Health

Stretching the Gluteal Muscles

By Dr. Grant Matkovich

Dear Runners,

This time we are going to look at how to stretch the Gluteal muscles.

The Gluteal muscles (Glutes) are your ‘butt’ muscles and are made up of three muscles. The 1. Gluteus Maximus, 2. Gluteus Medius and 3. Gluteus Minimus.

These butt muscles move the hip so are used a lot with running (like a lot!), so are often tight from being over-used. This is why the Gluteus are a common cause for butt, back of the leg and groin pain and tightness in runners.

So stretching them is important!

1. Gluteus Maximus

This is the main and biggest butt muscle.

It moves the hip backwards, so it works in every stride when you run.

Tips to do it correctly:

  • Pull the knee up to the chest towards the shoulder on the same side.
  • You should feel the stretch in your butt, there should be no pinching in your groin.
  • If you cant feel the stretch in your butt, then try pulling your knee over your body towards your shoulder on the opposite side. This should cause a deeper stretch in the Gluteus maximus.

Add this stretch to your routine after long runs, if you have low back pain when running or tight Gluteus muscles.

2. Gluteus Medius and Minimus

These muscles both help stabilize the pelvis (they help keep you up-right when you are standing) and they move the hip outwards. So can be stretched together.

These muscles are used when running. They are not used as much as Gluteus Maximus, but are still important and can cause pain.

Tips to doing this stretch correctly:

  • This is an awkward stretch to find the correct position. But with tight muscles you will feel the stretch in the position. If there is no stretch, the muscles may not be tight.
  • This is a good stretch to add if you have ITB issues.

For both these stretches:

  • Hold the stretch for 30 seconds, repeat 3 times. It is best to do both sides, even if the other side isn’t tight.
  • The ideal stretch is to find the position that is comfortable but not yet uncomfortable.

Next time we will look at the Piriformis muscle, which is under the Gluteal muscles and is also a common cause of pain in runners.

Real athletes don’t diet

By Ann Ashworth

Diet is not equivalent to nutrition
Diet, as in what an athlete eats day to day, has to be up there with one of the most frequently asked questions of any elite athlete. Followers and fans want to know if what an elite athlete eats, is the secret to their success. And it is, at the very least, a contributory factor.

Having said that, it is important to distinguish between a “diet” as the running public understand it: a list of do’s and don’ts as to what should be on your plate (or in your back pocket while training); versus the kind of readily available foods which offer your body the nutrients they require to perform at its best (or, to function optimally). Because there is difference.

You may choose to follow the banting diet plan, a low-carb, high fat diet that excludes all grains, added sugars, vegetable and seed oils, and any foods containing gluten, or similarly the Atkins diet. Another diet popular amongst active individuals is the paleo diet comprising about 20% carbohydrate (more than Banting), 40% fats and 40% protein and which similarly excludes sugars, grains, processed foods and legumes. Also popular is the practice of intermittent fasting where food intake is limited to a set window period during the day. In each instance, the goal of the diet is to “lose weight” (or, most frequently belly fat), gain muscle mass and/or improve your overall health.

Counterintuitively, each diet claims to be the only way to reach these goals successfully.
What you will find, however, is that the vast majority of successful athletes, and particularly elite athletes, follow what your Mum would have described as a “balanced diet”; a moderate mix of everything fresh, coloured and readily available. Whole foods, namely naturally grown and free from hydrogenated fats, artificial colourings/flavours and preservatives, are a stable in any athlete’s diet. Combine these with complex carbohydrates such as brown and wild rice, quinoa, potatoes, maize and other staples, as well as hormone-free proteins and you will have everything you need to sustain the activities in which you hope to achieve.


But, if you diet… and by that I mean follow a restricted regime of do’s and don’ts, count your calories and tailor your nutrition intake to the ideals of say, a supermodel… your performance will suffer. If not immediately then certainly within the medium to long term. There’s a reason why models while lean and lithe, aren’t likely to set any land-speed records over your favourite race distances; because they don’t fuel for performance, they fuel for appearance. And there’s a difference. Of course there are outliers, as there are with everything; that person who tells you the reason why they are suddenly looking so good or running so well is because of some new-fangled diet regime. Maybe whatever they are doing is
working for them, right now. Get back to me in 12 to 18 months and let me know if they were able to sustain those performance gains because, chances are, they will not. Or if they do, their diet probably won’t be as strict as it was when they first started and it will have moved closer to something more balanced… which is exactly what a diet should be.

Let’s also recognize that before “going on” or starting a particular regime, a person’s diet may not have been particularly good and may have contained a high proportion of fatty, sugary or highly processed foods. Their decision to start a new eating regime must have been motivated by something – usually a desire to eat better, to feel better and to lose excess weight. In that case, moving toward any kind of eating plan which incorporates fresh foods, of whatever nature and in whatever proportion, is going to be better for them than the diet they previously followed.

I have previously followed a high-protein, low-carbohydrate and almost fat-free diet in the pursuit of sporting excellence. And for a while it seemed that I had found the key. I was strong and lean and running faster times than I could have previously imagined. But as time progressed, my body started to fail me. By excluding certain foods from my diet and limiting my intake of others, I unknowingly started to deprive my body of essential nutrients which it required to keep me healthy. In the absence of essential fatty acids I stopped being able to generate certain hormones and chemicals required for everyday life. Without adequate carbohydrate my body didn’t have sufficient fuel for me to complete my training sessions or to facilitate recovery afterwards. Slowly but surely my body entered a state of chronic calorie deficit, my performance suffered and I started to break down; all the while filling my plate with loads of low-calorie, high protein food. Eventually I developed a condition known as RED-S – Relative Energy Deficiency in Sport.

It took me almost 2 years to recover from RED-S. It involved me taking a serious look at my diet and working together with one of South Africa’s most knowledgeable sports-focused dietitians. Within a few weeks of committing to a balanced diet, I finally felt like my old self. And better yet, I look far better than my old self – my hair has grown instead of falling out; my muscles are strong and lean. I can concentrate on what I am supposed to be doing instead of being easily distracted and half asleep. My sense of humour has returned and I don’t feel weirdly emotional for no reason. I’m back to being Ann… and my performance hasn’t suffered.


And so, in response to the question: do I follow a specific diet? I offer the following response: “My Mother always said that a little bit of what you fancy does you the world of good”.

I eat whatever is fresh and readily available, limiting my intake of highly processed, sugary and fatty foods, with the following core principles in mind:

  1. Breakfast is the most important meal of the day, especially if you train beforehand. Make sure you include a healthy dose of lean protein (at least 25g) and complex carbohydrate to keep you fueled for the day ahead. Always choose a 3-egg omelet and sourdough bread over cereal or toast with jam.
  2. It is imperative that you fuel for recovery. This means taking in at least 25g of lean protein post-workout. If you train before breakfast – incorporate your protein into breakfast. If you train later in the day, make sure you are slugging down a recovery protein shake with 30 minutes of your training session. No excuses.
  3. Women must eat within 30 minutes of waking up. This reduces your “fat-storing” hormones and ensures you start the day on the right foot. Think about a rusk, a small banana or a smoothie which you can get down pre-morning run.
  4. Life should be colourful – include a wide variety of fruit and vegetables into your diet.
  5. Don’t be afraid of carbohydrates – they fuel your performance. But, if you do want to manage your weight (particularly as you get older), eat vegetable-based carbs at night (butternut, potato, corn) as opposed to grains or pasta.

Tips from Dr. Mat – August 2021

Dr. Grant Matkovich

Dear Runners,

Stretching for runners is always a good thing. However, to stretch correctly is not always easy.

Here are some tips on how to correctly stretch the quads (front of the thigh) and hamstring (back of the thigh) muscles.

These muscles are used a lot with runners and always need same attention!

Quadriceps

Important to stretch this muscle if you have runners knee (pain in the front of the knee behind the kneecap, with a feeling that the back of your knee cap is grinding against the knee joint).

Tips to do it correctly:

  • Remember to balance / stabilize yourself with your other hand by holding onto a chair or a wall.
  • Make sure your knee is next to your other knee when you are stretching.
  • Make sure your upper body / torso is up right, ideally with your lower back slightly arched.

You should feel the stretch in the front of your thigh with the most of the stretch in the thigh slightly above the knee.

Add this stretch into your routine after you have done hill sessions or an especially hilly route as your quads work hard when running up hill.

If you are unable to balance or stand on your one leg you can change position to lying down on your side. Shown below.

Hamstrings

Always tight with runners, just try touch your toes with your legs straight!

This is a good stretch for runners with hamstrings that cramp often or with burning pain around your “bum bones”, the bones you sit on.

Tips to doing this stretch correctly:

  • Keep your pelvis straight with the floor, don’t ‘hike your pelvis.
  • Take both hands (not just one) down the leg on the side being stretched this will help stretch the whole hamstring muscle.
  • Bend your back forward over the leg being stretched this will help isolate the hamstring muscle more.

Like the quad muscles hold this stretch for 30s and repeat 3 times. Its best to do both sides even if the other side is not injured / tight/ giving issues.

This stretch can be painful. The ideal stretch is to find the position that is comfortable but not yet uncomfortable.

This stretch needs to be done regularly to increase hamstring flexibility which will help reduce low back and glute (butt) muscle pain when running.

Next time will be tips on how to stretch glute muscles.

Heidi’s new heights!

Heidi Groenewald

I turned 40 during 2020. We had just gone into hard lockdown 4 days before the big Four Oh and I had to cancel my fortieth birthday/house warming party. We moved into our new house on the 6th March and were so busy with house hunting, bond applications and packing and unpacking that my dream of being forty and fabulous had fallen along the wayside and I ended up celebrating my birthday being forty and fat!

Needless to say, we were all bored and had to find ways to keep sane during these crazy times. And this is probably where you are thinking that I decided to start running. Nope, I decided to indulge in one of my other pleasures….baking! And along with hubby’s love for cooking I grew even more fabulously fat!

Isn’t it amazing how we only notice what we really look like when looking at pictures? And during November 2020 I saw a picture of me that made me realise that I needed to find a hobby other than baking. A friend of mine was going through a weight loss journey at the same time and gifted me with a weight loss coach and an eating plan. Part of this weight loss program was having to make at least 10 000 steps a day. Ten thousand!? How was I going to do this when most of my day was spent sitting on my office chair in front of a computer!? Queue the running!!

I was serious about being forty and fabulous and went digging through my drawers to find the smart watch which hubby had bought for me more than a year ago. Hauled out my running shoes, which I had only used for gardening up until now. The plan was to start running with Ronnie, but I just never seemed to get around it. Life was always getting in the way and with three very busy kids, two of them being very sporty boys, there just never seemed to be enough time in a day. I decided that the only way that this was going to happen was for me to get up earlier. This being a struggle in itself as I am no early bird. But like clockwork I would get up every morning and jump on the treadmill in the corner of our room to try and get as many steps as I could before my day started. Headphones on and in the dark as Ronnie was still sleeping. I was oblivious to my thud, thud, thud, thud on the treadmill. Ronnie not so much! And on the 17th November 2020 he promptly decided that he would have to get up and do this with me….there was no sleeping through my thudding….but there was one condition….we were going to do it his way. I was secretly petrified knowing that he had completed three half marathons and was very chuffed with himself that he could run 13,5kms without stopping!

He downloaded an app called Couch2 5K on my phone and off we went every morning for me to train to run 5kms without stopping. Because I had to make 10 000 steps every day as part of my weight loss plan, we had no rest days. But this worked for me as routine and a new habit set in very quickly. I am a very organised person and routine is what makes me tick! And on the 27th December 2020 I ran my first 5kms without stopping! (And I lost 9kgs in the process!)

Getting up to go run had become easy and within two days we started the 10K training program. But the running wasn’t getting easier. It was getting hotter by the day and I literally felt like there was going to be nothing left of me by the end of each run. No energy and no fluids. But I pushed through each run.

Finally the day arrived on the 7th February 2020! I was going to do this! Ronnie decided that my first long run should be on the promenade. Just to make it a bit easier. Our son Daemien decided to run with us this day. It was really hot and my legs felt like lead. Admittedly I only start feeling comfortable after about 5kms into a run. But today was not getting easier. Daemien is just a natural runner and was a couple of steps ahead of me without having trained at all. Ronnie wasn’t having a good day and started battling at around 5kms. Daemien was ahead and Ronnie was falling behind. I was struggling in the heat and my legs were failing me. Was I going to give up and start walking with Ronnie? After all, he has always held back so that I can keep up. The urge to just start walking and the heat was just getting too much. My mind started taking over. I have trained so hard to get here and would have to wait a whole week before I could attempt this again. There is just not enough time in the mornings before work and school. And I had already started bragging to everyone about doing this ….no backing out now!

I asked Daemien to go check on Ronnie and he came back and told me that Ronnie was okay and said I must just go. Knowing that he was fine and no longer feeling guilty for leaving him behind put my mind at ease. And at around 7kms I just found my rhythm. Somehow my body just kept going and I managed to find a comfortable pace. By the time I reached Suncoast (running toward Bike & Bean, being the finish) it was extremely hot and I tried to keep to the shade as much as I possibly could. My legs no longer felt like they belonged to me. I remember thinking that I hope I don’t trip and fall down in front of Bike & Bean. And somehow I made it, past everyone relaxing and sipping their coffee and enjoying their breakfast, without face planting. I made it and I still had my own legs, although they felt like jelly at the time. I made it, although I had planned to divorce Ronnie many times in my head when he made me run hills. I had run 10kms without stopping!

And who knows….maybe there is a 21km on my horizon (with Ronnie by my side!)

LCHF – Fueling our bodies in a new way

By: Roger Scholtz

d587a4fc-4a79-4975-b14d-e2726e57a339On Thursday 3 May, Stella AC hosted an information evening that was addressed by Dr Glen Hagemann, a sports physician at the Sharks Medical Centre. His presentation was entitled “Low carb, high fat diets in elite and recreational endurance athletes.” The basis of the presentation is that the conventional wisdom of the importance and necessity of eating a carbohydrate-rich diet for athletic performance is being questioned and challenged. Increasingly, scientific studies and compelling anecdotal evidence suggest that a LCHF (low carb high fat) diet represents a more efficient alternative for fueling our bodies’ energy needs. Dr Hagemann’s stated objective was to present some of the evidence behind this approach to diet and nutrition, not to tell anyone what they should do, but so that people might be better informed as they consider their own dietary choices.

At the core of the LCHF approach is the understanding that in a low-carb environment the body is capable, over time, to adapt to burning fat as an immediate energy source, which is referred to as becoming “fat adapted”. One of the key advantages and benefits of this is that body fat is available in an abundantly more plentiful supply than the glycogen reserves (the energy source produced by carbohydrates) that can be stored in our muscles and liver. (This abundant supply of body fat is especially true for some of us!) The LCHF approach conditions our bodies to be able to tap into this bountiful energy reserve. A helpful analogy was given of a petrol-driven truck pulling a tanker of diesel, with the observation made that if the truck could find a way to access and use the diesel it was pulling around, it could continue driving almost indefinitely.

The presentation included a helpful mix of the science behind this approach, some of the latest research data to emerge in this field, and anecdotal stories of athletes (both elite and recreational) whose performance in endurance events like Comrades, Two Oceans and Iron Man have improved significantly on a LCHF diet. The down-side to a LCHF diet involves the tough lifestyle choices of changing the way one eats, having to say ‘No’ to things like the bread basket, sugary drinks and snacks, grains and pasta, and even (maybe) beer! The upside is that the strip of fat on your rump steak can be enjoyed guilt-free – not to mention other common benefits such as weight loss, added energy and improved running performance.  At the end of the day, everyone needs to decide for themselves whether this particular fuel price has gone up or down, and whether or not they are willing to reconfigure their body’s internal combustion engine.

Many thanks for a highly informative and worthwhile event.

On Running and Illness

By: Dr Anver Goga

We runners believe we are an invincible lot, immune from ills due to our fitness levels. Unfortunately we are just as prone to illness as everyone else, at times more so.

I am often asked, Doc, I have the `flu`; can I run? Can I sweat it out?

It is important to distinguish whether you actually have a simple cold or the dreaded influenza, which are quite different and caused by different viruses.

The common cold virus, most commonly caused by a group of viruses called Rhinovirus, affects us 3 – 4 times a year, causing an itchy nose, scratchy throat, itchy eyes and the sniffles. If these symptoms are mild and stay above the neck, don’t cause a fever then it is safe to run. You don’t need an antibiotic. Remember the common cold can become complicated with bacterial infections giving rise to sinusitis, ear infections and migrating down to your chest. Headaches, earaches, cough and yellow nasal discharge suggest this necessitating antibiotics and a longer duration of illness – running not allowed.

A completely different kettle of fish is when you have the actual flu virus, influenza virus. This usually comes around once a year, usually in April / May before the Comrades Marathon. The influenza virus affects the entire body; Fever, malaise, and especially for the runners, muscle soreness. The virus affects all muscles and can also affect the heart muscle leading to heart failure. Symptoms are above and below the neck. It is especially dangerous to run with the flu virus as running can further depress your immunity and raise the core temperature of the body facilitating spread of the virus. Running not advised.

So, how do we get these viruses?

We all know that when a symptomatic person sneezes and you are in close proximity, you are likely to inhale the virus. The virus is also spread by touch. An infected person who may be asymptomatic for up to 24hours after catching the virus spreads the virus by touching door knobs, gym equipment, escalator rails at shopping malls, eating utensils and fridge handles. By touching the infected apparatus ourselves we infect ourselves by touching our nose/ eyes.

How do we avoid getting colds and flu?

By frequent hand washing, especially after touching objects; avoiding people with the flu (easier said than done); by keeping your immunity high; avoiding work and domestic stress (again easier said than done), avoid overtraining, changing into dry clothes as soon as possible after a run and avoiding sudden changes in temperature. High dose Vit C, multivitamin supplements, zinc, ecchinacia; have not been shown to reduce the incidence of getting the flu / colds. Taking the flu vaccine at the end of February prevents getting the flu 70% of the time; Advisable to take it. The  vaccine has dead virus particles in it so you cannot get the flu by taking it.

What to take if you have the flu / cold?

Panado; nasal decongestants, together with lots of fluid and rest. Antibiotics are only needed if you develop bacterial infection. Avoid all anti inflammatory medication like Advil; Celebrex; Coxflam; Arcoxia; Aspirin; Mypaid; Voltaren and Myprodol, These decrease the blood supply to the kidneys and affect your stomach lining giving rise to ulcers. Especially avoid all forms of anti inflammatory medication when running races; disastrous complications can occur; especially renal failure.

Recommended time after having the flu to get back into running – at least 2-4 weeks.

The benefits of sports massage for runners

By: Margaryta Garidian

The benefits of massage therapy have been know by humans since ancient times. Roman gladiators were in fact prescribed massages before and after training. Nowadays, sports massage has become a necessary routine for many athletes in both preparation and rehabilitation.

Sports massage works on a simple principle, to manually increase blood flow to areas where it is needed or where it could be sluggish. Blood delivers oxygen and nutrients to the tissues and removes waste products away from it. This allows the body to heal itself in a safe and non invasive manner.

Some of the benefits of sports massage for runners include:

  • Helps prevent injuries and speeds up recovery of injury or after a long run.
  • Stretches the tissues that could not been stretched by usual methods.
  • Reduces pain by releasing endorphins (natural pain killers).
  • Breaks down scar tissue (when muscles are injured, the body creates scar tissue to glue micro-tears).
  • Relieves trigger points or hyper irritable “knots” found in muscle and fascia, that cause pain and restrict the range of motion.

The images below show some common runner trigger points and their referral pain pattern.

When should you have a  sports massage?

  • A deep thorough sport massage should ideally take place 7-5 days before the big race.
  • Any pre-event or inter-event massages should be short and vigorous.
  • Post race massages should be recovery focused and should involve lighter  pressure and relaxing techniques.
  • Don’t forget to hydrate properly after a massage to help flush out waste products.

In conclusion, sports massage will not only make you healthier, but may help to extend your running career and achieve the maximum from it.

To stretch or not to stretch….

by Dr Grant Matkovitch

DrG
Running training, especially when increasing mileage, adds a lot of stress to your muscles.

When a muscle becomes fatigued it becomes shorter. As the shortened muscle gets used over and over it becomes more shortened. Until the muscle becomes so shortened that the runner feels the ‘tight’ muscle, which feels weak, painful and limited in its movement. The muscle may even start cramping.

To stop the effects of tight muscles it is important to stretch as stretching helps lengthen the shortened muscle back to its normal length.

There is a lot of conflicting information about stretching (When to stretch, how to stretch). This has made it confusing on when and how to stretch.

As a specific guideline: Should you stretch?
Yes, it is a good idea to stretch, because as mentioned earlier, after months of training your muscles are very likely fatigued and would benefit from regular stretching, even if you can’t feel the tight muscle yet, they are there!

Which muscles should you stretch?
The best muscles to stretch are the Gluteus muscles (Max, Min and Med) otherwise known as your butt muscles, your hamstrings (back of the thigh), your quadriceps muscle (front of your thigh) and calf muscles.

How should you stretch?
‘Static’ stretches are the best. This means finding the position where you can feel the muscle stretching and holding that position. When you feel the stretch in the muscle it should be a pleasant sensation. It should have that “nice” pain sensation if it’s more than slightly uncomfortable then back off on the amount of stretch.

Unfortunately the idea “no pain, no gain” does not apply with stretching as if it’s too painful you might be aggravating the muscle and causing damage. Do not bounce in the stretch position (known as ballistic stretching) as this can badly damage the muscle!

How long and often should you stretch for?
Keep the stretch position for a recommended 30 seconds. This will help give a chance for the muscle fibres to lengthen. I would suggest introducing stretching of muscles 2/3 times per week. It can be done either in the morning or evening, no time has been shown to be better, so whichever time suits your schedule.

If you are having an issue with a specific muscle and it feels tight, painful or is hampering your running performance, then I would suggest increasing stretching to every day of the painful muscle. If a muscle is sore during a run, then stretch that muscle after the run.

Remember that if a muscle is causing pain and tightness whilst you are running, consider taking 3 mins out of your run/race to stretch the muscle on the side of the road. This might help release the tightness and lead to a more comfortable rest of the run (without the need for painkillers/supplements!).

As an add on to stretching consider putting a heat pack on your muscles whilst stretching or watching TV. The heat will increase blood supply to the muscle which will help flush the muscle of Lactic acid and metabolites that cause the muscle fatigue. It will also help promote healing in the muscle.