Health

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.