For the most part, walking and jogging in this text is viewed in the Physical activity is defined as any movement context of exercise. carried out by skeletal muscle that requires energy and is focused on building health. Health The Role of Walking and Jogging improvements would be seen as improved Walking and jogging can play a major , blood-lipid profile, and heart role in increasing these activity rates. Why? One health. Acceptable physical activity includes of the beauties of walking or jogging comes from their simplicity. For example, the basic given weekend, anywhere from 5 to 30 events requirements to begin a walking program are posted. Many of which carry low include: shoes, clothing, and a place to walk. For registration costs, short travel, and raise funds most, these items are readily available. In other for good causes. In addition to the old words, the excuse of cost and/or accessibility is fashioned 5k and 10k, many “new-age” events simply not a good one. have emerged with similar distances but that also include challenging obstacles and other If you’re wanting to be competitive and elements of fun such as color-runs or glow-in- not a just-for-fun kind of runner, there’s no the-dark runs. In other words, accessibility to problem with the availability of races. One of events is rarely an excuse. the fastest growing race distances, the half- , continues to grow with 1.8 million Walking generally attracts a less finishers in 2012 for the 13.1 mile event. The competitive group although many clubs and most popular events, 5k’s, included 6.2 million organizations exist to support competitive race finishers. Marathoners dropped slightly from walking, a sport included in the summer 2011-2012 to 478 thousand finishers of the 26.2 Olympic games. Not all finishers of mile events. The number of resources available are actually runners. Many are full-distance to runners has also increased with more and walkers. Regardless, most walkers are walking more online training programs, many of which for fitness or social enjoyment and not for are free. 5 competition so recommendations in this text primarily adhere to that non-competitive approach.

Health Benefits

Walking and jogging are considered —a type of exercise that requires -- more frequently referred to as simply “cardio.” Both walking and jogging not only improve health but also increase fitness levels. The health benefits of aerobic exercise By unknown, from Jackson Mississippi, USA (Blues Race thru have been well documented since Dr. Kenneth Belhaven) [CC BY-SA 2.0 (http://creativecommons.org/licenses/by-sa/2.0)], via Wikimedia Cooper wrote the book in the early Commons) 60’s.

In addition to the growth of half People, in general, exercise for many marathons and marathons, 10k’s and 5k’s have reasons. Ironically, most reasons lack a specific become easy ways for many organizations to focus on the health benefits. While that’s not a raise funds for a particular cause. As a result, problem, per se, it’s still important to these local weekend events can be found by the remember health as the main objective. dozens in many areas of the country. For Nonetheless, the exact reasons vary between example, Rungeorgia.com advertises a race genders and ages but include: calendar for the entire state of Georgia. On any Females Males Clearly, the more calories you burn 1. Weight Control Muscle tone during exercise the easier it will be easier to Feel good after Increased energy 2. prevent becoming or obese. 3. Increased Cardiovascular benefits energy Walking and jogging, especially at high 4. Muscle tone Weight control intensities require significant energy demands 5. Cardiovascular Feel good after and have been shown to reduce body weight if benefits performed consistently over several weeks. Not 6. Keep flexibility Reduce stress only do you burn extra calories during the 7. Reduce stress Build strength exercise, but metabolic rate remains elevated 8. Time for self Enjoy exercise 9. Enjoy exercise Keep flexibility for up to 24 hours after exercise burning 10. Improve self Time for self additional calories. esteem Source: Fitness Products Council/IHRSA/American Data, Exercise has not only been used as Inc., Reprinted in SGMA’s "Tracking the fitness movement" prevention for CVD and reports. but also as a treatment strategy after diagnosis. Cardiovascular Health Benefits In addition to CVD and obesity, regular aerobic exercise may also help prevent: While the exact details vary for how much exercise is required and at what intensity is • Diabetes (Type 2, gestational) most beneficial, little doubt exists as to whether • High or not exercise will significantly reduce risks of • Cancer of the breasts, prostate . Fit individuals, male or and colon and rectum female, are much less likely to die from • as well as cerebro- • Delay the onset of Alzheimer’s vascular disease (). Current research and Parkinson’s disease suggests “more is better,” in terms of • Osteoperosis cumulative energy expenditure, with the most • Kidney Disease pronounced change in risk seen with moderate • Improves levels of activity. Specific adaptations to the function cardiovascular system that occur as a result of exercise will be discussed in a later chapter. In addition to the preventive benefits, it can be used to treat: Obesity • Heart disease Obesity has become an epidemic in the modern • Asthma world with nearly 70% of all Americans being • COPD considered overweight based on body mass • Cystic fibrosis index measurements. Unfortunately, only about • Hyperlipidemia 21% of adults 18 and older engaged in regular • Multiple sclerosis physical activity according to the Center for • Arthritis Disease Control. 6 • • disorder • Improves academic performance

Clearly, Hippocrates was correct in his statement that regular exercise is “the safest way to health.”

1. Buckworth, Janet; Dishman, Rod K.; Exercise Psychology, 2002, Human Kinetics, Champaign, IL 2. Cartwright, Mark, The Ball Game of Mesoamerica, retrieved May 2017, http://www.ancient.eu/article/604/ 3. Wikipedia, History of Lacrosse, retrieved May 2017, https://en.wikipedia.org/wiki/History_of_la crosse 4. Center for Disease Control and Prevention, CDC Stats, retrieved April 2017 https://www.cdc.gov/physicalactivity/data/ facts.htm 5. USA, 2016 State of the Sport-Road Running Trends, retrieved May 2017, http://www.runningusa.org/state-of-sport- us-trends-2015 6. Center for Disease Control and Prevention, Overweight and Obesity, retrieved May 2017, https://www.cdc.gov/obesity/

and aspirations intended to reach an endpoint Chapter 2 in a short period of time. The idea of returning to teen level weight and/or fitness, while alluring and well-intended, are simply Getting Started With a unrealistic for most adults. The physical demands and time constraints associated with Walking/Jogging the adult life stage must be taken in to consideration in order to be successful. If not, Program goals remain dreams (at least until the next year).

Both walking and jogging are simple activities ften, the hardest thing to do in regards that promote health and fitness, as previously to beginning a new routine is simply discussed. Like any other lifestyle habit, optimal starting the new routine. Old habits, O health and fitness do not occur over night. Time insufficient motivation, support from others, and more importantly, consistency, drive health etc. all play a role in whether or not you and fitness outcomes. So, as you begin your successfully begin a new exercise program. program focus on what will make you Success, in this case, is measured by your ability consistent. The term lifestyle implies “habits, to consistently participate in the program to attitudes,…standards…that together constitute reap the fitness benefits associated with the the mode of living” 1(dictionary) or behavior activity. that is imbedded into your daily and weekly This chapter will cover the basics of beginning a routine. You’re not simply trying to change walking or jogging program in order to give you physically, but rather modify your mental the best chance of being successful. perception to promote long term health.

Think Lifestyle The steps below should guide you through this process. Before getting to the point of Beginning a walking or jogging program can be beginning your program, you should a daunting task. To illustrate the concept of understand the safety concerns associated with lifestyle, take a moment and consider your local exercise. . You may notice the attendance there in the month of January increases dramatically. Safety First Some estimates suggest as many as 80% have The physical challenges of beginning a new stopped coming by the second week of exercise program can place you at a greater risk February. However, as February and March of injury, illness or even death. Results from approach, attendance steadily declines various studies suggest vigorous activity eventually falling back to pre-January levels. increases the risk of acute cardiac heart attacks Why does this occur? Why aren’t these new and/or sudden cardiac death (ACSM pg. 10).2 customers able to continue the routine for the While that may seem contradictory to the entire year? One possible explanation: patrons previously suggested benefits of walking and are unsuccessful at viewing their routine as a jogging, the long term benefits of exercise lifestyle. The new year brings resolutions, goals

Chapter 2-Getting Started With a Walking/Jogging Program 1 unequivocally outweigh the risks during 5. Impaired fasting glucose (diabetes)- exercise. In active young adults (younger than blood sugar should be within the 35), incidence of cardiac events are still rare, recommended ranges affecting 1 in 133,000 in men and 1 in 769,000 in women. In older individuals, 1 in 18,000 Atherosclerosis-the progressive condition cardiac events occur. 2 of fatty substances depositing on arterial walls, leading to the development of Of those rare cardiac incidents that do occur, plaque and hardening of arterial walls the presence of preexisting heart disease is the common thread, specifically atherosclerosis. 6. Obesity- of >30, waist Atherosclerosis causes arteries to harden and circumference of >102 cm men, >88 cm become clogged with plaque which can break women, or waist to hip ratio of >0.95 apart, move to other parts of the body, and clog men, >0.86 women smaller blood vessels. In light of this, it is 7. -persons not meeting important to screen individuals for risk factors physical activity guidelines set by US associated with heart disease before they begin Surgeon General’s Report an exercise program. In addition to identifying your risk factors, you The American College of should also complete a Physical Activity recommends a thorough pre-screening to Readiness Questionnaire (PAR-Q). The PAR-Q identify any risk of heart disease. The 7 major asks yes or no questions about symptoms risk factors looking to be identified are below. 3 associated with heart disease. Based on your risk factors, and your responses in the PAR-Q, 1. Family history-if a cardiac event has you are then placed into a risk category: low, occurred with your father or first- moderate, high. degree male relative before the age of 55, or mother or first-degree female • Low risk persons are men younger than relative before 65, there could be a 45, women younger than 55 who genetic predisposition to heart disease. answer no to all of the PAR-Q questions 2. Cigarette smoking- currently smoke, or and have one or no risk factors. have quit in the past 6 months Although still a good idea, further 3. -Blood pressure at or screening such as getting physician’s above 140 mm/HG systolic, 90 mm/Hg approval isn’t necessary. diastolic • Moderate risk persons are men of or 4. Dyslipidemia-cholesterol levels that greater than 45, women 55 OR those exceed recommendations (130 mg/dL, who have two or more risk factors. HDL below 40 mg/dL, or total Because of the connection between cholesterol of greater than 200 mg/dL) cardiac disease, the seven risk factors, and risk during exercise, it is recommended you get physicians approval before beginning an exercise program.

Chapter 2-Getting Started With a Walking/Jogging Program 2

• High risk persons answer yes to one or • Create a plan (what route will you choose?) more of the questions on the PAR-Q. • Follow Through (start driving!) Physician’s approval is required before beginning a program. Assess Your Condition

Once you have determined your ability to safely In order to adequately prepare for starting your perform the demands of walking and jogging, personal walking and jogging program, you will you are now ready to move to the next steps in need to take a hard look at your current level of the process of beginning your program. Other fitness. With multiple methods of assessing safety concerns, such as where you walk and your fitness, you should select the one that best jog, how to be safe during your workout, and applies to you. Understand, however, that each environmental conditions will be addressed at a walking/jogging assessment discussed here is later time. attempting to estimate a key physiological marker, your maximal oxygen consumption.

As you look at the remaining steps, a simple Your maximal oxygen consumption, or VO2max, analogy may help to better conceptualize the measures your body’s ability to take in and process. utilize oxygen which directly correlates to your overall health and fitness. Obtaining a good Imagine you are looking at a map because you estimate of your VO2max will provide you a one- are traveling to a particular location and you’d time glance at your baseline fitness and health, like to determine the best route for your provide a baseline measurement and help you journey. To get there, you must first determine gauge the efficacy of your fitness program in your current location and then find the roads subsequent reassessments. that will take you to your desired location. You must also consider roads that will present the Some of the most common walking/jogging least amount of resistance, provide a assessments used to estimate your VO2max reasonably direct route, and don’t present any include the 12 minute Walk, 1.5 mile Run-Walk safety hazards along the way. Of course, , and 1 mile walk test. Unfortunately, these planning the trip, while extremely important, field assessments, although practical and isn’t the final step. You must now actually drive inexpensive, only provide good estimations. For the route, monitor your car for fuel and/or a more accurate assessment, you would need to malfunction, etc, and be prepared to reroute perform a lab-based VO2max test using should obstacles arise. equipment that measures the volume of oxygen and carbon dioxide being moved in and out of Preparing yourself for a walking and jogging the lungs during exercise. While more accurate, program and ultimately, trying to adapt a the expense and availability make it impractical lifestyle approach to exercise, requires similar for most. Unlike the lab test, the field preparation. You will need to: assessments are basically cost free, user • Assess your current fitness (where are you friendly and require very little expertise to on the map?) conduct or perform. In addition, the key point

• Set goals (what is your destination’s Maximal Oxygen Consumption (VO2max )-the location?) ability to take in and utilize oxygen

Chapter 2-Getting Started With a Walking/Jogging Program 3 of the assessment is measuring differences success. With goals, you get to determine what rather than absolute values and the field tests success is, you get to determine the end point. can accurately meet that objective. Without goals, you have no way to measure whether or not you’ve succeeded or not. In You will find information, such as how to safely other words, you could easily exceed your goals perform the assessments, at the end of chapter and actually think you failed. 2. To complete this step, select one or two of those assessments, read and follow the The art of setting goals includes stating them in instructions, and record your results. a clearly defined and measurable way. You should consider exactly what you would like to In addition to walking and jogging assessments, accomplish, make sure you can measure it, and other measurements can be helpful in establish a time frame in which you will have measuring the success of your activities. Given achieved your goal. These are often termed the top reasons both males and females SMART goals exercise, weight management and musculature, measuring body fat and weight along with • S-specific; be as specific as possible. anthropometric measurements will help • M-measurable; if you can’t measure it, determine if these areas are being affected by you won’t know you’ve completed the your walking and jogging routine. goal. • A-attainable; consider whether or not Set Goals you will have the resources to obtain Using an analogy of a map, you must determine your goal (time, cost, support, etc.) your current location in order to determine the • R-realistic; while your goal should be best route to get to your destination. In the challenging, it shouldn’t exceed previous step, you essentially figured out “your reasonable expectations. current location” and now must determine • T-time frame; set a deadline to “your destination” by setting up some goals. accomplish your goal.

In his bestselling book, 7 Habits for Highly A well stated goal will contain all of the SMART Effective People, the author Stephen Covey ingredients. Take a look at the well stated suggests you should “begin with the end in example below: mind.” 4 While this may not seem directly  I will improve my 12 minute distance applicable to walking and jogging, the greater by 10% within 2 months of the first concept of lifestyle certainly comes in to play assessment. here. Setting goals, in any activity, is important because it will lead to a greater chance of Note, all the ingredients of a well stated goal are present. It is specific (improve 12-minute Anthropometric measurements distance by 10%), measurable (10% (anthropometry)-the scientific measurement improvement), attainable and realistic (the of the body. Done by using a simple tape degree of improvement is reasonable in that measure to determine the circumference of time frame), and time frame (a clear deadline of large muscle groups, the waist, and hips. 2 months).

Chapter 2-Getting Started With a Walking/Jogging Program 4

Less effective goals would be stated like this: of fat for fuel and the number of calories burned. If you feel more interested in improving 1. I will run further next time I assess my your speed, you will need to dedicate more fitness. workout time to achieving those results. This 2. I want to jog faster. idea is associated with the training principle, 3. I will lose weight called specificity, which will be discussed more And a common one: extensively in a later chapter.

4. I will exercise 3 days a week at 60% Another key principle to be emphasized is to max for 45 minutes per rely on expert recommendations to safely and session for 2 months. effectively design your program. Organizations like the American College of Sports Medicine, At a closer glance, none of these examples Coopers Clinic, the Surgeon General and many contain all of the ingredients of a well stated more have extensively researched the optimal goal. How will you measure “faster?” “Further” frequency, intensity and duration for aerobic is not specific enough nor is “lose weight.” In exercise. As a result, recommendations have the last example, this is not a goal at all. It is a been widely distributed to help guide plan to achieve a goal that hasn’t been stated. participation in activities such as walking and jogging. Trained professionals such as personal In the end, setting up well stated goals will give trainers, coaches, and physicians have taken the you the best chance to convert good intentions recommendations and applied them to client’s in to a successful lifestyle. needs while modifying when necessary. To complete this step, you should write down 2- Thousands of books and articles have been 3 personal goals, stated in the SMART format, published to disseminate their ideas and how and put them in a place you will see them they can be applied to the general public. frequently. Because of the volume of information, much of Create a Plan the details of this step, creating a plan, have been entered in chapter 3 and 4. There, we will Now that you know exactly what it is you want discuss choosing proper equipment, the to achieve, begin generating a strategy that will adaptation to stress training principles, and the help you reach your goals. As you strategize, actual physiological adaptations that come from your goal in this step is to determine the aerobic exercise such as walking and jogging. frequency, the intensity, and duration of your After reading and understanding the material exercise sessions. While doing this, it is there, you will want to get your plan in writing. imperative to keep in mind a few key principles. At the end of chapter 3, you will find a form that will help you to complete this step. One obvious, but still key principle, is to use your goals as the foundation for your walking Follow Through and jogging program. If your goal is related to , this should drive the frequency, Once you’ve assessed your fitness and created duration, and intensity of your daily workouts your own plan, you’re over half way there to as these variables will influence your body’s use checking your goals off the to do list. Now is

Chapter 2-Getting Started With a Walking/Jogging Program 5 when the rubber hits the road, as the old adage days per week of activity, and realistic goes. With the investment of a well thought out periods of time (20-30 min per session). and designed program comes the returns from . Low Intensity/low volume-As fitness good execution. The planning is really the hard improves, you will want to gradually part. Now that you know what to do and how to increase your efforts in terms of quantity do it, it’s a simple matter of doing it. and quality. You can do this with more time and frequency (called volume) or you can Unfortunately, the ability to stick with a increase your intensity. In beginning a program has proven difficult for most (cite program, don’t change both at the same statistics of starting an exercise program). time. . In order to prevent getting derailed from your Keep Track-results from a walking and program you should identify barriers that may jogging program often occur slowly, subtly, prevent you from consistently following and in a very anti-climatic way. As a result, through. One of the most common challenges participants become discouraged when the cited is time. Work schedules, school, child care, immediate changes don’t seem to be and the activities of daily living can leave you happening. Keeping track of your consistent with little time to pursue your walking and efforts, body composition, and fitness test jogging goals. Make a list of the items that results will give you encouragement and prevent you from regular exercise and then motivation to continue as the subtleties of analyze when you could squeeze in your the results will be more obvious. . exercise time. This could be walking or jogging Seek Support-Look for friends, family during your child’s athletic practice, or members, clubs, or even virtual support extending the daily walking of the dog another using apps and other online forums. 15-20 minutes. Support is imperative as it will provide you with motivation, encouragement and Regardless of how you fit your exercise in, people who share a common interest, all of consider how you can do so consistently. Below which are factors in your ability to are a few additional tips on successfully consistently engage in your fitness program. becoming consistent in your routine. . Vary your activities from time to time-Your overall goals are to be consistent, build your . Think long term, think lifestyle-The goal is to cardiovascular fitness, and reap the health make walking and jogging an activity you benefits associated with your routine. From enjoy and can enjoy throughout your life. time to time, to avoid boredom, mix up This won’t occur overnight and will take your activities. Instead of walking, play time do develop your ideal routine. Begin or ride a bike. Go to different with this in mind and be patient as you locations such as , parks or work through the challenges of making this another “new” location to keep things a consistent routine. fresh. . Start out Slowly-Once again, you’re in this . Have Fun-You will have to enjoy your for the long haul. No need to overdo it in activities if they’re going to stick as a the first week. Plan for low intensity, 2-3 lifestyle. While you can’t expect everyday to be a party, you shouldn’t dread doing your

Chapter 2-Getting Started With a Walking/Jogging Program 6

walking and jogging routine. If you do, you coming traffic as opposed to going with the should consider varying your activities traffic and unaware of the approaching traffic more, or finding a new routine you find from behind. By wearing bright, reflective more enjoyable. material, a walker/jogger is more visible and . Eat Right and Exercise-Nothing can be more safer by going against traffic. frustrating than being consistent in your A second key principle is to recognize and to exercise but not seeing the results on the avoid the extremes. This can be applied in many weight-scale (a major reason for many ways. For example, areas of heavy traffic versus beginning a walking and jogging routine). Eating a balanced diet will accelerate your extremely isolated areas, heavy populated areas versus no one around, early morning results and allow you to feel more versus late at night, or times of extreme cold successful throughout your activities. More on eating properly can be found in Chapter versus extreme heat. These types of environmental conditions justify not using 5. headphones for better hearing, not Safety Habits walking/jogging alone, preparing for adequate hydration in the heat, and so on. Regardless, As activity rates among Americans improve, extreme conditions require extra vigilance on safety concerns become extremely important. your part. Unfortunately, the physical infrastructure of many American cities is simply not built to A third key principle is to simply use your brain. accommodate walkers and joggers without While this seems obvious, it unfortunately gets going to a local park or . Limited financial ignored too often. Always remember the resources and de-emphasis on health priorities purpose of your exercise is for enjoyment and for local and state governments make it tough the health benefits. If these objectives could be to build roads with sidewalks, walking trails compromised by going for a run at noon in 95- surrounding parks, bike lanes, etc. In addition, degree heat, or during morning rush hour in low time constraints and inconvenience make it light conditions, you should reconsider your challenging for participants to want to travel to plan. Before exercising in what could be a risky areas where these things are available. As a circumstance, you should ask yourself, ”Is there result, walkers and joggers use roads and a safer option available?” isolated trails/pathways inherently increasing the risk of being active. Last, be aware of the terrain and weather conditions. Walking or jogging on trails is a Whether on the road or off the beaten path, wonderful way to enjoy mother nature but there are a few critical concepts to safe walking exposed roots and rocks present a hazard for and jogging. The first key concept is visibility. staying upright. Wet, muddy, or icy conditions You want to be able to see what’s coming also create an additional variable to consider so ahead and you want those approaching to be you can complete your session without able to see you. This point can be illustrated by accident. going against traffic, although it may seem The below table outlines specific safety tips that counterintuitive, when walking or jogging on the road. This allows the walker to see the on- should help you stay safe in your activities.

Chapter 2-Getting Started With a Walking/Jogging Program 7

From the University of Texas-San Antonio in low volume and will become more yellow in color. https://www.utsa.edu/utsapd/Crime_Preventio n/Crime_prevention%20pdf/Safety%20Tips%20 Another simple method involves weighing for%20Runners.pdf yourself before and after a workout (see lab). This is a great way to see first hand how much Environmental Conditions water weight is lost during an exercise session When exercising outdoors, you must consider primarily as a result of sweat. Your goal is to the elements and other factors that could place maintain your pre and post body weight by you at abnormal risk of injury or illness. drinking fluids during and after the workout to restore what was lost. When combined with Heat Related Illness urine-monitoring, a fairly accurate level of monitoring hydration can be achieved. Heat related illnesses such as heat cramps, heat exhaustion, and heat stroke contributed to The best fluid for maintaining a hydrated state 7233 in the between 1999 is simply drinking plenty of water throughout and 2009. In a 2013 report released by the the day. In previous years, recommendations Center for Disease control, stated that about for the amount of water to drink were a one 658 deaths from heat related illnesses occurred size fits all of about 48-64 oz. per day, per every year which account for more deaths than person. In an effort to individualize hydration, tornadoes, hurricanes, and lightning combined. experts now recommend fluid intake based on Of those deaths, most were male, older adults. 5 your size, gender, activity levels, and climate. Generally, half an ounce (fluid ounces) to 1 The number one risk factor associated with heat ounce per pound of body weight is related illness is hydration. It is essentially the recommended.6 For a 150 lb. individual, this starting point of all heat related illness. would mean 75-150 oz. of water per day! While Unfortunately, sweat loss can occur at a faster there is still considerable debate over the exact rate than you can replace with fluids during amounts, you should continually monitor your exercise, especially at high intensities. Even hydration through the techniques mentioned when trying to hydrate, ingestion of large previously as insufficient hydration leads to amounts of fluids during exercise can lead to poor performance, poor health and potentially stomach discomfort. What does this mean? serious illness. Hydration must begin before exercise and must become part of your daily routine. It should be noted that electrolyte “sport” drinks (Gatorade, Powerade, etc.) are often Several practical methods of monitoring your used to maintain hydration. While they can be hydration levels exists. One simple method, effective, these types of drinks were designed while not full proof, is to simply monitor the to replace electrolytes (potassium, sodium, color of your urine. In a hydrated state, chloride) that are lost in sweat during activity. urination will occur frequently (every 2-3 hours) In addition, they contain carbohydrates to assist and urine will have very little color. In a in maintaining energy during activities of long dehydrated state, urination occurs infrequently duration. If the activity planned is shorter than 60 minutes in duration, water is still the

Chapter 2-Getting Started With a Walking/Jogging Program 8 recommended fluid. For activities beyond 60 • Stay dry-Heat loss occurs 25x faster in water minutes, a sports drink should be used. than on dry land. As such, keeping shoes/socks dry, shirts from accumulating

too much sweat, etc. will allow for more Cold Related Illnesses effective body temperature regulation. • Dress appropriately-Because of the Much like hot environmental conditions, cold movement involved, the body will produce weather conditions can be equally as dangerous heat during the exercise session. Therefore, without taking proper precautions. However, the key point is to direct moisture (sweat) unlike the heat, you are trying to prevent too away from the skin. This is controlled most much heat from being lost. The three major effectively by layering your clothing. A base concerns related to cold-related illnesses are: layer of moisture wicking fabric should be , frost-nip, and frost bite. used against the skin while additional layers should be breathable. This will channel As in the case with heat related illness, the moisture away from the skin and additional objective of preventing cold related illnesses is layers of clothing without becoming to maintain the proper body temperature of saturated in sweat. If exercising on a windy between 98.6 and 99.9 degrees Fahrenheit. If day, use clothing that protects from the body temperature falls below 98.6 F, multiple wind and is adjustable so you can manage symptoms may appear indicating the need to breathability. take action. Some of those symptoms include: • Cover the extremeties-Those parts of the • Shivering body furthest from the heart tend to get • Numbness and stiffness of and coldest first (toes, fingers, ears). Take the appendages appropriate steps to cover those areas by • Loss of dexterity and/or poor using gloves, good socks and the head. coordination

• Peeling or blistering of skin, especially to exposed areas References: • Discoloration of the skin in the 1. Dictionary.com, retrieved April 29, 2017, extremeties “lifestyle,” When walking or jogging in the cold it is http://www.dictionary.com/browse/lifestyl important to take the necessary steps to avoid e?s=t problems that can arise from the environmental 2. American College of Sports Medicine, 7th conditions. Edition, ACSM’s Guidelines for Exercise Testing and Prescription, Philadelphia, PA, • Hydration is key-cold air is usually drier air Lippincott, Williams and Wilkins, p. 10 which leads to moisture loss through 3. American College of Sports Medicine, 7th and evaporation. Staying Edition, ACSM’s Guidelines for Exercise hydrated is key in maintaining blood flow Testing and Prescription, Philadelphia, PA, and regulating temperature. Lippincott, Williams and Wilkins, p. 27

Chapter 2-Getting Started With a Walking/Jogging Program 9

4. Covey, Stephen R., retrieved April 2017, “7 Habits of Highly Effective People: Habit 2”, https://www.stephencovey.com/7habits/7h abits-habit2.php 5. Center for Disease Control, Retrieved April 2017, CDC: Quick Stats: Number of Heat- related Deaths, by Sex-National Vital Statistics System-United States, 1999-2010, https://www.cdc.gov/mmwr/preview/mm wrhtml/mm6136a6.htm 6. Mayo Clinic, retrieved April 2017, Water: How Much Should You Drink Each Day? http://www.mayoclinic.org/healthy- lifestyle/nutrition-and-healthy-eating/in- depth/water/art-20044256

Chapter 2-Getting Started With a Walking/Jogging Program 10

speed up to circulate more oxygen-rich Chapter 3 blood, your lungs must work harder to bring in more oxygen and get rid of carbon Principles of Stress and dioxide, the endocrine system must release additional hormones and much more. This Adaptations to Exercise is easily detected by the sensation of increased heart rate, faster breathing and eveloping aerobic fitness can be an maybe even sweating. These physiological exciting and invigorating task. If not changes, in response to exercise, illustrate done properly, however, it can also the concept of acute, or brief, adaptations. Dbecome very discouraging as your Specific acute adaptations as a result of perceived results seemingly don’t justify the walking and jogging: effort. To really understand if your training plan is working or not, you need to . Increased heart rate understand what to look for in terms of . Increased breathing rate and depth changes. In other words, you should be able of breathing to answer the simple question: How will my . Release of norepinephrine body change if I consistently perform a (noradrenaline), epinephrine walking/jogging routine? (adrenaline), , endorphins, When referring to change, exercise and inhibition of . scientists generally use the term . Body temperature increase “adaptation.” The has an followed with temperature amazing capacity to physically adapt when regulation. exposed to challenging or stressful activities . Blood pressure increase such as exercise. Adaptation to stress can . Increase in cellular occur as short or long term changes (acute . Increase in nervous system and or chronic adaptation, respectively). Most skeletal muscle activity importantly, fitness is the result of chronic adaptations. In this chapter, we will discuss From the short list above, it’s evident the physical changes that occur as a result that walking and jogging requires significant of exposure to exercise, specifically walking physiological changes, when compared to and jogging, and how to use that knowledge the resting state of the body, to manage the to your advantage when creating a personal energy requirements of an activity. For fitness plan. many, especially those unfamiliar with exercise, this experience can be quite Acute Adaptation uncomfortable when either starting the exercise session or first beginning a routine. At rest, the human body functions at a The resulting and occasional minimal level to maintain the necessary soreness can last for hours to days. functions required to sustain life. When you However, it is important to are exposed to a stressful situation, such as understand that this response is normal. walking at a brisk pace or jogging, your While the acute adaptations occur during body must respond to meet the increased every exercise session, your body will adapt demands of the activity. Your heart must over time, altering the degree of these

Chapter 3-Principles of Stress and Adaptations to Exercise 1 acute effects. For example, for individuals oxygen and in the blood. They who haven’t participated in vigorous also produce waste products as a result of exercise for several months but begin a new cellular metabolism which then enters the routine, they may experience significant blood circulation (see figure 3.1). soreness after the first few exercise At this point, a series of questions must sessions. But, beyond the first few sessions be answered to make this discussion the body will adapt. So long as they remain relevant. consistent in their efforts, they will likely not have to deal with soreness again. These • What is accomplished by the cardio- adaptations, labeled chronic adaptation, ? don’t simply go away when the exercise • Why do the cells need the oxygen session ends. They are long-term changes, and nutrients delivered in the though not permeant. blood?

Chronic Adaptations The answer to both questions is simple: energy. Before digging into specific adaptions, it is The cardiorespiratory system must important to understand the physical work effectively in order to create an demands of exercise. By understanding environment in the cell in which energy can what needs to change, it will be easier to be produced. Energy, in it’s basic form of understand what actual changes occur and (ATP), is created in how to change those areas when you create the cells and must be available for the body a training routine. to function. In other words, when you begin First, let’s take a look at the working walking or jogging, you must increase the parts of the body specific to walking and production of energy, or ATP, to meet the jogging. The cardiorespiratory system demands of the activity. Every activity, from consists primarily of the heart and lungs. rest to jogging a marathon, requires a The purpose of the heart is to pump certain amount of energy. In order to nutrients and oxygen rich blood to the improve your fitness, you must increase body’s cells and deliver waste product, such your capacity to generate more energy, i.e. as carbon dioxide (CO2), to the lungs. The adapt. This, of course, is driven by the lungs work in tandem with the heart to chronic adaptations which come as a result bring oxygen into the blood so it can then of consistent training. be pumped by the heart, and to get rid of As stated previously, in order to waste such as CO2 by exhaling into the produce more energy, you must become external environment. more fit. For example, if you would like to Of course the arteries, veins, and increase your mile jogging time from 10 capillaries (along with the heart are minutes to 9 minutes, you will need to alter collectively part of the cardiovascular the way your body produces energy. Figure system) cannot go with out being 3.1 illustrates a simplified version of the mentioned. They serve as the highways for working components of the cardio- delivering blood to the body’s cells. As respiratory system. another important part of this puzzle, the muscle cells serve as the endpoint for the

Chapter 3-Principles of Stress and Adaptations to Exercise 2

Pulmonary Adaptations

The lungs function to bring oxygen into the cardiorespiratory system. As you inhale, your lungs (right and left sides) fill with oxygen. As a result, the increased pressure inside your lungs drives oxygen into the poorly oxygenated blood circulating past the lungs. While oxygen moves into the blood, CO2 simultaneously moves out of the blood into the lungs and is removed when you exhale. In terms of adaptations, oxygen is key. Much like a manufacturer’s supply chain which requires more raw material to produce more product, the lungs must be able to handle more oxygen if more energy is to be produced. Interestingly enough, this is what happens with improved fitness. As a result of consistent training, two very important adaptations to respiration occur. First, the pulmonary ventilation capacity increases. This means the amount of air inhaled increases from about 100-120 L/min to about 130-150 L/min in previously untrained athletes. In large, well trained athletes, this number can exceed 200 L/min!1 Secondly, the air inhaled and it’s ability to move from the lungs to the bloodstream also changes (called pulmonary diffusion). Although your lungs may fill up with oxygen after a good breath, the total amount of oxygen in your lungs does not go into the blood stream. There is a “residual” amount left over which may linger in the lungs or be exhaled. However,

By Hikmet Gümüş - Own work, CC BY-SA 3.0, in trained individuals, a greater percentage https://commons.wikimedia.org/w/index.php?curid=28813430 of oxygen which initially fills the lungs moves into the blood stream.1 As you look at the illustration, think about Both of these adaptations are how these working components could be important because they enable more altered to enable more ATP production. oxygen to move into the blood, which can

Chapter 3-Principles of Stress and Adaptations to Exercise 3

then be delivered to cells for ATP same individual might find that at the same production. pace, the heart rate is now at 140 beats per minute. This means the heart doesn’t have Cardiovascular Adaptations to work as hard to do the same amount of work. More oxygen in the arteries would be As resting heart rate decreases, the meaningless unless this oxygen can then be resting time between heart beats is delivered to the cells. The heart serves as a extended. During this resting time is when pump, to generate pressure in the arteries the four chambers of the heart fill with so blood can flow efficiently to the areas of blood. With more time between beats, the body in need of what is found in the more blood can enter the heart’s chambers blood. in preparation for the next beat. In As a result of training, the heart’s combination with the more forceful capacity to circulate blood increases. One contractions, the increased filling time example of how this might occur can be contributes to an increase in stroke seen in the size of the heart. Like other volume, or the amount of blood being muscles of the body, the heart muscle ejected from the heart per beat. increases with training. Specifically, the left As you can see, both heart rate and ventricle, one of the four chambers of the contribute to the efficiency heart, increases in mass and thickness, a and capacity of the heart to circulate larger condition know as cardiac hypertrophy. amounts of blood. When combined into a With a larger heart muscle, the heart formula, the product of stroke volume and contracts more forcefully pumping more heart rate determine cardiac output (often blood per beat compared to the untrained labeled Q), a key indicator of cardiac health state. and fitness. Another example, which may be Q=stroke volume X heart rate related to cardiac hypertrophy, can be seen in the heart rate. It’s not uncommon to see At rest, in both trained and untrained resting heart rate decrease as a result of individuals, Q remains close to the same at . On average, the rate of about 5-6 L/min. The decreased resting the heart at rest or resting heart rate is heart rate essentially cancels out the around 70-75 beats per minute. While the increased stroke volume. However, during cause is not entirely known, some estimate exercise, Q is significantly higher in trained declines of 1 beat per minute, per week of individuals, reaching over 30 L/min as training. Highly trained endurance athletes opposed to 20 L/min in untrained may see their resting heart rate between 30 individuals. 2 and 40 beats per minute. Not only does this occur at rest, but also at a given The Cells submaximal work load. For example, if an untrained individual were to measure The endpoint for nutrition and oxygen his/her heart rate while jogging at 11 found in the blood is the cells. Cells need minutes per mile in an initial assessment oxygen and fuel to generate ATP. In order and found their heart rate to be 150 beats to produce more ATP, cells must increase per minute, with 6 weeks of training that

Chapter 3-Principles of Stress and Adaptations to Exercise 4

their ability to process oxygen and other When thought of in the context of specific nutrients. adaptations, the heart, lungs and cells all The beginning of this, at the level of play a significant roll in this measurement. A the cell, is to remove the oxygen from the large VO2max would indicate that the lungs blood. Just because it’s available in the are operating at high levels (taking in the blood, doesn’t do us any good unless we O2), the heart is pumping efficiently, and can extract it and use it. Scientists can the cells are processing the additional measure the amount of oxygen in oxygen properly. arteries/veins before and after it is taken in So, while measuring lung capacity, by the cells, a measurement called the stroke volume and a-vO2 difference is arteriole-venuole difference (a-vO2 diff). important, a better predictor of The difference indicates the amount taken performance can be seen by measuring the up by the cell. Trained individuals have a VO2max. Presumably, the greater the VO2max, greater a-vO2 difference than their the better an athlete can perform. Luckily, untrained counterparts, implying cell in VO2max is a very adaptable component of trained individuals can remove more aerobic fitness. By some accounts, it can oxygen into the cell than those who are increase by up to 50%, depending on the untrained. starting fitness level. In addition to the a-vO2 difference, It can also be used as a strong the working components of the cell must predictor of health when trying to assess adapt to promote increased ATP cardiorespiratory fitness. The ACSM production. Using the previous analogy of a suggests three important areas can be manufacturing supply chain, once the raw measured in maximal oxygen consumption materials arrive to the manufacturing measurements: an indication of factory, the factory must then be able to cardiorespiratory health, an indication of process the new materials. So it is with activity levels, and a predictor of all-cause energy production. mortality. 3 The work horse of aerobic VO2max is measured most accurately metabolism, and ATP production, occurs in in a laboratory in which the subject the mitochondria of the cell. In response to until complete exhaustion while aerobic training, cells develop more and using a special mouthpiece attached to a larger mitochondria. Clearly, this creates a computer to analyze oxygen intake and CO2 “bigger factory” for ATP production which output. in turn equals the ability to do more work. Other measurement techniques use prediction equations to estimate VO2max. VO2max While less accurate, these prediction equations provide a practical and simple So far, we have discussed specific way to assess cardiorespiratory fitness. For adaptations of the heart, lungs and cells. the purposes of the general public, the Collectively, these adaptations can be more important measurement is the measured by determining the VO2max. If change between beginning and ending you’ll recall, VO2max, or maximal oxygen fitness levels which these model can do consumption, is a measurement of the accurately enough. body’s ability to take in and utilize oxygen.

Chapter 3-Principles of Stress and Adaptations to Exercise 5

The VO2max measurement can be threshold. For example, a runner may reach expressed in multiple ways. Often, it is his/her LT when jogging a 7:30 min/mi measured in liters per minute (L/min), pace, and when the heart rate is at 156 indicating an absolute value of how much beats per minute. In order to improve oxygen has been taken in. Because adult fitness, this runner must adapt so that the males generally have larger lungs than new LT occurs at 7:00 min/mi pace and 163 females, an absolute measurement could beats per minute. In other words, the be interpreted as males being superior to runner can now buffer more females in aerobic capacity. However, the delaying fatigue and improving mile time by measurement more accurately compares 30 seconds per mile. Over the course of a men and women when expressed as marathon, that’s a 13-minute milliliters per minute per kilogram of body improvement! weight (mL/kg/min). When expressed this This is, in fact, what happens with way, size is incorporated into the consistent aerobic training. When charted measurement giving a much clearer picture along with the heart rate, the LT shifts to of true aerobic capacity. A chart of various the right (see figure 3.2) as fitness sports and average VO2max ratings can be improves. Well trained athletes may see found below. Also, a chart of ranges of their LT at 90% or more of their max heart VO2max can be seen at the end of this rate! This essentially means an athlete can chapter. exercise at near maximum effort without getting fatigued as a result of lactic acid Lactate Threshold build up.

Another area that significantly relates to Section II fitness is the body’s ability to buffer lactic

acid build up in the blood. Lactic acid, often Principles of Adaptation to Stress incorrectly associated with muscle

soreness, results from cellular metabolism. For many readers, the actual adaptations As cells process fuel (carbohydrates) in that occur as a result of consistent aerobic order to produce ATP, lactic acid is training are uninteresting and seemingly produced and released into the blood irrelevant to learning how to create a stream. At low levels, the body’s natural walking and jogging plan. However, because buffering capacity prevents lactic acid from these adaptations are key markers of building up and negatively impacting fitness, knowing what adaptations occur performance. However, during high should help guide you in how to target intensity endurance exercise, high levels of them in your plan. This section outlines the lactic acid is produced, overwhelming the principles of adaptation to stress, or the buffering capacity and fatigue ensues. That “how” part of organizing an exercise plan. tipping point, the point in which the buffering capacity is overwhelmed, is called Overload Principle the lactate threshold (LT).

Considered by most to be the best Consider the old saying, “No pain, no gain.” predictor of performance, the goal in What does this really mean? Is it really improving fitness is to improve the lactate

Chapter 3-Principles of Stress and Adaptations to Exercise 6

saying that exercise must be painful to get Each variable can be used independently or anything from it? Absolutely not. If that in combination with other variables to were the case, it would make exercise a lot impose new stress and stimulate less enjoyable. Maybe a better way to relay adaptation. Such is the case for frequency the same message would be to say and time. improvements are driven by stress. Physical Frequency relates to how often stress, such as walking at a brisk pace or exercises are performed over a period of jogging, places increased stress on the time. In most cases, the number of walking regulatory systems that manage increased or jogging sessions would be determined heart rate and blood pressure, increased over the course of a week. A beginner, may energy production, increased breathing, determine that 2-3 exercise sessions a week and even sweating for temperature are sufficient enough to stimulate regulation. The subsequent adaptations improvements in VO2max. On the other that occur, make it so that the same stress hand, a seasoned veteran may find that 2-3 previously experienced feels less stressful. days isn’t enough to really stress the As a result, more stress must be applied to system. Per overload principle, as fitness the system in order to stimulate improves so must the stress to continue to improvements, a principle known as the improve and avoid plateau. Expert overload principle. recommendations suggest for optimal For example, a beginning weight health and improvement you should plan to lifter performs squats with 10 repetitions at walk or jog “most” days of the week (4-5 150 lbs. After 2 weeks of lifting this weight, days a week). the lifter notices the 150 lbs. feels easier The duration of exercise, or time, also during the lift and afterward there is less contributes to the amount of stress fatigue. So, 20 lbs. are added and the lifter experienced during a workout. Certainly, a continues with the newly established stress 30-minute brisk walk is less stressful on the of 170 lbs. The lifter will continue to get body than a 4-hour marathon. Experts stronger until he reaches his maximum recommend 30-90 minutes per exercise capacity or the stress stays the same at session to adequately stimulate adaptation. which point his strength will simply plateau. In the beginning phases of developing a This same principle can not only be applied plan, you should aim for the lower range of to gaining muscular strength, but also the recommendations with the intent to flexibility, muscular endurance and gradually increase the duration of your cardiorespiratory endurance. sessions as your fitness progresses. Although independent, frequency and FITT time are often combined into the blanket term, volume. The idea is that volume more In exercise, the amount of stress placed on accurately reflects the amount of stress the body can be controlled by four experienced. For example, when attempting variables: Frequency, Intensity, time to create a walking and jogging plan, you (duration), and type, better known as FITT. may organize 2 weeks like this:

Frequency and Time • Week 1-three days a week at 30 minutes per session

Chapter 3-Principles of Stress and Adaptations to Exercise 7

• Week 2-four days a week at 45 performance in a 10k, you will need to minutes per session spend most of your training time jogging, as you would do in the actual 10k. In other At first glance, this might appear to be a words, train the way you want to adapt. good progression of frequency and time. This concept, called the principle of However, when calculated in terms of specificity, should be taken in to volume, you see the aggressive nature of consideration when creating a training plan. the progression. In week 1, three days at 30 In this discussion of type and the minutes per session equals 90 minutes of principle of specificity, a few additional total exercise. In week two, this amount items should be considered. Stress, as it was doubled with four days at 45 minutes relates to exercise, is very specific. There equaling 180 minutes of total exercise. are multiple types of stress. The three main Doing too much, too soon, will almost stressors are: metabolic stress, force stress, certainly lead to burn out, severe fatigue, and environmental stress. Keep in mind, the and injury. body will adapt based on the type of stress Scientists, such as Hunter Allen, being placed on it. have developed many ways to monitor the Metabolic stress results from proper amount of weekly volume by way of exercise sessions when the energy systems stress calculations. The concept takes in to of the body are taxed. For example, account the time, the intensity of effort, sprinting short distances requires near and the distance and creates a training maximum intensity and requires energy stress score (TSS). The TSS can then be used (ATP) to be produced primarily through to estimate possibility of over stressing the anaerobic pathways (pathways not body or fine tuning the amount of stress requiring oxygen to produce ATP). and rest so optimal fitness can be achieved. Anaerobic energy production can only be supported for a very limited time (10 Type seconds to 2 minutes). However, distance running at steady paces require aerobic Simply put, the type of exercise you energy production, which can last for hours. perform should reflect your goals. In As a result, the training strategy for the walking and jogging, the objective of the distance runner must be different than the exercise is to stimulate the training plan of a sprinter so the energy cardiorespiratory system. Other activities systems will adequately adapt. that accomplish the same objective include Likewise, force stress accounts for , biking, dancing, cross country the amount of force required during an skiing, aerobic classes, and much more. So, activity. In weight lifting, significant force these activities can be used to build lung production is required to lift heavy loads. capacity and improve cellular and heart The type of muscles being developed, fast- function. twitch muscle fibers, must be recruited to However, the more specific the support the activity. In walking and jogging, exercise the better. While vigorous ball the forces being absorbed come from the room dancing will certainly help develop body weight combined with forward the cardiorespiratory system, it will unlikely momentum. Slow twitch fibers which are improve your 10k time. To improve your unable to generate as much force as the

Chapter 3-Principles of Stress and Adaptations to Exercise 8

fast twicth fibers, are the type of muscle oxygen demands increase and so does heart fibers primarily recruited in this activity. rate. See figure 3.3. Because the force requirements differ, the Because of this relationship, heart training strategies must also vary to rate can be used to help in the design of develop the right kind of musculature. your walking and jogging program. This is Environmental stress, such as accomplished by creating heart rate zones. exercising in the heat, places a tremendous Heart rate zones represent an intensity amount of stress on the thermoregulatory range, a low end heart rate and a high end, to the heat, sweating increases as does in which you could carry out your walking or plasma volume, making it much easier to jogging session. keep the body at normal temperatures The first step in determining your during exercise. The only way to adapt is target heart rate (THR), is to determine through heat exposure which can take days your maximum heart rate (MHR), both to weeks to properly adapt. measured in beats per minute (bpm). In summary, being specific in your Generally, MHR is estimated to be your age training, or training the way you want to subtracted from 220 beats per minute. In adapt, is paramount. So, when you create other words, your heart rate should your training plan, base your training on theoretically stop increasing once it reaches your goals. the calculated maximum. While helpful, it’s not uncommon to see variances in the Intensity laboratory tested maximum heart rate versus the calculated method (see Max Intensity, the degree or difficulty at which Heart Rate below). Other studies have also the exercise is carried out, is the most determined that more accurate prediction important variable of FITT. More than any equations exist that is consistently more of the others, intensity drives adaptation. accurate such as 207-.7 x age. 3 However, Because of it’s importance, it’s imperative for the sake of what’s most commonly used, to quantify your intensity as opposed to we will use 220-age. estimating it as hard, easy, etc. Not only will The next step in calculating THR is to this help you understand your effort level calculate a percentage of your max. This is during the exercise session, but it will also done using two different methods. Keep in help you design your session to mind, finding the THR is the objective in accommodate your goals. both methods even though slightly different How then can intensity be numbers are used. measured? Heart rate is one of the best The first method, called Max Heart ways to measure your effort level. As Rate Method, is more commonly used. you’ve undoubtedly noticed, when you begin walking and jogging heart rate Max Heart Rate Method increases. Based on the function of the 1. Calculate MHR; MHR=220 – age. heart, this shouldn’t be a surprise. The 2. Calculate high and low THR by heart rate directly correlates with the plugging in a percentage range. In amount of oxygen being taken in by the this example, 60 and 80% are being lungs. As activity increases in intensity, used. MHR x .60 = THRLow

Chapter 3-Principles of Stress and Adaptations to Exercise 9

MHR x .80 =THRHigh example, 60 and 80% are being 3. The resulting low and high THR used. numbers represent the range, or THRlow = HRR x .60 + RHR target intensity. THRhigh = HRR x .80 + RHR 5. The resulting low and high THR The target intensity signifies an optimal numbers represent the range, or training zone for that particular walking or target intensity. jogging session. By keeping the heart rate within that range, you will drive adaptation As you can see, the Karvonen formula specific to that intensity. By using real, but requires a few more steps, specifically, the random numbers and plugging them into incorporation of the resting heart rate. the above equation this becomes apparent. Using the same female in the previous example along with a randomly selected Female, age 20 RHR, the THR looks like this: 1. MHR = 220 -20 MHR = 200 bpm; 1. MHR = 220 – 20 MHR = 200 2. THRlow = 200 x .60 2. RHR = 72 bpm (randomly selected) THRlow = 120 bpm 3. HRR = MHR – RHR HRR = 200 – 72 THRhigh =200 x .80 HRR = 128 THRhigh = 160 bpm 4. THRlow = HRR x .60 + RHR 3. THR = 120 - 160 bpm THRlow = 128 x .60 + 72 THRlow = 149 bpm As you can see, to achieve her self- established goals, the female in the THRhigh = HRR x .80 + RHR example above will need to stay within the THRhigh = 128 x .80 + 72 range of 120 and 160 bpm. If her efforts are THRhigh = 174 bpm intense enough that she begins to exceed 5. THR = 149 – 174 bpm 160 bpm during her session, or easy enough that her heart rate falls below 120 bpm, she At first glance, you will immediately see would need to change her intensity mid- that the low and high end of the Karvonen session to get the optimal results. formula is much higher than the Max Heart The Karvonen Formula or Heart Rate Rate method, even though the exact same Reserve Method percentages have been used. Certainly, by 1. Calculate MHR; MHR = 220 – age. using the Karvonen Formula you would find 2. Determine your resting heart rate yourself at a much higher intensity, (RHR). especially at the low end of the range (120 3. Find the heart rate reserve (HRR); vs. 149 bpm). How can this be? Aren’t these HRR = MHR – RHR formulas supposed to have the same 4. Calculate high and low THR by objective? plugging in a percentage range and While it is true that both equations then adding in the RHR. In this are used to estimate a target heart rate range, only the Karvonen Formula takes

Chapter 3-Principles of Stress and Adaptations to Exercise 10

into account the RHR, the lowest possible time you stopped, your heart rate would heart rate that can be measured for that slow making the measurement inaccurate. individual. The Max Heart Rate method Technology over the last 25 years assumes the lowest heart rate possible is has developed in a way that products can “0,” a number we would like to stay away now track heart rate and zones, keep track from if at all possible! Because of the of the duration of the session, track your difference between 0 and the maximum pace and distance, determine your stride heart rate, the calculated percentages rate and stride length, and even alert you if result in a much lower number. In terms of you go outside your preset parameters. For accuracy, the Karvonen method should be some devices, this data is recorded and used whenever possible. It simply is a available for download via software to better representation of true target ranges. analyze and scrutinize. The optimum ranges to achieve the For most of these products, simply best results range from >40% to <90% of called heart rate monitors, the baseline HRR. Once again, the target HR range purchase models include a chest strap that selected should be established based on serves as a heart rate detection device and individual goals. For example, walking at a wrist watch that serves as a receiver and low percentage of HRR results in a greater data collector. While exercising, your heart percentage of calories being burned from rate is detected by the chest strap sensors fat whereas more intense exercise will and displayed on the watch monitor. More result in a greater percentage of calories sophisticated models may display additional being burned from carbohydrate. This information such as current heart rate zone, would be helpful if weight loss were the pace and distance. desired goal. A more in depth look at this Although generally more expensive, phenomenon will be discussed in a later these types of devices prevent you from chapter. needing to stop to take your pulse and are able to average your heart rate during the Measuring Heart Rate session. As technology has advanced, you may even be able to pair up your device to While exercising, heart rate can be tricky to an app used by your smartphone where you measure. At rest, the index and middle can view a live feed of your distance and finger on your wrist or neck can easily be heart rate on your phone. In other words, used for an accurate reading. However, the your smartphone becomes the receiver so bouncing from ground impact and the no wrist watch is needed. dexterity to hold fingers in place required Less expensive models may help you while exercising make it very challenging to determine heart rate but do so by placing avoid over-counting beats, keep track of your finger on a button and holding it in counting and time, and convert that into place. This method is generally less target heart rate. Most people have to stop accurate, requires you to stop your to accomplish this seemingly simple task. To exercise, and does not keep track of an determine if you were in the proper zone, average over the session. Some phone apps you would have to stop multiple times use the same concept to give you throughout the session. Of course, each momentary readings of your heart rather than continuous measurements. One

Chapter 3-Principles of Stress and Adaptations to Exercise 11 exception to this can be found in the method is as simple as asking the question: Garmin fitness watches, FitBit devices, and overall, how hard do you feel like you’re smart watches which keep continuous working? The answer is given based on a measurements without a chest strap by scale of 6 to 20 with 6 being almost no using an infrared sensor. effort and 20 being maximum effort. Studies have indicated that when subjects Other Ways to Determine Intensity are asked to exercise at a moderate or heavy intensity level, subjects can Since not everyone owns a heart rate accurately do so, even without seeing their monitor, other methods of determining heart rate. As a result, using the RPE scale exercise intensity have been developed. can be an effective way of managing One particular method, called the rating of intensity. perceived (RPE), uses subjective The original RPE scale or Borg Scale, measurement to determine intensity. The designed by Dr. Gunnar Borg, was

Intensity Scales Modified General Talk Test Borg Borg RPE % HRR %HR Max 0 6 30 57 1 7 Easy 8 Light 2 35 60 Conversation 9 3 10 4 11 39 63 Brief 12 Sentences 5 40 64 Moderate 13 6 14 59 75 15 76 7 60 Vigorous A few words 16 8 17 89 95

18 Unable to 9 90 96 Anaerobic speak/one word phrases 19 10 20 100 100 Data are from: American College of Sports Medicine, ACSM’s Guidelines for Exercise Testing and Prescription, 9th Edition

Chapter 3-Principles of Stress and Adaptations to Exercise 12 developed to mimic generalized heart rate overstressing the athlete. This training patterns. The starting and ending point of principle, called periodization, is especially the scale are less intuitive than a typical important to serious athletes but can be scale of 1-10. By design, the 6 represents a applied to most walking and jogging plans resting heart rate of 60 bpm and the 20 an as well. exercise heart rate of 200 bpm, a beat Keep in mind, the overlying purpose count someone might experience at of developing a walking and jogging maximum effort. Over time, a modified program stems from creating a simple way Borg Scale was developed using a simple 1- to live an active lifestyle. Up to this point in 10 scale with 1 being resting effort and 10 the discussion, the principle of stressing the being maximum effort. Even though more body to adapt has been emphasized to the intuitive, the traditional scale is still used point it could be misunderstood as a non- more frequently. stop thing. The principle of periodization, however, suggests that training plans Walking and jogging not only incorporate phases of stress followed by benefits physical health, but many enjoy phases of rest. Without rest, the body the social benefits by exercising with becomes overstressed. friends. When walking or jogging with Training phases can be organized on friends, intensity can easily be measured by daily, weekly, monthly, and even multi- monitoring your ability to carry on a annual cycles (called micro-, meso-, conversation. With the Talk Test, if you are macrocycles, respectively). An example of only able to say short phrases or give one this might be: word responses when attempting to converse during an exercise session, this Week Frequency Intensity Time Type would suggest you’re working at a high 1 3 days 40% HRR 25 min walk enough intensity in which your breathing 2 4 days 40% HRR 30 min walk 3 4 days 50% HRR 35 min walk rate makes conversation difficult. Certainly, 4 2 days 30% HRR 30 min other if you can speak in full sentences without getting winded, the intensity would be very As you can see, the volume and intensity light. So, just like RPE, the Talk Test is yet changes from week 1 to week 3. But, in another way to subjectively measure your week 4, the volume and intensity drops intensity which can then be correlated with significantly to accommodate a designated heart rates (see figure 3.4). rest week. If the chart were continued, weeks 5-7 would be “stress” weeks and Periodization week 8 would be another rest week. This pattern could be followed for several For hundreds of years, athletes have months. wondered how to their exercise Without periodization, the stress from efforts with performance improvements exercise would continue indefinitely and adequate rest. Over this time frame, eventually leading to fatigue, possible exercise scientists and athletes alike have injury, and even a condition known as determined that by dividing the training syndrome. Overtraining phases into blocks, or periods, optimal syndrome is not well understood but results fitness can be achieved without

Chapter 3-Principles of Stress and Adaptations to Exercise 13

from psychological and physiological factors Not only is endurance training which cause a decline in performance and affected, but muscular strength, muscular cannot be fixed by a few days’ rest. Instead, endurance and flexibility all show similar weeks, months and even years are results. sometimes required to overcome the symptoms of overtraining syndrome. Individual Differences Symptoms included are: While the principles of adaptation to stress • body weight loss can be applied to everyone, not everyone • loss of motivation responds to the stress in the same way. In • inability to concentrate or stay the HERITAGE Family study, families of 5 focused (father, mother, and 3 children) • feelings of depression participated in a training program for 20 • lack of enjoyment in things that weeks. They exercised 3 times per week, at normally are enjoyable 75% of their VO2max, for up to 50 minutes by • disturbances the end of week 14. By the end of the • change in appetite study, a wide variation in responses to the same exercise regimen were seen by Reversibility individuals and families. Those who saw the most improvements, saw similar percent Chronic Adaptations are not permanent. As improvements across the family and vice the saying goes, “use it, or lose it.” The versa. Along with other studies, this has led principle of reversibility suggests that researchers to believe individual differences activity must continue at the same level to in exercise response are genetic. Some keep the same level of adaptation. As experts estimate genes to contribute as activity declines, called detraining, much as 47% to the outcome of training. adaptations will recede. Besides genes, other things can In cardiorespiratory endurance, key affect the degree of adaptation such as the training status at the start of a program, areas such as VO2max, stroke volume, and cardiac output all declined with detraining age, and gender. As you might expect, those while submaximal heat rate increases. In with less training background show rapid one study, trained subjects were given bed improvement whereas those who are well rest for 20 days. At the end of the bed rest trained improve at a slower rate. Regardless, it is important to phase, VO2max had fallen by 27% and stroke volume and cardiac output had fallen by understand as you establish your goals that 25%. For the most well trained subjects in you may not have the same response as the study, it took them nearly 40 days after your peers. Setting realistic goals and bed rest to get back into pre-rest condition. modifying them if necessary are important In a study of collegiate swimmers, lactic to avoid frustration and program cessation acid in blood after a 2-minute swim more than doubled after 4 weeks of detraining, showing the ability to buffer lactic acid was rd dramatically affected. 5 1. Wilmore, Jack H., Costill, David L., 3 Edition, Physiology of Sport and

Chapter 3-Principles of Stress and Adaptations to Exercise 14

Exercise, Champaigne, IL, Human Kinetics 2. American College of Sports Medicine, 5th Edition, ACSM’s Resource Manual for Guidelines for Exercise Testing and Presctiption, Philadelphia, PA, Lippincott Williams & Wilkins 3. American College of Sports Medicine, 7th Edition, ACSM’s Guidelines for Exercise Testing and Prescription, Philadelphia, PA, Lippincott, Williams and Wilkins, p. 27 4. Gellish, RL, Goslin BR, Olson RE, McDonald A, Russi GD, Moudgil VK, May 2007, Longitudinal Modeling of the Relationship Between Age and Maximal Heart Rate, Medicine and Science in Sports and Exercise Vol. 39 (5), p. 822- 829 5. Wilmore, Jack H., Costill, David L., 3rd Edition, Physiology of Sport and Exercise, Champaigne, IL, Human Kinetics

Chapter 3-Principles of Stress and Adaptations to Exercise 15

entirely possible a change wouldn’t be Chapter 4 needed for some. However, for those that do, it could help increase pace, conserve energy, and most importantly help prevent Technique: The Art of Jogging injury. and Walking Injury prevention might be the best reason to change. It would be difficult to quantify

how many injuries occur to walkers and alking and jogging is not joggers as a result of poor technique. completely a function of fitness. However, a good argument could be made While significant, fitness reflects that 100% of injuries are related to poor Wonly one element of the sport. The form. Why? Unlike contact sports where objective of improved running and walking injuries often result from sudden impact extends beyond fitness and in to injury trauma such as American football, jogging prevention and conserving energy through or walking injuries generally occur as a efficiency. These “secondary” elements can cumulative effect of repetition (i.e. overuse be accomplished by developing proper injuries). Changes in running technique technique and are the main focus of this could be as simple as angling the toe inward chapter. slightly, a change of only a few centimeters. However, the accumulation of those For some, technique can be a difficult centimeters over the course of a half concept to understand. After all, most marathon, for example, add up to a humans begin walking within the first 1-2 significant change. years of life which almost certainly do not involve any type of advanced instruction on To apply this concept to injury prevention, the technical aspects of gait patterns or consider the load the feet/legs must carry energy conservation. Most parents will to run a half marathon (13.1 miles). An simply encourage an infant to simply “take average runner’s feet will strike the ground a step.” In contrast, a running coach may about 85 times per minute (42-43 per foot) instruct a teenager or collegiate athlete while bearing the load of 2-3 times the body how to hold their arms or emphasize proper weight with each step. If it takes this 150- foot placement. Often, this “new” style pound runner 9 minutes to run a mile, that requires significant changes from the infant runner’s feet will strike the ground 765 and juvenile technique that happens so times per mile or roughly 10,000 times naturally. during the full race! At impact forces of 2 times the body weight, that’s 3 million So, the reader has to ask the question: If I pounds of weight the feet/legs must learned to walk or run naturally, why should absorb! By altering technique, even a small I learn a new method? Or, another way to change, big results will occur. In other put it: Wouldn’t my walking/jogging pattern words, overuse injuries may be less about I learned naturally be the best suited for quantity of use and more an issue of using me? The answer to that question is a the /muscles improperly through difficult one but in short, yes and no. It’s technique flaws.

Chapter 4-Technique and Equipment 1 pattern. Use the below image to assist in understanding the description. Proper Technique • Pull back-This phase begins from the While walking varies less, it may be outward extension of the leg and when surprising to know there are multiple styles, the leg starts moving backwards or techniques for running. For example, the towards the body. Chi Method and Pose Method are both • Ground Contact-When the foot hits the popular running styles. Other methods ground. include the Alexander Method, the Yessis • Kick-after ground contact, the leg “Explosive Running” technique, or more continues its backwards movement. recent trends emphasizing barefoot • Recovery-after the kick, the leg initiates running. It is not the intention of the author it’s movement to extension out in front to detail each running style but rather of the body. outline some of the common, and important points of each. Characteristics of Good Walking Technique As mentioned previously, the main objectives of monitoring and possibly Specific photos of walking technique can be changing your walking technique relates to viewed here: injury prevention and improved efficiency. http://racewalk.com/howTo/basicTechniqu However, other positive side-effects such as e.php increased comfort, better muscle conditioning and faster times may occur. Head and Body Position

To begin examining your technique, it’s Good posture is imperative to walking advisable to use a video recorder or technique. You should walk like a photographs to see your current positioning “peacock.” Head up and eyes forward, chest and gait pattern. Do you really know what out (like a peacock) by standing tall. An easy you look like when you walk or jog? While way to envision your posture is to stand we may have a mental image of ourselves with your heels, head, glutes and shoulders as Hasselhoff on the beach in a scene from against the wall. By doing this, you will Baywatch, we may actually look more like notice the chest opens up which promotes Napoleon Dynamite. Using these types of airflow and the lower back moves to a media should help you visualize and neutral position setting the hips up to carry internalize your positioning. From there, the upper body. This alignment between you can begin to make changes where the shoulders and hips should remain necessary. throughout the walking session although the body position may be slightly leaned In order to properly address technique, it is forward. You should notice however, the important to understand some of the lean doesn’t change straight, tall posture terminology associated with a normal gait because you lean from the hips as opposed to bending at the lower spine.

Chapter 4-Technique and Equipment 2

moving to closely to the center line of your Arm Position and Movement body. You want them to land in a way so that they aren’t rolling from heel to toe Keeping the shoulders and hands relaxed, over the side of the foot (outside of heel to the elbows should be bent at approximately little toe, called pronation) or just the 80-90 degrees while walking for fitness. The opposite (over the inside of the heel to big arm swinging motion is initiated at the toe-called supination). In other words, shoulders and works like a pendulum widen your stance so your feet are rolling swinging anywhere between the 3 and 9 over the full surface of the foot and o’clock position (relative to the upper arm, finishing with the middle/big toe pushing elbow-shoulder). As speed increases, the off. This is easier visualized by thinking of a amount of arm swing will also increase. car tire. Proper alignment makes it so the flat area of the tire makes contact with the In relation to the legs, the arms work in ground as opposed to the inner or outer opposites. For example, during the recovery sides of the tire, which would wear quickly phase of the left leg, the right arm will also and force you to replace. Likewise, you swing forward. As the arms swing forward want your foot to roll over the “flat” area. and backward, they will ideally not cross the This is achieved by widening your stance body too much. In other words, they should slightly. move as close to straight forward and backward as possible as opposed to side to Proper Jogging Technique side movements. Head and Body Position Foot Placement and Foot Strike Much like the technique for walking, you During walking, the ground contact phase should stand tall, straight and keep your begins almost exactly when the recovery head up and eyes forward. The primary swing ends. There is very little pull back difference here is there will be more upper time. The ground contact phase should body lean as speed increases. An easy way occur with the foot slightly out in front of to visualize this can be done by standing up the body, with the ankle flexed at about 45 with good running posture and then gently degrees. The foot contacts the ground with leaning forward. As you lean forward, bend the heel and then rolls forward to the toes as little as possible at the hip area while as the body passes over foot. Once this bending at the ankles. You will begin to fall occurs, push off with your toes and the kick forward and will reflexively move one of phase begins. your legs forward to catch yourself from falling all the way to the ground. To a Occasionally, you will want to look down at certain degree, running is simply leaning your feet to assure proper placement. forward and preventing yourself from Doing this too often or continuously should hitting the ground. Keep in mind as you be avoided as it’s counter-productive to lean, you aren’t dramatically changing the good posture. When looking down at our hip/torso angle, you’re simply changing the feet, make sure your middle toe is pointed angle of the shoulders hips relative to the straight ahead, and your feet are not ground by bending at the ankles.

Chapter 4-Technique and Equipment 3

Likewise, the runner must keep the foot Arm Position and Movement strike underneath the body and use the momentum of the pull back to maintain Arms should be bent at the elbow to 80-85 momentum. degrees. Shoulders and hands remain relaxed as the arms pendulum back and Foot placement in jogging/running is exactly forth. As speed increases, the pendulum the same as in walking with the purpose motion will lead the elbows closer to 3 and being to make contact with the ground 9 o’clock positions. Arms should move in a using the large surface of the foot rather straight line back and forth rather than than the outside or inside areas. inward and outward towards or away from the body. Walking Jogging

Head/Body Looking Looking Foot Strike and Foot Placement Position straight ahead, straight ahead, tall stance, tall stance, The key difference in running is the foot mostly upright some lean strike. Because of the speed of the leg Arm Elbows bent to Elbows bent to Position about 90 about 80 movement and momentum of the leg degrees degrees during the recovery phase, there is a more Foot In front, heel Underneath, pronounced pull back. In addition, the foot Placement strike forefoot strike should land more underneath the body than the walking stride. By doing this, the ground contact will more likely occur with the foot landing on the flat surface or Indirect Influencers of Good Running forefoot rather than the heel. Form

This aspect of running is imperative in Several factors, beyond what was preventing injury. When the foot lands out mentioned above, indirectly influence how in front of the body, called over-striding, running form is carried out. Some of these the impact forces significantly increase and factors will be discussed in greater detail at place tremendous stress on the ankles, a later point in the book. However, they’re knees and hips. Over-striding is the important enough to go ahead and mention equivalent of putting on the brakes with here. each step leading to inefficiency along with the extra wear and tear. Using another • Flexibility-muscle tension influences the analogy, think of a skateboarder. To move length of muscles, their ability to move forward and keep the momentum going, through a full range of motion, and the skateboarder must contact the ground general comfort during a running with the pushing foot landing underneath session. Improving flexibility will the body. Otherwise, if the foot lands significantly improve chances at behind the body, very little force is successfully modifying your form and generated. If too far in front, the angle of reduce your risk of form related injuries. the leg when the foot makes ground Stiffness changes range of motion contact slows the forward momentum. making it more likely to begin

Chapter 4-Technique and Equipment 4

overcompensating (when one leg begins In an interesting and popular book amongst to do more work as a result of disuse of runners titled “Born to Run,” the author the other). Christopher McDougall goes to the Copper • Core strength-developing good posture Canyons in Northern Mexico to connect comes from excellent core strength. with a people that are believed by some to Core strength relates to those muscles be the best runners on the planet. One of in the hip and abdominal region (front, his most interesting findings were that the back and side areas). As fatigue begins meager shoes they wear consist of a dense to set in, many runners and walkers leather bottom with some Greek style begin to slouch which places more leather laces to secure them to their feet. stress on the spinal column and legs, This indigenous people, the Tarahumara, impedes breathing, and squashes don’t simply run a few hundred meters, or a efficiency. Development of a strong core few miles, but ultra-marathon-like distances results in a self-perpetuating cycle of in these shoes. One take home message for good form which drives fitness and vice many readers (although not the purpose of versa. More about will the book) from McDougall’s book was an be discussed later. increase in interest for “barefoot” running • Self-awareness-this applies not only to began, a style that was already gaining paying attention to your body in the some notice. Since then, the already- context of fatigue and aches and pains, changing styling in shoes progressed rapidly but also in the context of special from well cushioned to minimal shoe awareness. Developing the ability to soles. 1 “feel” your body position, foot placement, and leg motion will greatly This increase in interest for minimal shoes assist you in practicing good form on a stems from several ideas related to consistent basis. barefoot running: • Barefoot is the natural, most Equipment efficient, and intended method for humans to walk/jog. One of the major selling points for walking • The additional cushioning and and jogging is the simple fact that very little support of shoes hinders strength in equipment is required to participate in this the feet and actually promotes lifetime sport. In it’s most basic form, you injury. simply need comfortable clothing and shoes Although widely debated, there does seem and a safe place to perform your exercise. to be some validity to these claims. For In some locations, even shoes (and clothes) example, as mentioned in the technique are a luxury! Beyond that, other items fall section, a feel for foot placement will into the “unnecessary-but-could-help” improve technique. By using shoes with category. minimal cushioning and support, the nerves of the foot engage more during the run and Shoes promote an improved feel for your foot when striking the ground. In addition, the support shoes offer may serve as a “crutch,” by making it so the muscles of the

Chapter 4-Technique and Equipment 5

foot don’t have to work as hard (the shoe is gradual change over the course of 2- doing it for them). The result is weakness in 3 shoe life-spans is recommended to the foot and eventual injury. Once again, avoid injury. while many of these ideas seem plausible 3. Cushioning-cushioning in a shoe is and may very well be true, each walker and most often associated with comfort. jogger should examine their own needs However, it should also be when selecting footwear. considered in the light of efficiency. Finding that balance, especially for Here are specific items you should look for shoe makers, can be tough to do. A when purchasing footwear (in no particular well cushioned shoe will fit your order): specific needs. Walkers need more cushioning in the heel because of 1. Cost-of all of your walking and the heel foot strike pattern. Runners jogging gear, your shoes are the need more cushion in the forefoot most important. Do not skimp on area. However, too much cushioning this item, especially if you plan to can lead to inefficiency. A thick, soft increase mileage over time. There’s shoe sole will absorb the downward no need to go and break-the-bank, forces from the foot strike. but you generally get what you pay However, when the foot pushes off, for when it comes to shoe forward propulsion will be lost in the purchases. “give” of the cushion resulting in 2. Heel-to-toe drop-all shoes are more energy needed to move at a offset, or designed to have an offset faster pace. Shoe makers are now height at the heel and forefoot. The trying to make good cushion with greater the offset or difference, the more “springy” materials to avoid more cushioning you’ll find in the this dilemma. heel. The less the offset, the more 4. Durability/comfort-Look for a shoe “barefoot” the shoe will feel. When that is durable and comfortable. considering this element before Many durable materials are stiff and purchasing, think about what your inflexible. While resistant to wear intended use of the shoe will be. A and tear, the lack of flexibility and greater offset can be found more weight aren’t very comfortable. often in the walking shoe, which Shoes that are lightweight, promotes heel strike. A smaller breathable, flexible, made from offset tends to promote forefoot materials like mesh and soft leathers and front-foot ground strike. make for good comfort and usually Because of the differences in shoe good durability. offset, the smaller heel-to-toe drop 5. Purpose (trail/track/road)-the days will stretch the calves more with of the Taylor Berry Converse all- each foot strike resulting in fatigue purpose shoes are long gone. Shoes and possibly soreness after the first have become remarkably specific to use, especially if you’re not used to terrain and purpose. You will find the small offset. So, if you’re used to shoes designed specifically for trails, larger heel-to-toe difference, a pavement, and cross training shoes.

Chapter 4-Technique and Equipment 6

In addition, flats, long distance running, , and Other Equipment walking shoes are all designed specifically to meet the demands of While shoes would be considered the most the event. Determine your purpose important piece of walking or jogging of use and look for shoes that meet equipment, there are other items that may that need. help you be comfortable and enjoy your 6. Support-with the increasing interest exercise experience. in barefoot, support has almost become a bad word! Support in Clothing shoes is based on the needs of the

foot and incorporated into the It goes without saying that comfortable design of the shoe. For example, if clothing is necessary to enjoy your walking you land on the outside of your foot or jogging experience. Like shoes, endless at ground strike, you may need a styles exist which have been designed shoe designed for pronators. An specifically for various environmental over-pronation shoe will generally conditions and even some with claims to have a thicker arch and support promote blood flow and recovery. plate in the shoe sole to keep the Regardless, the key objectives are two fold: ankle from rolling inward and comfort and functionality. prevent the arch from collapsing too

much on foot impact. Shoes for Clothing options begin with the under- mild-pronators are often labeled garments, specifically briefs and bras. Briefs “stability” shoes. Most people have should be breathable fabric and help this gait pattern. For those manage too much rubbing which would walkers/joggers with serious over- cause chafing. Much of this goes to pronation challenges, they will find personal preference in regards to the level more success with shoes labeled of support needed. Many shorts have briefs “motion control” and/or “stability.” built into the shorts making it possible to “Neutral” shoes work great for those avoid an additional article of clothing. In non-pronators. Many shoe stores addition, many manufactures claim their now offer a free gait analysis before under-garments, or built in briefs, have purchasing their shoes to help you anti-microbial properties. The validity of purchase the correct shoes. You can these claims have yet to be determined but also easily determine your gait the concept is ideal to avoid bacterial pattern by looking at the tread wear contact and smelly underpants. on the bottom of your shoe.

Pronators generally have the most Females should consider sport specific bras tread loss on the outside heel of the using the same basic criteria as briefs: shoe and on the inner front (near moisture wicking, breathable, and the location of the big toe). supportive. Special attention should be

given to the location and feel of the straps

Chapter 4-Technique and Equipment 7 as they can rub under the arms, neck and and impractical measurement devices can back. now be downloaded to the palm of your hand through smart phones. Shorts and shirts should be loose enough to allow for ease of movement but tight Heart Rate Monitors enough in the right areas to prevent chaffing. Areas of specific concern include One of the most common and most widely the inner thighs, under the arms and used tools is the heart rate monitor (HRM). sometimes the nipples. Socks should be Because the heart rate monitor has been moisture wicking fabric (cotton/polyester covered extensively in chapter 3, details will blends) and should fit snug to the foot so be limited here. HRM’s are what could be the shoe doesn’t rub creating foot blisters. termed, “effort based” devices simply because your heart rate will reflect your Depending on when and where you run, effort level. your clothing should provide reasonable protection from the elements. In both Of course, heart rate can change as fitness hotter and colder climates, wear clothing improves. For example, a beginning runner that wicks moisture away from the skin. may run at a pace of 8 min/mi with an 80% Hats can be used to protect your face from effort level (reflected by heart rate) of 167 sun exposure and help keep sweat from bpm. However, after months of training, dripping into your eyes. Sun sleeves reflect this same athlete may actually do the same radiating heat away from the arms which pace at 160 bpm. This would of course may help to maintain a good body reflect an improvement in fitness and temperature. would change the effort level since the max heart rate would stay the same. Work Rate Monitors In summary, heart rate monitors create an excellent way to measure intensity, or work For decades, experts and amateurs have rate, during the exercise session and track found ways to measure the amount of work progress over time. they are doing when performing cardiorespiratory-type exercises. As Step Counters mentioned in chapter 3, the amount of work that can be done while exercising Step counters have been used for decades ultimately determines the level of now and still come as a feature in many performance and fitness. These smart phone apps. Because they’re measurement tools have included inexpensive (often free) and easily ergometers, heart rate monitors, step accessible, they often are used for large counters, pacing charts, and more recently group contests and other challenges. through power meters. The objectives of They’re primary function, to count steps measuring work rate are to measure throughout the day or during exercise, can calories burned, distance traveled, then be used to estimate a distance performance, and progression over time. traveled. The American College of Sports With the advancement of technology in Medicine estimates 2000 steps to be one recent years, many of these once expensive mile for the average adult, making the

Chapter 4-Technique and Equipment 8 average stride length approximately 31 meter intervals which would be done at a inches. Using the recommended daily step faster pace than the 1 mile pace. Or, count of 10,000 steps and this would stamina type running session designed to accumulate to about 5 miles per day.2 simply build endurance rather than speed which would be done at a slower pace. A It’s important to note that these are great place to see an example, and one of approximations. In many cases, a change in the more accurate pace calculators, can be the direction of the accelerometer, inside seen at www.mcmillanrunning.com. the step counter, is what signals the step to be counted. So, simple movements that As noted, this type of tool is primarily used shake the accelerometer could be for those interested in improving interpreted as steps. Also, stride length performance rather than those interested varies widely throughout the day as in improving only health or weight loss. climbing stairs makes for short stride However, it is better in improving lengths and stepping over objects, such as a performance than by using the heart rate puddle of water, make for longer strides. monitor to achieve the same objective.

Pacing Charts A criticism of this tool stems from it’s application to a single course. If the above Pacing charts are generally more mentioned jogger ran a personal best on a performance oriented tools designed to track, flat terrain, it would be unlikely to see improve fitness. The pace is the rate at that same pace on course with rolling hills. which the walking and jogging is taking Therefore, a pacing chart would need to be place and is generally expressed as minutes created for each course with different per mile. For example, if a one mile terrain. Additionally, environmental assessment is completed in 9 minutes and conditions such as head-winds and sun may 36 seconds, the pace is 9:36 min/mi. Pace make it very difficult to hold a particular based training varies from effort based pace although effort could be quite high. As training because pace doesn’t include heart a result, this could lead to overtraining and rate as a marker. frustration.

To generate a pacing chart, it’s important to Power Meters establish a “personal best” pace on a given course such as a 1-mile assessment or 5k. Recent technology has taken a tool that was Once the personal best pace is established, once primarily associated with the sport of the time can then be used to calculate cycling and made it available to runners. other training or race paces for various While the validity and usefulness of the distances. For example, a jogger who product is still being evaluated, like a cycling measures a 9:36 min/mi could use this pace power meter, it attempts to determine the to calculate how fast they should try and amount of wattage (power), that is being jog at a 10k, half marathon, and marathon used during a jogging session. As a result of as well as use that pace to establish training having this information available, a much paces for various kinds of training sessions. more precise means of gauging effort can These training sessions could include 400 be used. This would help a jogger improving

Chapter 4-Technique and Equipment 9 pacing, determine a more precise amount need to make sure it will fulfill it’s purpose: of calories burned, and predict the impact make fluids easily accessible to you with as of the exercise session on the body for little discomfort as possible. Ultimately, recovery purposes. As with the pacing your choice will come down to personal charts, this tool is all about improving preference but there are several options performance. available. • The hydration backpack uses a Smartphone Apps backpack with a bladder inserted into the satchel portion of the pack. Smartphone apps can be very helpful in A long straw-tube leading from the tracking many or all of the above bladder is then used to access the information either as a stand alone tool or water. when paired with other devices. For • Hydration belts use a belt around example, many apps use the GPS tool in the waist with various smartphones to track distance over the compartments to hold small flasks course of a day’s activities which could be for easy access to fluids. used to track distance as opposed to using a • Hand held water bottle covers allow step counter. Or, a heart rate strap could be for a water bottle to be inserted in purchased and paired with a phone app the casing carried in the hand by using the Bluetooth in the smartphone. By using a strap that goes around the doing this, a detailed history of activities palm of the hand. can be kept, improvements tracked, and activities shared with others. A few Summary smartphone apps are:

• MapMyRun In summary, improving technique should be • Strava viewed as important, if not paramount, in • GarminConnect (needs to be paired preventing injury and improving with Garmin product) performance. Likewise, equipment can do much of the same, help you from Hydration Systems overtraining by monitoring your work rate and helping you improve your performance. As mentioned in chapter 3, staying hydrated is key to preventing both heat References related and cold related illnesses. However, many walkers and joggers find it difficult 1. McDougall, Christopher, 2009, Born stay hydrated during their workouts to Run, New York, Vintage Books without excessive stopping. The importance 2. American College of Sports of this concept, and impracticality of Medicine, retrieved April 2017, frequent stops, has lead to the ACSM Step Counters development of multiple hydration systems. https://www.acsm.org/docs/brochu res/selecting-and-effectively-using- If and when you consider a means of a-.pdf staying hydrated, i.e. hydration system, you

Chapter 4-Technique and Equipment 10

Flynn

• Micronutrients-nutrients we need in Chapter 5 small amounts and do not contain energy (calories). o Vitamins Nutrition and Energy o Minerals Requirements o Water Macronutrients egardless of the goals or tools used to monitor effort, both walkers and Macronutrients are needed in relatively joggers must fuel their body to do large quantities for good health. Generally, Rthe work needed to perform the exercises. these nutrients are measured in grams. As you might imagine, exercising on an Reading food labels on food packaging will “empty tank” would be very uncomfortable help to understand the makeup of the food. if not impossible. This chapter will cover the As you can see in the food label below, basics on nutrition, how much energy is macronutrients are organized in grams and required for walking and jogging, energy account for the caloric make up of each sources, and ways to apply these concepts. serving.

Nutritional Basics

While eating for energy is essential to our survival and good health, it’s not the only reason we eat. Eating also gives us access to other essential nutrients that help to promote cellular activity, repair damaged tissue, produce chemicals such as hormones and neurotransmitters, and countless other functions. Experts have identified 45 essential nutrients that we must get from food because we don’t produce them at all or quickly enough.

These 45 nutrients can be broken down into two major classifications: macronutrients and micronutrients. Within each of the two classifications, 3 subcategories can be formed. • Macronutrients-nutrients we need in large amounts and that contain energy (calories). Carbohydrate By BruceBlaus (Own work) [CC BY-SA 4.0 o (http://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia o Protein Commons o Fats https://commons.wikimedia.org/wiki/File%3AFood_Label.png Chapter 5-Nutrition and Energy Requirements 1 Flynn

Food manufacturers often alter the Proteins are the building blocks and major properties of unsaturated fats to create a structural components of nearly all cells and hybrid fat known as trans fats. These fats function to aid in bone repair, muscle, skin may be solid at room temperature but and blood cells. A protein is made up of a liquid when used to cook. Shortenings, series of building blocks called amino acids. margarines, and other hybrid fats should be There are 20 amino acids necessary for avoided because of the negative impact optimal functioning for humans but the they can have on health. body only manufactures 11 of those. The remaining 9 amino acids are termed In order to deliver fats to the body’s cells, essential amino acids and must be obtained fats are packaged together with cholesterol from our foods. The foods that contain all of in units called lipoproteins. These the essential amino acids we need come lipoproteins are collectively called from complete protein sources, primarily cholesterol (Low-density lipoproteins (LDL) animal sources such as red meat, poultry, and high-density lipoproteins (HDL)). fish, eggs, and milk products. Incomplete Cholesterol is important for cellular health sources come from plant sources such as but when LDL’s are in excess, they can nuts, beans, seeds and leafy green invade damaged cells and cause arteries to vegetables. harden and become blocked. HDL’s, on the other hand, help remove excess cholesterol. Fats, or lipids, are also important for our While aerobic exercise will help manage diet. Fats are important for flavor in foods, cholesterol levels by increasing HDL’s, bad energy, thermoregulation, cushioning of food choices can negatively impact organs, and cellular function. There are 3 cardiovascular functioning by increasing different types of fats, all are named based LDL’s. Over consumption of saturated fats on their molecular structure (specifically, and trans fats leads to excess LDL the number of carbon bonds taken by production so these foods should be hydrogen). consumed in limited quantities.

Saturated fats have all bonds filled by Carbohydrate are chains of sugar molecules hydrogen and can be found in animal and their primary function is energy. There products such as red meats and dairy are two types of carbohydrate, simple and products. Saturated fats should be complex. Like proteins, they’re labeled consumed in limited amounts. based on their molecular structure. Simple carbohydrates have 1-2 sugar chains and Unsaturated fats have bonds available and can be found in fruits, sugar cane, and some may be monounsaturated (single bond vegetables. Complex carbohydrates have 3 available) or polyunsaturated (multiple or more sugar chains and can be found in bonds available). These fats usually consist grains, rice, potatoes and vegetables. of oils such as olive or vegetable oil and can While carbohydrate consumption often gets be found in fish oils (omega 3 and omega 6). a bad name, carbohydrates are important Unsaturated fats are the healthiest of the for energy and should not be overlooked. fats. Complex carbohydrates should be the staple of carbohydrate consumption as they

Chapter 5-Nutrition and Energy Requirements 2

Flynn

not only contain energy, but also carry chemical reactions in the cells and body. multiple other nutrients important for They can be broken down into two energy production. They also contain fiber, categories: major and trace minerals. a non-digestible carbohydrate that improves benefits the digestive tract as well Major minerals consist of minerals such as as several other benefits. calcium, sodium, potassium, and chloride. Each of these minerals plays specific roles in Micronutrients nervous system function, bone health, muscular contraction, cardiovascular Micronutrients are needed in relatively functioning and fluid balance. small quantities and are generally stated in milligrams. However, don’t mistake their Trace minerals consist of several minerals importance because of the small amount such as selenium, iron, chromium, needed for good health. As you see in the magnesium, zinc, iodine, phosphorous, food label above, they are measured in copper and fluoride. Those of special milligrams (for example, sodium, 300 mg). interest include iron which is important for blood and fluoride which is important for Vitamins teeth.

Vitamins can be broken down into two Water primary types, each having similar functions which promote all the chemical reactions Unlike the other micronutrients, water is needed for cellular health. These two types needed in large amounts. However, water are: water-soluble and fat-soluble vitamins. doesn’t have any calories associated with it making it a perfect fit for the micronutrient Water-soluble vitamins are easily absorbed category. About 60% of the body is made with water and consist of vitamins C and up of water making it an absolutely critical the B-vitamins. These vitamins assist in . While you could live for weeks on immune system health and the breakdown energy storage you could only live for days of fats and carbohydrates so they can be without adequate water. Water is the processed by the cells for energy solution where all the chemical reactions production. must occur. Changes in fluid volumes can result in an inability to properly transport Fat-soluble vitamins require fat to be substances from one area of the body to available to be absorbed and consist of another, improper pH balance, and vitamins A, D, E and K. These vitamins assist improper balance of salt solutions within in healthy blood cells, bone and eye health, the cells. digestive health and growth and repair of tissues. The average adult needs approximately 48- 64 ounces of water every day to maintain Minerals this delicate balance. In addition to getting water from the tap or bottled sources, Minerals have very similar functions as water can be obtained from foods we eat, vitamins in that they assist in regulating

Chapter 5-Nutrition and Energy Requirements 3

Flynn

especially water rich foods like fruits and to ATP are fats and carbohydrates. Four vegetables. calories can be found in 1 gram of carbohydrate. One gram of carbohydrate can then be broken down into individual Eating for Health and Fitness glucose molecules and broken down and processed in the body’s cells to produce Eating Energy Dense Foods ATP. Similarly, fats are broken down by to body and processed by cells to generate As you may have noticed, much of the food ATP. However, 9 calories can be found in we should be eating evolves around fruits, one gram of fat. While protein does contain vegetables, and whole grains. One major 4 calories per gram, protein is used reason for this comes from the fact that sparingly if at all for energy during physical these foods can not only provide energy, activity. but they can also deliver the nutrients needed. This concept is termed eating The balance of food, or energy balance nutrient dense foods. equation, suggests that in order to maintain weight the same amount of energy As an example, consider eating a snack such consumed must be burned. In other words, as a candy bar of 250 calories. While the if you eat 2500 calories you must burn 2500 candy bar would have plenty of caloric calories to maintain your current weight. In value, very few additional nutrients tag simpler terms, energy in must equal energy along for the ride. By contrast, eating a out. By consuming more calories than Greek yogurt and some strawberries would needed, would result. By provide plenty of protein and be packed consuming fewer calories than needed, with vitamin B and vitamin C, all around the weight loss would be the result. Regardless same 250 calorie range. Not only that, but of the goal, the foundation of this equation you would likely be more filling than the is understanding how many calories are candy bar meaning you would eat less over needed on a daily basis. the course of the day. To find your total daily energy expenditure, Energy Balance, Eating the Right Amounts you need to calculate the components of your energy expenditure. The 3 ways you Just as important as knowing your target burn calories are: heart rate is knowing how many calories (BMR), food digestion, and physical activity. you need on a daily basis. This will provide the foundation of planning your fuel BMR accounts for the greatest amount of consumption for the day. Calories, give us a energy out so it’s a great place to begin the way to measure how much fuel we are calculations. The most widely used equation putting into our bodies. As previously is know as the Mifflin-St. Jeor equation, noted, the basic unit of energy the body named for it’s founders. Here is the must produce and use is ATP. In order to equation: produce ATP, we must eat! The primary • For men: BMR = 10 x weight (kg) + 6.25 substances in our foods that are converted x height (cm) – 5 x age (years) + 5

Chapter 5-Nutrition and Energy Requirements 4

Flynn

• For women: BMR = 10 x weight (kg) + case). That same food label may indicate 6.25 x height (cm) – 5 x age (years) – the amount of protein consumed, for that 161 particular food, accounts for 10% of the total recommended amount out of 2000 Once the BMR is calculated, the addition of calories. In other words, the protein the food digestion and physical activity can content of that food product equals 200 be added in. To do this, simply multiply the calories which is being suggested as 10 BMR by 1.2-1.9 based on your estimated percent of what is recommended. daily activity levels. For mostly sedentary behavior, use 1.2 and for very active However, the recommendations were behavior use 1.9. created as ranges, not set amounts. An elite endurance athlete may need close to 65% Generally, these numbers are an estimate of his/her total daily calories to come from of what you do on a daily basis and may carbohydrate to support the energy exclude specific exercise sessions. Of course requirements of the daily training and this means the additional exercise sessions frequent competitions. While someone would need to be included in the final needing to lose weight may elect to stick calculations. For example, the BMR and closer to the 45% range of carbohydrate activities may account for daily functions and 30% range of protein. Unfortunately, such as work, housework, childcare, etc. but no magic number exists for everyone so will not account for a 30-minute evening finding the right distribution range can be a jog. So, the evening jog would be totaled process. and added to the BMR and activities. Nutritional Tracking Macronutrient Distribution Keeping track of the number of calories, the Another way of examining and analyzing quality of foods being eaten, and the eating patterns is to determine what’s best distribution of calories can be an arduous in regards to adequate macronutrient task. Fortunately, technology has enabled distribution. Remember, macronutrients this task to be done quite easily. Multiple consist of proteins, fats and carbs. The food logs exist online and as applications on recommendations for how much to smart phones. Both Fitday.com and consume of each category are wide open myplate.gov fit into this category. giving freedom to adapt to your personal circumstance and needs. Regardless, the good ones have foods loaded into a database allowing users to The distribution ranges are expressed as look up specific foods eaten and select percentages of the total diet. The them as part of their food consumption for recommended amount of protein, fat and the day. Once the food is selected and carbohydrate for an adult range from serving size indicated, the total calories 10-30%, 20-35%, and 45-65%, respectively. from the food are generated along with a For example, food labels are based on the distribution and micronutrient profile. daily values assuming 2000 calories to be Additionally, by entering a user profile, BMR the magic number for everyone (not the and activity rates can be calculated in terms

Chapter 5-Nutrition and Energy Requirements 5

Flynn

of calories and then compared with total over time or distance. For example, a sedan food consumption. As a result, an easy automobile may be able to go 35 miles in visual of energy in versus energy out can be using only 1 gallon of gas, or a large truck done. may only be able to go 15 miles in using one gallon of gas. In walking or jogging, you may Some of these applications also offer use 100 calories to travel one mile. suggestions for improving nutrition based on life stage, eating trends and activity What do these terms have to do with habits. They also allow you to set goals and walking and jogging? The amount of energy provide information and tracking on how needed is directly affected by efficiency and many calories would be needed to be economy. So, this can be tied back to the restricted in order to reach those goals. eating habits of the individual. A walker who walks with poor technique will be very Application to Walking and Jogging inefficient and economy will be low, requiring more calories for the exercise To understand the energy requirements of session. From a performance perspective, walkers and joggers, it is important to this wouldn’t be a good thing. understand two terms that are often used in correlation with how much energy is From a weight loss perspective, burning being used: economy and efficiency. more calories, i.e. having a low economy, would be precisely what is needed. So, the Efficiency, in the context of human question in this context would be: how do I movement, is the amount of energy being burn more calories? converted from the foods consumed (calories) to work stated as a ratio or Chart 4.1 helps explain how walking and percentage. An automobile may take 17 running speeds correlate with energy gallons of gasoline, but only a certain expenditure. percentage of that gasoline can be utilized to produce forward motion while the 20 remaining amount is given off as heat and 18 waste product. Likewise, an athlete may 16 14 consume 2500 calories throughout the day 12 but only about 23-28% of that “fuel” can be 10 converted into actual work. The remaining 8 amount is given off as heat and waste 6 Energy (Cal/p/min) 4 product. In other words, human movement 2 Speed (kph) is not very efficient. 0 0 5 10 15 Economy is a term very similar to efficiency Walking Running and often used interchangeably. However,

they are very different terms. While Chart 4.1 efficiency describes the percentage of energy converted into work, economy From chart 4.1, walking at 4 kph (about 2.5 describes how much energy is consumed mph) leads to burning about 3.3 calories

Chapter 5-Nutrition and Energy Requirements 6

Flynn

per minute or 198 calories over the course the effectiveness of walking for fitness and of 4 kilometers (2.5 mi). However, as weight management while walkers may walking speeds increase, the economy argue that walking poses less risk of injury changes. At 10 kph (about 6.2 mph), and burns as many calories as jogging the calories are being burned at over 11 same distance. For purposes of this chapter, calories per minute! Compare that to the 4 that question can be examined through the kph pace who burns 198 calories, and the eyes of energy expenditure. faster walker would burn 271. Chart 4.1 illustrates a general idea of the This phenomenon is related to the amount of calories being burned for both mechanics of walking. Consider what was walking and jogging. As you can see, jogging previously discussed in chapter 4 with results in a greater absolute amount of walking technique. As the speed of walking calories burned (with the exception of increases, stride length will increase and so faster walking speeds). However, there is will the arm movements. This leads to more to be considered. inefficient walking in the context of energy expenditure, but progress in the context of During exercise, fats and carbohydrates speed and weight management. from foods consumed are broken down and utilized to help produce ATP. The intensity An additional note from chart 4.1 comes of exercise governs the ratio of fats to from the overlapping energy cost in running carbohydrates used for that session. For and walking. You have undoubtedly walked example, participating in a 10k (6.2 miles) at fast enough at some point that it’s no a lower intensity walking will lead to more longer comfortable to walk so you begin a fat being used for energy than would high light jog. Based on energy cost, this is a intensity running. In other words, walking at natural response since jogging at 9 and 10 20% of your maximal capacity would result kph is more economical than walking at in close to 60% of your energy coming from those same speeds. fat, 40% coming from carbohydrate. If intensity increased to 70% of maximal While this might seem unimportant, it once capacity, only about 30% of energy would again goes back to the basic idea of energy come from fat. expenditure and consumption. If the goal of a walker is weight loss, understanding this In terms of absolute calories, let’s compare concept of economy will assist in food a walker to a jogger of the same size who selection and consumption amounts based participates in the same 10k. The walker on the activity’s energy cost. Or, for a that walks at 7 kph (about 4.5 mph), jogger, this same understanding may corresponding to 50% of the max capacity present the right tools to fuel their body would be able to complete the 10k in 1 through a marathon race. hour and 22 min. Based on chart 4.1, this would equate to 6.5 cal/min for 82 minutes, Walking or Jogging? or 533 calories. Of those 533 calories, 40% of them would be derived from fat (so, 213 The question of whether to walk or to jog is calories from fat, 320 from carbohydrate). a hotly debated topic. Joggers may criticize

Chapter 5-Nutrition and Energy Requirements 7

Flynn

A jogger who jogs at 12 kmh (about 7.5 burn more calories, weight could be added mph), corresponding to 70% of max by using a weight vest, backpack, or other capacity would be able to complete the 10k objects. in about 50 minutes. Based on the chart 4.1, this would equate to 14.3 calories per min, Another way to increase energy or 715 calories. Of those 715 calories, 25% expenditure is to change the grade of of them would be derived from fat (so, 179 terrain. Walking up hills requires more calories from fat, 536 from carbohydrate). effort and consequently burns more calories than downhill or flat surfaces. So, if In short, jogging would have the greater the goal is to burn more calories, hills are a energy cost burning almost as many calories great way to do that. from fat as total calories by the walker and significantly more from carbohydrate. It should also be noted that inefficient is not the same as poor technique. Technique Other Ways to Burn More Calories should always be monitored so that injury risk can be minimized. Adding weight and It may appear contradicting at this point to terrain changes can alter good form and say “be inefficient” if you want to burn result in injury. more calories but that rings true in this context. As has been illustrated, walking at Nutrient Timing faster speeds results disproportionately in more arm movement, longer strides and In recent years, attention has not only will burn more calories as a result of this looked at what is being consumed at meal inefficient walking pattern. time but also the timing of the meals. Weight lifters have long used protein before One additional element that hasn’t been and after workouts to help produce more mentioned in the energy expenditure muscle and aid in recovery in between conversation is body weight. As you might workouts. As a result, questions have come imagine, a walker who weighs 115 lbs. will up about how soon should meals be eaten require fewer calories than a walker who before a workout and when to eat after the weighs 180 lbs. This can easily be workout. This question not only stems from monitored by using a heart rate monitor. a desire to improve performance but also to The 115 lb walker may be working at 50% of avoid gastrointestinal discomfort and speed his/her max while the 180 lb walker may be up recovery. working at 65% of his/hers on the same course and pace. There are two key take- Most experts suggest eating 2-3 hours away points to this concept that have been before a workout allowing ample time for lightly touched on in chapter 4: exercise digestion so as to avoid stomach and/or prescription in cases like this should be gastrointestinal (GI) discomfort. Eating a customized for each individual (by using meal with ample carbohydrate is suggested effort based methods), and weight to provide adequate energy that can be significantly influences caloric expenditure. used during the activity. If hungry before This last point can be used for anyone. For the workout, try and consume a small example, if the 115 lb walker wanted to amount of carbohydrate to get through the

Chapter 5-Nutrition and Energy Requirements 8

Flynn

workout. Something like a granola bar, a Ultimately, weight loss can be achieved by few pretzels and peanut butter, or some eating fewer calories than calories burned. fruit could be used. Keep in mind, walking This negative energy balance must be and jogging consists of up and down and accrued over long periods of time. In some side-to-side movements making it general, it is believed that 3500 calories easy for foods to be sloshed around in the equal 1 pound of fat. In the context of daily stomach. Foods that are greasy and fatty, eating, a safe amount of calorie restriction like potato chips and fried foods are not would be 500 calories. By continuing that recommended as they take longer to digest, for 7 days, a negative energy balance of sit heavy in the stomach, and can cause GI 3500 calories could be achieved and a distress. pound of fat lost.

Each time you eat a meal, the It is important to remember that energy out carbohydrates you’ve consumed are broken is not only achieved through calorie down and, in part, stored in the muscles as restriction. Energy out consists of BMR, . This glycogen is then readily food digestion, and physical activity. The available for use during the next activity. healthiest way to lose weight comes from Once the workout is complete, muscles may restricting calories and maintaining a be depleted of glucose/glycogen stores so consistent exercise program. For example, consumption of carbohydrate within an not drinking a soda, a daily habit for many, hour after the workout is recommended. would mean 250 calories have been Because exercise can lead to muscle restricted each day. A daily ,2.5 mile, brisk, breakdown, protein post-workout can help walk roughly burns 250 calories which goes speed up recovery by making needed amino on to the energy out side of the scale. acids available to muscle tissue in need of Together, subtracting the 250 calories from repair. A ratio of 4 grams of carbohydrate to the soda and adding the 250 calories from 1 gram of protein will give optimal results. the walk would generate a negative energy Foods like Greek yogurt, chocolate milk, and balance of 500 calories. This is a simple specially formulated protein shakes are lifestyle change for most which could yield excellent post-workout products. large results!

The amount of post-workout calories should be determined by the length and intensity of the workout. Of course the References: energy balance concept applies. Shorter workouts of less than 30 minutes and/or 1. Freedieting.com, retrieved April 2017, low intensity workouts will require little to Determining Daily Calorie Needs, no post-workout food while activities https://www.freedieting.com/calorie_n beyond 30 minutes are more and/or very eeds.html intense workouts likely justify post-workout 2. Hall, C., Figuoroa, A., Fernhall, B., calories. Kanaley, J. 2004, Energy Expenditure of Walking and Running: Comparison with Eating for Weight Loss Prediction Equations, Medicine and

Chapter 5-Nutrition and Energy Requirements 9

Flynn

Science in Sports and Exercise Vol. 36 (12), p. 2128-2134 3. Brianmac.com, retrieved April 2017, https://www.brianmac.co.uk/energyexp .htm

4. Food and Nutrition Board, Institute of Medicine, 2003, Dietary Reference Intakes: Application in Dietary Planning, Washington D.C., National Academy of Sciences

Chapter 5-Nutrition and Energy Requirements 10

and other bone related problems occur less Chapter 6 frequently. Of course, this is a good thing because many soft tissue injuries can be treated at home and don’t require the time Injuries and Care or expense of visiting a physician. However, it is imperative that as you begin a program nfortunately for some walkers and you become familiar with your body’s joggers, beginning a new program response to exercise so you’re able to U or even maintaining a program differentiate between minor tweaks and doesn’t always go as smoothly as planned. strains and significant injuries that would As mentioned previously, the physical require medical attention. If in doubt, see a challenges of beginning a new exercise physician. program can place you at a greater risk of injury, illness or even death. Results from PRICE various studies suggest vigorous activity increases the risk of acute heart attacks The acronym PRICE describes the proper 1 and/or sudden cardiac death. approach to soft tissue treatment.

In addition to the increased risk of P-Prevention cardiovascular events, muscle strains, joint R-Rest and pains, broken and soft I-Ice tissue damage can occur as a result of C-Compression walking and jogging. In a large study at the E-Elevation Cooper Clinic in Dallas, Texas, regular walkers and joggers were tracked for 8 Because prevention is so important, a larger years to determine how many of them section of text has been devoted to required physician visits as a result of prevention at a later point. musculoskeletal injury. Of the nearly 3,000 participants, walkers were less likely to be Rest injured compared with young and old male runners. In addition, the researchers found Once injury has occurred, treatment should that running for greater than 30 min posed begin as soon as possible. The first step in more risk than walking for a similar or soft-tissue treatment comes from resting greater time frame.2 Regardless of the the injured area. Resting, or discontinuing differences in risk, when considering use of the injured area helps prevent walking for fitness or jogging, one should additional damage and allow for the natural consider all of the costs and benefits. healing processes to occur. The amount of resting or time off depends on the severity of the injury. In some cases, time off may Basic Treatment of Injuries not be required. In other cases, not resting, or just dealing with the pain, may lead to Most injuries occurring with walkers and additional damage to the injured area and joggers would be classified as soft-tissue overuse to areas of the body that now must injuries. This simply implies that fractures

Chapter 6-Injuries and Care 1 compensate for the damaged area’s easier for an accumulation of blood to inability to function properly. Post injury, occur, i.e. swelling. By elevating the injured rest should last for 24-48 followed by area above the level of the heart, gravity modified activity when possible. helps push blood back to the heart and reduce swelling and removal of Ice accumulating metabolites in the injured area. 3 Ice, or cryotherapy, serves two purposes. First, it helps reduce by Additional Treatments reducing blood flow to the injured area. Second, it helps with pain. Ice should be There are many methods athletes treat administered as soon as possible and injuries. It is not within the scope of this continue for 48 hours in the pattern of 15- class to explore them all. In many cases, 20 minutes per hour or several times per those that require advanced treatments are day. Continuing use in this fashion beyond elite or competitive endurance athletes 48 hours may delay healing. However, a rather than walkers and joggers who are single treatment of ice may be needed after simply trying to improve fitness and modified exercises have been performed. maintain good health.

Compression Anti-inflammatory Medications

Edema, or swelling may result from injury Injuries often result in inflammation which leading to pain, stiffness, and low blood causes pain, interferes with blood flow and flow. In order to attempt to manage the delays healing time. Medications that swelling, compressing the area may be reduce inflammation, anti-inflammatory necessary. This can effectively be done with medications, can be used in conjunction an elastic bandage (such as an Ace with other treatments to alleviate pain and bandage). Caution should be taken to avoid obviously, reduce inflammation. wrapping any bandage too tightly which will stop or significantly reduce blood flow to Over-the-counter anti-inflammatory extremities beyond the injured area. medications are used most commonly. This Symptoms of a bandage that is too tight includes drugs such as ibuprofen, aspirin include skin discoloration, loss of feeling, and naproxen which are also grouped into a and/or a tingling sensation in the area category of drugs known as Non-steroidal below the wrapped area. Anti-inflammatory Drugs (NSAID’s). These can be a very effective means of treating Elevation soft-tissue injuries when used properly (consult a pharmacist, physician, or the When muscles contract, the contraction packaging for proper dosage amounts). actions also serve as a pump, pumping blood in the veins back towards the heart. Steroidal medications differ from NSAID’s in While resting an injured area, muscular their chemistry and the way the body contractions will be at a minimum making it processes them. These medications are

Chapter 6-Injuries and Care 2

administered under a physician’s This raises the question of whether or not supervision as shots or in oral form. Shots, the science supports the anecdotal opinions like cortisone shots, are injected into the of professional coaches. In other words, local area of the injury and linger over a while significant scientific evidence may not long period of time to alleviate pain and exist supporting the claims of or inflammation. several other factors, there may still be a benefit to paying attention to areas like Surgery stretching which have long been believed to contribute to injury prevention. Of course, While every attempt should be made to that goes for each factor. avoid it, surgery may be the only way to deal with some injuries. Fortunately, Regardless, while not implicated surgery isn’t a frequent treatment for specifically, walkers and joggers will almost walking and jogging related injuries. Most certainly benefit from identifying these injuries can be treated at home, with factors and taking action to minimize the physical , and common sense. The associated risks. key point is to not allow injuries to go untreated so that they get to the point Factors Related to Prevention of Injury were surgery might be needed. Later in this chapter, the most common P for Prevention injuries associated with walking and jogging will be examined more closely. However, at The old adage, “An ounce of prevention is this point the focus is turned to what is worth a pound of cure” holds true in believed to generally be the most common walking and jogging. There is no better way causes of injury. It should be noted that to avoid treatment of injury than to prevent identifying the causes also identifies the it from happening altogether. In a 2010 treatment strategy. researchers published a meta-analysis of runners identifying multiple factors that As these causes are outlined, it may be could be implicated as possible causes of easier to understand by considering the injury. Of those factors identified, only one muscles and bones in the legs as being a strong correlation between injury part of a chain, beginning in the feet and prevention and weekly mileage was ending where the gluteal muscles end determined. Of the other factors cited such (buttocks) attach to the hips in the lower as strength, pre-exercise stretching, and back. Each muscle, or chain link, serves a shoes, the researchers found that more specific purpose to aid in the running or research was needed to connect these walking movement. This chain, is often factors with injury occurrence. referred to as the kinetic chain.

However, in their findings of pre-routine stretching, it was noted that 95% of coaches still believed it helped prevent injuries and Muscle weakness has been identified as a 73% believed there were no drawbacks.4 problem for many runners with injuries in the hip, thigh and knees. Of course this

Chapter 6-Injuries and Care 3

seems logical when you consider the exercises, muscles are strengthened and movement pattern of walking and jogging. injuries avoided. Once again, in thinking of the leg as a chain of connected muscles, beginning at the feet Anatomical Factors, Orthotics, Shoes and ending in the lower back where the buttocks muscles attach to the hips, it’s Unfortunately, some factors are genetic and easy to visualize how one weak link would can’t be modified very easily. For example, cause the other links to have to “pick up the the degree of arch in the feet appear to be slack.” As a result, the additional load leads connected to injuries of the knee. High to overuse which leads to pain, arches (cavus) can alter the way the foot inflammation and ultimately injury. contacts the ground, making it so the foot Therefore, attempting to strengthen each rolls from the outside to inward rotation. As “link” through strength training, an area of a result (consider the kinetic chain), the fitness often avoided by cardio-lovers, has ankle bends inward as does the knee long been recommended by coaches and making the muscles in the thigh and hip other experts. engage to stabilize the inward forces. Other genetic factors may be the width of the hips Muscles to Be Strengthened: and differing leg lengths. Of course, little • Gluteus Maximus can be done to anatomically change these • Gluteus Minimus factors.4,6 • Hamstrings • Calf muscles However, physicians and shoe • Quadriceps (vastus lateralis, vastus manufacturers attempt to minimize the medialis, rectus femoris, bicep femoris) effects of these genetic differences by using • Core muscles (abdominal muscles and orthotics and shoes specifically designed for those surrounding the hips). certain gait patterns (as mentioned in previous chapters). Conflicting evidence Muscle weakness in the feet and ankles is implies that either of these methods one of the primary arguments by significantly reduce the risk of injuries in 6 proponents of barefoot running. runners. Nonetheless, patients and Proponents believe that cushioned and consumers abundantly support the use of motion control shoes serve as a “crutch” to orthotics and motion control shoes showing muscles in the feet. This weakness leads to they believe they are helpful. unnatural movement of the ankles and over-stress in the foot which causes the Training Errors muscles in other areas of the body compensate. For example, inward rotation Not only do weak muscles and anatomical of the ankle requires additional rotation at factors pose a risk to joggers and walkers, the knee. The additional work of the but the type, frequency and volume of illiotibial band (IT band), used to stabilize training also increase the risk of injury. Of the knee, can lead to inflammation of the IT all the factors listed, the one with the band. By walking and jogging without that strongest correlation to injury is weekly support and cushion, or performing specific mileage. In general, the greater mileage

Chapter 6-Injuries and Care 4

(40+ miles per week), the greater the idea and in some cases may actually show chance of being injured. However, in some that stretching before exercise may actually studies more mileage may have actually have the opposite effect.9 prevented knee injury although injury to the thighs and hamstrings were more More recently, studies have been designed frequent. to include stretching after the workout has been finished. The authors of one such In addition to weekly mileage, the study assessing hamstring injuries and frequency and time also affected the stretching post-workout, followed a single occurrence rates of injury. Studies team for four playing seasons and found comparing runners of 1, 3 and 5 days a that hamstring injuries decreased from 11 week for 20 weeks, and 15, 30, and 45 min to 4 injuries and the number of days missed for 20 weeks found that the rate of injury from injury went from 38 to 16. While more increased in both control groups, i.e. as evidence is needed, injury prevention volume and frequency increased, so did through stretching may be optimized by injury rates. simply changing the timing of when it is performed.10 Changes in running schedules have also been linked to injury. For example, sudden Warm up increases in volume of training or modifying a running program to include more difficult Much like stretching, the warm up, a phase types of workouts (hill training, interval of the exercise session used to gradually training) may be too much for the body to increase body temperature through low- absorb without a gradual build up. This was intensity movements, has been used under observed by researchers who examined the pretense that it would help prevent injury rates of military recruits. Those injury, improve performance and help recruits that entered basic training with a relieve muscle tension. In the context of running background had fewer injuries than injury prevention, a meta-analysis by those who did not. 8 Fradkin et al. concluded there was a small reduction of risk from using a warm up.11 As outlined in chapter 2, starting out slowly Furthermore, another study used two and gradually increasing the volume and intervention groups, one who just did the intensity are very important to staying warm up and another that did the warm up healthy. and stretched. The warm-up plus stretching group had fewer injuries than the warm-up Stretching alone group. Once again, this seems to imply that much of the anecdotal evidence Stretching has long been used before the from those coaches and athletes may be warm-up phase of an exercise session with more useful than the current scientific the intent of loosening up (reducing muscle literature. tension), improving performance, and preventing injury (overtension may lead to Terrain and Running Surfaces pulling or straining a muscle). Research over the years has not been able to confirm this

Chapter 6-Injuries and Care 5

Combined or in isolation, the type of terrain training should be included and volume and (hilly vs. flat) and the actual running intensity should be kept low to gradually surfaces (pavement vs. rocky vs. dirt path) build muscles so they are prepared to are often linked to injuries. While there may absorb the impact forces of walking and not be large amounts of scientific evidence jogging. to support this idea, runners and walkers alike feel strongly that these factors strongly contribute to injuries. Common Injuries

For example, paved roads are not only Medial tibia stress syndrome (MTSS) unforgivingly hard surfaces but are also

constructed so that they can easily drain Medial tibia stress syndrome (MTSS), better water. To accomplish this, the middle of the known as shin splints, is one of the most road sits higher than the outer edges. When common lower leg injuries accounting for walking or jogging on roads, the inside about 15% of all running injuries. Shin leg/foot makes contact with the pavement splints are small tears in the connective at a different height than the outside tissue where the soleus muscle connects to leg/foot altering the “natural” gait pattern. the anterior and medial area of the tibia Repeatedly running on these types of roads (the large bone of the lower leg). could lead to injuries such as iliotibial band Symptoms Shin splints are easily identified syndrome (ITBS), knee pain, or ankle pain. by pain or discomfort that runs along the

shin bone (tibia). Pain may go away during Or, running down hill frequently may place activities, once muscles are loosened up, additional stress on the quads and knee and return during rest but may also be leading to knee pain and other problems. present before, during, and after the Much like volume and intensity, terrain and activity in more severe cases. running surfaces should vary often to avoid Causes The exact cause of shin splints is potential injuries and boredom. unknown but is believed to be related to

fatigue of the soleus muscle. As the soleus Weight , the impact forces are absorbed more by the tibia itself. The additional Elite endurance athletes pay close attention stress causes the tibia to bend or bow, to achieving their “ideal” race weight. Not leading to connective tissue tearing. Those only is this good for performance but also at greatest risk of developing MTSS are to avoid injuries. During walking and those with flat feet or high arches, inflexible jogging, tremendous stress is placed on the muscles, running on uneven terrain such as involved bones and muscles. Each step frequently running downhill, running on means the legs must absorb 2-3 times the pavement/hard surfaces, and improper or body weight. It seems only logical that the worn out shoes. However, those who try to greater the weight, the greater the chance do too much, too soon (mileage, intensity) of injury. This should be taken in to are probably most likely to develop shin consideration when planning the volume splints.13 and intensity of a training session. When excessive weight is present, resistance

Chapter 6-Injuries and Care 6

Treatment Fortunately, shin splints are very Muscle Soreness treatable at home. Rest from high impact activities is needed along with anti- Many believe the idea that if your muscles inflammatory medications and ice. aren’t sore after a workout you haven’t Exercises to strengthen the lower leg done enough. While a good workout may muscles should also be performed. In cause muscle soreness, it is certainly not addition, shoes should be examined and what defines the quality of a workout. On replaced with a more suitable pair if the contrary, you should not be sore after needed. Finding alternate walking/jogging every workout. Delayed Onset Muscle trails or paths could also be used to Soreness (DOMS), is a condition that occurs alleviate the volume of training that occurs when microscopic tears form in the muscle on hard surfaces. tissue leading to stiffness and general soreness in the muscles. This is a result of stress placed on the muscles during activity. You’ve undoubtedly experienced this Plantar fasciitis is the inflammation of the immediately following your first workout thick band of tissue (called fasciae) that after a long period of inactivity. This connects your heel to your toes. This band soreness, DOMS, may continue for days supports the arch of your foot. If it is while your muscles are naturally repairing stressed too much, small tears in the fasciae themselves. You might even feel this way develop leading to foot pain and after the first two or three workouts. inflammation. However, if you are continuously sore after Symptoms Plantar Fasciitis can be your walking/jogging sessions, you need to recognized by stiffness and pain in the reconsider what you’re doing as it is likely bottom of the foot, usually closer to the too much stress for your body to handle. heel. This will likely be felt in the mornings or after a period of sitting, when the foot DOMS, when experienced occasionally, isn’t in use. should not be a cause for major alarm. Causes Overuse of the area in a fatigued Unfortunately, there isn’t much that can be state. For example, standing for long done to treat it. Rest and anti-inflammatory periods of time. Of course, the “too much medication may provide some relief. to soon” concept also applies here. Flat or high arches and overpronation also are Patellofemoral Pain Syndrome (Runner’s linked to plantar fasciitis along with shoe Knee) type. More often, individuals with really tight calves develop this condition. Patellofemoral Pain Syndrome is a general Treatment according to the American term that describes pain in the part of the Orthopedic Foot and Ankle Society, knee where the femur (thigh bone) and stretching your calves is the best treatment patella (kneecap) come together. Often for plantar fasciitis.7 You can also apply ice called Runner’s Knee, this pain can result to the foot/feet affected 2-4 times a day for from several scenarios such as about 20 minutes to reduce the Chondromalacia Patella or patellar inflammation.14 misalignment. In Chondromalacia Patella, the cartilage underneath the patella

Chapter 6-Injuries and Care 7

becomes worn and breaks down, leading to when the heel impacts the ground when pain and inflammation in the surrounding walking. This can also occur near the hip but area. With patellar misalignment, the more often occurs in the knee area. A kneecap doesn’t track in it’s normal clicking, or popping sensation may also pattern. Normally, the patella sits in a grove occur each time the knee is bent then and tracks along the groove when the knees flexed with ITBS. is bending. When misaligned, the kneecap Causes There can be several causes to ITBS tracks to one side causing irritation and making it very difficult to pinpoint. pain. Improper technique during walking or Symptoms According to the Academy of jogging, weak glute and thigh muscles, low Orthopedic Surgeons, the most common arches, and simple overuse all contribute to symptoms is a dull, aching pain in the front development of this condition. of the knee. This pain can increase during Treatment Like other walking and jogging repetitive activity where the knee is conditions, stretching, anti-inflammatory bending or after long periods of sitting. medications, strengthening and rest can be Causes Weak and inflexible quadriceps good short-term solutions. Long-term muscles play a significant role in this injury solutions should focus on technique, since these muscles are the primary possible shoe changes, and a continued stabilizers of the kneecap. Simple overuse is stretching and strengthening program.16 also connected to this condition. Treatment RICE is the suggested method to Achilles injuries (tendonitis) treat this condition at home. A change to lower impact activity may be required while The Achilles tendon connects the muscles healing to improve the response to of the calf to the heel. This thick tendon can treatments. Strengthening exercises become irritated during activity causing combined with flexibility should also be pain and discomfort in the heel. This used.15 irritation of the tendon is called tendonitis (inflammation of the Achilles tendon). Iliotibial Band Syndrome (ITBS) Symptoms Pain in the heel(s), sometimes going away during the activity but present The iliotibial band is located on the outer before and after is the primary symptom of part of the thigh and connects the pelvis to tendonitis. the tibia (bone in the lower leg) just below Causes The inflammation usually stems as a the knee. This band of tissue, supports and result from overuse, inflexible and weak calf stabilizes the knee during activities like muscles. Changes in shoes, such as those walking and jogging. As the IT band passes with a lower drop, might also contribute to over the outside portion of the knee, it can tendonitis because the calves are now often rub against a bony protrusion on the stretching more with each step. femur. When this occurs frequently, the Treatment RICE is the best method of area of the knee being rubbed can become treatment to prevent making the condition inflamed, leading to ITBS. worse. Anti-inflammatory medications, Symptoms Most often, ITBS can be strengthening of the calves and stretching detected by pain and possibly swelling in the calf muscles should also be used to the outside portion of the knee especially prevent and treat this condition. 13

Chapter 6-Injuries and Care 8

Causes are related to overtension which Stress fractures could occur for multiple reasons such as poor flexibility or poor strength. Treatment Unlike blunt-force fractures, stress fractures strategies include RICE, strengthening and develop in the bones over time as a result gentle stretching of the injured muscle. of excessive use. Stress fractures of the foot and heel are most common in runners but Illness can occur in areas such as the shins. Additionally, fractures in the bones cannot While not exactly considered an injury, be treated as easily as other soft-tissue walking and jogging and illness should also injuries. be addressed. Many avid endurance Symptoms Sharp pain in the specific area of athletes live by the adage, ”above the neck, the fracture develops and is sensitive to the you’re okay to exercise, below is a no go.” touch and when walking and jogging. This simply implies that if the illness is Causes Overuse is the primary cause of isolated to an area above the neck, you are stress fractures. probably okay to exercise without making Treatment While many of the soft-tissue the condition worse. Above the neck injuries can easily be diagnosed and treated illnesses, much of the time are things like at home, stress fractures require proper allergies, congestion, headache, etc. In medical attention. Discontinuation of other words, illnesses that likely won’t activity is necessary to give the bone time worsen if you exercise. Below the neck to heal. 13 illnesses might include upset stomach, chest congestion, and body aches signaling Muscle Strains, Hamstring Strains more of a widespread infection. Exercise in this state may make the condition even Muscle strains are injuries of the muscle worse, prolonging recovery. In this case, tissue caused by overstretching or you should wait until 24 hours after the overstraining the muscle. Strains can be symptoms are gone to resume your detected by a pain, sometimes sharp in exercise routine. Regardless of the location nature, to a particular area of a muscle. of the illness, caution and good old Hamstring strains are a common running fashioned common sense should be used. If injury along with calf muscle strains. All you’re unsure, don’t exercise. strains, especially in the hamstring, can be very frustrating to deal with because they Stomach or gastrointestinal distress may can occur spontaneously and seemingly pose an additional risk since they are without warning, rhyme or reason. Pain usually associated with vomiting and/or may not be present during everyday diarrhea, i.e. fluid loss. To avoid activities but when attempting to jog or dehydration, exercising during or after a walk may surface making it a challenge to illness with fluid loss should be avoided. understand when resuming activity would be safe. Depending on the severity, References: activities can be put on hold for weeks.

Chapter 6-Injuries and Care 9

1. American College of Sports Medicine, a study of entrants to a 10,000 meter 7th Edition, ACSM’s Guidelines for race. Am. J. Sports Med. 1986; 14:151Y5 Exercise Testing and Prescription, 9. Ryan MB, MacLean CL, Taunton JE. A Philadelphia, PA, Lippincott, Williams review of anthropometric, and Wilkins, p. 10 biomechanical, neuromuscular and 2. Colbert LH, Hootman JM, Macera CA, training related factors associated with 2000, Physical Activity-Related Injuries injury in runners. Int. J. Sports Med. in Walkers and Runners in the Aerobics 2006; 7:120Y37 Center Longitudinal Study, Clinical 10. Verrall, GM, Slavotinek, JP, Barnes, PG. Journal of Sport Medicine vol. 2005, The Effect of Sports Specific 10(4):259-63. Training on Reducing the Incidence of 3. WebMD.com, April 2017, Rest, Ice, Hamstring Injuries in Professional Compression, Elevation (RICE)-Topic Australian Rules Football Players. Br. J. Overview Sports Med.; 39:363Y8 http://www.webmd.com/first- 11. Fradkin AJ, Gabbe BJ, Cameron PA. Does aid/tc/rest-ice-compression-and- Warming Up Prevent Injury in Sport? elevation-rice-topic-overview The evidence from randomized 4. Fields, Karl B., Sykes, Jeannie C., Walker, controlled trials? J. Sci. Med. Sport. Katherine M., Jackson Jonathan C., 2006; 9:214Y20 2010, Prevention of Running Injuries, 12. Van Mechelen W, Hlobil H, Kemper Current Sports Medicine Reports, vol. 9 HCG, et al. Prevention of running (3): p. 176-182 injuries by warm-up, cool-down, and 5. Ferber, Reed, Hreliac, Alan, Kendall, stretching exercises. Am. J. Sports Med. Karen D., 2009, Suspected Mechanisms 1993; 21:711Y9 in the Cause of Overuse Running 13. Aschwanden, Christie, April 2017, The Injuries, Sports Health, Vol. 1 (3): 242- Big 7 Breakdowns: How to Avoid and 246 Recover from the Most Common 6. Campitelli, Nicholas A., April 2017, Do Running Injuries, 2011, Runner’s World Runners Need Orthotics, Podiatry http://www.runnersworld.com/health/t Today, he-big-7-body-breakdowns http://www.podiatrytoday.com/blogge 14. American Orthopedic Foot and Ankle d/do-runners-need-orthotics Society, April 2017, Plantar Fasciitis, 7. Boven AMP, Janssen GME, Vermeer http://www.aofas.org/footcaremd/cond HGW, et al. Occurrence of running itions/ailments-of-the- injuries in adults following a supervised heel/Pages/Plantar-Fasciitis.aspx 15. American Academy of Orthopedic training program. Int. J. Sports Med. Surgeons, April 2017, Patellofemoral 1989; 10(Supp 3):S186Y90 Pain Syndrome, 8. Jacobs SJ, Berson BL. Injuries to runners:

Chapter 6-Injuries and Care 10

http://orthoinfo.aaos.org/topic.cfm?top ic=A00680 16. Wedro, Benjamin, April 2017, Medicine.net, Iliotibial Band Syndrome, 2/22/2016, http://www.medicinenet.com/iliotibial_ band_syndrome/page2.htm

Chapter 6-Injuries and Care 11

that normal ROM can be achieved. The term “normal” relates to population studies that FLEXIBILITY have measured various areas of the body and established an average degree of movement for a particular joint. ne of the five health related O components of fitness is flexibility. THE BENEFITS OF FLEXIBILITY Flexibility relates to the ability to move a joint through it’s full range of motion (ROM). AND STRETCHING To develop a complete fitness program, you There are many benefits to regular should take time to emphasize this stretching with the most important of those component in your routine by stretching. being simple: being flexible will help you Unfortunately, “…most people neglect move freely and complete activities with flexibility training, limiting freedom of greater ease. movement, physical and mental relaxation, release of muscle tension and soreness, and HEALTHY JOINTS AND injury prevention.” (American Council on As many as 28 percent of all adults report Exercise) pain and stiffness in joints. That number increases dramatically with age and women Flexibility is classified into two types: are more likely to develop joint symptoms. static and dynamic. Static flexibility is a For adults, arthritis is one of the most measure of the limits of a joints overall range common conditions with 54% of people 75 of motion. It’s measured by stretching and years and older having been diagnosed with holding a joint in the position of it’s arthritis. Regular exercise, including regular maximum range while using a measuring stretching, is essential for people with instrument to quantify that range. To arthritis to maintain function and manage achieve the maximum range, passive forces joint pain. Even for those not affected by are required (force generated from an joint conditions, stretching increases joint external source). Dynamic flexibility is a mobility and function, and decreases joint measure of overall joint stiffness during stiffness and pain. movement. Unlike static flexibility, dynamic flexibility requires active force production Pain can also be related to imbalances in (your own muscles contracting). Because it’s the muscles. For example, if the front of your difficult to quantify “stiffness,” dynamic thighs and hips get too tight from a lack of flexibility is measured more subjectively. For flexibility, the tension will pull on the hips example, how easy is it to swing a (where the muscles are attached). The result racket, climb steps, or get in and out of a car? is the pelvis may be pulled forward and The target of any good stretching program is cause greater sway in your lower back. This to improve static and dynamic flexibility so

1 affects your posture and can eventually lead elasticity that occurs with aging to pain and stiffness in the neck, shoulders with muscle fitness and and lower back. Stretching regularly, for all stretching exercises can reduce major muscle groups/joint areas, promotes your risk of developing lower- good alignment and balance. back pain.

MUSCLE RELAXATION AND STRESS RELIEF Staying in one position for long periods of LEXIBILITY AND GING time, repetitive movements, and other F A everyday stressors can result in stiff muscles For many young adults, the thought of and knots (also called trigger points). Regular long term flexibility can be taken for granted. stretching decreases anxiety, blood For example, how hard is it to bend over and pressure, and breathing rate which help to tie your shoes? How difficult is it to walk relax muscles and aches and pains related to around campus with a backpack? As young neuromuscular tension (stress). Flexibility adults, most of those activities are likely has also been prescribed successfully to encountered with little pain or resistance. treat dysmenorrhea (painful menstruation) However, ROM declines with age. Simple and to relieve muscle cramps during things like rotating the head and neck to participation of exercise/sports. glance over the shoulders, getting in and out of a vehicle, or carrying groceries can be OTHER BENEFITS painful. Therefore, flexibility is critical to In addition to the benefits listed above, maintaining a high quality of life in older several other benefits have been researched years. and characterized as good reasons maintain HE NACTIVITY OBILITY YCLE a regular routine of stretching: T I -M C If you have ever been injured to the point • Increased blood flow- Blood that required immobilization of a joint, you carries vital nutrients and oxygen realize how important mobility is in relation to muscles and tissues. Stretching to your overall health. Unfortunately, as increases blood flow to the joints ROM is restricted from arthritis or muscles being stretched which other injuries, activity declines. As activity may help them recover from declines, the ROM likely continues to suffer exercise faster. as a result of inactivity and the vicious cycle ensues. A simple stretching program can • Reduction of Future Lower Back help alleviate this problem and help break Pain-Most experts agree (while out of the cycle. research is still inconclusive) that counteracting the natural loss in muscle and connective tissue IMPROVING RANGE OF MOTION

2 Joint ROM results from a combination of structure cannot be altered. As a result, little factors which could be classified as internal can be done in this area to improve or external. Internal structures relate to the flexibility. physical structures of body materials and Not only is range of motion related to the tissue. External factors are non-structural joint structure, but flexibility exercises are and include environmental temperature, joint-specific. In other words, you can’t gender, age, excess fat mass, muscle mass, stretch your hamstring and expect your and restrictions in clothing or equipment. shoulders to improve. Likewise, you can be Internal factors include joint flexible in your shoulder but very “stiff” in structure/joint mechanics and the your fingers or ankles. So, a complete connective and soft tissue surrounding the stretching program must include multiple joint. Because muscular actions such as stretches for various joints. muscular contractions and stretching are controlled by the nervous system, another CONNECTIVE AND MUSCLE TISSUE internal factor can be attributed to the Joints are surrounded and connected by neuromuscular system and how the muscles, tendons, ligaments, and skin. For stretching and tension is managed. example, the head of the humerus fits into a small cavity to create the shoulder joint. JOINT STRUCTURE However, those bones can only remain in A joint is a location on the body in which place as a result of the muscles, tendons, and two or more bones intersect and interact. ligaments that keep the joint tight an in For example, the humerus (upper arm) place. In addition, muscle tissue is intersects with the radius and ulna (lower surrounded with connective tissue, primarily arm) at the point of the elbow. The bony collagen and elastin. As a joint moves formation of each joint structurally limits the through it’s normal range of motion, all of ROM. For example, the shoulder joint which this soft tissue must stretch to is structurally a ball-in-socket joint, can accommodate the movement. Therefore, rotate in multiple directions. In other words, static and dynamic flexibility is probably it has a wide range of motion. However, the most limited by the flexibility of the knee joint is a modified hinge joint which is surrounding soft tissue, specifically the limited to essentially a forward-backward connective tissue. direction of movement. Additionally, While the exact biomechanics of how excessive fat mass surrounding a joint or flexibility is changed isn’t well understood, it even large muscle mass may limit the ROM does appear to be related to the elastic and for a particular joint. Although weight loss plastic properties of the connective tissue. could affect amounts of fat mass Elasticity is defined as the ability to return to surrounding a joint, or loss of muscle, joint resting length after passive stretching (i.e.

3 elastic recoil). Like a spring, soft tissues causing the stretched muscle to contract. In stretch and then recoil to their resting other words, there is some resistance to the position. Plasticity is the tendency to assume stretch generated by the nervous system’s a greater length after passive stretching (i.e. reflexive stimulus sent to the stretching plastic deformation). In other words, taking muscle. This is called the myotatic or stretch that stretchy spring and changing the resting reflex. Additionally, that same signal also position to a new longer length. The goal of causes the antagonist (the opposing) muscle a flexibility program, is to repeatedly to relax, called reciprocal inhibition. So, overload the elastic properties of the muscle when you stretch your upper thigh to elicit plastic deformation over time. (quadriceps) your hamstrings (antagonist to Several studies have suggested that a slow, the quadriceps) are relaxed. sustained stretch of 30-90 seconds is The GTO’s are located near the musculo- necessary to produce chronic plastic tendon junction (the end points of the deformation. muscle) and relay messages to the central NEUROMUSCULAR SYSTEM nervous system regarding muscle lengthening and tension of the muscle. Modern cars come equipped with a When activated, its signal will override the central computer and sensors throughout to stretch reflex causing a sudden relaxation of troubleshoot problems with the vehicle. the stretching muscle. This is called Sensors in the engine determine autogenic inhibition or the inverse myotatic temperature. Sensors on the wheels reflex. This inhibitory reflex can only occur determine tire pressure while sensors in the after the muscle has been stretched for 5 gas tank tell you when the gas tank is low in seconds or longer. This is why, in order fuel. Much like car, our bodies are equipped effectively stretch, it must be done in long, with sensors, called proprioceptors, that slow increments of time. Otherwise, the help us manage movement and prevent resistance encountered from the stretch injury. reflex will prevent the muscle from being Muscles have two specific types of over proprioceptors that determine the length In both cases, the neuromuscular system and tension of the muscle. These manipulates the stretched muscle by either proprioceptors are called muscle spindles facilitates or inhibits presumably as a and Golgi tendon organs (GTO’s). protective mechanism. Muscles spindles, lie parallel to the regular muscle and help determine the WAYS TO IMPROVE FLEXIBILITY length of muscles when they are being stretched. When a muscle is stretched, they STRETCHING TECHNIQUES send signals to the

4 Multiple stretching techniques have been course this could apply to any of the researched with results showing they can be techniques. beneficial in improving ROM. Regardless of the specific technique or specific mode used, BALLISTIC STRETCHING each technique can be performed using two Ballistic stretching involves forceful basic modes: active or passive. Active bouncing or ball-like movements that quickly stretching, also called unassisted stretching, exaggerate the joint ROM without holding suggests that the actual stretch is done the position for any particular duration. This individually without an external stimulus. type of stretching involves dynamic Passive stretching, or assisted stretching is movements like those done by athletes when a partner or trainer is used as the during sports events. In that regard, ballistic stimulus in the stretching exercise. Both stretching is seen as being very specific to modes are effective and can be applied to and beneficial for athletes. However, one each of the techniques mentioned below. criticism of ballistic stretching is that because of the short duration of the stretch, STATIC STRETCHING and ballistic movements that can be forceful, The most commonly prescribed and most the muscular contraction from the stretch commonly used technique for improving reflex may cause muscle soreness or even flexibility is the static stretch. A static stretch injury. For that reason, many athletic involves slow, gradual and controlled coaches feel ballistic stretching is unsafe. movements. The muscle group is stretched Also, many researchers feel it is less toward the end of the joint ROM until the effective at improving ROM. Nonetheless, point of mild discomfort is reached. Once the ACSM still recommends ballistic as one that point is reached, the stretch is held in a method to effectively increase flexibility. “static” position for 30 to 90 seconds. After the prescribed time, the stretch can be DYNAMIC STRETCHING repeated. Common ways in which static Ballistic stretching is a form of dynamic stretching is applied would be in Yoga stretching. However, when referring to routines or stretching after a workout or dynamic stretching routines, most fitness athletic event. professionals are referring to dynamic movements that don’t involve forceful Some of the major advantages for static bouncing motions. Instead, dynamic stretching is that it is generally considered stretching, in this context, suggests safe (see Stretches to Avoid), it is simple to performing exaggerated sports movements perform and effective at increasing ROM. in a slower, more controlled manner. For The only major disadvantage comes from example, a sprinter may use several when it is done too much which can reduce exaggerated stride lengths before a race to strength and may make joints unstable. Of improve hip ROM.

5 An advantage of dynamic stretching is the stretch either uses the activity of the that it will target and improve dynamic antagonist muscle to get the target muscle flexibility which in turn may improve to relax or the target muscle itself to relax as performance. A disadvantage comes from a result of the contraction. the type of movements which often require While many experts feel that PNF good balance and coordination. So, learning stretching is the most effective technique, correct form and being able to perform studies that compare static and PNF dynamic stretches may take a little time to stretching are inconclusive. Regardless, it learn or may not be applicable to certain does appear to be very effective at populations. increasing static flexibility. Some PROPRIOCEPTIVE NEUROMUSCULAR disadvantages to PNF is that it generally FACILITATION (PNF) STRETCHING requires a knowledgeable partner, it’s This type of exercise usually involves a somewhat complicated, and can cause some partner. The partner will passively stretch soreness from the contractions. the muscle, immediately followed by an isometric against CREATING AN EFFECTIVE resistance. This contraction is then followed STRETCHING PROGRAM by another passive stretch. This type of stretch is also named contract-relax stretch The ACSM has made specific because of the sequence of movements recommendations on how to design a involved. Other types of PNF stretching flexibility program. However, before getting involve contract-relax-antagonist contrac- into the design, you should know your tion, also describing the sequence of current flexibility status by assessing various movements involved but adding an joint’s ROM. Specifically, performing the sit- additional step. and-reach test will assess your hamstring and lower back flexibility while using a As the name of the technique implies, goniometer can be used to assess your PNF stretching emphasizes the natural ankles, knees, hips, neck and shoulders. interaction of the proprioceptors with the Instructions on how to perform these muscles to increase the ROM during the assessments will follow later. stretch. Remember that during the stretch, the muscle spindles cause two things to SET GOALS happen, the stretch reflex and reciprocal Once you learn where you are most and inhibition (the antagonist muscle to relax). least flexible, you should make some realistic After 5 seconds, the GTO’s then override the goals to improve or maintain your ROM. Be muscle spindle’s signals causing autogenic specific when you set goals. Instead of just inhibition. Because the muscle is relaxed, it saying, “I want to increase my flexibility,” can more easily be stretched. In other words,

6 you will want to state the specific area of the seconds. Two to four repetitions of body you intend to improve. You will also each stretch should be done. want to make sure your goal can be • Type (mode)-Select from either of measured. A better way to state your goal the above techniques mentions that may be, ”I will improve my sit-and-reach best suit your circumstances (Static, score by 4 cm by the end of the semester.” Dynamic, Ballistic, or Proprioceptive Notice this goal, as stated, includes a specific Neuromuscular Facilitation). area, is measurable, and includes a deadline. By stating your goal properly, you will WHEN TO STRETCH increase the likelihood of actually achieving it. Although stretching can be done at any time of the day, the ACSM has traditionally APPLY THE FITT PRINCIPLE recommended that flexibility training be incorporated into the warm up or cool down As mentioned previously, the ACSM has phase of an exercise session. Recent studies made recommendations for carrying out a have provided evidence against stretching flexibility program based on the FITT before exercise session suggesting that Principle (Frequency, Intensity, Time and stretching will compromise the force- Type). As you select the areas you want to producing capabilities of muscles. Therefore, stretch, keep in mind it is recommended that it is recommended that stretching take place multiple stretching exercises should be only after the body temperature and of the performed to target all major joints including muscles has increased, i.e. after the warm up the neck, shoulders, elbows, wrists, trunk, or after the workout. Additional confirming hips, knees, and ankles. (insert link to evidence of this concept has shown that specific exercise here). After selecting your applying heat packs for 20 minutes to exercises, follow the below increase muscle temperature can increase recommendations when performing your hamstring flexibility more so than 30 routine. : seconds of static stretching. As you can see, • Frequency-Stretch a minimum of 2-3 temperature also plays a significant role in days per week, ideally 5-7 days per muscle ROM. week. HTTP://WWW.ACSM.ORG/PUBLIC- • Intensity-Stretch to the point of INFORMATION/ARTICLES/2016/10/07/IMPROVING- YOUR-FLEXIBILITY-AND-BALANCE tightness or mild discomfort.

• Time (or duration of each STRETCHING SAFELY stretch)-a minimum of 10 seconds In addition to warming the muscle before for very tight muscles with an performing stretching exercises, there are emphasis to progress to 30-90 other things that can be done to make your

7 flexibility routine safe. When muscles are http://wps.aw.com/bc_hopson_health_2/214/54 stretched quickly and forcefully, the stretch 825/14035385.cw/index.html reflex can be activated. This creates significant tension because the muscle fibers will not only be stretching but also References attempting to contract. As mentioned, this is BIOMECHANICS OF STRETCHING one of the reasons ballistic stretching may http://medind.nic.in/jau/t06/jaut06p3.pdf not be suitable for everyone. To avoid this, PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION stretch slowly and in a controlled fashion (PNF): ITS MECHANISMS AND EFFECTS ON RANGE while holding the stretch for 10 seconds or OF MOTION AND MUSCULAR FUNCTION https://www.ncbi.nlm.nih.gov/pmc/articles more. /PMC3588663/ In addition, some stretches are not recommended, or contraindicated. IMPROVING FLEXIBILITY AND BALANCE

Researchers have determined that some HTTP://WWW.ACSM.ORG/PUBLIC- stretching exercises may not be beneficial at INFORMATION/ARTICLES/2016/10/07/IMPROVING- all or may cause injury. A list of YOUR-FLEXIBILITY-AND-BALANCE contraindicated stretches and alternative VIDEO FLEXIBILITY stretches can be found by clicking on the link below. However, this is not a comprehensive HTTPS://YOUTU.BE/XEEIOGMLDYC list of potentially risky stretches. It is important to understand personal limitations before or during a stretch exercise to avoid injury.

CONTRAINDICATED STRETCHES HTTP://WWW.MHHE.COM/SOCSCIENCE/HHP/OTW/FIT_W ELL/WEB12/WEB12_IPT_BAD_EXERCISES_FLEX.HTM

ASSESSING YOUR FLEXIBILITY, LABORATORY EXERCISES The first step in creating a successful flexibility program is to assess your own flexibility. Follow the link below to understand how you can perform these assessements. Those that may be most helpful include sections 5.1, 5.2, and 5.3.

8