Triathlon as Therapy

I’d like a show of hands: who, out there, does NOT do triathlons (or marathons, or ultras, or endurance whatever) as a way of getting some really good, pretty cheap therapy?

I’ll be the first to admit that triathlon is my therapist.

“Therapy”—loosely defined as a practice that brings about physical, spiritual, emotional, and/or mental wellbeing—is sometimes considered taboo, but this bias is diminishing as our culture starts to recognize that by virtue of being alive, we are all in need of some sort of therapy. During high school, I probably needed therapy. During my first romantic relationship, I probably could have used some therapy. Heck, medical school should have COME with therapy attached. But thankfully, through most of the trials and tribulations of life that ordinarily would have called for some sort of traditional, structured therapy, I’ve had my bike, my running shoes, and enough motivation to get my butt out the door.

I’m about to make a huge generalization here and, fully aware, welcome comments and criticism—but I’m going to go ahead and say that triathletes and endurance runners engage in, and consistently return to, such “punishing” (at least by the outsider’s eye) sports because they serve us in ways that are therapeutic.

Have you ever met someone who does Crossfit because it’s psychologically and emotionally therapeutic? I’m sure these people exist, but I have met far more Crossfitters who are interested in a six-pack (sorry to pick on you all, but I had to pick on someone!). On the contrary, have you met many triathletes who train in pursuit of a six-pack? Again, they’re out there—but most of us who are seasoned in the sport know that endurance athletics are certainly not the most efficient way to get shredded—at least for most of us. No, we endurance athletes return time and time again to the toils of our sport because it is cleansing and calming not only to our bodies, but to our minds and spirits as well.

Exercise can turn a bad day around completely. This understanding is shared by everyone from recreational exercisers to more serious athletes. String together enough bad-days-turned-around, and you’ve turned a bad life around completely.

The thing about endurance sport is this: there’s something about that repetitive motion, that feeling of covering large amounts of ground, and that ability to let the mind wander just enough to invade some of the farthest reaches of our minds and hearts—this is what makes endurance sport therapeutic in a unique way. A long run can either be met with an icy and distracting focus, or a passivity that lends itself to observation and confrontation of our mind’s inner workings. Training for endurance involves spending a considerable amount of time training not only the body, but the mind: to be patient, to be persistent, to be disciplined and responsible, to be forgiving.

Perhaps one of the greatest therapeutic gifts endurance sport has to offer is the elation of crossing a finish line. This tangible experience, which is often met with a flood of endorphins and utterly delirious fatigue, is a concrete proclamation of our minds’ and bodies’ incredible potential. It is rare to meet such a definitive and celebratory benchmark in ordinary, day-to-day existence. The happiest moments of my life occurred when I crossed the finish line of my first marathons, or finally arrived on the west coast after riding across America. The profound impact of these feelings–ones of pure, uninhibited ecstasy and disbelief–have fueled a much higher level of self-esteem, belief in my untapped potential, and tendency to really push the envelope. I’m not sure traditional psychotherapy of any kind would have gotten me to quite the same place.

So here’s to endurance: to enduring, and coming out better as a result.

Zen & the Art of DNF

A couple of weeks ago I wrote a post titled, “Oops…I overtrained. Again.” This post, a brutally raw admission of my constant struggles to maintain a balanced, healthy training regimen, was not easy to write. I had a really great autumn season this year, training for nothing in particular but coming off a rest-filled summer with the gusto and enthusiasm of a newbie. But suddenly, like a ton of bricks, a deep fatigue set in around the end of December–a fatigue that was all-too-familiar, and surely indicative of my overdoing it, yet again. I was met with a pervasive, intuitive sense that if I didn’t take a rest week (or two), I’d crumble. I’d hit a physical limit.

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It can be incredibly humbling to meet one’s own limitations, whether physical, psychological, or emotional. At the same time, it can be excruciatingly difficult to tease apart the subtle nuances through which psychology and emotion are intermixed with our physical capacity–especially in endurance sport. When was the last time you heard someone refer to an endurance event as [at least] “90% mental?” For me, it was only a few days ago. Anyone who’s run a marathon or done a long-course tri knows this as fact–and probably has this mantra engraved across his consciousness as gospel. And I tend to agree that the mind is the biggest player–for most of us mere mortals, at least.

But what about those times when the cold, hard boundary of our physical limitations is actually hit, head on? How do we know when to put our egos in our back pockets and keep soldiering on, and how do we know when it’s time to stop?

I have never had a problem motivating myself to keep going in a long race after “hitting the wall”–with enough pep talk, those last few miles, although painful, slowly begin to melt away. However, I have plenty of friends who hold DNFs to their names, and I expect my turn is coming soon. Most professional athletes also boast DNFs, but I think that’s a little bit of a different story given that many of them are attempting to defend titles and personal records; a DNF can be a good way to save face as a pro. That aside, I remain curious about age-group DNFers.

If I were a psychology grad student, I might make a dissertation out of interviewing DNFers to try to elucidate their thought processes when they decided to withdraw from a race. What physical limitations did they experience? How did they know when they’d reached the “point of no return”? Did the decision feel more voluntary, or more essential for survival?

Most importantly, though, would be the thought processes of these athletes. What algorithms did they use to weigh the risk-benefit ratio of continuing the race? Or was logic thrown aside because the physical suffering was too much to bear? Endurance athletes tend to be stubborn folks with few qualms about pushing through minor- to moderate-physical unpleasantries that others would balk at. Also, considerable research has suggested that as a group, age-group triathletes tend to have a much higher pain tolerance than the general population, and even other athletes. As such, I approach my theoretical dissertation with a wary eye.

I recently started watching a Discovery channel documentary series following a team of mountaineers up Everest. One of the crew members, an ultra-fit Danish triathlete with an incredibly endearing, humble personality, is attempting to summit without oxygen–the holy grail of Everest climbing–after three prior unsuccessful attempts. Despite a personal history of severe asthma, Mogens Jensen pushes on with vigor and a charmingly positive attitude. I imagine all audiences following this documentary cheering hard for this delightful Dane, who displays the classic “90% mental” attitude so characteristic of his endurance sport roots.

Unfortunately, Mogens decides–or is forced, rather–to turn back a mere 350 meters from the summit of Everest due to severe frostbite secondary to oxygen deprivation. Obviously this is a rather extreme example, but I wonder how Mogens came to the conclusion that it was time to turn around–especially after encountering numerous prior obstacles that would have sent anyone else scurrying back down the mountain face. How did he know he’d hit that “point of no return”? Plenty of mountaineers push on through frostbite; some make it, some don’t. But Mogens seemed to possess an uncanny ability to understand exactly when he could push on, and when he absolutely needed to stop. He was so close to clinching that dream–and after three prior attempts at that–but he knew that he had to relinquish it this fourth time.

Perhaps most indicative of this minor tragedy was the team guide’s response to Mogens’ defeat. Russell Brice, one of Everest’s most seasoned mountaineers and guides, notes that while he would have been extremely impressed by an asthmatic summiting Everest sans oxygen, he was considerably more impressed by Mogens’ very wise ability to sense exactly what he was dealing with.

This art is utterly beyond me, but I imagine with more experience I’ll have a better understanding of how to interpret the fine gradations of physical wellbeing. Until recently, there was little incentive to develop this talent; I’d always had fine success pushing through and finding comparable alternatives rather than stepping back. More recently, I’ve hit an obstacle that feels a little more concrete–a wall that won’t budge. For the first time in my life, I can’t simply charge through like a rhinoceros at full-speed: rather, I have to stop and turn around–or even better, find a creative way to circumnavigate the boulder blocking my path.

I think I’ll take up rock climbing. I hear it’s good cross -training.

All or none: the power of black-and-white thinking.

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Warning: This post may offend those who like to live life in moderation. I am not one of those people.

Here goes.

The key to success and happiness in life is to adopt more black-and-white thinking.

Wait, what? What about all of the “gray areas”? Isn’t it true that nothing is either black nor white, but somewhere in between? And what about moderation?

Yes! Almost everything IS gray. Which is why getting a little more black-and-white about things can be a good thing. It can push us into a darker gray, or a lighter gray, depending on what we value and want to achieve. We’re all humans, and with being a human comes the inevitability of human error. We’re destined to fall somewhere in the gray area…but why not try to make it to somewhere on one or another end of the gray spectrum?

For me, adopting slightly more black-and-white thinking about things–especially things that pertain to my biggest, most “extreme” dreams–can be incredibly useful, as long as I truly listen to my body while doing so. An almost unavoidable outcome of being just a tad more black-and-white is falling more into the realm of extreme people rather than those living in moderation. But is that necessarily such a bad thing, if I’m happy being one of the “extreme” people?

Our society places value in living in moderation and “finding balance” between all aspect of one’s life. While balance can at times be the key to keeping an especially hectic life manageable, I’m not sure it’s always the right solution for everyone. I think that for some of us, living moderately is a recipe for stagnation. Chasing down big dreams requires big, not moderate efforts. And at its most malignant, extolling the virtues of “living in moderation” is a really excellent and clever way to pardon ourselves for undesirable habits or traits.

I say, blah. Living life in the middle of the gray area is a recipe for a gray experience.

Living life in the black-and-white–well, that’s a whole other story. Life in extremes is a tumultuous, adventurous, fulfilling mixture of giving 200% and recovering 200%. The balance between the two makes it possible, but the existence on one extreme or another is what makes it worthwhile–and it is a sweet existence indeed.

In psychology, the concept of black-and-white thinking is often referred to as “splitting,” also known as “all-or-nothing thinking.” While I do firmly believe that utilizing black-and-white thinking at times optimally hijacks our brains to our advantage, I do not suggest taking it to the extremes that manifest in Borderline Personality Disorder.

Over the past decade or so, nothing has taught me the power of black-and-white thinking more tangibly than sport. Simply put, in this arena, using polarities yields results. Training days are either incredibly easy or incredibly challenging. In fact, Runner’s World magazine recently published an article in its October 2013 issue titled, “Benefits of Polarized Training.” Nutrition, to the athlete, is either medicinal or malignant: some foods hinder performance, while others foster it. Thinking in terms of good vs. bad, exertion vs. recovery, full effort vs. surrender is the linchpin to success and fulfilling experiences in sport–and it seems to extrapolate pretty darn well to other aspects of life as well.

I’ve run this idea of “the power of all-or-none thinking” past a few friends over the years, and have received more negative, if not mixed, responses to my “insane,” “impractical” theory than almost anything else I’ve proposed. Everyone, it seems, wants to err on the side of gray–or, the way I see it, on the side of caution. This is disappointing to me. While I believe that gray is often the inevitable solution to moral dilemmas and perhaps orthopedic problems, I don’t think gray is something to actively seek out for myself.

The ones who seem to be best capable of grasping the positive applications of black-and-white thinking are those who have struggled with addiction. I think vegan Ultraman and Epic 5 triathlete Rich Roll said it best in his book, Finding Ultra:

“When I decided to change my diet, I initially experimented with a vegetarian diet. Why? Not because I read a bunch of books and concluded it was the healthiest approach. It was attractive because it was so black and white. In recovery, you are either using or you are sober—no middle ground. As a vegetarian, you are either eating meat or you are not. I could wrap my brain around that.”

Rich seems to understand how the brain works, on both an experiential and theoretical level. The neuroscience definitely speaks in favor of black-and-white thinking in behavior modification. If we really want to change something about ourselves, then we have to change our brains (perhaps this is a form of biohacking, if you will). The building blocks of our nervous system, the neurons, function on an all-or-none principal: either they fire in response to something, or they don’t. The action potential doesn’t “just kind of fire” or fire less robustly in proportion to a stimulus. Even a tiny, minuscule droplet of impetus can set an entire neural pathway ablaze with activity.

Every day, I consciously make black-and-white decisions for myself. To others, this manifests as “extreme” discipline, but for me, this way of thinking has trampled down some pretty well-worn neural networks. I either wake up at 4:30 a.m. and kick butt, or I sleep in until 8 and take it easy. I either put in several hours of base miles for the day, or I sit in bed and read a book from cover to cover. Listening to my body is without question a key within all of this, but assuming I’m feeling well, it’s going to be a 4:30 a.m. day, darnit!

My general paradigm is this: every day, I try to reinforce more black-and-white thinking with myself, while simultaneously trying to adopt less black-and-white thinking with others and my external world. This is what keeps me reliable, disciplined, and true to myself, and also prevents me from ever feeling too heavily let down by anything outside of me.

I think Dean Karnazes, the “Ultramarathon Man,” said it best when he wrote: “My suspicion is that, like me, most of you reading these pages are drawn to extremes. Moderation bores you. You seek challenges and adventures that dwell on the outer edges. The path of most resistance is not a route often traveled.”

Dwelling on the outer edges sounds pretty fun to me. What do you think?

Oops…I overtrained. Again.

I’m sure we’ve all heard this oft-referenced Einstein quote before: “The definition of insanity is doing the same thing over and over again and expecting different results.”

Well, the evidence is clear. I’m officially insane.

Einstein seems to have been right about everything (I’d like to point out that he was also a very strict vegetarian).

I encountered my first brushes with overtraining during my second year of medical school. A combination of intense, drawn-out, daily trail runs and mounting stresses from my life outside of the mountains ended up being a recipe for disaster. Hugely in denial, reluctant to give up the one thing I felt was serving me at the time (trail running), and being the know-it-all med student I was (smack in the middle of my endocrine unit, nonetheless), I did what any running addict would do: I just kept running.

They say hindsight is 20/20, and in retrospect, I recognize today just how stupid this was. I had all of the classic symptoms of what is referred to in the sports medicine literature as uncompensated overreaching-induced overtraining syndrome: debilitating lethargy, complete lack of motivation, mental fog, slowed heart rate, orthostatic hypotension (e.g. “seeing stars” every time I stood up), decreased appetite, and fitful, unsatisfying sleep. Basically, the concept here is that if an athlete does not compensate (a.k.a. “rest”) after overreaching (a.k.a. pushing hard for a couple of days or even a week), an almost inevitable outcome is insurmountable stress overload on the body: hormonal systems are suppressed, neurotransmitters shut down or dysregulated entirely, oxidative damage skyrockets, inflammation goes unchecked, and a deep, unshakable fatigue settles into the very bones of one’s body. It really kind of sucks.

overtraining-syndrome

The physician in me knows today—and even back then, knew—exactly how to remedy this. It was fairly clear that I was in the early stages of some sort of adrenal insufficiency, and perhaps even hypothyroidism, induced by overtraining, and the natural sequela would be Addisonian Crisis if I didn’t just stop, take the time to recover, nourish my body appropriately with rest, nutrition, and adaptogens, and re-hash my approach to running and training. Instead, I’d down a couple of cups of black coffee, take a pretty heavy-hitting dose of Siberan Eleuthero, and be jazzed up enough to convince myself I was fine.

I rarely felt bad during a run. But it was afterward that I’d feel like I’d been hit by a bus.

I employed stopgap therapies to try and fix the problem while still being able to run large volumes on a daily basis. I took supportive, adaptogenic herbs by the fistful. I set an early bedtime and tried to force myself to sleep for 9, 10, 11 hours a night. I took melatonin, licorice, ginseng, ashwagandha. I even stopped being vegan and started eating meat and eggs for a period of about four months. I only felt worse.

The answer was clear: I needed to rest. By six months into my stint with chronic overtraining, I had read nearly every medical journal publication out there on the subject. I was an expert. Every description pointed to exactly what I was experiencing. And the recommendations at the end of each publication were unequivocal: rest was the primary solution. In some cases only a few weeks of rest do the trick; in others, athletes toe the line between chronic burnout and wellness for years or even decades. Years? Decades?! Even the concept of weeks was unfathomable to my endorphins-hooked brain.

Rest was never an option for me. If I stopped being my endurance junkie self—admittedly, an enormous slice of my identity—then just who would I be?

I would be just another twenty-something girl. Just another medical student. Just another sister, daughter, friend, and girlfriend. While I appreciate these aspects of my identity enormously, I can’t help but admit that they feel frighteningly banal in comparison with my identity as an endurance sport lover.

So what did I ultimately end up doing? I continued to live in denial for another year or so, but during the spring of 2013 my behavior caught up with me. At the time, I was living in New York, but flew back to San Francisco to attend to some school-related things and visit my sister. I distinctly remember feeling so tired, so foggy, and so out of it while I was there. I could hardly motivate myself to get up from the chair I was sitting in. Climbing up a small hill in Bernal Heights Park—a hill that normally would seem like child’s play to me—I felt my heart thumping wildly in my chest and my blood pressure dropping precipitously. I felt so weak that I was sure I was going to pass out. While everyone else around me was enjoying the view and enjoying their lives, I was seeing stars and wishing I could crawl under the covers. That was the catalyst. When I flew back to Connecticut to spend a few days with my parents, I completely broke down, and resolved to give several weeks of rest a genuine try.

It was extraordinarily difficult at first, and I have to admit, it didn’t get much easier. As someone who has grown psychologically accustomed to being very physically active on a daily basis, putting the lid on training for a while was agonizing. I traded my long runs for long walks and long cuddle sessions on the couch with my dog. I dabbled in gentle and restorative yoga. I drank green juices and ate avocados by the bushel. All the while, I felt mentally restless. It was hard to see my running shoes stare up at me from the depths of my closet floor each morning. I had to put them in the basement.

I took some time to rest last summer, and got back into the swing of things last fall. Yet, like any endurance junkie, my tendency to overdo things—without realizing I’d overdone it until far, far after the fact—got the best of me. So here I am, in January, looking back at my insane training log from November and December and, from a logical perspective, not wondering in the least how I’ve managed to find myself in the same exact predicament.

Remember that definition of insanity? Yeah, that’s definitely me.

So what conclusions have I come to as a result of experiencing this? And what advice would I give?

Well, for one, overtraining is definitely a very real thing—and not something to be messed with. Secondly, I think it’s critical that anyone involved in very taxing and stressful endurance sports on a regular basis honestly assess his or her ability to cope with stress, period, at any point in life. At the time when I first began experiencing symptoms, I was puzzled as to why—I had, after all, had no problem recovering from similarly intense levels of activity in previous years. Why such a sudden and drastic shift? It is now clear to me that the non-physical stresses in my life at the time–the unending demands of medical school, the sadness of a failing long-term relationship, confusion and distrust of my own body through experiencing illness–were all taking an enormous amount out of me as it was. Add to that the stress of endurance exercise, which is well-documented to interfere with some of the body’s most vital functions, and overtraining becomes a distinctive possibility.

As I’ve opened up to friends and family about this rather humbling experience, I’ve been met time and time again with a very similar response: “Imagine how much better of a doctor this will make you!” Very true words, but they don’t console the fact that I can’t bust out 18-mile runs every day a la Dean Karnazes. Bummer.

Alas, I suppose I am only human after all. I guess I actually do have to take rest days.

The question, then, is this: what to do with all of the extra free time I’ll gain by having rest days?

Maybe go swimming?

Meh, once an addict, always an addict…

Stop being a boring adult, and start dreaming again.

In my December post titled “How to Date a Triathlete,” I talked about our tendency to become jaded in adulthood, and how our abandonment of wonderment and big dreaming becomes an accepted fact of life as we exit adolescence and enter the murky realm of grown-upness.

I also mentioned my desire to resist this state of mind, and how training for endurance races has been a powerful influence in my ability to maintain a childlike sense of possibility well into my 20s.

Recently, I stumbled across a video on YouTube by one of my favorite personalities in the vegan running community, Tim VanOrden. Tim, also affectionately known as “TVO,” has served as an extraordinarily influential pioneer in the raw vegan community, as well as an instrumental figure within the running community. A 9-time U.S. masters track/cross-country champion and snowshoe racing whiz, TVO is one of the few visionaries who have put the whole concept of eating a vegan diet for improved athletic performance on the map. 

TVO makes these great YouTube vids–most of them shorts–which are entirely comprised of “video selfies” while he’s coasting down a mountain trait in Vermont, mind abuzz with that characteristic clarity of thought that hits runners 5, 10, 15 miles into their runs. I love how he unabashedly whips out his video recorder and videotapes his disheveled, winded, sweaty self to share the tidbits of wisdom he gleans while out in nature. There is so much truth to what TVO has to offer. A true philosopher, his pep talks speak to everyone, and apply to universal life experiences–vegan or not, runner or not.

The video, titled “The Delusional Beginnings of Running Raw,” does a beautiful job of elucidating the concept of remaining open to limitless possibility no matter one’s age or past experiences.

In case you’re not keen on watching TVO’s video selfie, here’s the script:

“When I started this journey, I was a painter. I was adding to the canvas. I was only looking at possibility: to see what’s possible; to be what’s possible. And at that time, I believed anything was possible.

But I’ve been running for six years now, and I’ve been tested again and again, and fallen again and again. And I keep getting back up and I keep getting better. But instead of continuing my path as a painter, I’ve become a sculptor. And instead of adding to a canvas, I’ve begun to take away from a stone, chisel away, removing possibility with each nick of the knife.

And every time I make a mistake and knock off more of the stone than I intended, I know I have even less possibility to work with, and I have to reduce and change the ultimate sculpture. And I’ve found myself, now at forty-four, highly defined, and limited with this sense that less is possible because I know more. I chipped away at the stone and I see what’s left, and it keeps getting smaller. The ceiling has gotten lower. I don’t see the same possibility that I saw at the beginning of this journey, which was an Olympic team. And maybe that was delusional. But seeing it as a possibility, whether it was a reality or not, got me in the game, it got me in action, it excited me. And now that the ceiling has come way down, I still see myself improving but it’s not nearly as exciting because that ceiling’s not far away.  I don’t have much room to grow.

I’ve got to find a way to get back into the painter mode and add to my training, add to my life, add to my thinking, and add to my abilities. Because I know I’m not done yet, but there’s a part of my mind that’s trying to convince me that I am. I can’t fight that thought. I can’t chip that thought away. I have to add other thoughts. I have to simply paint over it.

In life, often, we try to chip away at our negative thoughts. We try to remove them. We punish ourselves. We’re hard-wired to be sculptors and to chip away at life, and chip away at possibility. But I think the greatest gift of the human mind, the thing that separates the human mind from the minds of other creatures, is our ability to paint. This is trained out of us somewhere in childhood or adolescence. We’re taught to face the “real world” and start chipping away, and get the job, and get the house, and get the family, and get the car and just settle in to this reduced mode of living, rather than being that child who paints possibility with every stroke.

 There’s a story about Winston Churchill. He was driving through the country one day when he came across a woman staring at a blank canvas. She was looking out at a pastoral landscape, which was beautiful. Winston walked up and he said, “What’s the problem?” and she said, “I’m not sure where to start.” So he took her paintbrush, dipped it in black paint, and put a big black mark across her canvas. He said, “There. Now you’ve started.” 

And that’s how life is. Sometimes life gives us this big black mark. And rather than chipping away and saying, “Oh, we’ve got a black mark, the canvas is ruined, we can’t use it anymore,” you can add to it. What can I do with that black mark? What possibility can I discover? How can I take paint and add? How can I take thought and add to this? Make it better? Improve upon it?

 Think about that. How to add to your life. How to add possibility back in to your life. Not by getting rid of things. But just by painting a different color over things. Or next to them. Or turning them into a new design. Black line—what can I do with a black line? Every tree that I’m running by has black lines in it. Every root that I’m jumping over as I make this video has black lines in it.

 Paint with them. Create a forest of possibility.”

78384 Maple and Birch Trees in Fall Color, Adirondack Park and Preserve, New York

How I Injury-Proofed My Legs: 10 Unorthodox Practices I Use to Run High-Mileage Pain-Free

Injury. It’s the endurance athlete’s worst nightmare. It’s an almost inevitable experience that comes with being a runner. Heck, my personal experiences with sports-related injuries have been so poignant as to drive me to center my career around identifying and treating them.

I currently run more based on how I feel than any set training plan; that said, most of my runs are over ten miles. Some weeks I run up to 60 miles, other weeks I might run 20. However, there was a distinct period of time, several years ago, when I noticed my body starting to break down if I went over 30-35 miles per week. Fearing injury and almost constantly plagued with some strange ache, pain, or tightness, I kept my mileage capped at less than 40 miles per week. Looking for a more sustainable way to continue running and also up my mileage, I started to tinker with my habits and daily practices to find a long-term plan to keep me running strong well into adulthood.

We are all an experiment of one, and here’s what I’ve cooked up in my laboratory so far when it comes to preventing running-related injury for myself. My disclaimer is that what works for me might not work for everyone. That said, I came to these methods after years and years of trial-and-error, and only after I’d mustered up the courage to break away from some of the classic dogma that has come to define running as a sport irrespective of science.

I hope these prove useful, and if anyone has any additional insights or experiences to offer, please post in the comments below!

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Not my legs. But a girl can dream, no?

1. I stopped running every day. Prior to 2012, I let my ego get in the way and was intent on running every.single.day. I wanted to be a “streaker“–and I succeeded somewhat, running at least one mile every day for 1,812 consecutive days (or just shy of five straight years). I ran through many minor running injuries, employing band-aid and stopgap therapies to keep me on my feet. However, a traumatic knee injury brought that chapter of my life to an abrupt standstill, and through rest and periodization of training, I learned so much about how my body responds to and recovers from running. In fact, I not only healed well from my injury by significantly cutting back on my running, but I also got faster!

I can’t say that running less is what caused my improvement so much as an integration of all of the following practices listed below. Regardless, I really do think there’s something to taking at least one–but preferably two or three–days off between runs to allow the body time to repair all of the microdamage that occurs to bones, joints, and connective tissue during the run. Today, I run 2-3x per week, but I make those runs really count. I also never run if I don’t feel fully “healed” from my prior running session. I haven’t had an injury in the two years since I’ve implemented this practice.

2. I started pushing heavy resistance. Want to bulletproof your legs? Pedal backwards on the elliptical, at the highest resistance you can maintain for a minute at 150-180 rpm. Rest. Repeat.

I know “elliptical” is a dirty word among running purists, however for me, high resistance training on the elliptical and bike has been the cornerstone of keeping my legs super strong. Pushing heavy resistance here doesn’t mean classic weight training, although I know that targeted strength training can have huge benefits for injury-prone runners. Instead of doing endless squat and lunge variations, which I find cause flare-ups in my patellofemoral pain, I have found that pushing heavy resistance on low- or non-impact cardio equipment, such as bikes and ellipticals, has a significant impact on my ability to push power as well as withstand pavement pounding.

I think that high resistance and lower cadence, especially on the bike, is underrated. This method of training improves both strength and cardiovascular endurance as well as VO2max, and can be sustained for longer periods if done in an interval format. I have had to do some experimentation to find out which types of ellipticals work for me, since some position my feet awkwardly in the foot pedals and screw with my kneecap tracking. Generally speaking, though, the higher-end ellipticals (Precor, Cybex) that allow the user to alter incline and direction in addition to resistance really provide the most bang for your buck, as they allow you to truly tax every major and minor muscle group in the lower body, depending on angle and direction.

3. I cross-train like it’s my job. See above. Hiking, uphill walking, ellipticalling, pool running, trail running, and snowshoeing together comprise far more of my training time than simple road running.

4. I rotate my running shoes. I rarely wear the same shoe two runs in a row. These days, I am running in everything from super minimalist (New Balance Minimus trail shoe, Vivobarefoot Breatho trail shoe) to super maximalist (Hoka One One Bondi B) to everything in between (Mizuno Wave Rider, Pearl iZumi EM Road H3, Brooks Pure Flow, Nike Free 5.0). As an osteopath and biomechanics nerd, I have come to understand that variety, and keeping the body constantly guessing, are key to injury prevention. I keep a wide variety of radically different shoes on heavy rotation, because each shoe causes a very subtle and slight change in my gait, foot strike, and stride, stressing different muscles and aspects of connective tissue. This is why, at least anecdotally, trail runners are far less likely to experience injury than road runners–they are constantly mixing up their terrain, and landing in novel ways depending on the surface presented to them. As for whether or not there is one optimal and pure foot strike for everyone, well, the jury’s still out on that one. But striving to land midfoot certainly can’t hurt.

5. I stopped stretching so much. Disclaimer: I am already incredibly flexible, and prone to hypermobility. In fact, it was my tendency to have hypermobile joints that caused me to injure my knee several years ago, when my kneecap became dislocated. Someone like me needs to work more on restoring stability and strength to the knees, ankles, and hip girdle rather than encouraging them to become even more lax through extreme yoga postures and stretching. If I feel specific tightness in a certain area, I hit the foam roller instead–that way I can target the muscle belly, rather than risk overstretching tendons, ligaments, joint capsules, etc.

6. I alkalized my diet. What does that even mean? Simply put, it means I have made fruits and vegetables comprise the vast majority of my diet. Because of the vitamins and minerals present in plant foods, along with the process by which they are digested, fruits and vegetables encourage the blood as well as body tissues to shift their pH from a more acidic to a more alkaline state. An alklaline state is a healing state; it is naturally anti-inflammatory, and encourages the healing of tissues as well as improved immune function. You can imagine what this means not only for injury recovery, but also for keeping injury at bay.

Alkalinizing foods include pretty much anything fruit and vegetable. On the flip side, acidifying foods include concentrated protein sources (especially animal products such as meat, eggs, and dairy; but also concentrated vegetarian proteins such as tofu, tempeh, seitan, etc.), some oils, some grains, refined flours, refined sugar, and certain fats. Most whole grains, nuts/seeds, legumes, and pulses are either neutral or very slightly acidic.

Highly acid-forming foods, especially animal protein, have such a profound effect on blood pH that eating even moderate amounts can encourage the body to leach calcium from bones, causing demineralization as calcium serves as a very potent buffer of the acidic conditions. Sounds like a recipe for a stress fracture to me.

So, long story short, I eat tons and tons of fruits and veggies. As much as I can. That’s not to say I don’t eat acid-promoting foods; as a whole foods vegan, grains, nuts, seeds, etc. are an important part of my diet. I just eat them in much smaller amounts.

7. I ignored the scale. Many runners tend to be a little too weight-obsessed, in my opinion. Obviously being somewhat on the lighter side is an advantage, but only up to a point. In my experience, I found that I was actually–and this may seem paradoxical–far more injury prone at a lower weight. Why? I’m not sure exactly, but more and more evidence is lending itself to the notion that nutritional status–especially among women–is a crucial component of the body’s ability to deal with stressful exercise, both on a hormonal level as well as a musculoskeletal level. I think that most of us have a “sweet spot” where are bodies are most nutritionally replete while also balancing athleticism and power. We may not look like Kara Goucher or Josh Cox at said sweet spot, but who gives? Running isn’t about how we look anyway–it’s about how we feel. Right? Who’s with me?

8. I stopped weight training. See #2 and #3. While I do still do some strength work, I have found that classical weight training aggravates my joints, especially in my lower body, a little too much to be worth it. I have found high intensity, high resistance cross-training to be more than sufficient in making my lower body strong and bulletproof.

9. I nipped niggles in the bud. Say wha? Okay, this term–“niggle”–is one I stole from Chrissie Wellington. She refers to little odd aches and pains, muscle tightness at an early stage, etc. as “niggles.” A niggle is that very subtle sensation of tightness in your IT band that occurs after a long run. It’s that slight cramp in your calf after a hill workout. Nipping it in the bud involves attacking it–not too aggressively, though–at first sign. My methods of choice involve foam rolling, Epsom salts baths, magnesium oil, Po Sum On (a Traditional Chinese Medicine remedy), and osteopathic manipulative medicine (if I can cajole one of my poor unsuspecting osteopath friends to fix me!).

10. I trashed the ibuprofen. It is only on extraordinarily rare occasions (read: once every two or three years) that I use any sort of NSAID, such as ibuprofen (Advil, Motrin) or naproxen (Aleve). If I do feel that a certain amount of inflammatory pain is hanging around a little too long–which, to be honest, these days is a rarity–I prefer to use herbal anti-inflammatories, such as Boswellia Serrata and Cat’s Claw (both of which are evidence-based for their ability to attenuate musculoskeletal inflammation). These herbal medications have a lighter, more subtle effect than traditional synthetic NSAID drugs, and also have a lower side effect profile. Why not just go for the ibuprofen, you ask? Well, mounting evidence suggests that turning inflammation completely off, as NSAID drugs do, may not be such a good thing, especially when it comes to healing. Rather, a healthy level of post-exercise inflammation is an important impetus for the regeneration and renewal of muscles, tendons, bones, and joints. In summary, a small amount of inflammation encourages the body to recruit healing cells, such as white blood cells, fibroblasts, and chondrocytes, to areas of microtrauma, such as ligaments and tendons. So instead of popping “vitamin I” so I can run the next day, I take a day–or three–off.

So there you have it–my personal prescription for running pain-free high mileage.
How do you keep your running sustainable?

New Year’s Resolutions of an Endurance Junkie

While I overheard some of my friends’ new year’s resolutions at a gathering last night (“I’m gonna hit the gym at least 3x a week!”, “I’m going to start waking up earlier!”, “I’m going to drink more water!”), my junkie self couldn’t help but be glaringly reminded of what a junkie I’ve become, and feel at least a little bit envious of their abilities to live life in moderation.

Me, I’m the girl over in the corner nursing a PBR and resolving to herself, under her breath, “This year, I’m not going to overtrain!”

The thing about new year’s resolutions is this: I don’t believe in them. Perhaps it’s the part of me that got all caught up in this vegan, endurance sport lifestyle to begin with that drives this bias. Because that’s the part of me that believes in setting new goals and challenging myself to be better, to be healthier, to be stronger not just come January 1st, but 365 days a year.

In the past, I’ve waited for dates to come: marathon race dates penned into my calendar months in advance; a long run scheduled for Sunday; medical school board exams set in stone. But even before this became a habit, I was much more flexible: my mantra was to work hard always, and race when I felt ready–whether that was in May or in October, but in any case, it was usually “tomorrow!”.

When I was younger and less cautious, I did this frequently, and it lent itself to a certain level of happiness and spontaneity that is decidedly lacking in my adult way of going about training and living. I had confidence in my capacity, and simply wasn’t afraid of failing. I ran my first marathon without “proper” training, signing up a mere week beforehand and saying a prayer to the wing-footed Hermes the night before. What’s more, at the time, I was a brand-new study abroad student in Barcelona, and barely spoke the native language of the city I’d be running in.

To top it all off, only 9% of the runners in the race were women (European women aren’t as into the whole “exercise” thing as we Americans are…except maybe the Scandinavians and their bicycles). I didn’t care. I was fearless. Sure, you could easily argue I had a very sick case of newbie’s naïveté, but it wasn’t the first–nor the last–time I’d do something so “irrational.”

I didn’t exactly turn heads as I crossed the finish line, but I did it. Ignorance is bliss, but confidence in oneself and a taste for adventure are what drive long-term happiness.

A mere six months prior to my marathon debut, I hopped a bicycle and rode cross-country with a group of cyclists working to raise money and build homes for affordable housing organizations. Think I’d ever really cycled in my life before? Negatory.

I didn’t care. I was fearless.

(Notice a theme here?)

On day one of my cross-country ride, I distinctly remember doing a rather ungraceful face plant in the parking lot as I navigated my clipless pedals for the first time. And yes, the first few days were rough. But within less than two months, I had ridden across the United States.

It’s been a long, long time since I’ve really gone out on a limb and done something “crazy,” something I’m relatively “unprepared” for or “inexperienced” with. But I’m starting to miss the rush, the excitement, and the fun that comes with just putting myself out there, taking chances, and having faith in all of those base miles and speed sessions.

So I suppose I’m a sucker for new year’s resolutions after all, because as I bring this post full-circle I can’t help but think to myself: that’s it. That’s my new year’s resolution.

Mid-February of 2014 marks my 26.2nd birthday. A few weeks ago, I shocked myself by accidentally running 21 miles on a run in which I got very, very lost. At the end of that day, I resolved to run 26.2 miles on my 26.2nd birthday. I’ve since been toying with the idea, vacillating between thinking it’s pure genius and completely idiotic. My logical, adult, non-spontaneous brain keeps telling me that there’s no way I’ll be “properly” trained for a marathon by February–I’m more cycling fit right now than anything else–but who cares? Why not just go for it?

2014 marks the year of just going for it, of self trust, and of running marathons on a whim. Again. Look out, Paradise Coast Marathon. I’m registered and comin’ for ya.

Happy 2014 everyone!

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