Distance Running

Training for
DISTANCE
RUNNING
A SPECIAL REPORT FROM
PEAK
PERFORMANCE
The research newsletter on

stamina, strength and fitness
Training for
DISTANCE
RUNNING
Green Star Media Ltd 2014
Published by Green Star Media Ltd, Meadow View,
Tannery Lane, Bramley, Guildford GU5 0AB, UK
Telephone: +44 (0)1483 892894
ISBN: 978-1-905096-29-9
Publisher Jonathan A. Pye
Editor Sam Bordiss
Designer The Flying Fish Studios Ltd
The information contained in this publication is believed to be correct at the time of
going to press. Whilst care has been taken to ensure that the information is accurate,
the publisher can accept no responsibility for the consequences of actions based on
the advice contained herein.
All rights reserved. No part of this publication may be reproduced, stored in
a retrieval system, or transmitted in any form or by any means, electronic,
mechanical, photocopying, recording or otherwise without the permission of
the publisher.
OTHER TITLES IN THE

PEAK PERFORMANCE
SPECIAL REPORT SERIES
ACHILLES TENDINITIS PREVENTION AND TREATMENT
CARBO LOADING FOR THAT EXTRA EDGE
COACHING YOUNG ATHLETES
CREATINE CUTTING THROUGH THE MYTHS
DYNAMIC STRENGTH TRAINING FOR SWIMMERS
TRAINING FOR MASTER ATHLETES
FEMALE ATHLETES TRAINING FOR SUCCESS
SHOULDER INJURIES PREVENTION AND TREATMENT
MARATHON TRAINING FOR YOUR PERSONAL BEST
NUTRITIONAL SUPPLEMENTS BOOSTING YOUR PERFORMANCE
SPORTS PSYCHOLOGY THE WILL TO WIN
TRAINING FOR SPEED, POWER & STRENGTH
ALL WEATHER TRAINING BEATING THE ELEMENTS
BODY FUEL FOOD FOR SPORT
TRAINING FOR ENDURANCE
FOOTBALL PERFORMANCE HOW TO RAISE YOUR GAME
TRAINING FOR RUGBY
TRAINING FOR CYCLING
RESISTANCE TRAINING THE NEXT LEVEL
CORE STABILITY INJURY FREE PERFORMANCE
TRAINING FOR ROWING
SPORTS PSYCHOLOGY II THINK YOUR WAY TO SUCCESS
ANTIOXIDANTS TRAIN LONGER, TRAIN HARDER
TRAINING FOR TRIATHLON
FOOTBALL PERFORMANCE II NEW GOALS FOR SUCCESS
KNEE PAIN PREVENTION AND TREATMENT
CONTENTS
Page 11 Muscle Training Why distance runners cannot afford to
ignore the vital contribution of fast-twitch muscle fibres
John Shepherd
Page 21 Physiology The relationship between the importance
of body fat and distance running is investigated
Ron Maughan
Page 31 Training Methods A former European 5000m champion
discusses the benefits of intensive training for runners
Bruce Tulloh
Page 39 Biomechanics Its back to basics, analysing the fundamental
principles behind successful running technique
Raphael Brandon
Page 51 Running Technique Following the fundamentals, Pose running
is introduced as a potential injury-free running technique
Scott Smith
Page 61 Physiology It isnt an injury but it can certainly jeopardise
a race; the mysterious stitch is analysed
Alison McConnell
Page 71 Nutrition If the previous chapter has you in a stitch,
perhaps it is worth considering the new carbo-drink
Andrew Hamilton
Page 83 What the Papers Say Explosive type strength training
enhances distance-running performance
Page 84 What the Papers Say Creatine serum offers no advantages
for runners
Page 85 What the Papers Say The benefits of training backwards
Page 86 What the Papers Say Why long, slow training runs may be
best after all
Page 87 What the Papers Say No link between hydration and cramps
Page 89 What the Papers Say Runners high: a new explanation
Page 90 What the Papers Say Nature and nurture in Ethiopian
endurance running success
From the editor

istance running is perhaps a vague term. After all 100m is
a distance, and there are some people I know whod
describe it as long-distance! However for the sake of this
special report we will define distance using Olympic races. The races
in between the blue ribbon events, the 400m and marathon, are
what we might describe as distance running. That means the 800m,
1500m, 5000m and 10000m. The 800m is perhaps a little short but
it is included because of the energy system it requires.
This talk of Olympics may have some less ambitious athletes
running scared rather than running distances. Theres no need
to worry though. Whilst the articles in this report are appropriate
for elite athletes, they are just as beneficial for social runners
seeking to improve times, or competitive runners aiming to
compete in fantastic events such as the Great North Run.
The opening chapters in this report will get runners thinking
about their body composition, firstly muscle fibres then
percentage body fat. In the third chapter a former European
5000m champion discusses training intensity. The fourth and
fifth chapters question running posture and techniques, vital for
injury-avoidance and top performance. Chapter six investigates
the dreaded stitch which could leave you keeling over, in need of
refreshment. Luckily the final chapter introduces a new carbodrink for distance runners.
I hope this special report helps everyone from Sunday
morning joggers to gold medal hunting Kenyans achieve great
times in their chosen distance.
Sam Bordiss
PAGE 9
PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT
PAGE 10
MUSCLE TRAINING
Why distance runners

cannot afford to ignore the
vital contribution of fasttwitch muscle fibres
This opening chapter focuses on getting the most out of muscle fibre
for endurance activity. Biopsies are used to determine what types of
fibres exist within our muscles. A special needle is pushed into the
muscle and a grain-of-rice-size piece of tissue extracted and
chemically analysed. Two basic fibre types have been identified via
this process: slow-twitch (also known as type I or red fibres) and
fast-twitch (aka type II or white fibres). Type II fibres, as we shall
see, can be further sub-divided into type IIa and type IIb variants.
Slow-twitch muscle fibre contracts at almost half the speed of
fast-twitch fibre at 10-30 twitches per second compared with
30-70. Slow-twitch fibre has a good level of blood supply, which
greatly assists its ability to generate aerobic energy by allowing
plentiful supplies of oxygen to reach the working muscles and
numerous mitochondria.
Mitochondria are cellular power plants; they function to turn
food (primarily carbohydrates) into the energy required for
muscular action, specifically adenosine triphosphate (ATP).
ATP is found in all cells and is the bodys universal energy
donor. It is produced through aerobic and anaerobic energy
metabolism and, consequently, through the associated actions
of both slow and fast-twitch muscle fibre.
Slow-twitch fibre is much less likely than its fast-twitch
counterpart to increase muscle size (hypertrophy), although
well-trained endurance athletes have slow-twitch fibres that are
PAGE 11
slightly enlarged by comparison with sedentary people. The

most notable training effects, however, occur below the surface.
Subject to relevant endurance training, these unseen changes
include:
An improved aerobic capacity caused by fibre adaptation.
Specifically this involves an increase in the size of
mitochondria, boosting the ability of the fibres to generate
aerobic energy;
An increase in capillary density, which enhances the fibres
capacity to transport oxygen, and thus to create energy;
An increase in the number of enzymes relevant to the
Krebs cycle a chemical process within muscles that
permits the regeneration of ATP under aerobic conditions.
The enzymes involved in this process may actually increase
by a factor of two to three after a sustained period of
endurance training.
Blood lactate plays a crucial role in energy creation which is not,
as many people mistakenly assume, restricted to the latter stages
of intense exercise. Lactate is actually involved in energy
production in our muscles at all times, although response to
lactate generation varies according to fibre type. A brief
consideration of this process will begin to explain why the
relationship between fast and slow-twitch fibre is crucial to
optimum endurance.
Fast-twitch fibres produce the enzyme lactate dehydrogenase
(LDH), which converts pyruvic acid (PA) into lactic acid (LA).
The LDH in slow-twitch muscle fibre however, favours the
conversion of LA to PA. This means that the LA produced by
the fast-twitch muscle fibres can be oxidised by the slow-twitch
fibres in the same muscle to produce continuous muscular
contractions.
When LA production reaches a level where it cannot be
recycled to generate steady-state aerobic energy, endurance
exercise moves into anaerobic territory with less reliance on
oxygen and more on stored phosphates for energy production.
There will come a point, under these conditions, when an
PAGE 12
athlete reaches their lactate threshold, at which point further

exercise becomes increasingly difficult and the athlete is forced
to slow down and ultimately stop.
As we shall see later, this anaerobiosis and its exercisehalting effect may be as much a consequence of brain activity as
of muscular limitations, especially under extreme endurance
conditions.
Well-trained endurance athletes are able to generate blood
lactate levels that are 20-30% higher than those of untrained
individuals under similar conditions. This makes for significantly
enhanced endurance as their muscles no longer drown in lactate
but rather drink it to fuel further muscular energy. To continue
the analogy, the untrained individuals muscles would get
drunk on lactate after just a few intervals or should that be
rounds!
As noted, failure to train fast-twitch fibre to contribute to
endurance performance will result in lactate threshold being
reached and performance arrested at a much earlier point.
Unlike the 100m sprinter, who can ignore his slow-twitch fibres
altogether in training without damaging performance, the
endurance athlete has to train all fibre types in order to
maximise sustained muscular energy.
Athletes are made rather than born

Most people are born with a relatively even distribution of fast
and slow-twitch fibres, suggesting that power and endurance
athletes are made rather than born. As exercise physiologists
McKardle, Katch and Katch point out, studies with both
humans and animals suggest a change in the biochemicalphysiological properties of muscle fibres with a progressive
transformation in fibre type with specific and chronic training (1).
Table 1, overleaf, shows the extent to which fibre type can be
altered after training for selected endurance activities,
although whether these changes are lasting is open to debate,
as we shall see.
We have shown how slow-twitch fibre adapts to endurance
training. Now lets take a look at how fast-twitch fibres respond.
PAGE 13
Type IIa or intermediate fibres can, in elite endurance

athletes, become as effective at producing aerobic energy
as slow-twitch fibres found in non-trained subjects. Like
slow-twitch fibres, these fibres (and their type IIb
counterparts) will benefit from an increase in capillary
density. In fact, it has been estimated that endurance
training that recruits fast and slow-twitch muscle fibre
can boost intramuscular blood flow by 50-200% (2);
Type IIb fibres can play a much more significant role
in sustained energy release than had been assumed,
according to research carried out by Essen-Gustavsson
and associates (3). These researchers studied muscular
enzyme changes brought about by endurance training
and concluded that type IIb fibres were as important to
endurance athletes in terms of their oxidative energy
production and the clearance of exercise-inhibiting
phosphates as type IIa fibres.
A raft of relatively recent research indicates that intense training
efforts eg three-minute intervals at 90-95% of max heart
rate/over 85% of VO2max, with three-minute recoveries are
great ways to boost lactate threshold (as well as VO2max,
economy and strength). These lactate-stacker sessions, by their
very nature, rely on fast-twitch fibre to generate power. Note,
though, that these workouts are very tough and stressful and
should be used judiciously.
Endurance gains can be made much more quickly through
capillary adaptation in fast and slow-twitch fibre with anaerobic
training methods, such as the lactate stacker workouts, than with
Table 1: Percentage slow-twitch fibre in male
deltoid (shoulder) muscle
Endurance athlete
Canoeist
Swimmer
67%
Triathlete
60%
Adapted from McKardle et al

PAGE 14
% slow-twitch fibre in deltoid muscle

71%
(5)
less intense aerobic training. Although it is possible to train fasttwitch fibre to take on more of the slow-twitch blueprint, taken
to extremis especially through the use of slow-twitch steady
state training this may not actually be the best strategy for
endurance athletes.
The marathon runner Alberto Salazar once said that he aimed
to train aerobically hard enough to lose his ability to jump (4). In
other words, he was trying to convert all his fast-twitch fibres into
slow-twitch ones in terms of their energy-producing potential so
that they could contribute all their energy to his marathon running.
However, for a variety of reasons, losing all fast-twitch speed
and power ability may not actually be a good idea. For example,
at the end of a closely-fought marathon there may be a need for
a sprint, requiring fast-twitch fibre input. This becomes yet more
appropriate when considering middle distance running.
Even more specifically, there is the anaerobic/aerobic
component of an endurance activity to consider, and the speed
required to complete it competitively. An 800m race calls for an
anaerobic energy contribution of around 40%, and athletes in
these disciplines must be fast and powerful to succeed.
Fast-twitch fibres have to be trained accordingly; its no good
turning them into plodders with an emphasis on slow-twitch,
steady state work, if they are needed to produce a short or
sustained kick and a sizeable energy contribution.
The recent research into lactate stacker sessions and the vital
role of lactate threshold as the key endurance performance
variable further substantiates the need for the development of
a high-powered endurance contribution from fast-twitch fibres.
Despite virtually undisputed evidence that all muscle fibre
types will adapt to a relevant training stimulus, it is less certain
whether these changes are permanent. One of the few studies
concerned with the long-term effects of endurance training was
conducted by Thayer et al, who looked at muscle-fibre
adaptation over a decade (6). Specifically, they compared skeletal
muscle from the vastus lateralis (front thigh) in seven subjects
who had participated in 10 years or more of high intensity
aerobic training with that of six untrained controls.
PAGE 15
They found that the trained group had 70.9% of slow-twitch

fibres compared with just 37.7% in the controls. Conversely, the
trained group had just 25.3% fast-twitch fibre, compared with
51.8% in the controls. The researchers concluded that
endurance training may promote a transition from fast to slowtwitch fibres, and that this occurs at the expense of the fasttwitch fibre population.
Fibre reversion after inactivity
It is possible
that athletes
'learn' how
to tolerate
pain and
consequently
become
better able to
recruit their
muscle fibre
PAGE 16
However, it seems that slow-twitch (and fast-twitch) muscle

fibre tends to revert back to its pre-training status after a period
of inactivity (although aging may provide an exception to this
rule, as we shall see later). In fact, the theory is that muscle fibre
has a fast-twitch default setting. This is entirely logical: since we
use our slow-twitch fibres much more than our fast-twitch ones
on a daily basis, a period of inactivity would de-train slow-twitch
fibre and allow fast-twitch fibre to regenerate and convert back
to a faster contraction speed. The interesting and slightly less
logical aspect of this process is that it does not necessarily
require speed training, as demonstrated by research on muscle
tissue rendered inactive by accident or illness (7).
When it comes to recruiting winning muscle, it is impossible
to overlook the vital role of the brain. Muscle fibre can only
function at the behest of our brains, and it is possible that
athletes learn how to tolerate the pain associated with lactate
build up, for example, and consequently become better able to
recruit their muscle fibres.
Recently, research has begun to appear on the so-called
central governor, which is seen to be the determinant of the
bodys ability to sustain endurance activity by tolerating
increasing intensities of exercise. It has been argued that the
governors setting can be altered through the experience of
intense exercise and a corresponding shift in willpower to permit
greater endurance perseverance. This theory has been
substantiated by evidence that muscles can still hold onto 8090% of ATP and some glycogen after intense endurance efforts
ie when the athlete has decided to stop exercising.
It has been suggested that the body and, for our purposes,
its muscles will always hold onto some crucial energyproducing materials, just in case it is called upon to react in an
emergency. This is seen as a legacy of the unpredictable past that
confronted our prehistoric ancestors, who never knew if they
would need a bit more energy to flee from a sabre-toothed tiger
after a long days hunting and gathering!
The central fatigue hypothesis

Closely related to the thoughts on the governor is the central
(nervous system) fatigue hypothesis, postulating that the brain
will shut down the body under certain conditions when there
is a perceived threat of damage to vital organs, irrespective of
an individuals fitness. The conditions specifically identified to
trigger central fatigue are high altitude and high temperatures,
although researchers believe it could also swing into play under
less taxing conditions.
The famous exercise physiologist and runner Tim Noakes
states: There is no evidence that exhaustion under these
conditions is associated with either skeletal muscle anaerobiosis
or energy depletion. There is sufficient evidence to suggest
that a reduced central nervous system recruitment of the active
muscles terminates maximum exercise (8).
Various methods have been used to try to trick the brain into
keeping muscle fibre recruitment going under extreme
conditions. With regard to high temperatures, these involve
pre-cooling strategies, such as ice baths or ice helmets. These
and similar strategies are designed, quite literally, to cool the
brain and extend the bodys heat stop switch threshold.
As mentioned previously, aging also has an influence on the
development of endurance muscle fibre, with fast-twitch fibre
declining much more rapidly than its slow-twitch counterpart
by as much as 30% between the ages of 20 and 80. By contrast,
endurance athletes can expect to maintain their slow-twitch
fibres and even increase them by as much as 20%, over a
sustained training career. The trouble is, though, that without
fast-twitch fibres endurance performance will inevitably decline.
PAGE 17
In summary, then, developing your endurance capacity relies

on a number of adaptations, as follows:
Enhancing the already high oxidative capacities of
slow-twitch fibres;
Improving the capacity of fast-twitch fibres to contribute
to endurance activity, taking account of distance and the
need for both sustained and kicking power. This process
may, in fact, hold the physiological key to optimising
endurance performance;
Working on mental strategies to develop increased
endurance tolerance and the sustainable contractile
properties of all muscle fibre types;
Using pre-cooling techniques to delay physiological
shut-down.
John Shepherd
References
1 McArdle, Katch and Katch, Exercise Physiology, Williams &
Wilkins, 1994
2 Acta Physiol Scand 1984 Apr: 120(4):505-515
3 J of App Phys, vol 62, 438-444, 1987
4 Salazaar Nike lecture, Nike HQ Oregon October 2002
5 Dick FW, Sports Training Principles, A&C Black 4th edition, 2002
6 J Sports Med Phys Fitness 2000 Dec;40(4):284-9
7 Pflugers Arch 2003 Mar; 445(6): 734-40 E Pub 2003 Jan 14
8 Peak Performance keynote lecture, September 2000
PAGE 18
PAGE 19
PAGE 20
PHYSIOLOGY
Running and body fat

walking the tightrope of
optimum performance
All runners know that excess body fat can hinder running performance.
However the relationship between running performance, dietary
intake and fat levels is not quite as straightforward as it seems
Although its immediately apparent that there are substantial
differences in physical characteristics between sprinters and long
distance runners, elite runners at all distances come in a variety
of shapes and sizes, and there are perhaps too many exceptions
to make all but the broadest generalisations. Generally speaking
though, sprinters have powerfully developed musculature of the
upper body and of the legs, while distance runners have low body
mass, with smaller muscles and extremely low body fat levels.
The one outstanding anthropometric characteristic of
successful competitors in all running events is a low body fat
content. The textbooks tell us that the body fat stores account
for about 15-18% of total body weight in normal young men,
and in young women the figure is about 25-30%.
Normal, of course, is changing, and those ranges should be
qualified as being normal for healthy people. Most of this fat is
not necessary for energy supply and is simply extra weight that
has to be carried throughout the race. This is not to say that
people carrying extra fat cannot complete a longer distance race
they just cant do it in a fast time.
Our fat stores are important and the fat cells play many key
roles. As well as acting as a reserve of energy that can be called
upon at times of need, fat is important in the structure of tissues,
in hormone metabolism, and in providing a cushion that
protects other tissues.
PAGE 21
An excess of body fat, however, serves no useful function for

the endurance athlete. It can help the sumo wrestlers, and
perhaps may not even be a disadvantage for the shot putter, but
not the runner. Extra fat adds to the weight that has to be carried,
and thus increases the energy cost of running. Even in an event as
long as the marathon, the total amount of fat that is needed for
energy supply does not exceed about 200g for the average runner.
A very lean male 60kg runner with 5% body fat will have 3kg
of fat; a typical elite 55kg female runner with 15% body fat will
have more than 8kg of body fat. Non-elite runners will
commonly have at least twice this amount, and many runners
further down the field will be carrying 20kg or more of fat.
Although not all of this is available for use as a metabolic fuel,
the amount of stored fat is greatly in excess of that which is
necessary for immediate energy production. Within limits,
reducing this will lead to improvements in performance, but if
the loss is too sudden or too severe, then performance and
health may both suffer.
It is probably not sensible for men to let their body fat levels
go below about 5% and for women below about 10-15%.
Theres good evidence that the immune system is impaired
when body fat stores are too low (1). A reduced ability to fight
infections means more interruptions to training and more
chance of being sick on race day.
For female athletes, there are some very immediate
consequences of a low body fat level, including especially a fall
in circulating oestrogen levels (2). This in turn can lead to a loss
of bone mass, causing problems for women in later life through
an increased risk of bone fracture. Equally, though, performance
will suffer if the body fat level is too high, so staying healthy and
performing at peak level is a real challenge.
Fat typically contributes about half of the total energy cost of
a long run (this is very approximate, and will depend on speed,
fitness, diet and other factors). The graph (opposite) shows that
at low running speeds, the total energy demand is low and most
of the energy supply is met by oxidation of fat, with only a small
contribution from carbohydrate in the form of muscle glycogen
PAGE 22
120
120
100
100
80
80
60
Muscle
glycogen
Fat
60
40
40
Blood glucose
20
10
12
14
16
Running speed (km/h)
18
20
%VO2max
22
20
24
Rate of carbohydrate utilisation (g/min)
Energy cost (kJ/min)
Contribution of fuel sources as a function of

running speed
The left-hand vertical axis shows total energy expenditure in kilojoules per minute
(kJ/min); the red shaded area at the bottom represents the contribution of blood
glucose to energy supply level; the pink and black shaded areas show the relative
contributions from fat and muscle glycogen respectively to energy demand.
and blood glucose (which is continuously being replaced by

glucose released from the liver).
As speed increases, the energy cost increases more or less in
a straight line, but the relative contribution from fat begins to
decrease, with muscle glycogen becoming the most important
fuel. The problem with running slowly to reduce body fat levels
is that it takes a long time, because the rate of energy expenditure
is too low. Run too fast, and you burn only carbohydrate, leaving
the fat stores more or less untouched.
Importance of fat
To get an idea of the importance of fat, you can try the following
sums. For simplicity, well assume that:
The energy cost of running is about 1 kilocalorie per
kilogram body mass per kilometre;
The energy available from fat oxidation is 9 kilocalories
per gram;
PAGE 23
About half of the energy used in a run will come from fat
(this amount will actually be greater at low speeds and for
fitter runners, and will also be higher if the run is completed
after fasting overnight as opposed to just after a high
carbohydrate meal).
Example 1
If you weigh 50kg, the total amount of energy you will use in a
10km run is 50x10 = 500kcals. If all of the energy were to come
from fat, this would use 500/9 = 56 grams of fat. Half of this is
28 grams fat (almost exactly one ounce in old units).
Example 2
If you weigh 80kg the total energy cost of running a marathon
(42.2km) is 80x42.2 = 3,376kcals. If all of the energy were to
come from fat, this would use 3,376/9 = 375 grams. Half of this
is 188 grams or around 7oz.
Three things emerge from this:
1. The amount of fat you need for even a marathon is small
compared to the amount stored; a 70kg runner with 20%
body fat has 14kg of stored fat. A 60kg runner with 30% fat
has 18kg.
2. Even though the amounts of fat used may seem small,
regular running will nibble away at the fat stores good
news if your aim is to use exercise to control or reduce your
body fat levels. A runner who uses 28 grams three times per
week will lose about 3.5kg of fat over the course of a year.
The results are not immediate but, if you persist, the
cumulative results are impressive.
3. Running speed does not figure in the equation. If you run
for 40 minutes, you might do 5km or you might do 10km.
Body fat and performance

In a study of a group of runners with very different levels of
training status and athletic ability, scientists observed a
significant relationship between body fat levels and the best time
that these runners could achieve over a distance of 2 miles (3).
PAGE 24
Strategies for controlling weight and body fat

while maintaining training
Pay attention to the portion sizes you consume at meals to
ensure that overeating does not occur due to habit;
Use well chosen snacks between meals to maintain fuel levels

for training sessions or to avoid excessive hunger, but avoid
snacking for entertainment, for comfort or just to keep others
company. Snacks can often be organised by saving part of a
meal for a later occasion, rather than by eating extra food;
Use low-fat or at least reduced-fat strategies in choosing
foods and while cooking or preparing meals;
Make meals and snacks more filling by including plenty of
salads and vegetables, by taking higher-fibre options when
these are available, and by including low-glycaemic forms of
carbohydrate;
Keeping a food diary in which you write down everything you eat
and drink for a week will help to identify the difference between
your ideal eating plan and your actual intake. Many people are
unaware of the habits that sabotage their eating goals.
Although these results indicated that leaner individuals seem

to perform better in races at this distance, some complicating
factors have to be taken into account.
The relationship between body fat and race time may at least
in part be explained by an association between the amount of
training carried out and the body composition. It would hardly
be surprising if those who trained hardest ran fastest, and it
would also not surprise most runners to learn that those who
train hardest also have the lowest fat levels. Indeed, body fat
content does tend to decrease as the volume of training
increases, as we found out some years ago when we studied a
group of local runners in Aberdeen (4).
We recruited a group of runners who had been running for at
least two years, and asked some sedentary colleagues to act as a
control group. All had maintained the same body weight for at
least two months before we measured them, and all had had a
constant level of physical activity over that time. We measured
PAGE 25
body fat levels and also got a record of the weight of all food and
drink consumed over a one-week period.
As you can see from the following graphs, the runners
covering the greatest distance in training had the lowest body fat
levels. They also ate more food than those who did less running.
There are, of course, some people who do not fit the line as well
as others, but there are many factors that explain this variability.
We would expect the people who eat more to be fatter, but no!
The subjects who did most running had the lowest levels of body
fat, even though they did eat more. Thus, we can separate food
intake from body fatness if we add exercise to the equation.
Relationship between body fat and weekly running distance
Body fat (%)
20
15
10
5
0
40
80
120
160
Weekly running distance (km)
Daily energy intake (J/kg)
Relationship between calorie intake and body fat

300
250
200
150
100
5
10
15
Body fat content (%)
PAGE 26
20
Relationship between energy intake and weekly running

distance
Energy intake (MJ/kg/d)
0.3
0.2
0.1
0
40
80
120
160
Weekly running distance (km)
How is body fat measured?

There are problems in applying the standard methods for
assessment of body composition to athletic populations, and it
is not clear that any of the methods commonly used for the
general population is entirely reliable. At health clubs and
elsewhere, fat levels are usually assessed by use of skinfold
callipers to measure the thickness of the fat layer that lies below
the skin at various different sites on the body. The results are
then fed into an equation that predicts the body fat level based
on a comparison with more accurate measurements made on a
group of normal people. Predictive equations for estimating
body fat content based on indirect methods are unreliable for
several reasons, not least because the equations that are
generated from normal populations are not applicable to elite
athletes. Such methods have been widely used, but the results
of these measurements must be treated with caution, especially
if you are an athlete.
Fat levels in elite runners

Skinfold thickness estimates of body composition in 114 male
runners at the 1968 US Olympic Trial race gave an average fat
content of 7.5% of body weight, which was less than half that of
PAGE 27
a physically active but not highly trained group (5). Since then,
similar measurements have been made on various groups of
runners, and the findings are fairly consistent.
The low body fat content of female distance runners is
particularly striking; values of less than 10-15% are commonly
reported among elite performers, but are seldom seen in healthy
women outside sport. The occasional exceptions to the
generalisation that a low body fat content is a pre-requisite for
success are most likely to occur in womens ultra-distance
running, and some recent world record holders at ultradistances have been reported to have a high (in excess of 30%)
body fat content. However, this probably reflects the underdeveloped state of womens long distance running; as more
women take part, the level of performance can be expected to
rise rapidly, and the elite performers are likely to conform to the
model of their male counterparts and of successful women
competitors at shorter distances.
Although theres an intimate link between body fat levels and
running performance, its important to remember that reducing
fat levels will not automatically guarantee success and may even
be counter-productive. If you reduce fat by a combination of
training and restricting diet, you are walking a fine tightrope.
While a reduction in body fat may well boost running
performance, cut down food intake too drastically and not only
will training quality suffer, but the risk of illness and injury also
increases dramatically.
Ron Maughan
References
1. Journal of Sports Science 2004; 22:115-125
2. Journal of Sports Science 2004; 22;1-14
3. Journal of Sports Medicine 1986; 26:258-262
4. Proceedings of the Nutrition Society 1990; 49:27A
5. Medicine and Science in Sports 1970; 2:93-95
PAGE 28
PAGE 29
PAGE 30
TRAINING METHODS
Time-efficient running
should you run less to
run faster?
Ever since the marathon boom of the early 1980s, high-mileage
training has been the accepted paradigm among middle and long
distance coaches. However cutting back the miles and concentrating
on quality is not only more time-efficient, it can also produce
superior results for all but very elite runners
In every walk of life there are trends, and in spite of our claims to
open-minded scientific principles, this applies to training theories
as much as to clothes or automobiles. Lets take mileage, for a
start. Back in the 1950s, interval training was perceived to be the
only way to success. Then along came Percy Cerutty, coaching
Herb Elliott. Herb won the Olympic 1,500m title in a world
record time at the age of 21, leading most of the way.
This was evidence enough for many people to switch away
from boring interval training on the track and go running up
sandhills instead. Almost simultaneously came the Lydiard
system, based on running 100 miles a week, which was the basis
of the gold medals and world records of Peter Snell and Murray
Halberg, and this became the key to success.
The American physiologist David Costill established the fact
that at up to about 80km a week there is a straight-line
relationship between mileage per week and improvement in
VO2max, which added scientific credibility to practical
experience (1). From the start of the marathon boom in the
1980s, high mileage has been the theme of all middle and long
distance coaching. Exceptions have been rare, partly because
coaches have not dared to go against the trend, and partly
PAGE 31
because, for professional marathon runners with all day to train,

mileage is the answer.
However, what applies to full-time marathon runners does
not necessarily apply to those running shorter distances. What
Costill did not do (because there are too many variables
involved) was to compare the results of, say, 50km per week of
intensive training against 80km of steady running.
Tim Noakes, whose book The Lore of Running remains the
bible of most distance coaches, sets out several basic principles,
one of which is always do the minimum amount of training,
which is not as paradoxical as it may appear (2). What he means
is: do the minimum amount you need to achieve your goal. If
you dont reach your goal, you can always do more.
Low-mileage
Lets take a couple of examples. Steve Jones broke the world
marathon record in a time of 2.08.05, and later ran a 2.07.13
marathon, on about 80 miles a week. No European runner has
improved much on this time, even though some have gone to
150 miles a week or more.
Looking at the 5,000m and 10,000m distances, when I broke
the European record for three miles, my average mileage for
the previous ten weeks was 28 miles a week, including warm-ups
and races. The training was hard, but it didnt take much time,
with sessions such as 15 x 400m with a 50-second recovery, or
2 x 2,000m fast. An actual week of training during that summer
is shown below:
Mon: warm-up, 2,800m time trial, on grass;
Tues: 6 x 880yd on track, averaging 2mins 10secs;
Wed: 8 x 700m on grass;
Thurs: warm-up, fast strides, 2 x 440yd in 56 and 58 seconds;
Fri: rest;
Sat: warm-up, 2-mile race.
(total miles for the week = 30)
In the following three weeks I ran fewer miles but had 10 races
(mostly club races) where I led all the way. If I could run 13min
PAGE 32
12sec for three miles on 28 miles a week, while working full-time,

then this kind of training is going to be perfectly adequate for an
athlete trying to break 30 minutes for 10k and more than
adequate for someone trying to break 40 minutes! You may
argue that natural ability has a lot to do with these performances,
but all anyone can do is fulfil their genetic potential. In my case,
even though I doubled my mileage in later years, I merely
equalled that time, never improved on it.
In 2004, a study was published which showed that a threedays-per-week training programme produced significant gain
in aerobic power (3). The runners were put onto a training regime
that consisted of just three carefully structured running
workouts per week, and as a result showed a marked (4.8%)
improvement in their VO2max. In a follow-up trial, 25 runners
were put on to a three-days-per-week marathon training
schedule. After 16 weeks, 21 of the runners started the race; all
finished, 15 with personal bests, and four of the remaining six
ran faster than in their previous marathon.
A trial like this is not, strictly speaking, scientific evidence,
because the numbers were small and there was no control group.
Several of them were first-timers, and we have no information
about whether the participants were aiming for sub-three hours,
sub-four hours or sub-five hours. Almost any group of runners
will show improvement if they are part of a closely monitored
programme, particularly those at the slower end. The fact that
they showed an average of 8% reduction in body fat suggests that
they were not very fit to start with. What was significant, though,
was that the low mileage did not prevent them from running a full
marathon. Based on their own ability, they were given schedules
with one endurance session, one tempo session and one speed
session per week. They were also encouraged to do two days a
week of cross training, such as cycling or strength training.
The point about training is that it is specific to the event. If you
want to run a 31-minute 10k (ie at five-minute mile pace) then
you have got to become really efficient at running at that pace.
You can work on your oxygen uptake and lactate tolerance by
running at a faster pace, and you can work on your endurance,
PAGE 33
heat tolerance and mental strength by running longer distances,

but speed endurance is what counts.
If there is a single session that I would nominate as the key to
success at 5k and10k, it is long rep training sessions like 3 reps
of 1 mile or 5 reps of 1,200m for the 5k runner, and 5-6 reps of 1
mile or 4-5 reps of 2,000m for the 10k runner.
10k programme
When you are preparing a training schedule, the objectives should
always go at the top of the page. For a 10k runner these should be:
Increase aerobic fitness;
Increase speed endurance;
Maintain or increase endurance;
Avoid injury.
A time-efficient programme would look like this:
Week 1 (no race)
Tues: 10 mins warm-up, 10 x 45 secs uphill fast,
10 mins warm-down;
Thurs: 6-mile run, including 3 x 8 mins fast, 2 mins jog
(10k pace);
Sat: 10 mins warm-up, 2 x 15 mins threshold pace
(2 mins recovery);
Sun: 8-10 mile run, starting slow, finishing faster.
Total mileage 24-26
Week 2 (racing week)
Tues: 1-mile jog, 2-3 mins stretching, 12 x 400m at 5k
pace (60 secs recovery), 800m warm-down;
Thurs: 5-mile run, including 8 x 2 mins fast, 1 min slow;
Sat: 15 mins warm-up, 8 x 150m fast stride, 5 mins jog;
Sun: warm-up, race 5-10 miles, warm-down.
Total mileage 21-26
This programme would run for 8-10 weeks, with the idea of
making each two-week block harder than the one before. In the
racing week the focus is on performing well in the important races.
PAGE 34
Marathon programme
For a marathon runner, the priorities would be:
Increase endurance;
Improve aerobic fitness;
Avoid injury.
A time-efficient two-week programme would look like this:
Week 1 (no race)
Tues: warm-up, 8 x 800m on track (90 secs recovery jog)
at 5k pace;
Thurs: 10 mins warm-up, 2 x 20 mins at threshold pace;
Sat: 10 mins warm-up, 6 x 1 mile off road, (3 mins
recovery) at 10k pace;
Sun: long run, 18 miles; 6 miles easy, 6 miles at marathon
pace, 6 miles a bit faster.
Total mileage 41 approx.
Week 2 (racing week)
Tues: warm-up, 5 sets of [600m at 5k pace/200m jog/
400m at 5k pace];
Thurs: 8-10 miles run, with 6 x 5 mins fast interspersed
with 2 mins slow;
Sat: 5 miles fartlek, off road;
Sun: warm-up, 10-mile or half-marathon race, warmdown.
Total mileage 38 approx.
This programme would start ten weeks before the race, giving
four turns of the two-week cycle, followed by a two-week taper.
The long progressive runs would be 15, 18, 18 and 20 miles in
those four cycles.
The advantages of low-mileage training

Low-mileage training saves time all the training is purposeful
and theres also less likelihood of injury through over-use.
However, there are drawbacks including:
Decreased general endurance, leading to;
PAGE 35
Increased vulnerability ie a more rapid loss of fitness

when training is missed;
An increased chance of injury due to running hard on
stiff muscles.
In defence of the low-mileage programme, its no problem to
have an easy day if you are still tired or stiff from the previous
session. All training programmes have to be related to the
athletes physical status. The additional easy runs, which many
athletes incorporate for therapeutic reasons, could equally be
replaced by a walk, a swim or a massage. The running surface is
also of crucial importance, because doing every session on the
road will increase the chances of injury. Only two road sessions
should be performed each non-race week, and using a treadmill
in the winter or a synthetic track surface will help decrease
impact stress.
Cross-training and alternate training
The essence of low-mileage training is that it allows the busy person
to stay very fit with less time commitment, but, if time allows, the
addition of cross-training can make it more interesting and boost
general endurance. Cycling or rowing, indoors or out, provides
excellent cardiovascular training and weight training can increase
all-round muscular strength and decrease the chances of injury. I
would only recommend swimming as a recovery session, unless the
athlete is specifically training for a triathlon.
Bruce Tulloh
References:
1.Costill, DL (1986) Inside Running: Basics of Sports Physiology.
Indianapolis: Benchmark Press
2. Noakes, T (1985) The Lore of Running. OUP
3. Furman Univ Human Performance Lab 2004, quoted in
Runners World Feb 2006
PAGE 36
Frequently asked questions about low-mileage

training
1. What about loss of endurance? Will this lead to a fall-off in
performance? No training system should be identical all the
year round. If you are normally used to running bigger mileages,
you can come down to the more intense system for 8-10
weeks to improve your racing performance and then switch
back again to build more endurance for the next season.
2. Does following a low-mileage programme affect your long-term
progress? The bodys memory is not that long. How you
perform depends mostly on what you have done in the last
three months, and partly on what you have done in the last six
months. There is no problem in moving up in mileage I was
able to move up to 120 miles a week when it was necessary.
The problem comes from sustained high mileage. Those who
are running 80 miles a week in their teens are very unlikely to
have a long career. The low-mileage athlete has a much better
chance of surviving uninjured.
3. Is it essential that I run four days a week? In any two-week
period, missing one of the eight runs is not crucial, but running
three days a week regularly, though still good, is less effective
than four.
PAGE 37
PAGE 38
BIOMECHANICS
From faulty movement

patterns injuries arise.
Here we go back to basic
principles in running.
Running is both a very popular competitive sport in its own right
and a fitness activity used at all levels, from recreational gym
routines to elite sports training programmes. But running requires
the body to absorb continuous repeated impact forces, and runningrelated injuries are a common presentation in any physiotherapy
or sports medicine clinic. At the extreme, elite endurance runners
will probably require a weekly physiotherapy treatment, all year
round, to keep their bodies healthy.
There is a complicated and highly individual interaction
between intrinsic (personal) and extrinsic (environmental)
factors that may contribute to a running injury. Specifically the
research suggests that the biggest predictors of injury are the
following two extrinsic factors:
total volume of running undertaken;
sudden changes in volume or intensity of running.
By contrast, research is equivocal when it comes to pinpointing
specific biomechanical patterns (intrinsic factors) that cause
injury. That said, it is probably safe to assume that, for a given
amount of weekly running, an individual with an abnormal or
inefficient running action is more likely to suffer injury than
someone with good mechanics.
It is impossible to say, for instance, that all runners who
over-pronate (tilt heavily inwards) at the foot will definitely
PAGE 39
suffer injury. Every runner will have their own threshold of

tolerance to the stresses of running, and it will take a unique
combination of factors to tip that runners body over the
threshold and cause injury.
This article describes the biomechanics of running, focusing
for each body part on what is considered normal mechanics
and then discussing how deviations from that norm may
increase stress on the body, and lead to injury. We are confining
our scope to distance running, and therefore research from the
analysis of running speeds between 12 and 16 kph (about 8 to 6
minutes per mile). The sprint action (9-10 metres per second or
faster) is distinct from running at these more moderate speeds.
The running cycle

Running can be seen as a series of alternating hops from left to
right leg. The ankle, knee and hip provide almost all the
propulsive forces during running (apart from some upward lift
from the arms). The running cycle comprises a stance phase,
where one foot is in contact with the ground while the other leg
is swinging, followed by a float phase where both legs are off
the ground.
The other leg then makes contact with the ground while the
first leg continues to swing, followed by a second float phase. At
running speeds of about 6 min/mile, a single running cycle will
take approx 0.7 sec, out of which each leg is only in contact with
the ground for 0.22 sec.
It is, not surprisingly, during the stance phase that the greatest
risk of injury arises, as forces are acting on the body, muscles are
active to control these forces, and joints are being loaded.
Two sub-phases of stance

The first sub-phase is between initial contact (IC) and
midstance (MS). IC is when the foot makes the first touch with
the ground. MS is when the ankle and knee are at their
maximum flexion angle. This sub-phase is called the absorption
or sometimes the braking phase. The body is going through a
controlled landing; the knee and ankle flex and the foot rolls in
PAGE 40
Table 1: Stance phase in running

Sub-phase
from to
action
Absorption (braking)
IC (initial contact) Foot makes first ground contact

MS (midstance)
Ankle and heel at greatest flexion
Propulsion
MS (midstance)
Ankle and heel at greatest flexion
TO (toe-off)
Foot leaves the ground
to absorb impact forces. At this point the leg is storing elastic

energy in the tendons and connective tissue within the muscles.
The second sub-phase is between MS and toe-off (TO).
TO is the point where the foot leaves the ground. The period
between MS and TO is known as the propulsion phase. The
ankle, knee and hip all extend to push the body up and
forward, using the recoiled elastic energy stored during the
absorption phase.
This is an efficient way for the body to work. The more free
recoil energy it can get from the bounce of the tendons the less
it has to make or to draw on from its muscle stores. Research
shows that at least half of the elastic energy comes from the
Achilles and foot tendons a reminder of how important the
lower leg is to running efficiency.
Ankle, knee, hip mechanics

The ankle, knee and hip motion are described in the side view
(sagittal plane). At IC the ankle will be slightly dorsiflexed,
around 10 degrees; the knee will be flexed at 30-40 degrees and
the hip flexed at about 50 degrees relative to the trunk (a fully
extended hip is at 0 degrees when the midline of the thigh and
the midline of the body form a straight line through the centre of
the pelvis). The further forward the trunk leans, the greater the
hip flexion. Prior to IC the hip is already extending (the leg is
moving backwards) and so the foot at IC is moving back towards
the hips. If the gluteal-hamstrings are not actively pulling the foot
backwards prior to IC, then the foot contact will be too far ahead
of the hips and the braking forces on the leg are increased.
During the absorption phase the angles change. By MS the
ankle dorsiflexion angle has increased to around 20 degrees and
PAGE 41
The role of
the muscles
therefore is to
control the
joint position
PAGE 42
the knee has also flexed to 50-60 degrees. This ankle and knee
flexion is coordinated to absorb the vertical landing forces on
the body, which at distance running speeds are in the order of
two to three times bodyweight.
This is where eccentric strength in the calf and quadriceps
muscles is required to control the knee and ankle joints, otherwise
the knee and ankle would collapse or rotate inwards. In fact the
quadriceps and calf muscles are active prior to IC, and at their
most active between IC and MS to help control the braking forces.
The hip continues to extend through the absorption phase of
stance, reaching around 20 degrees of flexion by MS.
During the propulsion phase the ankle and knee motion is
reversed. By TO the ankle is plantarflexed to around 25 degrees
and the knee has re-extended to 30-40 degrees. The hip
continues to move to 10 degrees of extension by TO.
Thus during the second half of the stance phase the ankle,
knee and hip combine in a triple extension movement to provide
propulsion upwards and forwards. The calf, quadriceps,
hamstring and gluteal activity during the propulsion phase is less
than during the absorption phase, because the propulsion
energy comes mainly from the recoil of elastic energy stored
during the first half of stance.
The role of the muscles therefore is to control the joint
positions, creating stiffness in the leg system that allows the
tendons to lengthen and then recoil.During the swing phase
between TO and IC the knee and hip flex to maximum flexion
angles of 130 degrees and 60 degrees respectively and then reextend prior to IC, with the ankle dorsiflexing throughout swing
to 10 degrees at IC.
Good runners will follow these movement patterns. It is
essential that the ankle and knee can quickly control the braking
forces and create a stable leg system to allow the tendons to
maximise their recoil power. This is where good technique is
vital. Too much upward bounce will increase the landing forces,
putting greater stress on the joints and requiring more muscle
force to control. Runners need to learn to bounce along and not
up, by taking quick, light steps.
It is also important to bring the foot back prior to IC using

active hip extension as this reduces braking forces and time
needed for the absorption phase. The benefits of a quick
contact and a horizontal running style will be discussed in the
next chapter, Beginners guide to pose. Good strength in the
gluteals, hamstrings, quadriceps and calf muscles will help
runners achieve this.
In summary, excessive braking forces can contribute to injury.
The correct movement patterns of the hip, knee and ankle
combined with correct activation and strength of the major leg
muscles will help control braking forces during running and
result in a more efficient action using tendon elastic energy and
minimising landing forces.
Pelvis and trunk mechanics

The motion of the pelvis and trunk are described in side and rear
views (sagittal and frontal planes). The angle of the pelvis from
the side view is called the anterior-posterior tilt (A-P tilt), with a
positive angle describing a tilt down towards the front. The trunk
angle from the side is described relative to the horizontal.
At IC the trunk will be flexed forward between 5 and 10
degrees and the A-P tilt will be 15-20 degrees. During the
absorption phase from IC to MS, trunk flexion increases by 2-5
degrees while the A-P tilt remains stable. This slight forward
flexing of the trunk during the braking phase helps to maintain
the bodys forward-horizontal momentum. Gluteal-hamstrings,
abdominals and erector spinae are all active to control the trunk
and pelvis during the absorption phase.
During the propulsion phase the trunk re-extends to the initial
position, so the trunk angle at TO will be similar to that at IC.
The A-P tilt however will increase by 5-7 degrees in concert with
the extension. This slight shift in the anterior tilt of the pelvis
helps to direct the propulsion forces of the leg horizontally. If the
pelvis were in neutral then the triple extension of ankle, knee and
hip would be directed more vertically.
A slight forward lean and anterior pelvic tilt is thought efficient
for running. Too much forward lean may suggest that the posterior
PAGE 43
chain muscles (hamstrings-gluteal-erector spinae) are not strong

enough and this may increase the strain on the hamstrings and
back during the running action. Too upright a posture may
encourage vertical movement which will increase landing forces.
Too much A-P tilt between IC and MS suggests that the gluteals
and abdominals do not have the strength to control the pelvis
adequately during landing and/or may indicate incorrect
quadriceps activation and reduced hip flexibility. Excessive AP tilt during the propulsion phases is normally associated with
tight hip flexors and inadequate range of motion during hip
extension. This will reduce the power of the drive from the hip
and encourage a compensatory reliance on lumbar extension.
In general, a poor trunk position or lack of pelvic stability is
likely to reduce the efficiency of the running action, creating
extra load on the leg muscles or increasing stress through the
lumbar spine and pelvis. Any of these negative factors can
increase the likelihood of injury.
From the rear view the pelvic angle is described as a lateral
tilting, with a negative angle meaning the pelvis is tilted down
towards the swing leg side. The trunk is described as lateral
flexion with a positive angle meaning the trunk is leaning down
towards the stance leg side. At IC the lateral pelvic tilt is
around 5 degrees (ie a small tilt downwards on the contact
side). This position may increase slightly (up to 5 degrees)
during the absorption phase, although ideally very little
movement will occur. At faster running speeds, the lateral tilt
will be bigger.
Trunk lateral flexion is about 2 degrees at IC, which increases
to 5 degrees at MS. This lateral flexion counterbalances the
pelvic tilting. Between MS and TO the pelvic lateral tilt should
revert to +5 degrees by TO and trunk flexion should return to
0 degrees (ie vertical spine alignment). This balanced spine
position allows the propulsion forces to be directed forwards at
TO and the positive lateral hip angle supports the knee lift of
the swing leg.
The aim of the pelvis and trunk in the frontal plane during
stance phase is to be stable and provide balance. The gluteus
PAGE 44
medius muscles (abductors) are of primary importance in

providing lateral stability: their contraction prior to and during
the absorption phase prevents the hip from dropping down too
far to the swing leg side. The muscles will be acting eccentrically,
or even isometrically, to prevent this movement.
An excessive or uncontrolled pelvic tilt increases the forces
through the lumbar and sacroiliac joints, and forces the knee of
A poor trunk
the stance leg to internally rotate, which in turn may increase
position or
the pronation forces on the ankle. It is possible to observe a
lack of pelvic
correlation between excessive pronation and excessive pelvic
stability is
tilting in runners, and it is a good illustration of how one
likely to reduce
unstable link in the biomechanical chain can have an adverse
the efficiency
knock-on effect and increase the risk of injury.
of the running
action
Foot mechanics
The outwards and inwards roll of the foot during running, as

seen from the rear view, are called supination and pronation.
This rolling action is normal and healthy. It is only excessive
pronation or supination that leads to injury.
At IC the foot is in a supinated position, with the rear foot
inverted. During the absorption phase between IC and MS, the
ankle is dorsiflexing which because of the way the subtalar
joint works also causes the foot to pronate. Pronation
combines rear foot eversion with tibial internal rotation, and
allows the foot to be flexible and absorb the impact forces
of landing.
At around midstance the foot begins to re-supinate. This
inverts the rear foot and externally rotates the tibia, moving
the foot into a more rigid position to allow for a stronger pushoff and more efficient recoil through the foot and Achilles
tendon. You can feel the difference for yourself: roll your heel
and ankle inwards and your foot will feel soft and flat. Then
roll your heel and ankle out, and your foot should feel strong
with an arch.
Pronation and supination both involve three-dimensional
movements (heel eversion/inversion, ankle dorsi/plantar flexion
and tibial internal/external rotation), which makes them very
PAGE 45
difficult to measure. The most commonly used approach is to

measure the inversion and eversion range of motion of the rear
foot during the stance phase, representing the pronation and
supination movement patterns.
Inversion and eversion angles are calculated by the angle
made between the midline of the calcaneus and the midline of
the tibia, viewed from the rear. In normal movement, at IC the
rear foot is inverted by 5-10 degrees. The maximum pronation
angle will occur around MS and will be an everted position of
around 10 degrees.
However, foot mechanics are highly complex and these
values must be read as simply one part of the picture. Similarly,
you should interpret with caution any qualitative video analysis
you make of a runners rear foot motion. Dont rush to
judgement about the need for orthotics based solely on a visual
reading of rear foot movement.
An excessive supinator will typically land in the inverted
position and then remain inverted during the stance phase. This
means that they will lose out on the shock-absorbing benefits of
the normal pronation movements. Excessive supinators tend to
suffer from injuries to the lateral knee and hip, and can also be
prone to stress fractures, because of the higher repetitive impact
forces they incur.
Excessive pronators come in three types:
those who land inverted as normal but rotate across into an
excessively everted position (such as 20 degrees);
those who may pronate normally on landing but then stay
everted throughout the stance phase;
those who seem to pronate through a normal range but do
it very rapidly.
We do not know which of these three faulty movement patterns
is most likely to lead to injury, but logically all three can be
problematic. If a runner spends too long in pronation, the foot
will not be in a strong position to assist push-off during the
propulsion phase, so the lower leg muscles will have to work
harder. If the runner pronates too far or too quickly, the
PAGE 46
rotation forces acting on the tibia and knee joints may lead to
problems. Excessive pronators tend to suffer from anterior
knee pain, medial tibial stress syndrome, Achilles and foot softtissue injuries.
Upper body and arm mechanics

The main function of the upper body and arm action is to
provide balance and promote efficient movement. In the
forward horizontal plane the arms and trunk move to oppose
the forward drive of the legs. During the braking phase (from
IC to MS), the arms and trunk produce a propulsive force and
during the propulsion phase (MS to TO) the arms and trunk
combine to produce a braking force. This may seem a little
weird, but in fact it is an advantage: the out-of-phase actions of
the arms and trunk reduce the braking effect on the body and
so conserve forward momentum.
In the vertical plane around the centre, the arms and upper
trunk also oppose the motion of the pelvis and legs. For
example, as the right knee drives up and through in front of the
body producing an anti-clockwise angular momentum the
left arm and shoulder move forwards creating a clockwise
angular momentum and counteracting the knee motion,
thereby helping to reduce rotation forces through the body
during the whole gait cycle. Although the legs are much heavier
than the arms, the shoulders are wider than the hips, so the arms
are well positioned for their job of counterbalancing the leg
rotation. This may explain why female runners use a slightly
wider or rotating arm action to compensate for their narrower
shoulders and lighter upper body.
The normal arm action during distance running involves
shoulder extension to pull the elbow straight back; then, as the
arm comes forward, the hand will move slightly across the body.
The arm action has more to do with running efficiency than
with injury prevention directly. A good arm action needs to be
encouraged to counterbalance lower-limb forces and angular
momentum, which may in turn help reduce injury. The arm
action also contributes a little to the vertical lift during the
The normal
arm action
has more to do
with running
efficiency than
with injury
prevention
directly
PAGE 47
propulsion phase which may help the runner to be more

efficient, reducing the work done by the legs.
The relationship between biomechanics and injury is specific
to each body part. Overall though, poor mechanics of any body
part will either increase the landing forces acting on the body or
increase the work to be done by the muscles. Both increase the
stress, which depending on the individual and the amount of
running can become excessive and cause injury.
Raphael Brandon
General references:
Cavanagh P (Ed.) (1990), Biomechanics of Distance Running.
Human Kinetics.
Mann et al (1986), Comparative electromyography of the lower
extremity in jogging, running and sprinting. Am J of Sp Med. Vol
14(6): 501-510.
Novacheck T (1998), The biomechanics of running. Gait and
Posture Vol 7, 77-95.
Schade et al (1999), The coordinated movement of lumbo-pelvic
hip complex during running. Gait and Posture Vol 10, 30-47.
PAGE 48
PAGE 49
PAGE 50
RUNNING TECHNIQUE
A beginners guide
to Pose running
If running is natural, why do we keep on injuring ourselves? Here
an Australian physio takes a look at a controversial alternative style
that claims to reduce the risk of damage.
The popularity of running as a leisure pursuit has increased
throughout the past 25 years, reflecting social trends away from
organised team sports and towards less time-consuming, more
flexible and independent ways of keeping fit and active. Over
the same time period there has been an explosion in sports
science and sports injury research and therapeutic practice.
Among other things, this has produced a wealth of advice on
baseline fitness and training for running, and huge advances in
footwear technology.
Yet runners keep on injuring themselves. They continue to
seek treatment, typically, for Achilles tendinosis, patellofemoral
pain, repetitive calf muscle strains, big toe pain and low back
pain and it seems to those of us who have been around the
sports therapy world for a while that the incidence of running
injuries has not reduced significantly. Is it time to return to the
fundamentals of running to find out why so many people are
still hurting themselves?
Coaches, trainers, therapists and athletes have no difficulty
agreeing that technique has an important role to play in leisure
pursuits such as rowing, golf, swimming and ballet, but when I
ask my running patients about their technique whether, for
instance, they heel-strike or land with their knees straight I
receive blank expressions. In most sports, enthusiasts will
expect to devote months and even years to working on
movement technique, whereas with running we tend only ever
PAGE 51
to focus on how to run faster and/or further, and how much fitter
we can get as a result.
In other words, running is practised rather than taught. This
leads to the question: is there an optimal running technique that
enables athletes to train without fear of injury, with a real
reduction in their injury risk and with the prospect of still being
able to improve their performance?
One recently developed technique, called pose running, lays
claim to be able to do all three things. Pose running was invented
by Nicholas Romanov, a Russian scientist now based in Miami
and consultant to the British, US and Mexican triathlon
associations. During the 1970s and early 80s, Romanov was
heavily involved with athlete training in Russia, where he
observed that as his athletes turned up the workload, so they
would start to break down physically. At that time there was
little strength and conditioning training. With a heavy emphasis
on improving mileage and speed, the athletes focused on
increasing their cardiovascular and respiratory systems, and
paid little heed to their underlying running technique.
The pose method

Romanov proposes one universal technique for all runners,
regardless of speed or distance: a 100m sprinter runs with the
same underlying technique as a 10km long-distance runner. The
technique is designed to prevent undue strain on the joints and
requires a great deal of muscular endurance and resilience.
The elite British triathletes Tim Don, Andrew Johns and
Leanda Cave have all adopted the pose method under
Romanovs guidance. According to Romanov, the Ethiopian
distance champion Haile Gebrselassie and the US sprint legend
Michael Johnson are both examples of runners with a natural
pose style born with perfect technique.
The distinguishing characteristic of pose running is that the
athlete lands on the midfoot, with the supporting joints flexed
at impact, and then uses the hamstring muscles to withdraw
the foot from the ground, relying on gravity to propel the
runner forward. This style is in clear contrast to the heelstrike
PAGE 52
method that most runners deploy and

Fig 1: Heel-toe running
which is advocated by some health
care professionals (see Fig 1).
The concept is simple enough, but
the practice is extremely hard to
master. It is only with expert tuition
and dedicated training that the athlete
can perfect the technique. Running in
pose is physically demanding, so
runners must undertake strengthening
drills before starting the programme.
Maybe it is this added balance and
stability training that allows the athlete to remain injury free?
As yet there is no body of research to help answer this question.
Principles
Running should be easy, effortless, smooth and flowing. We
have all seen and heard the heavy runner who pounds away on
a gym treadmill. Romanov says the runner is only as good as his
change of support and that the runner should have a very high
cadence not a long, extended stride length. In pose running,
the key is to maximise your effort in removing your support foot
from the ground; good training is essential to ensure that you
dont over-stride or create excessive vertical oscillation. The
runner should fall forwards, changing support from one leg to
the other by pulling the foot from the ground, allowing
minimum effort and producing minimum braking to this body
movement. The idea is to maximise the use of gravity to pull the
runner forward.
The pose method is centred on the idea that a runner
maintains a single pose or position, moving continually forwards
in this position. Romanov uses two models to explain the
rationale behind pose:
the mechanical model the centre of gravity, which is
around the hip position, should move in a horizontal line,
without vertical up and down displacement;
the biological model the rear leg maintains an S-like
PAGE 53
Fig 2: the cheetah
form, and never straightens. This

notion comes from animals such as the
cheetah which do not land on their
heels but run on the midfoot and
deploy a pulling through action using
their hamstrings rather than pushing
the foot into the ground (see Fig 2).
Perhaps the most useful imagery to help with this technique is to

imagine a vertical line coming from the runners head straight
down to the ground. The raised front leg should never breach this
line, but remain behind it. This focuses the effort firmly on pulling
the ankle up vertically under your hip rather than extending
forward with your quads and hip flexors (front of thighs).
The power behind the pose

Pose is by no means universally accepted by the running
fraternity. While top athletes have sought Romanovs help
because of injuries, the method does require good scientific
research to back it up. It is quite possible that many of the
benefits experienced by pose athletes are the result of the
rigorous strengthening programmes they undertake.
The training regimes focus on proprioception (joint stability
and balance), together with the strong imagery of the technique,
changes the physical placement of the limbs and reduces the
downward displacement force of the foot on to
Fig 3: Toe running
the ground.
That said, I know of people who have tried to
run in pose and have sustained injuries such as
calf strains and lower back problems, because
they did not get their pose stance right and did
not have sufficient hip control.
You need to be committed to learning the new
technique: once you have decided to learn to run
in pose, you cannot expect to chop and change
between running styles at will. The technical
drills outlined below can be very strenuous and
PAGE 54
may be harmful if attempted, for instance, at the wrong point

in an injured runners rehabilitation phase. Runners and
coaches alike should adopt these drills with proper caution.
How to do it: pose drills

If you are embarking on a serious transition to pose, you should
practise the drills (building up the level of difficulty) once or
twice daily, three sets of 10 to 15 reps per drill. Drills should be
practised for at least a week before attempting to run in pose,
and should be performed before a run. All drills should be
performed barefoot for added awareness of the movements, on
a forgiving surface such as grass or a running track.
The drills fall into three sections:
a) Basic drills to reinforce the pose position, the use of the
hamstring in pulling the foot from the ground and the feeling
of falling forward under the effect of gravity (drills 1-7);
b) Intermediate drills to reinforce these feelings (drills 8 and 9);
c) Advanced drills to aid speed, balance, strength and
reflexiveness (none shown here).
Drill 1 (Fig 4):
Pose stance
This to be practised as a static pose, held for up to
Fig 4: Pose stance
30 seconds. It requires good postural control; no
support is allowed. The idea is to challenge the
mechanoreceptors in the joints and soft tissues to
provide feedback to the brain regarding joint position
and muscle tone.
It is the basic position to hold and to practise
balance
The use of a mirror is recommended
Shoulder, hip and ankle should always be
vertically aligned
Point of contact with the ground is always the
midfoot
Hip is always held over the support point, which is the
midfoot.
PAGE 55
Drill 2:
Change of support without moving
Shift centre of gravity sideways from one leg to the other,
maintaining support on the midfoot
You must feel the weight shift from one leg to the other
before pulling up
It is important to feel the weight shift and then the acceleration
of this movement by the pulling-up of the hamstring
Pull the ankle up vertically under the hip using the
hamstring only, not hip flexors or quadriceps
Allow the leg to drop to the ground do not drive it down
Mental focus is on the pulling-up action, not the leg drop.
Drill 3 (Fig 5):
Pony
This practises changing support using minimum effort and
minimal range of movement
Simultaneously lift the ankle of the support leg while
allowing your body weight to shift to the other leg
Use only the hamstring. Keep in mind your support point
on the midfoot (toes will also be in contact).
Drill 4 (Fig 6):
Forward change of support
This puts the pony into action; practise slowly at first
Fig 5: Pony
PAGE 56
Fig 6: Forward change of support
Lean slightly forward and simultaneously pull the ankle up

under the hip using the hamstring and allow the nonsupport leg to drop to the ground under the force of gravity
Make sure the weight transfer is effortless and that the foot
is allowed to fall.
Drill 5 (Fig 7):
Foot tapping
Single-leg drill, 10-15 taps per set
Fig 7: Foot tapping
This emphasises the vertical leg action and use
of hamstrings rather than driving the knees up
and forward using your hip flexors and quads
It prevents your foot from being too far out in
front of the body, which would cause you to land
on your heel and create a braking action
Aim for rapid firing of the hamstring, lifting the
foot from the ground as soon as it touches down
You must feel the muscles fire and then relax.
Avoid a forceful pull all the way up. If you are
doing it correctly the lower leg will decelerate
after the initial firing and accelerate as gravity returns it
to the ground.
Drill 6 (Fig 8):
Hopping
This movement progresses the tapping drill. The
momentum for the hopping support leg should come
from the hamstring action on the non-hopping leg.
Take care: this is an advanced movement which will
place unhealthy stress on structures such as the
Achilles/calf muscles if not performed correctly.
Start by pulling up the non-hopping leg with your
hamstring and use the reaction force of the
ground to aid this recoil effect
Do not push with the calf but just lift the ankle
with the hamstring and make sure the ankle is
relaxed between hops.
Fig 8: Hopping
PAGE 57
Drill 7 (Fig 9):

Front lunge
Single-leg drill which increases the range of movement of
the hopping drill. This truly forces you to isolate the
hamstring muscles
Practise initially on the spot until you are stable enough to
allow forward movement
Keep weight on front leg; the back leg drags behind
Pull ankle vertically up under the hip, using the hamstring
Keep contact time with the ground as short as possible
Allow rear leg to follow loosely
Remember to land on the ball of your foot
Forward movement is created not by pushing off but by
leaning forward from the hips. You drag the rear leg behind
you for balance.
Drill 8 (Fig 10):
Switch
Both ankles are being picked up
Thistimeyouarepickingtherearlegupaswellwiththehamstring
Transfer weight from one leg to the other as you alternate
support
Keep contact time with the ground to a minimum, only as
necessary to change support
Keep heels off the ground and land on the balls of your feet
Fig 9: Front lunge
PAGE 58
Fig 10: Switch
Always think of the pose stance: good vertical alignment of

shoulder, hip and foot.
Drill 9:
Running lunge
This is pose running, but with a deliberate emphasis on the
speed of the hamstring pull-up
The aim is to teach the working leg to react as quickly as
possible, minimising support time on the ground
The runner pulls the heel up vertically from the ground but
allows it to fall easily to the ground.
Scott Smith
Further reading
Pose Method of Running by Nicholas Romanov (2002), PoseTech
Press ISBN: 0-9725537-6-2
Reduced Eccentric Loading of the Knee with the Pose Running
Method, Arendse, Regan E; Noakes, Timothy D; Azevedo, Liane
B; Romanov, Nicholas; Schwellnus, Martin P; Fletcher, Graham in
Medicine & Science in Sports & Exercise: Volume 36(2) February
2004 pp272-277.
POSE PRINCIPLES IN SUMMARY
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
Raise your ankle straight up under your hip, using the hamstrings;
Keep your support time short;
Your support is always on the balls of your feet;
Do not touch the ground with your heels;
Avoid shifting weight over your toes: raise your ankle when
the weight is on the ball of your foot;
Keep your ankle fixed at the same angle;
Keep knees bent at all times;
Feet remain behind the vertical line going through your knees;
Keep stride length short;
Keep knees and thighs down, close together, and relaxed;
Always focus on pulling the foot from the ground, not on landing;
Do not point or land on the toes (see Fig 3: Toe running);
Gravity, not muscle action, controls the landing of the legs;
Keep shoulder, hip and ankle in vertical alignment;
Arm movement is for balance, not for force production.
PAGE 59
PAGE 60
PHYSIOLOGY
A pain in the side why

stitch can turn a sporting
demigod into a DNF
When Haile Gebrselassie dropped out of the 2007 London
Marathon, no one was more shocked than the man himself. But why
should an athlete of his ability and experience be struck down by
something as mundane as a side stitch?
The sight of Haile Gebrselassie pulling out of the 2007 London
Marathon was almost as shocking to onlookers as Paula
Radcliffes untimely exit from the Olympic Marathon in
Athens. The double Olympic 10,000m champion dropped out
of the lead group shortly after the 30km mark, clutching his ribs.
I had a stitch here in my chest and could not continue. Im not
injured I just couldnt breathe, he told BBC Sport, with more
than a tinge of exasperated disbelief in his voice.
The manner of Gebrselassies exit is almost as surprising as
his failure to finish; surely succumbing to stitch is not something
that we associate with one of the greatest distance runners who
has ever lived? Stitch is what fun runners get a rite of passage
en route to becoming real runners, isnt it? However, as
Gebrselassies exit from the London Marathon demonstrates,
this is clearly not the case!
The lack of a definitive scientific explanation for a stitch
shouldnt really surprise us since its a very difficult phenomenon
to study using normal experimental methods. Experimental
scientists generally study a phenomenon by inducing it, or
manipulating it, and in doing so they derive a better understanding
of its characteristics and the mechanisms that control it.
However, stitch is notoriously unpredictable in its onset, so
PAGE 61
studying a stitch is very much like trying to study a condition such

as acute mountain sickness (AMS); we know AMS occurs in some
people when they ascend to altitude, but the symptoms vary
between people, AMS doesnt always affect the same person in
the same way, and it doesnt affect everyone at the same altitude.
This means that the only way you can study AMS is to observe a
huge number of people, wait for AMS to develop in some of
them, and then record the circumstances under which it occurred.
This observational or epidemiological research generates
information that is analysed by cross-referencing many factors
in order to tease out the common denominators within the
symptomology and physiology. Associations between these
factors then provide pointers to the underlying cause(s). But even
when these links are identified, the best that can be achieved with
epidemiological research methods is circumstantial evidence of
underlying mechanisms.
What is a stitch?
One theory is that a stitch is caused by the movements of the
stomach and liver, which places strain on the diaphragm
ligaments and/or the ligaments supporting the abdominal organs.
Another theory is that a stitch is just plain old diaphragm
ischaemia (insufficient blood flow for the metabolic demand),
and/or a diaphragm spasm (cramp) (1). A more recent theory is that
stitch is a symptom of an irritation of the lining of the abdominal
cavity (peritoneum) caused by friction between the abdominal wall
and the abdominal organs (1). However, the jury is still out and
there is, as yet, no unequivocal scientific evidence to implicate
any one of these potential mechanisms.
So it is for the stitch. Until 2000, there had been no data

published on the phenomenon in the medical literature since 1951.
Even those data that now exist are primarily epidemiological, and
have originated from just one research group in Australia. For
example, in one study these researchers administered a
questionnaire to 848 people who took part in a 14km run (2).
Twenty seven per cent experienced a stitch and it was twice as
common in those who ran in the event than in those who walked.
PAGE 62
This tells us that a stitch arises frequently, but what are the
common denominators in terms of its occurrence?
Causal factors in stitch

Studies have also used epidemiological techniques in an attempt
to identify causal factors, as well as its prevalence. For example,
a survey of almost 1,000 regular sports participants in Australia (3)
found that the prevalence of stitch declined with increasing age,
and that neither gender, nor training experience appeared to
influence stitch.
Facts about stitch

Only a few studies have been conducted into the causes of stitch,
but heres what we know so far:
1. Stitch is most common during running (almost 10 times more
common than in cycling) (3);
2. The site of stitch varies, but is most commonly the mid/lateral
abdomen (1);
3. Stitch decreases with increasing age (3);
4. Stitch may be more common in people who train less regularly (3);
5. Stitch is sometimes linked to food or fluid intake(5,6);
6. Stitch is sometimes also associated with shoulder tip pain (3,4);
7. Stitch can lead to difficulty in breathing;
8. Stitch also occurs frequently in horse riding and other sports in
which the torso is subjected to movement (team sports and
swimming)(3).
In addition, they noted that a stitch was often associated with

shoulder tip pain; the shoulder tip is a site for referred
diaphragm pain (in much the same way that people get pain in
their left arm when they are having a heart attack, pain in the
right shoulder is linked to a problem relating to the diaphragm).
In another survey from the same research group (4), 1,000
participants in running, swimming, cycling, aerobics, basketball
and horse riding were compared. The authors found that the
stitch was most common in sports that involve repetitive
movement of the torso, either vertically (eg running and horse
riding), or in longitudinal rotation (eg swimming).
PAGE 63
There have been only two interventional studies of the

stitch, ie studies where the experimenters tried to induce a
stitch deliberately. In the first of these the experimenters
administered a range of different drinks in an attempt to
differentiate the influence upon stitch of fluid per se, as well
as the effect of the composition of the fluid upon blood flow
to the stomach and intestines (5). After ingesting the fluid
(14mls per kg body mass) the subjects were required to
perform repeated bouts of hard running on a treadmill. They
found that the composition of the fluid had little or no effect
upon the development of stitch. In a separate part of the
study the subjects performed a number of manoeuvres after
the onset of stitch in an attempt to alleviate its intensity. The
most effective of these were:
bending forwards while contracting the abdominal muscles,
or tightening a belt around the waist;
breathing through pursed lips with an increased breathing
volume.
The second study that attempted to deliberately induce stitch
also examined the influence of the composition of different
drinks upon the severity and subjective experience of the stitch
(6)
. The researchers selected 40 subjects who were susceptible
to stitch, and compared their responses to four treadmill
running trials (one control and three test drinks). Drinking fruit
juice appeared to be more provocative than the other
conditions, but there was no statistical difference between
taking no fluid and taking flavoured water, or a sports drink.
However, the difference between the sports drink and the other
two conditions (water or no drink) was nearly statistically
significant and the authors concluded that susceptible
individuals should avoid fruit juice and other high carbohydrate
drinks before, or during exercise.
So what does all this tell us about the causes of a stitch? The
fact that it occurs more often in sports that involve jarring and/or
twisting of the torso suggests its linked to the movement of the
bodys internal organs, and that factors that are involved in
PAGE 64
maintaining postural stability may be involved. The shoulder tip

pain indicates that the diaphragm muscle may be involved, while
the fact that having food or fluid in the stomach increases the
prevalence of stitch points to the involvement of organs that are
in close proximity to the diaphragm (stomach and liver). Finally,
the clincher is the fact that a stitch makes it very, very
uncomfortable to breathe. All in all, the evidence adds up to the
pain originating from the diaphragm muscle.
The role of the diaphragm

Its pretty well understood by most people that the diaphragm
is the main muscle of inhalation, but what is less widely
appreciated is that the diaphragm is also a vital part of the group
of muscles known as the core stabilisers. The core stabilisers
include superficial muscles that form a muscular corset, which
encapsulates the abdominal compartment of the body, as well
as deep muscles that stabilise the spine and pelvis.
These muscles are responsible for keeping the body upright
during activities that perturb the centre of gravity, such as
bending, jumping, running, riding a horse, etc. They also help
to provide a stable base from which other torso muscles can
twist the trunk during actions such as throwing, hitting a ball, or
even front crawl and backstroke swimming. Perhaps the most
important role for the core stabilisers is to protect the spine and
pelvis from damage during lifting and any actions that load or
impose stress upon these parts of the skeleton.
In its role as a core stabiliser, the diaphragm is activated
subconsciously during the preparatory phase of most limb
movements (7). In doing so it raises the pressure inside the
abdomen, which acts to increase spinal stability (8). This function
presents no problem when standing still, but when exercising,
theres an additional demand placed on the diaphragm that
comes from the requirement to breathe more vigorously. Put
these two demands together, as occurs during running, and it
easy to see how the diaphragm can become overloaded (9).
In other words, the diaphragm is subjected to competing
demands in its roles as a vital core stabiliser and the principal
PAGE 65
muscle of breathing. In addition, because it is surrounded by

large, heavy organs (specifically the stomach and the liver below
it), there are some situations that make life even more difficult
for the diaphragm. If breathing and stride cadence arent
synchronised, the diaphragm can be buffeted by the movements
of these large organs as they move up and down under the force
of gravity and in synchrony with the foot strike.
Not only does this stretch the diaphragm, but it also means
that it must work against the buffeting, which adds considerably
to the amount of work it must do. This can be a particular
problem on uneven terrain when its hard to get into a rhythm,
and the postural role of the diaphragm and other trunk muscles
is also being challenged. Ever had rib ache the day after a crosscountry run? Thats because your ribcage and diaphragm
muscles have been fighting hard to keep you from landing on
your face in the mud!
Diaphragm discomfort
As a scientist, I must resist the temptation to apply my personal
experience of a phenomenon to its interpretation. However, I
have observed a consistent response across a large number of
people, and over many years. These observations (combined
with the circumstantial evidence that exists within the literature)
suggests, to me at least, that a stitch is almost certainly
diaphragm discomfort arising because of an inability to cope
with the demands that are being placed upon it.
Most people are inherently poor and inefficient breathers;
they just let it happen automatically, and pay no attention to the
muscles that are used to do it. Of the many muscles involved in
breathing, the diaphragm is by far the largest, strongest and
most resistant to fatigue. Accordingly, the diaphragm is the
muscle that should be employed to undertake the lions share
of the work of breathing, not the rib cage muscles.
Sadly, in my experience, few people use their diaphragm as
effectively as they could. In order to do so, they have to re-educate
themselves into a way of breathing that was second nature to them
as infants. This re-education is possible through a conscious
PAGE 66
process of focusing inspiratory effort upon the diaphragm, and is

best practiced in the first instance while not exercising.
Unfortunately, the conscious shifting of effort towards the
diaphragm during running can have an initial downside, and
many people find that they experience the most frequent and
severe stitch pains theyve ever had. However, in my experience,
with perseverance over a two- to three-week period, most
people also find that the pains gradually reduce in frequency
and severity.
My interpretation of this phenomenon is that during the initial
phase, the diaphragm is subjected to an increased demand to do
more of the work of breathing, leading to overload and
ultimately, a stitch. However, over a two/three-week period, the
diaphragm does what every other muscle in the body does when
you ask it to do more than its used to it adapts. This adaptation
means that the diaphragm becomes better able to cope with the
increased demand and the result is that the stitch no longer
occurs. But is this the only way to reduce the risk of a stitch?
In the course of my academic research, I have studied the ways
in which breathing limits exercise tolerance and performance for
over 15 years. This research led to the development of a device
that trains the diaphragm (an inspiratory muscle trainer) by
imposing a resistance to inhalation that is akin to lifting a
dumbbell. Our laboratory studies have shown that this training
improves performance by making exercise feel easier, and by
preventing the inspiratory muscles from diverting blood away
from the legs during exercise.
The reason this type of training is relevant to stitch is that one
of the anecdotal observations of many people who train their
inspiratory muscles using such devices is that they no longer
experience stitch pain. In addition, some also reported that if
they trained their inspiratory muscles within an hour or so of
going for a run, they often got a stitch. In other words, they went
for a run with the diaphragm in a pre-fatigued state, which
predisposed them to getting a stitch. These observations are
strongly indicative that stitch is a response of the diaphragm to
a situation it can no longer cope with.
PAGE 67
Coping with a stitch

So, what should you do if you suffer a stitch during a race? One
option is to drop out, which is unfortunately what Gebrselassie
felt forced to do, but a stitch doesnt have to spell the end of
the race. Stitch pain will subside if you allow the diaphragm to
rest, so you can either slow the pace right down, or even walk
for a while.
Alternatively, you can give your diaphragm a breather by
consciously shifting the work of breathing away from your
diaphragm for a few minutes, or until the stitch subsides. This
tactic has to be a last resort, because your ribcage muscles will
also fatigue if you rely on them too heavily.
Other techniques that are supported by the evidence of one
study (5) are to:
1. Bend forwards while contracting the abdominal muscles, or
to tighten a belt around the waist;
2. Breathe deeply through pursed lips. A technique that
appears effective for some athletes Ive worked with is to
bend forwards, tighten the abdominal muscles (especially
transversus abdominis) and press inwards and upwards
(hard!) on the site of the pain with your palm for 10-15
seconds.
Prevention is much better than cure, so lets consider what can
be done to minimise the risk of developing a stitch in the first
place. The research suggests that ingesting large volumes of
food or drink, especially if its high in carbohydrate, should be
avoided immediately before, or during exercise.
However, perhaps the best advice is to train your diaphragm
so that its never faced with a situation that it cant cope with (see
box). As weve seen, no amount of ordinary training can do this;
if it did, then the likes of Gebrselassie would surely be immune
to stitch, and he patently isnt. If you dont want to experience
the same fate, then a little heavy breathing will help ensure that
your diaphragm can cope with anything you care to throw at it!
PAGE 68
Inspiratory muscle training (IMT)

IMT requires a specific training device, such as a POWERbreathe. A
typical IMT session consists of inhaling against a moderate training
load (around 50% of the maximal voluntary contraction force of the
inspiratory muscles) for around 30 repetitions (breaths). This
magnitude of load corresponds to the 30-repetition maximum (RM)
for the inspiratory muscles, ie the maximum load that can be
sustained for 30 repetitions. This is identified by trial and error (just
as you would when identifying the 12-RM for a bench press). This
foundation training is undertaken in the standing position twice
daily for 4-6 weeks, and a typical session requires just 2-3 minutes.
After completing this foundation block, you can move to a more
sport-specific training routine. This is achieved by introducing
posture specificity to the session in order to challenge both the
breathing and postural roles of your inspiratory muscles. If
eliminating stitch is the main goal, then specificity can be achieved
by challenging the postural stabilising role of the diaphragm while
undertaking IMT eg by standing on a wobble board, air pillow, or
Bosu ball while performing IMT.
Alison McConnell
References
1. Br J Sports Med 2003; 37:287-8
2. J Sci Med Sport 2005; 8:152-62
3. Med Sci Sports Exerc 2002; 34:745-9
6. Int J Sport Nutr Exerc Metab 2004; 14:197-208
7. J Appl Physiol 2000; 89:967-76
8. J Biomech 2005; 38:1873-80
9. J Physiol 2001; 537:999-1008
PAGE 69
PAGE 70
NUTRITION
Carbohydrate drinks
can fructose enhance
endurance for runners?
Despite the numerous claims to the contrary by the sports nutrition
industry, real advances in sports nutrition are comparatively rare.
But recent research into carbohydrate absorption and utilisation
could herald a new breed of carbohydrate drink, which promises
genuinely enhanced endurance performance.
Before we go on to discuss carbohydrate formulations, its
worth recapping just why carbohydrate nutrition is so vital for
middle distance runners. Although the human body can use fat
and carbohydrate as the principle fuels to provide energy, its
carbohydrate that is the preferred or premium grade fuel for
sporting activity.
There are two main reasons for this. Firstly, carbohydrate is
more oxygen-efficient than fat; each molecule of oxygen yields
six molecules of ATP (adenosine triphosphate the energy
liberating molecule used in muscle contraction) compared with
only 5.7 ATPs per oxygen molecule when fat is oxidised. Thats
important because the amount of oxygen available to working
muscles isnt unlimited its determined by your maximum
oxygen uptake (VO2max).
Secondly and more importantly, unlike fat (and protein),
carbohydrate can be broken down very rapidly without oxygen
to provide large amounts of extra ATP via a process known as
glycolysis during intense (anaerobic) exercise. And since all but
ultra-endurance athletes tend to work at or near their anaerobic
threshold, this additional energy route provided by
carbohydrate is vital for maximal performance. This explains
PAGE 71
why, when your muscle carbohydrate supplies (glycogen) run

low, you sometimes feel as though youve hit a wall and have
to drop your pace significantly from that sustained when
glycogen stores were higher.
Carbohydrate storage
Endurance training coupled with the right carbohydrate loading
strategy can maximise glycogen concentrations, which can
extend the duration of exercise by up to 20% before fatigue sets
in1. Studies have shown that the onset of fatigue coincides
closely with the depletion of glycogen in exercising muscles (2,3).
However, valuable as these glycogen stores are, and even
though some extra carbohydrate (in the form of circulating
blood glucose) can be made available to working muscles
courtesy of glycogen stored in the liver, they are often
insufficient to supply the energy needs during longer events.
For example, a trained marathon runner can oxidise
carbohydrate at around 200-250g per hour at racing pace; even
if he or she begins the race with fully loaded stores, muscle
glycogen stores would become depleted long before the end of
the race. Premature depletion can be an even bigger problem in
longer events such as triathlon or endurance cycling and can even
be a problem for athletes whose events last 90 minutes or less and
who have not been able to fully load glycogen stores beforehand.
Given that stores of precious muscle glycogen are limited, can
ingesting carbohydrate drinks during exercise help offset the
effects of glycogen depletion by providing working muscles with
another source of glucose? Back in the early 1980s, the prevailing
consensus was that it made little positive contribution. This was
because of the concern that carbohydrate drinks could impair
fluid uptake, which might increase the risk of dehydration. It
was also mistakenly believed that ingested carbohydrate in such
drinks actually contributed little to energy production in the
working muscles (4).
Later that decade, however, it became clear that
carbohydrate ingested during exercise can indeed be oxidised
at a rate of roughly 1g per minute (5-7) (supplying approximately
PAGE 72
250kcals per hour) and a number of studies subsequently

showed that this could be supplied and absorbed well by
drinking 600-1,200mls of a solution of 4-8% (40-80g per litre of
water) carbohydrate solution per hour (8-11). More importantly,
it was also demonstrated both that this ingested carbohydrate
becomes the predominant source of carbohydrate energy late
in a bout of prolonged exercise (10), and that it can delay the onset
of fatigue during prolonged cycling and running as well as
improving the power output that can be maintained (12,13).
Drink formulation
The research findings above have helped to shape the
formulation of most of todays popular carbohydrate drinks. Most
of these supply energy in the form of glucose or glucose polymers
(see box for explanation) at a concentration of around 6%, to be
One of the
consumed at the rate of around 1,000mls per hour, so that around
goals of sports
60g per hour of carbohydrate is ingested. Higher concentrations
nutrition
or volumes than this are not recommended because not only
has been to
does gastric distress become a problem, but also the extra
see whether
carbohydrate ingested is simply not absorbed or utilised.
it's possible
But as weve already mentioned, 60g per hour actually
to increase
amounts to around 250kcals per hour, which provides only a
the rate of
modest replenishment of energy compared to that being
carbohydrate
expended during training or competition. Elite endurance
replenishment
athletes can burn over 1,200kcals per hour, of which perhaps
1,000kcals or more will be derived from carbohydrate, leaving
a shortfall of at least 750kcals per hour. Its hardly surprising,
therefore, that one of the goals of sports nutrition has been to
see whether its possible to increase the rate of carbohydrate
replenishment. And now a series of studies carried out by
scientists at the University of Birmingham in the UK indicates
that this may indeed be possible.
Carbohydrate type and performance

Many of the early studies on carbohydrate feeding during
exercise used solutions of glucose, which produced demonstrable
improvements in performance as discussed. In the mid-1990s,
PAGE 73
some researchers experimented by varying the type of

carbohydrate used in drinks, for example by using glucose
polymers or sucrose (table sugar). However, it seemed that
there was little evidence that these other types of carbohydrate
offered any advantage (3).
But, at about the same time, a Canadian research team were
experimenting with giving mixtures of two different sugars
(glucose and fructose) to cyclists. In one experiment cyclists
pedalled for two hours at 60% of VO2max while ingesting
500mls of one of five different drink mixtures (14):
50g glucose;
100g glucose;
50g fructose;
100g fructose;
100g of 50g glucose + 50g fructose.
These sugars were radio-labelled with carbon-13 so the
researchers could see how well they were absorbed and oxidised
for energy by measuring the amount of carbon dioxide containing
carbon-13 exhaled by the cyclists (as opposed to unlabelled carbon
dioxide, which would indicate oxidation of stored carbohydrate).
The key finding was that 100g of the 50/50 glucose fructose mix
produced a 21% larger rate of oxidation than 100g of pure glucose
alone and a 62% larger rate than 100g of pure fructose alone.
Although these findings provided experimental support for
using mixtures of carbohydrates in the energy supplements for
endurance athletes, it wasnt until 2003 that researchers from
the University of Birmingham in the UK began looking more
closely at the issue. In particular, they wanted to see whether
combinations of different sugars could be absorbed and utilised
more rapidly than the 1.0g per minute peak values that had been
recorded with pure glucose drinks.
One of their early experiments compared the oxidation rates
of ingested carbohydrate in nine cyclists during three-hour
cycling sessions at 60% of VO2max (15). During the rides, the
cyclists drank 1,950mls of radio-labelled carbohydrate solution,
which supplied one of the following:
PAGE 74
1.8g per min of pure glucose;

1.2g of glucose + 0.6g per minute of sucrose;
1.2g of glucose + 0.6g per minute of maltose;
Water (control condition).
The results showed that while the pure glucose and glucose/
maltose drinks produced an oxidation rate of 1.06g of
carbohydrate per minute, the glucose/sucrose combination
drink produced a significantly higher rate of 1.25g per minute.
This was an important finding because while both maltose and
sucrose are disaccharides (see box, below), maltose is composed
of just two chemically bonded glucose molecules, whereas
sucrose combines a glucose with a fructose molecule. This
suggested that it was the glucose/fructose combination that was
being absorbed more rapidly and therefore producing higher
rates of carbohydrate oxidation.
CARBOHYDRATE BUILDING BLOCKS

The fundamental building blocks of carbohydrates are molecules known as sugars. Although
there are a number of sugars, the most important is glucose, which can be built into very long
chains to form starch (found in bread, pasta, potatoes, rice etc). Fructose is also important,
accounting for a significant proportion of the carbohydrate found in fruits. The disaccharide
(ie two sugar unit) sucrose is composed of glucose and fructose linked together and is more
commonly known as table sugar.
Sports drinks often contain glucose and fructose, but also other carbohydrates such as dextrins,
maltodextrins and glucose polymers. These consist of chains of glucose units linked together, with
varying amounts of chain length and branching. Because of their more complex structure, more
digestion is required, which tends to slow the rate of absorption, resulting in a smoother, more
sustained uptake into the bloodstream.
OH
O
HO
OH
6
CH2OH
O
HO
CH2OH
O
5
1
2
OH
GLUCOSE
CH2OH
1
3
CH2OH
Glucose
SUCROSE (TABLE SUGAR)
= GLUCOSE + FRUSTOSE
5
1
Fructose
CH2OH
O
2
3
Glucose
1
2
Glucose
MALTOSE (BREWERS SUGAR)

= GLUCOSE + GLUCOSE
PAGE 75
Intestinal absorption of glucose and fructose

Like many nutrients, sugars arent absorbed passively ie they
dont just leak across the intestinal wall into the bloodstream.
They have to be actively transported across by special proteins
called transporter proteins.
We now know that the intestinal transport of glucose occurs via
a glucose transporter called SGLT1, which is located in the brushborder membrane of the intestine. It is likely that the SGLT1transporters become saturated at a glucose ingestion rate of
around 1g per minute (ie all the transport sites are occupied),
which means at ingestion rates above 1g per minute, the surplus
glucose molecules have to queue up to await transportation.
In contrast to glucose, fructose is absorbed from the intestine by
a completely different transporter called GLUT-5. So when
carbohydrate is given at 1.8g per minute as 1.2g per min of
glucose and 0.6g per min of fructose rather than 1.8g per min of
pure glucose, the extra fructose molecules dont have to queue
up as they have their own route across the intestine independent
of glucose transporters. The net effect is that more carbohydrate
in total finds its way into the bloodstream, which means that more
is available for oxidation to produce energy.
Fructose connection
The same team had also performed another carbohydrate
ingestion study on eight cyclists pedalling at 63% of VO2max
for two hours(16). In this study the cyclists performed four
exercise trials in random order while drinking a radio-labelled
solution supplying of one of the following:
1.2g per min of glucose (medium glucose);
1.8g per min of glucose (high glucose);
1.2g of glucose + 0.6g of fructose per minute
(glucose/fructose blend);
Water (control).
There were two key findings; firstly, the carbohydrate oxidation
rate when drinking high glucose drink was no higher than when
medium glucose was consumed; secondly, the peak and average
PAGE 76
oxidation rates of ingested glucose/fructose solution were

around 50% higher than both of the glucose-only drinks.
These findings point strongly to the fact that the maximum
rate of glucose absorption into the body is around 1.2g per
minute because feeding more produces no more glucose
oxidation probably because the absorption mechanism is
already saturated. But because giving extra fructose does
increase overall carbohydrate oxidation rates, they also indicate
that fructose in the glucose/fructose drink was absorbed from
the intestine via a different mechanism than glucose (see
box above).
The studies above and others (17) had shown that glucose/
fructose mixtures do result in higher oxidation rates of ingested
carbohydrate, especially in the later stages of exercise. But what
the team wanted to find out was whether this extra carbohydrate
uptake could help with water uptake from the intestine, and also
whether the increased oxidation of ingested carbohydrate had
a sparing effect on muscle glycogen, or other sources of stored
carbohydrate (eg in the liver).
To do this, they set up another study using a similar protocol
to that above (eight trained cyclists pedalling at around 60%
VO2max on three separate occasions, ingesting one of three
drinks on each occasion (18)). However, in this study, the duration
of the trial was extended to five hours during which the subjects
drank one of the following:
1.5g per minute of glucose;
1.5g per minute of glucose/fructose mix (1.0g glucose/
0.5g fructose);
Water (control).
The water used in the drinks was also radio-labelled (to help
determine uptake into the bloodstream) and the cycling trials
were conducted in warm conditions (32C) to add heat stress.
Exercise in the heat results in a greater reliance on carbohydrate
metabolism, which is thought to be due to increased muscle
glycogen utilisation, and is associated with higher levels of
fatiguing lactate concentrations.
PAGE 77
There were a number of important findings from this study:

During the last hour of exercise, the oxidation rate of
ingested carbohydrate was 36% higher with
glucose/fructose than with pure glucose (figure 1);
During the same time period, the oxidation rate of
endogenous (ie stored) carbohydrate was significantly less
with glucose/fructose than with pure glucose (figure 1);
The rate of water uptake from the gut into the bloodstream
was significantly higher with glucose/fructose than with
pure glucose (figure 2);
The perception of stomach fullness was reduced with the
glucose/fructose drink compared to pure glucose;
Perceived rates of exertion in the later stages of the trial
were lower with glucose/fructose than with pure glucose.
Although no direct muscle glycogen measurements were made,

the kinetics of the rate of appearance and disappearance of
glucose in the bloodstream from the drinks led the researchers
to postulate that the extra carbohydrate oxidation observed
could be as a result of increased liver oxidation, or the
formation of non-glucose energy substrates during exercise,
such as lactate, which is known to be an important fuel for
exercising muscles. More research is needed to determine the
exact mechanisms involved.
Implications for athletes

These research findings are very encouraging; higher rates of
energy production from ingested carbohydrate, lower rates
from stored carbohydrate and increased water uptake sounds
like a dream combination for endurance athletes. But can a
glucose/fructose drink actually enhance endurance performance
in real athletes under real race conditions?
Thats the question scientists at the University of
Hertfordshire are currently trying to answer in a double-blind,
placebo controlled study to test commercially available drinks,
which was set up earlier this year. The main goal is to compare
the effects on cycling performance of a popular glucose/glucose
PAGE 78
Figure 1: Drink type and fuel usage

Relative contribution to
total energy expenditure
100%
Fat
Exogenous
carbohydrate
Endogenous
carbohydrate
75%
50%
25%
0%
GLU
WAT
GLU+FRUC
Relative contribution of fat, exogenous (ingested) and endogenous (stored)

carbohydrate to energy expenditure during last hour of exercise
Figure 2: Drink type and water uptake

Relative water uptake
125
Water
Glucose
+fructose
Glucose
100
75
Relative amount of
water absorbed
from the gut into
the bloodstream
during the last hour
of exercise
50
25
0
0
15
30
45
60
75
90
105
120
Time (min)
polymer (containing very low levels of fructose ~3-4%) drink

with a 2:1 glucose/fructose drink (trade name of Super Carbs
33% fructose) on cycling performance. The results of these
trials are yet to be published, but according to the research team,
the initial findings are very promising.
Recommendations for athletes

Is it worth rushing out and trying to get hold of a glucose/
fructose drink to use during training/competition? Despite the
promising initial research, the cautious approach would be to
hold back until scientists have confirmed beyond doubt that
these drinks really do confer a performance advantage.
However, fructose is cheap, which means these drinks are no
PAGE 79
more expensive than conventional glucose/glucose polymer

drinks; as all the indications are that any performance
differences produced by a glucose/fructose drink will be
positive, theres certainly no harm in a try it and see approach,
and possibly much to gain.
Having said that, its important to remember that
conventional glucose/glucose polymer drinks can still confer
proven advantages for endurance athletes when taken during
training or competition; both glucose/glucose polymer and
glucose/fructose drinks can boost endurance performance over
using nothing at all! But should the initial findings above be
confirmed, the future for glucose/fructose carbohydrate drinks
looks bright.
Andrew Hamilton
References
1. Sports Med 1997; 24:73-81
2. Acta Physiol Scand 1967; 71:129-139
3. Williams C, Harries M, Standish WD, Micheli LL (eds) (1998)
Oxford Textbook of Sports Medicine, 2nd edn. New York:
Oxford University Press
4. Int J Sports Med 1980; 1:2-14
5. Sports Med 1992; 14: 27-42
6. Metabolism 1996; 45:915-921
7. Am J Physiol Endocrinol Metab 1999; 276: E672-E683
8. Med Sci Sports Ex 1993; 25:42-51
9. Int J Sports Med 1994; 15:122-125
10. Med Sci Sports Ex 1996; 28: i-vii
11. J Athletic Training 2000; 35:212-214
12. Int J Sports Nutr 1997; 7:26-38
13. Nutrition Reviews 1996; 54:S136-S139
14. J Appl Physiol 1994; ss76(3):1014-9
PAGE 80
15. J Appl Physiol 2004; 96:1285-1291

16. J Appl Physiol 2004; 96:1277-1284
17. Med Sci Sports Exerc 2004; 36(9):1551-1558
18. J Appl Physiol 2006; 100:807-816
PAGE 81
PAGE 82
WHAT THE PAPERS SAY

Reports on recent running-related studies
Explosive type strength training

enhances distance-running
performance
One of the most fundamental rules of training is specificity; if you want
to train for an event, your training should replicate the demands of that
event. The rule of specificity arises because different events tend to rely
on different energy systems in the body (which need to be specifically
trained) and also because many disciplines require a specific set of
motor skills and neurological adaptations.
However, the reality is that while many endurance events draw heavily
on the aerobic energy system, they often also require short high-energy
bursts provided by the anaerobic energy pathways (for example, during
the sprint for the line) pathways that are often neglected in training
because of the desire to concentrate on endurance performance. But new
research by Finnish scientists at the Research Institute for Olympic Sports
suggests that this strategy may be counterproductive for endurance
runners, and that anaerobic performance can be readily enhanced
without increasing training volume or compromising endurance.
In the study, the effects of concurrent explosive strength and
endurance training on aerobic and anaerobic performance and
neuromuscular characteristics were studied in 25 distance runners,
who were split into an experimental group (13 runners) and a control
group (12 runners). All of the runners trained for eight weeks with the
same total training volume, but in the experimental group 19% of the
endurance training time was replaced by explosive-type training,
including sprints and strength drills. After the eight-week training
programme, all the runners were evaluated for various aspects of
performance with the following results:
Compared to the controls, the maximal speed during a maximal
anaerobic running test and 30-metre speed improved in the
experimental group by 3.0% and 1.1% respectively;
PAGE 83
The concentric and isometric forces generated during leg extension

increased in the experimental group but not in the controls;
The experimental group improved their muscular force-time

characteristics and had rapid neural activation of the muscles (ie
they were able to generate more power through more rapid muscular
contractions);
The increase in thickness of quadriceps muscles after eight weeks
was nearly double in the experimental group compared to the
controls;
Importantly, the maximal speed during an aerobic running test, the
maximal oxygen uptake (VO2max) and the running economy (how
efficiently the runners used oxygen to for any given running speed)
remained unchanged in both groups.
The implications of these findings are clear; if you are an endurance
athlete whose event also demands brief bursts of high-intensity work,
substituting some of your endurance training (up to 20%) with
anaerobic work neednt necessarily involve a drop in aerobic
performance, and may even give you a competitive edge.
Int J Sports Med 2007; 20 [Epub ahead of print]
Creatine serum offers no

advantages for runners
The cheapest and most popular form of creatine (and the sort used
extensively in scientific studies) is creatine monohydrate, a white powder
that needs to be mixed with water/fruit juice etc before use. More
recently, other more exotic and expensive forms of creatine have
appeared, which claim to offer performance benefits over standard
creatine. One of these is creatine serum, a liquid form of creatine that
is claimed to offer a number of other advantages over powdered creatine,
including instant absorption, no side effects (such as water retention,
bloating or cramping) and complete assimilation into the muscles.
To test this theory, Californian researchers examined the effects of
ingesting creatine serum on cross-country runners. All the runners
underwent baseline testing by completing a 5,000m outdoor run
PAGE 84
followed by a VO2max test on the treadmill the same day. The runners
were then split into two groups; 13 took the manufacturers
recommended dose of 5mls of serum (2.5g of creatine), while the
control group took an inert placebo.
As well as VO2max, heart rates, run times and perceived rates of
exertion were recorded. The results showed that runners taking the
serum had a significantly lower perceived rate of exertion and also
managed longer durations on the incremental VO2max test. However,
the actual VO2max figures were not significantly different between
serum and placebo groups, and there was also no improvement in
5,000m run time in the serum group.
The scientists went on to conclude that their data did not support
the ergogenic claims of creatine serum in its current form and dose.
J Strength Cond Res 2005; 19(4):730-4
The benefits of training backwards

Backward walking and running is recommended for the rehabilitation
of overuse injuries and knee joint problems because it increases the
strength and power of the quadriceps muscles while reducing
compressive forces at the knee joint, preventing overstretching of the
anterior cruciate ligament (ACL) and decreasing force absorption.
But thats not all: according to a new study from South Africa,
backward locomotion training also improves cardiorespiratory fitness,
while causing significant changes in body composition, and may thus
be a useful supplement to coventional running training programmes.
This study investigated the effects of a backward training programme
on healthy young female university students. Twenty-six students took
part in three different baseline tests (body composition, a submaximal
treadmill test and a 20m shuttle run test) before and after a six-week
training programme.
For the training programme they were divided into two groups:
1. A training group who completed a six-week backward run/walk
training programme, consisting of three sessions per week for a total
of 18 sessions, with the duration of the sessions progressively
increased over the study period;
PAGE 85
2. A control group who followed their normal daily activities.

On retesting, the trained group were found to show:
a significant decrease in oxygen consumption during both

submaximal forward and backward exercise on the treadmill (30%
and 32% respectively);
statistically significant decreases in skinfold thickness (19.6%) and
percentage body fat (2.4%) at the end of the study period;
statistically significant increases of 5.2% in maximal oxygen uptake.
The researchers conclude: The results of this study provide, for the first
time, evidence that backward locomotion can improve cardiorespiratory
fitness and possibly lead to positive body composition changes in young
women.
Int J Sports Med 2005; 26:214-219
Why long, slow training runs may

be best after all
For some time now, experts have been downgrading the value of long
slow workouts for endurance runners in favour of briefer bouts of high
intensity exercise.
But now a Spanish study, which followed eight well-trained sub-elite
endurance runners during the six-month lead-up to their national crosscountry championships, has thrown that wisdom into doubt.
The researchers found that the runners spent most of their training time
at low intensities (below 60% VO2max). But they also found evidence
to suggest that total training time spent at low intensities was associated
with improved performance in highly intense endurance events.
The runners heart rates were continuously recorded, using a
technique called telemetry, during each training session between
August and February leading up to the championships, where they
competed either in the short race (4.175k) or the long race
(10.130k).
The researchers quantified total cumulative time spent by each
runner in zone 1 (low-intensity), zone 2 (moderate intensity 60-85%
PAGE 86
VO2max) and zone 3 (high intensity above 85% VO2max) and then
related these to final race performance. Their two key findings were:
That these regional/national class endurance runners spent most
(71%) of their training time in zone 1 and a mere 8% in zone 3;
That total training time spent in zone 1 was linked with improved
performance time during both races, particularly the long one.
Our findings suggest, the researchers conclude, that total training
time spent at low intensities might be associated with improved
performance during highly intense endurance events, at least if the
event duration is [around] 35 minutes. Interventional studies are
needed to corroborate our findings.
They cannot easily explain these unexpected results but suggest that
athletes might engage in a form of pacing that occurs over a very long
period of time. Just as athletes must distribute their energetic resources
within a competition it appears that they must also perform a certain
level of pacing over long periods of time, so that the balance of the
training stress and training adaptations remains favourable.
Med Sci Sports Exerc, vol 37, no 3, 496-504
No link between hydration and

cramps
The popular theory that exercise-induced muscle cramping (EAMC) is
caused by fluid imbalances, particularly dehydration and abnormalities
in blood electrolyte levels, has been overturned by a South African study
of ultra-distance runners.
Electrolyte and fluid disturbances have been associated with muscle
cramps in certain clinical conditions, explain the researchers, and it is
therefore often assumed that EAMC has the same cause despite a lack
of evidence to that effect.
They set out to determine whether acute EAMC in distance runners
is related to changes in serum electrolyte concentrations and hydration
status. A cohort of 72 male runners participating in the Two Oceans
Ultra-marathon, a 56k road race held annually in Cape Town, were
asked about their history of EAMC and then followed up for the
development of the condition during the race.
PAGE 87
All subjects were weighed before and immediately after the race to
assess changes in hydration status. Blood samples were taken before,
immediately after and 60 minutes after the race and analysed for
glucose, protein, sodium, potassium, calcium and magnesium
concentrations, as well as various markers of hydration status.
Of the 72 runners in the study, 45 had a history of EAMC, while 27
had no previous experience of muscle cramping. In the event, 21 of
the 45 runners with a history of cramping suffered acute EAMC either
during the race or within 60 minutes of completing it, while 22 of the
27 runners with no history of cramping formed a control group for
comparison purposes.
Key findings were as follows:
All episodes of cramping occurred in the latter half of the race
or immediately afterwards, with most affected runners reporting
three or more episodes. Most commonly affected muscles were
hamstrings (48%) and quadriceps (38%). Most cramps were
moderate-to-severe in intensity and best relieved by slowing the
pace or passive stretching;
There were no significant differences between the groups for pre- or
post-race body weight, per cent change in body weight, blood
volume, plasma volume, or red cell volume, indicating no difference
in hydration status;
Immediate post-race serum sodium concentration was significantly
lower in the cramp group, while serum magnesium concentration
was significantly higher. However, these differences were considered
to be too small to be of clinical significance.
Furthermore, report the researchers, the decrease in serum sodium
concentration following the race in the cramp group is probably related
to an increased fluid intake during the race in this group. Although
drinking patterns were not measured directly, increased drinking in the
cramp group is likely because of the well publicised belief that cramping
is caused by dehydration.
This supposition was supported by the finding that runners with
EAMC were less dehydrated than non-cramping runners immediately
after the race, with per cent decreases in body weight (pre- to postrace) of 2.9% and 3.6% respectively.
PAGE 88
The results of our study, conclude the researchers, do not support

the common hypotheses that EAMC is associated with either changes
in serum electrolyte concentrations or changes in hydration status
following ultra-distance running. An alternative hypothesis to explain
the [cause] of EAMC must therefore be sought.
Br J Sports Med 2004; 38:488-492
Runners high: a new explanation

The state of euphoria induced by prolonged exercise was known first
as second wind and more recently as runners high. Scientists
originally attempted to explain the experience in terms of the effects of
the stress hormones adrenaline and noradrenaline. Then came the
endorphin hypothesis. And now we have the endocannabinoid
hypothesis: a suggestion that the physical and psychological wellbeing
experienced by many endurance athletes is due to the exercise-induced
activation of endogenous cannabinoids lipids whose actions in the
body resemble those of the active constitutent of cannabis.
This theory, supported by scientific evidence that exercise boosts blood
concentrations of endocannabinoids, is given a thorough airing in a review
by US researchers published in the British Journal of Sports Medicine.
Their first point is that the endorphin hypothesis that the runners
high is induced by the release of endogenous opioids in response to
exercise doesnt hold water because, among other lesser reasons,
these chemicals are simply too large to cross the blood-brain barrier
and exert the central effects that are claimed for them.
The endocannabinoid hypothesis, on the other hand, is supported
by the following observations:
Unlike opioids, endocannabinoids can suppress pain at peripheral
sites as well as centrally;
Unlike opioids, they do not produce such side effects as severe
respiratory depression, pinpoint pupils and constipation;
Endocannabinoids inhibit swelling and inflammation and reduce
pain caused by the release of chemicals (such as lactic acid);
The intense psychological experiences reported by users of cannabis
sedation, reduced anxiety, distortions of time estimation, euphoria,
PAGE 89
enhanced sensory perception and feelings of wellbeing are

strikingly similar to the experience of runners high;
Research on animals has suggested that one of the principal roles
of the endocannabinoid system may be the refinement of
movements needed for coordinated locomotion;
Activation of endogenous cannabinoids through exercise could
account for the phenomenon of exercise addiction;
Endocannabinoids act as vasodilators and bronchodilators, which
should make exercise feel easier.
As the authors of the review point out: Further research is necessary
to characterise the precise nature of this endocannabinoid response
to exercise, specifically the relative importance of factors such as the
nature of the activity, exercise duration, exercise intensity, sex and age.
But in the meantime they suggest that the endocannabinoid
hypothesis is a feasible alternative to the endorphin theory and should
be investigated as such.
Br J Sports Med 2004;38:536-541
Nature and nurture in Ethiopian

endurance running success
In the increasingly competitive world of international sport, identifying
the key predictors of success has become a major goal for many sports
scientists. And nowhere has the hunt been more focused than in East
Africa, where the overwhelming success of male endurance athletes
has kept the nature v nurture debate simmering.
Saltins famous study comparing Kenyan and Scandinavian athletes
suggested that it was the distance the Kenyans travelled to school on
foot in childhood that gave them an edge in endurance athletics.
That theory has now received further backing from a major British
study comparing the demographic characteristics of Ethiopian athletes
with non-athlete controls from the same country.
An additional fascinating finding was that lite Ethiopian distance
runners are ethnically distinct from the general Ethiopian population,
raising the possibility that genetic factors might also be involved.
PAGE 90
Questionnaires seeking information on place of birth, spoken

language (by self and grandparents), distance from and method of travel
to school were given to 114 male and female members of the Ethiopian
national athletics team and 111 Ethiopian controls, none of whom were
regularly training for any track or field athletic events. The athletes were
separated into three groups for comparison: marathon runners (34), 510km runners (42) and other track and field athletes (38).
After analysis, the main findings were as follows:
l In terms of regional distribution, there was a significant excess of
athletes, particularly marathoners, from the Arsi and Shewa regions
of Ethiopia. 73% of marathon runners hailed from one of these two
regions, compared with 43% of 5-10km runners, 29% of track and
field athletes and just 15% of controls. To put those figures in
context, Arsi is the smallest of Ethiopias 13 regions, accounting for
less than 5% of the total population, but housing 38% of the
marathon athletes in this study;
The origin of language of all the athlete groups differed significantly
from that of the controls. Three separate language categories were
used: Semitic, Cushitic and Other; and Cushitic was significantly
more predominant in each of the athlete groups than among the
controls. The effect was most pronounced in the marathon group,
where 75% spoke languages of Cushitic origin compared to 30%
of controls;
In terms of distance travelled to school, the marathon athletes
differed significantly from all other groups. 73% of marathoners
travelled more than 5k to school each day, compared with 32-40%
of the other groups. And marathoners were much more likely to run
to school each day than the other groups (68% v 16-31%).
Where does this leave the nature v nurture debate? The findings about
travel to school undoubtedly point to environmental influences, as the
researchers acknowledge.
the results implicated childhood endurance activity as a key
selection pressure in the determination of Ethiopian endurance
success, they say. With the prevalence of childhood obesity in the
United States and Great Britain at an all- time high, and physical activity
levels among such populations in stark contrast to the daily aerobic
PAGE 91
activity of Ethiopian children, these factors may offer an explanation for

the success of East-African athletes on the international stage.
On the other hand, the findings about regional and ethnic origins
point to genetic influences. Or do they? The regions of Arsi and Shewa
are situated in the central highlands of Ethiopia, intersected by the very
same Rift Valley that has been implicated in the success of Kenyan
endurance runners. This may seem to support a link between altitude
and endurance success. But it doesnt explain why Arsi is also
considerably overrepresented in track and field athletes (18%), who
would not be expected to benefit from living and training at altitude.
The researchers put forward an alternative, somewhat more prosaic,
hypothesis. One of the senior Ethiopian athletic coaches informed the
investigators that most of the marathon athletes would be found to be
from Arsi, they explain. If those in charge of athletic development
believe this, it may cause a self-fulfilling prophecy through talent scouts
focusing more attention to this region or through increased regional
development of athletics.
What of the findings about language? The fact that most of the
marathoners spoke languages of Cushitic origin (mostly Oromigna, the
language of Oromo people) may reflect a high frequency of potential
performance genes within this particular group.
However, it is much more likely, the researchers add, that the
distinctive ethnic origin of the marathon athletes is a reflection of their
geographical distribution, as primarily Oromo people populate Arsi.
Although not excluding any genetic influence, they conclude, the
results of the present study highlight the importance of environment in
the determination of endurance athletic success.
Med Sci Sports Exerc, vol 35, no 10, pp1727-1732
PAGE 92
Contributors
Raphael Brandon MSc is a sports conditioning and fitness specialist.
He is also London region strength and conditioning coach for the English
Institute of Sport.
Alison McConnell BSc, MSC, PhD is currently professor of applied
physiology at Brunel University, a Fellow of the American College of
Sports Medicine and a British Association of Sport and Exercise
Sciences accredited sport scientist; her research interests are in
respiratory limitations to exercise performance.
Andrew Hamilton BSc, MRSC trained as a chemist and is now a
consultant to the fitness industry and an experienced science writer
Ron Maughan is professor of sport and exercise sciences at
Loughborough University
John Shepherd MA is a specialist health, sport and fitness writer and
a former international long jumper
Scott Smith is an Australian physiotherapist. He works at Albany Creek
Sports Injury Clinic in Brisbane, specialising in running and golf injuries
Bruce Tulloh was European 5,000m champion in 1962 in a time of
14:00.6. The championship record is now 13:10, but the 2002 title
was claimed in 13:38.
PAGE 93

Distance Running

Uploaded by

Copyright:

Available Formats

Distance Running

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Distance Running

Uploaded by

Copyright:

Available Formats

What are some of the topics covered in the special report?

What are some of the topics covered in the special report?

What factors are said to contribute to the success of Ethiopian distance runners?

What factors are said to contribute to the success of Ethiopian distance runners?

Training for

The research newsletter on

OTHER TITLES IN THE

From the editor

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

Why distance runners

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

slightly enlarged by comparison with sedentary people. The

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

athlete reaches their lactate threshold, at which point further

Athletes are made rather than born

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

Type IIa or intermediate fibres can, in elite endurance

Adapted from McKardle et al

% slow-twitch fibre in deltoid muscle

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

They found that the trained group had 70.9% of slow-twitch

Fibre reversion after inactivity

However, it seems that slow-twitch (and fast-twitch) muscle

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

The central fatigue hypothesis

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

In summary, then, developing your endurance capacity relies

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

Running and body fat

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

An excess of body fat, however, serves no useful function for

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

Running speed (km/h)

Rate of carbohydrate utilisation (g/min)

Energy cost (kJ/min)

Contribution of fuel sources as a function of

and blood glucose (which is continuously being replaced by

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

Body fat and performance

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

Strategies for controlling weight and body fat

Use well chosen snacks between meals to maintain fuel levels

Although these results indicated that leaner individuals seem

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

Body fat (%)

Weekly running distance (km)

Daily energy intake (J/kg)

Relationship between calorie intake and body fat

Body fat content (%)

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

Relationship between energy intake and weekly running

Weekly running distance (km)

How is body fat measured?

Fat levels in elite runners

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT

PEAK PERFORMANCE DISTANCE RUNNING SPECIAL REPORT