Four Ways to Stop the Dreaded Side Stitch

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From Runner’s World

Few things are worse than get­ting a side stitch dur­ing a run. Here are three ways to pre­vent the prob­lem, and one strat­egy for stop­ping a stitch in its tracks:

Eat mind­fully pre-run. There are many the­o­ries as to why stitches occur, and one of them fac­tors in what and when you eat pre-run. Foods that are higher in fat and fiber take longer to digest. That doesn’t mean they are bad foods, but if you eat them within one to two hours before a run, they can cause havoc—creating stom­ach upset, stitches, and other prob­lems. Exper­i­ment with a vari­ety of foods pre-run, eat lightly, and give your­self plenty of time to digest. One person’s per­fect pre-run fuel is another’s disaster.

Invest in a solid warm-up. Going from sit­ting to run­ning speed may save you time on the watch, but it can cre­ate irreg­u­lar, rapid-fire breath­ing pat­terns, which can trans­late to you bend­ing over in pain on the side of the road (with a side stitch). Invest in two to three min­utes of brisk walk­ing, grad­u­ally work into an easy run­ning effort, and then into your planned run­ning work­out pace. Doing so will increase the qual­ity of your work­out and decrease the risk of stitches that arise from push­ing the throt­tle too soon.

Reg­u­late your breath­ing. Run like a swimmer—with effi­cient breath­ing pat­terns that are in sync with your body. Swim­mers can only breathe when their faces are out of the water (obvi­ously), so they focus much of their time learn­ing their breath­ing tempo and match­ing it to the rhythm of their stroke. Run­ners can ben­e­fit from the same tech­nique by match­ing their breath­ing to their strides—inhaling for two to four strides and exhal­ing for the same. The faster the pace, the shorter the sequence (fast pace = one or two strides per breath, slower = three or four strides per breath). This can not only pre­vent stitches, but also improve the effi­ciency of your oxy­gen trans­port. Plus, it’s a great way to keep in touch with your run­ning effort lev­els with­out a watch.

Slow down and exhale to release the stitch. If you still get another side stitch, imple­ment this strat­egy and it will go away in sec­onds (I promise). Slow your pace and exhale as the foot on the oppo­site side of the stitch strikes the ground. This doesn’t mean every time that foot hits the ground, but as you exhale, do so in sync with that oppo­site side. When you exhale, you use the mus­cles of your diaphragm. When this hap­pens in uni­son with your foot strik­ing the ground, the impact forces travel up the body and through your core (your side too) and exac­er­bate (piss off) the mus­cles in spasm cre­at­ing that stitch. When you change the side of the land­ing forces to the oppo­site side, the ten­sion caus­ing the stitch releases. For exam­ple, your stitch is in your right side. You slow your pace, and exhale as your left foot is hit­ting the ground. Voila! Side stitch is his­tory and you’re run­ning with­out swear­ing once again.

Happy Trails!

Coach Jenny Had­field is the co-author of the best sell­ing Marathon­ing for Mor­tals and Run­ning for Mor­tals. She is a nation­ally rec­og­nized speaker, writer and endurance athlete.

Solving the Puzzle: 4 Tips for Injury-Free Running

From Active​.com

In March 2008, I ran a marathon for the first time in four years. The long hia­tus was due to a mad­den­ing series of overuse injuries. Dur­ing most of the four years between marathons I doubted I would ever again be able to train at a high level in this dis­ci­pline, and indeed I quit run­ning in despair at least half a dozen times.

What got me over the hump? It was not a sin­gle, all-encompassing cure. Since running-related injuries affect most triath­letes, I would like to take this oppor­tu­nity to share with you four key pieces of my injury-prevention puzzle.

First Piece: Tar­geted Stretching

Much has been made of recent research demon­strat­ing that rou­tine stretch­ing does not pre­vent overuse injuries in endurance ath­letes. While it may be true that a gen­eral stretch­ing rou­tine does not pre­vent injuries in gen­eral, cer­tain spe­cific injuries are caused in part by abnor­mal tight­ness in par­tic­u­lar mus­cles and ten­dons. Stretch­ing every­thing is a lit­tle like try­ing to true a wheel by loos­en­ing the spokes on both sides. Stretch only what’s too tight and you’ll see bet­ter results.

Sec­ond Piece: Cor­rec­tive Strength Training

Knee pain in run­ners is often linked to weak­ness in the hip abduc­tors (the mus­cles that keep your pelvis from tilt­ing lat­er­ally when you’re sup­ported by only one leg) on the affected side. A sim­ple test you can use to deter­mine whether your hip abduc­tors are weaker on one side is to per­form a single-leg squat with each leg.

As you lower your butt toward the floor, even­tu­ally your thigh will rotate inward, swing­ing your hip out­ward, which is a sign that your hip abduc­tors have become over­whelmed and need help from other mus­cles. If this com­pen­satory action hap­pens ear­lier on one side than on the other, that side is weaker and you are more prone to knee pain in the cor­re­spond­ing knee.

I started to even out the strength of my hip abduc­tors by doing single-leg squats, step-ups and other such exer­cises three times a week, chal­leng­ing my right side more than my left so that the gap steadily closed.

Third Piece: Gait Retraining

Con­ven­tional wis­dom holds that the run­ning stride you’re born with is the one you’re stuck with. But the con­ven­tional wis­dom is wrong. Recent research has shown that par­tic­u­lar running-related overuse injuries can be over­come by mak­ing key mod­i­fi­ca­tions to one’s stride.

The most com­mon injury-causing stride flaw is over­strid­ing, or land­ing heel first with your foot well ahead of your body’s cen­ter of grav­ity, instead of land­ing flat-footed with your foot directly under­neath your head. A sim­ple way to cor­rect his flaw is to tilt your entire body very slightly for­ward from the ankles (not the waist) as you run, as though you’re con­stantly falling for­ward or run­ning downhill.

This lit­tle tweak forces your foot to land flat­ter and closer to your cen­ter of grav­ity. Cor­rect­ing the over­strid­ing flaw makes it eas­ier to main­tain proper sta­bil­ity in your hips and pelvis on impact and reduces the like­li­hood of injuries, includ­ing ili­otib­ial band fric­tion syn­drome and runner’s knee.

Fourth Piece: High-tech Nutrition

Remark­ably, doc­tors still do not know exactly what runner’s knee is. They used to think it was chon­dro­ma­la­cia, or dam­age to the knee car­ti­lage, but many run­ners with chon­dro­ma­la­cia run pain-free, and many run­ners with knee pain don’t have chondromalacia.

The lat­est the­ory is that runner’s knee, or patellofemoral pain syn­drome, is caused by the body’s fail­ure to fully repair trauma suf­fered dur­ing runs by the patella and the fat pad under­neath it. Every run­ner expe­ri­ences such trauma in every run, but some run­ners (espe­cially those who over­stride and have weak hip abduc­tors) incur more than oth­ers, and the more you run, the less likely it is that the affected tis­sues will achieve com­plete home­osta­sis between runs.

By chang­ing my shoes, strength­en­ing my hip abduc­tors and retrain­ing my gait, I suc­ceeded in reduc­ing the amount of dam­age my right knee suf­fered dur­ing a run. Thus, I was able to run more before the pain became debil­i­tat­ing. But I still wasn’t able to run enough.

The final piece of the puz­zle: I needed some means of repair­ing the dam­age more quickly between runs. I found this in a spe­cial sup­ple­ment called hyper­im­mu­nized milk fac­tor (HIMF). HIMF is a col­lec­tion of anti-inflammatory pro­teins derived from cow’s milk. By reduc­ing post-workout inflam­ma­tion, it facil­i­tates faster tis­sue repair in ath­letes for whom inflam­ma­tion has become chronic.

As yet there are only a cou­ple of HIMF sup­ple­ments on the mar­ket: Micro­Lactin, which is mar­keted mainly to arthri­tis patients, and RX-98, which com­bines HIMF with a whey pro­tein iso­late and is made specif­i­cally for athletes.

The Real Cure

Ear­lier in this arti­cle I said that there was no sin­gle, all-encompassing cure for my injury woes. But it might be bet­ter to say that the true cure was research and exper­i­men­ta­tion. Once com­pleted, the injury-prevention puz­zle looks a lit­tle dif­fer­ent for each ath­lete, but the only way for any ath­lete to put it together is by mak­ing an unflag­ging effort to dig up mea­sures that are worth try­ing and giv­ing each a fair try.

Active Expert Matt Fitzger­ald is the author of sev­eral books on triathlon and run­ning, includ­ing Brain Train­ing for Run­ners and Runner’s World Per­for­mance Nutri­tion for Run­ners (Rodale, 2005).

3 Exercises to Cure Your Knee Pain

By Natalie Gin­gerich, Active​.com

The jury is in: “Bad knees” aren’t sidelin­ing your work­out; your hips may be the guilty party. Accord­ing to a review of 28 years’ worth of research on com­mon exer­cise injuries, hip strength is the biggest pre­dic­tor of knee pain. So grab a resis­tance band and do these moves daily, work­ing up to 3 sets of 10 reps on each side.

Don’t for­get to add flex­i­bil­ity exer­cises to your strength train­ing. Stretch­ing helps pre­vent injury and strength­ens joints, espe­cially for those 40 and over.

Side Swing: Anchor band on left side at floor height and loop band around right ankle. Bal­anc­ing on left foot (hold on to some­thing if needed), raise right leg out to side; lower.

Front Kick: Turn so band is anchored behind you and around left ankle, foot flexed. Swing left leg for­ward about 12 inches, keep­ing it straight, and return to start.

Seated Rota­tor: Sit so band is anchored to right and around left ankle. Cross ankles. Keep­ing knees together, rotate left leg out­ward about 12 inches. Return to start.

Ice Massage for Soft Tissue Injuries

FROM ABOUT​.COM SPORTS MEDICINE

Icing injuries can be one of the most impor­tant imme­di­ate treat­ment steps for acute injuries such as sprains and strains, overuse injuries, con­tu­sions and bruises.

Why Ice a Soft Tis­sue Injury?
Apply­ing ice to a soft tis­sue injury can help reduce swelling and inflam­ma­tion by reduc­ing blood flow to the injured area. Ice also pro­vides tem­po­rary pain relief after an acute or trau­matic injury. In order to get the best result, it’s impor­tant to ice the injury dur­ing the 48 hours after the injury, before the swelling becomes advanced.

Ice ther­apy that reduces the tem­per­a­ture of the injured tis­sues by 10 to 15 degrees for short, repeated peri­ods of time also appear to have the best results.

For Soft Tis­sue Injury, Ice Mas­sage Is Best
Ice mas­sage is the most effec­tive method of apply­ing ice to an injury. The research regard­ing the use of ice on soft tis­sue injuries con­tin­ues to sup­port the fol­low­ing guide­lines for icing an injury. These steps result in the best treat­ment out­comes for many acute sports injuries.

How to Per­form an Ice Mas­sage
The eas­i­est way to per­form ice mas­sage on an injury is to freeze water in a small paper cup. Rip the cup to expose the ice. With the injured body part ele­vated above the heart (if pos­si­ble) to reduce swelling, mas­sage the injured area. Keep mov­ing the ice in a cir­cu­lar motion for 10 min­utes; never hold it in one place. As the ice melts, tear down the sides of the cup to expose the rest of the ice.

Tip: So you always have a handy way to do ice mas­sage, keep small paper cups filled with water in your freezer.

Repeat­ing the Ice Mas­sage
The most effec­tive and safest use of ice has been found with a repeated appli­ca­tion for 10 min­utes at a time. Allow the injured body part to warm for at least an hour before repeat­ing the ice mas­sage. Using repeated, rather than con­tin­u­ous, ice appli­ca­tions helps sus­tain reduced mus­cle tem­per­a­ture with­out com­pro­mis­ing the skin. It also allows the super­fi­cial skin tem­per­a­ture to return to nor­mal while deeper mus­cle tem­per­a­ture remains low.

How Long to Con­tinue Ice Mas­sage
The amount of time you con­tinue the ice mas­sage cycle is depen­dent upon the amount of pain and swelling you have, the extent of the injury and your per­sonal pref­er­ence. In gen­eral, repeat­ing the ice mas­sage 3 to 5 times a day in the first 24 to 48 hours is help­ful. After 48 hours, there is less evi­dence that icing the injury will improve your heal­ing time.

Cau­tions With Ice Mas­sage
Icing an injury too long can cause fur­ther dam­age to the soft tis­sues, and even result in frostbite.

Keep in mind that your reflexes and motor func­tions are also impaired fol­low­ing ice treat­ment, so you may be more sus­cep­ti­ble to injury for up to 30 min­utes fol­low­ing treat­ment. For this rea­son, avoid using the injured body part until the tis­sue has warmed back up (about an hour).

Sources:

MacAuley, DC. Ice ther­apy: how good is the evi­dence? Inter­na­tional Jour­nal of Sports Med 2001 Jul;22(5):379–84

Choice Chiropractic is My Choice

BY ANDREW

This past week was par­tic­u­larly hard. I had a cold from too many miles on the road and then I got bit­ten by the ledge on the wall jumps in the cen­ter of the active oval. In the process I man­aged to twist my back com­pletely out of line.

When my eldest daugh­ter was born she arrived with the ulti­mate cone-head. She looked like she had just walked off the set of some SNL skit with Dan Ack­royd. It was really bad. My wife had been see­ing a chi­ro­prac­tor in the months prior to our daughter’s birth. She was just down the hill from us in Boston and it was really easy to get to when there was no ice on the hill. One of the first peo­ple we went to see after the birth was this per­son. Upon see­ing my daughter’s head she offered to push it in to shape. Are you nuts???? What kind of quack are you???

Need­less to say the next time I approached a chi­ro­prac­tor it was more than ten years later.

Recently I changed my mind and only because I was in such pain and hav­ing a very tough time run­ning. So I went to see our res­i­dent chi­ro­prac­tor: Ter­resa, and Choice Chi­ro­prac­tic & Well­ness.

She started by not offer­ing to reshape my daughter’s head, which by the way, is quite round now. She asked me what was wrong, she did not give me a lec­ture on why I should respect her more than other doc­tors and she very clearly explained what she was doing and why. My aches and pains have not gone away, but they have dimin­ished and that they can be man­aged with a lit­tle care. Thank you Terresa.

I did a lit­tle research and found that chi­ro­prac­tors actu­ally have a con­sid­er­able amount of work to do before they can prac­tice, that they are reg­u­lated, and that they can make a dif­fer­ence if you are as active as we all are. Our bod­ies get out of line and we can all do with a lit­tle help lin­ing them up, so why not go to the right person?