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Official NHS running advice- Do we agree with justin??

Discussion in 'Biomechanics, Sports and Foot orthoses' started by footfan, Feb 1, 2011.

  1. footfan

    footfan Active Member


    Members do not see these Ads. Sign Up.
    Came across the NHS Couch to 5k plan, I personally thought it was a good intro for couch potatoes and took it for what it was then i read a comment by Justin that slated the information, which i thought was a bit harsh.

    See what you guys think ..............at one point he advises Chi running technique ???


    Do you think this advice on running is ok for the NHS?
    Link:
    http://www.nhs.uk/Livewell/c25k/Pages/C25K-tips-for-new-runners.aspx
     

    Attached Files:

  2. CraigT

    CraigT Well-Known Member

    Ok- First problem with Justin's statement...
    "why do Paula Radcliffe and Haille run on the balls of their feet?"
    A- Not sure they actually land on the balls of their feet, but I would suggest they are more accurately described as midfoot strikers.
    B- foot strike is more closely related to speed- they are running faster than the average person (sarcasm)- if you can manage their marathon pace for 100 metres, I would expect that you would not be heel loading as much as you would be if you were running at your easy slow pace.
    Next- "Joints receive 4-5 times the load when you heel strike"
    Actually no. The internal forces are the same. There is an increased strike transient when you heel strike which is unclear if it has anything to do with injury....


    As for the article I think it is pretty sound advice although the statement that you 'should always land on your heels' is just as flawed as saying that you should always land on your forefoot or chi/pose running is better for everyone.
     
  3. Griff

    Griff Moderator

    Although 'Justin' has been a bit aggressive he makes some good points, (but with some inaccuracies as Craig has pointed out above). This article by the NHS does lack a bit of substance - a bit too simplified perhaps? Recommending all new runners to heel strike is probably inadvisable.
     
  4. BEN-HUR

    BEN-HUR Well-Known Member

    The above information from the article (particularly associated with an absolute term i.e. "always") isn't good advice.

    There are many factors which may influence foot strike across a range of individuals, thus I'll probably leave this issue alone at this stage - particularly when the information is intended for beginners.  

    The important thing is to get them off the couch & into a regular exercise routine so they can gradually develop aerobic fitness & general strength. Once this develops, the beginner can then do a bit more training & focus on other areas which may help limit the chance of injury as well as improve performance (which is a good motivating factor) in the future. 

    In regard to stretching: there are various types of stretching (with differing purposes). I wouldn't recommend static stretching before running - a good warm-up is conducive - one that initiates a slight sweat (pending on the weather - it was 40 deg. Cel. in Sydney today), increase heart rate with some mild range of motion exercises will suffice (i.e. mild dynamic stretching). 

    I certainly wouldn't recommend beginners get mixed/messed up with "Pose" or "Chi" method running... having said this, there are some sound principles associated with the methods... yet, there are some false ones also.

    I don't believe barefoot running was mentioned once :) !
     
  5. Griff

    Griff Moderator

    I agree - if they really are just "off the couch" then rather than getting caught up in technique it would be more advisable for them to go out and run with a self selected movement pattern to start with. I think the NHS article would have been better if it actually gave a structured breakdown of the training steps, with gradual increases in distance in line the adaptation of the "potatoes" strength, conditioning and fitness. Much more useful information for a newbie than what to wear or what to eat.
     
  6. footfan

    footfan Active Member

    I think if it was any more technical or even longer in length even less people would read it , the problem with most sedentary people is they are looking for a quick fix and they usually dont like sport which is the reason they are sedentary. one of my patients (21yo Female) said she didnt like sport because it made her sweat and feel horrible- I advised swimming =S . If my dentist gave me a load of instructions 10 pages long on correct brushing and flossing
    I wouldnt read it =D but im just lazy
     
  7. Sports Biomechanics ain't really my thing. But I would hazard a guess that any advice on these lines which makes bold statements about what is right for EVERYONE will be wrong for SOMEONE.
     
  8. Griff

    Griff Moderator

    If your dentist issues you a 10 page document on appropriate oral hygeine which is accurate and evidence based, and you don't read it and then lose all your teeth then who is liable? Not him/her. It is our job as health professionals to give appropriate advice. Not watered down or inaccurate versions for fear that noone would read them otherwise. Patients have to take some responsibility for themselves.

    Patient: "Should I floss my teeth?"
    Dentist: "Only the ones you want to keep"

    I'm not suggesting the article shouldve been significantly longer or more 'technical', but I do think it shouldve contained some better information on how to achieve a 5k run for a beginner. This was its aim - and I don't think it achieved it. Make everything as simple as possible, but no simpler.

    You know it.
     
  9. Who is this Justin guy and why is he advising beginning runners to forefoot strike? In addition, there is no evidence that light stretching before running causes "microtears in muscles"...that's a bunch of BS. These types of comments are just the type of thing that causes injuries for beginning runners. In addition, these types of comments from know-nothings gives me fits in my office......counseling injured runners that actualy listen to and follow the advice of people who think they are running experts.:mad::bang::butcher:
     
  10. footfan

    footfan Active Member

    I agree its a persons own responsibility but i see it everyday with our diabetic patients who refuse to modify thier diet/lifestyle and then have amputations and blame everyone else because it was information overload.

    I think the fact is some people just dont have the knowledge to distinguish accurate information from anecdotal, which is why i agree the NHS should have sourced better advice before publishing it.

    Ian what do you feel if you had to choose just one aspect is the most important information lacking in this publication?

    Thanks

    Jon
     
  11. Because research PROVES that forefoot striking causes less impact and EVERYONE knows that impact is the same as injury. QED. :pigs:

    Honestly Kevin, I'd have thought you'd have picked that up from the extensive blogging on the subject by barefoot-genericarse. :rolleyes: Ask them, they'll soon put you right. :D They read a research once. From harvard. *

    Isn't life easy when we can deal in broad, simplistic "rules".

    Robert

    *Well, maybe not read. But they read something someone else said about it which is basically the same right?
     
  12. Griff

    Griff Moderator

    If I put myself in a couch potatoes shoes, who has no previous knowledge or running or no real care about the musculoskeletal system then what information would I want to read to achieve my goal of running 5k...

    I certainly wouldn't care about what to eat or wear for that matter. Most people have a comfy pair of trainers and jogging pants which would be just fine to start with.

    I also wouldn't care about the load deformation characteristics of human tissues, or the effect of training at a cellular level etc so with that regard you are right - technical jargon would be pointless at this stage.

    For me (like most I imagine) I would want spoon feeding. Tell me what to do and when to do it. Day 1: do X. Day 2: do Y. Day 3: do Z. That is what this article lacks (in my opinion).

    You can get people into sensible training habits and practices early on just by giving them a programme. Then when they improve and start taking it a bit more seriously (which they all do eventually) they'll come back and beg you for the technical stuff.
     
  13. As just such a couch potato, that sounds about right to me.
     
  14. footfan

    footfan Active Member

    lol i agree
     
  15. BEN-HUR

    BEN-HUR Well-Known Member

    "Light stretching" is rather a subjective term. There are various types/styles of stretches which address different purposes. Some I consider of no use & even dangerous (particularly if the individual is not conditioned & experienced). Whilst some I would consider disadvantages towards performance i.e. if done before an activity i.e. long held static stretching during a warm-up before a running race (i.e. adversely affecting the "leg stiffness" efficiency factor). However static stretching could be advantages for people who find it hard to exercise or for the elderly as this form of stretching helps improve muscle tone - which brings me to my next point...

    On the issue of stretching causing micro-tears: even though I haven't looked into this issue specifically, I would not be surprised if this was the case to some degree. Subsequently I am a bit surprised that you would consider this assumption as a... "bunch of BS". I am sure I have read research in the past which have touched on this issue but have not specifically noted it down... I should probably look into it further.

    Anyhow, I know some people who are strictly against stretching i.e. weakens muscles. In fact I once had a bit of a debate with someone (of 'expert' rapport) on a running forum who thought stretching was to be avoided at all cost. I feel certain types of stretching do have its place (at a certain time) in the training program. I also feel we shouldn't have a "throw the baby out with the bathwater" approach to stretching per se by getting rid of the concept as a result of some research stating unconducive aspects of its application i.e. as stated here... Stretching Before Running May Lower Endurance.

    The following video from renowned middle distance runner Sarah Hall (wife of Ryan Hall - 2.06 marathon runner) does a nice job in explaining to beginners how to get started in a running program...

     
    Last edited by a moderator: Sep 22, 2016
  16. Stretching the gastroc/soleus and hamstrings for about 1-2 minutes before a run is something runners have done for decades, myself for 40 years, without "muscle tears". As I am getting older now (just turned 54 last a few days ago), I stretch for about 1 minute after I do a slow warmup of about 2 minutes of running. Whole generations of high school and college runners in my era stretched before they ran with no increase in injury.

    So what do we have now, another running fad: many runners are now advocating no pre-run stretching, so what is else is new......there also many runners advocating running in Vibram FiveFingers and running barefoot and telling beginning runners to not heel-strike, so this means nothing to me.

    Until research shows that runners that lightly stretch for 1-2 minutes before a run causes more injuries or "muscle tears" or "muscle weakness", I'll still be advocating this pre-run stretching technique as I have over the past 25+ years to my runner-patients. That is why the statement "stretching before a run causes muscle tears" is a bunch of BS!

    Mathew, do you have any research that shows that a short 1-2 minute stretching routine prior to exercise causes an increased injury rate, increased muscle tears, or increased muscle weakness? I won't hold my breath.....:butcher:
     
  17. BEN-HUR

    BEN-HUR Well-Known Member

    G'day Big Kev (a bit of Australian humour there :D - Big Kev was a large enthusiastic character that use to promote cleaning materials in T.V commercials). Anyway, I stand by the comments/assumptions made in my previous post - I really don't see them as all that controversial.

    Anyhow, this "Justin guy" stated the following...
    For starters, I'm not in 100% support of the above view... but I do think it is somewhat valid i.e. stretching could cause tears in the "micro-fibres"; static stretching is more conducive after exercise than before - particularly strenuous exercise &/or a performance orientated event (race) &/or endurance event. As I stated in my previous post, there are various types of stretching (i.e. static, dynamic, ballistic, isometric, PNF). I also stated that one type of stretch may be less conducive at a certain time in a running/racing program than another type i.e. I feel the dynamic type (i.e. activity specific ROM exercises) to be more beneficial than the static (stretch & hold) type stretches before running... & vice versa for after the event... although dynamic stretches afterwards may help flush the system better (particularly after say a track workout – but probably not after a gruelling 35km long run).


    Yes, I know. However, none of us can say that there has not been any "muscle tears" (i.e. of a micro nature, as the quote in question stated) in any of these thousands of runners over the decades. Who knows, a pre-run stretching routine may have quite easily lead to any injury during a training session, or it may have made one predisposed to an injury as a result of a weakened state or reduced limb ‘stiffness’ efficiency. I think this would be a fairly hard thing to analyse but I'm willing to support the notion that static stretching may be a causative factor (just one of potential many). Particularly if the athlete was doing a track session with already fatigued/tight/sore muscles. Let's face it, a serious runner who is running 100miles (160km) a week will usually arrive at a track session (or fartlek session) in this state. Let alone a beginner who would reach this state after doing just 5km the previous day.


    Happy Birthday.

    I presume you are still a conditioned runner from what you have said here & what I have read in the past. I too stretch before running to some degree - the dynamic variety. I believe the Kenyon athletes stretch in a similar way. I must say the closest I come to a static stretch is when I focus on the Gastroc/Soleal/Achilles group... being that I feel these are the most important to get adequate ROM with due to the higher load/stress they are subjected to right from the start.


    Yes, well... no one knows this for sure (for reasons already stated above)... it is potentially quite a subjective, anecdotal evidence-based area i.e. state of muscle before the stretch routine, force applied to the stretch, fitness/strength of the individual etc... I don't believe there has been specific research done on this area (pre-run stretching types & running injury). I’ll have to look into it.


    I wouldn't look at this stretching issue as a "fad" (at least I have never seen it that way). I know the V5F & B.F issues can be rather annoying :craig: but I don't see the stretching issue to be in the same boat.


    Well I suppose it depends on the nature of stretching you advise for "1 - 2 min." I don't get much info. from what you have stated. Who knows, it may be something similar to what I do. All I'm saying is that I feel the static stretch & hold type stretching is not conducive before running (i.e. in a warm-up), yet it is more suitable after running.

    I use to do a lot of static type stretching before running (in warm-up). When I was younger my coach was a big advocate for it. She was a very experienced coach (she coached multiple Olympic Gold medallist Betty Cuthbert & other internationals) & had connections with the Australian Institute Of Sport as well as the then (1980’s) East German Athletic team (which endorsed Ballistic Stretching). Hence I know & have experienced both sides of the coin when it comes to pre-run stretching routines. As irrelevant or anecdotal you may view this but I feel better running after doing a dynamic type pre-run stretch routine as opposed to the static type pre-run stretch routine. This may have something to do with the "leg stiffness" efficiency factor; it may be due to my muscles being less strained or subsequently weakened somewhat from doing a static pre-run stretch routine. It wouldn’t be an easy issue to answer, which leads to the next issue...


    No, I don’t have any with me at hand. Yet, now that we’ve got somewhat bogged down on this issue, it may be a good time for me to specifically look into it. As anecdotal the evidence either way may be on this issue. However, I really do think this is a valid area to look into which does potentially have important physiological relevance... thus like I said in my previous post... I just wouldn’t’ put it into the B.S category... at least not just yet.

    PS – Do you (or anybody else) feel that stretching could have an adverse affect on the "leg stiffness" efficiency factor? ... could this be a predisposing factor to injury... or at least reduced athletic performance?
     
  18. NeedingMassage

    NeedingMassage Active Member

    Hi guys,
    I know you like to promote running at any cost but wouldn't a couch potato be best advised to buildup to walk 5kms first (with or without the NHS 5 minute warm-up walk) prior to even considering running of any kind.
    Regards,
    Owen.
     
  19. Mathew:

    Many runners are able to exercise daily without injury. Some stretch before running, others don't. The point is that if the stretching is done gradually enough and for a short period of time, the muscles won't tear....why would they if the much more violent eccentric loads from the running activity itself doesn't tear them?!

    My viewpoint is that to tell a runner not to stretch before an exercise because it will cause "tears in the muscle" is not based on any scientific research, it is not based on my personal experience of running one to two workouts per day, 50-100 miles/week for 20 years during my more competetive years and stretching before every run, it is not based on my personal experience of knowing 100's of competetive runners that have stretched before running without injury, and it does not make biomechanical sense considering the viscoelastic mechanical properties of the muscle-tendon unit.

    Please, Mathew, if you can't give me any solid scientific evidence of why a runner shouldn't stretch before running, then at least provide me with a biomechanical reason of how a slow gradual stretch of 10-15 seconds for each muscle group for each leg, gastrocnemius, soleus and hamstrings for a total of 1-2 minutes before running would cause muscle tears.

    If you can't, then it's still all B.S. to me.:drinks
     
  20. JB1973

    JB1973 Active Member

    "Mathew, do you have any research that shows that a short 1-2 minute stretching routine prior to exercise causes an increased injury rate, increased muscle tears, or increased muscle weakness? I won't hold my breath"

    Kevin, do you have and research that says it doesnt? other that youve did it for years and been ok? isnt that what we have been slaughtering the minimalist movement for?

    I dont stretch pre or post run usually and its never done me any harm. wee warm up and cool down usually suffices.

    JB
     
  21. JB:

    I was not the one that was making or supporting the statement that stretching prior to running causes muscle tears.

    From Bonnie Spain.
     
  22. BEN-HUR

    BEN-HUR Well-Known Member

    I agree with the above statement. I have not stated anything contrary to it. Please remember, I too do a form of stretching before running. Here lies the issue; it is the nature of the stretch I am wishing to discuss on - not getting rid of the concept of stretching all together - no one has stated this - not even the person in question which sparked this thread. Please also remember that the original issue was in relation to beginners - i.e. those with little experience & conditioning.

    Besides, I feel this is very much a subjective issue based on many factors (as I have already stated) i.e. conditioning, state of muscle (i.e. fatigued), forces applied etc... thus your above statement isn't conclusive i.e. eccentric loading forces will cause tears pending on the above stated conditions... it is just that some runners will reach their 'break-down' (micro-tear) state/threshold at different levels i.e. my next door neighbour will likely reach his threshold at say 5km, whilst I may possibly reach mine at 35km. Thus not all stretching sessions will cause "tears" which could hinder performance; subsequently, not all stretching sessions won't cause "tears" which may hinder performance. I am just putting forward an idea that some forms of stretching have their place & thus could be more conducive as part as a pre-exercise routine as opposed to another i.e. dynamic (ROM) stretch as opposed to the static (stretch & hold) stretch.

    However, you have helped me realise something else... could pre-run stretching affect the ability of one to withstand the degrees of eccentric loading forces... could eccentric kinematics be affected by the act of pre-run stretching - if so, what variety of stretch could be likely to have greater impact... could this affect injury rates &/or performance????

    A brief look in Google Scholar did reveal that this has at least been touched on...
    Acute Effects of Stretching Are Not Evident in the Kinematics of the Vertical Jump.
    Maybe more in depth research is needed on general sports activities/performance.

    But Kevin, no one here is saying that a runner should not stretch before exercise (at least I'm not). You are putting forward a straw man argument. You have no doubt come across people of this ilk but I'm not one of them. It is just the nature of the stretch routine that I had intentions on discussing here. I thought it would have been a valid issue to bring up & discuss.

    Please, Kevin, once again, I have not stated or endorsed that runners (of any ability) should not stretch before a workout. People conduct their own stretching sessions in various ways & intensities. Your "slow gradual stretch of 10-15 seconds" is your routine (which has appeared to serve you well), however there are many others of varying duration & intensities of a static stretch nature that I feel should be assessed & weighed up against other versions of stretches - stretches that I feel are more activity specific for the intended activity i.e. dynamic ROM exercises reflecting the act of running may be more beneficial... with static type stretches more beneficial after activity or throughout the day.

    On another issue, your "10-15 seconds" stretching each muscle group for each leg ("gastrocnemius, soleus and hamstrings") for a total of 1-2 minutes may not have been sustained long enough to effect changes in the musculotendinous unit to have much effect either way.

    I certainly feel that stretching has the potential to cause tears to some degree. I feel that this is not always a bad thing. These micro-tears may help develop strength & provide better muscle tone (I have read research on this) - which certainly has its place in the training program... however, may not be a conducive time to do so just before a running workout as these micro-tears just may weaken the muscle integrity (which could prove injurious) as well as affect performance (which has been researched - this link) via affecting amongst other things the "muscle stiffness" efficiency factor (or eccentric kinematics).

    Anyway it is just a thought I perceived was worthy of putting out there & bouncing a few ideas around, which I feel is conducive to learning on this education based forum.

    *** After a quick search of Google Scholar I came up with these papers which are related to the topic/issues we have been discussing...

    - Stretching Before and After Exercise: Effect on Muscle Soreness and Injury Risk:
    - Stretching before exercise does not reduce the risk of local muscle injury: a critical review of the clinical and basic science literature:
    - Prevention of running injuries by warm-up, cool-down, and stretching exercises:

    - Effects of stretching before and after exercising on muscle soreness and risk of injury: systematic review:
    - A randomized trial of preexercise stretching for prevention of lower-limb injury:
    - The Impact of Stretching on Sports Injury Risk: A Systematic Review of the Literature:
     
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