Tuesday, October 18, 2011

On multiple counts... WHY?

Don't I look exasperated?
MRI—Why?
So one of the things that really pisses me off about having taken 7 weeks off of running is that it may have been unnecessary or at least I feel it could have been lessened. As soon as I started to get pain on top of my foot, I did research and identified a metatarsal fracture as one of the possibilities. Don't you love how darned smart the web has made us? I went to a very qualified Orthopod at Rush in Chicago. He didn't think I had a fracture and said that I may have a pinched nerve. He gave me some topical cream and sent me on my way. So, what did I do? I took his word for it, kept running on it and ignored the pain until it got unbearable. I can guarantee that was the point when I went from one to two stress fractures. Why no MRI? I just don't get it. Doctors are usually like drugged-up youngsters at a strip club when it comes to spending your insurance money. For some reason, they draw the line at MRI's? There are now three occasions where I have paid the price for this precious MRI behavior. The first was when I had a tear in my shoulder that was misdiagnosed because they didn't do an MRI initially. The second was when I was hospitalized for pneumonia when a student doctor accidentally ordered me an MRI. Even when it showed something that made them hospitalize me, the attending was annoyed! My foot is number three! I am not an advocate for exposing the human body to an MRI ever five minutes but I think there is something really wrong here. If this is my margin of error, what is the general margin because of the reluctance to MRI?


Minimalist Shoes—Why?
So, there is a hot debate going on about minimalist shoes. Experts can't agree. Runners can't agree. What one person claims is barefoot is minimal. What another says is minimal isn't actually minimal. It's a bit of a mess. There is also a lot of finger pointing going on too. Why the confusion? Why the hate? Normally, I would stay away from a ridiculous goat rodeo like this but, so many people have given me shit about minimalist shoes since I got stress fractures that I feel like I have to say something. Let's be clear. This is just my personal POV on how I see it and what works for me.

  • I know that humans were designed to be barefoot. 
  • I know that human feet were designed to be zero-drop (flat and not raised at the heal). 
  • I know that human feet were designed to have natural movement and not be supported or restricted. 
  • There is no such thing as a barefoot shoe or a barefoot-like shoe. That is just marketing nonsense. You are either barefoot or you are wearing shoes. Silliness!
  • Minimalist to me means shoes that are so minimal, they provide basic shoe protection while allowing feet to move freely/naturally and offer runners the best possible ground-feel. I think it would be fair for people to claim that they are barefoot inspired.
  • I believe that modern long distance running is an extreme behavior that is above and beyond the basic human design and therefore, foot protection makes sense. Even the Raramuri (Mexican running tribe made famous by the book Born to Run) wear sandals.
  • I believe that everyone's body tolerates the stresses of long distance running in a unique way (some better than others).
  • I believe that some people may require a level of foot support but I also believe that some people could benefit from no support in order to gain foot strength and improve foot or gait issues.
  • I believe that transitioning to barefoot or minimalist will get you injured if you are not very careful. Bodies become reliant on supportive shoes.
OK, so what has been my personal experience or journey?
  • Wearing minimalist shoes changed the way I run and stopped me from having constant injuries through heal striking. It took me months to transition.
  • I haven't run barefoot but would do it to help strengthen my feet. I'd have to do it on a beach or on a soft track. I have no interest in running barefoot on rough trails or dirty city streets.
  • Wearing minimalist shoes with no arch support has given me a higher arch. I know it sounds unbelievable but it is true. My shoe size is smaller because of it.
  • I like to buy shoes that are zero-drop or close to zero-drop because that is the way feet are meant to relate to the ground. Why would you run on a wedge unless you are a heal striker?
  • I like shoes that allow my feet to move naturally, so that means no support and plenty of room for my toes to splay, etc. I like to wear shoes for protection—not to change my mechanics.
  • I actually like the minimal ground feel and lightness of my New Balance MT10's but I feel like for distance on roads, I need padding to help me lessen the impact on my feet.
I think New Balance are pretty well aligned with the way I think about things.

Diet—Why?
I discovered something that makes no sense when it comes to running and diet. This is what I would have assumed before I started running:
  • Running takes up a lot of energy and therefore, you feel more hungry after a long run.
  • Running burns off so many calories that you feel entitled to indulge. You should be able to eat more.
  • Running gives you permission to cheat with bad foods once in a while because you know that you are going to burn it off quickly.
For me, the truth is that when I run, I tend to eat less and eat healthier. The healthy part makes sense. You are committed to training, so the eating component compliments the physical commitment that you are making. Why would I feel generally less hungry though? It makes no sense. I have yet to find anything that explains this and it seems to go against most people's experience.

I know that I still have to gain more readers in order to get more comments but if you want to chime in, I'd be interested in your opinions on the three issues at hand:
  • Why are doctors so slow to do MRI's when they do many other things that are potentially harmful to their patients?
  • Why does the minimalist craze create so much tension?
  • Why do I feel less hungry when I run?

2 comments:

  1. Hey Simon,

    I found this article:
    http://www.livestrong.com/article/438884-how-can-i-suppress-my-appetite-without-pills/ and several others as well. Unfortunately, none of the articles point to the elusive "British Study" referred to in the articles.

    My own experience is in line with the results of the study. I find myself having to force myself to eat knowing I need the nutrition following an intense workout.

    ReplyDelete
  2. Thanks for this. Interesting. So, in the journal ghrelin (which can make you hungry) dropped and peptide YY (which stops you from being hungry) increased. It did it with aerobic but not non-aerobic exercise. 90 mins of aerobic exercise seems to suppress appetite for 30 mins. They haven’t yet tested active ghrelin to see it’s impact on appetite suppression in the brain results in a drop in food intake but it is interesting.
    You can see the journal here:
    http://www.the-aps.org/press/journal/08/41.htm
    You can also hear Dr. David Stensel of Loughborough University talk about the it here. Click episode 16.
    http://www.lifelines.tv/
    If this is true, why do so many people online talk about how darned hungry they are after running? I asked the APS if they could put me in touch with Dr. Stensel to see if I could ask him about it.

    ReplyDelete

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