Wednesday, February 22, 2012

Long Distance Running

I've recently had several discussions with people about jogging and running.  These discussions often come up naturally in conversation about my views on strength and conditioning.  Some of them were precipitated by some of my comments in my recent "More is NOT Always Better" post, wherein I suggested that jogging 10, or 26.2, miles isn't necessarily better than running shorter distances, faster.
Since running various distances was only an example, and not the main topic of my post, I didn't elaborate much.

This left several readers in a state of consternation, and I received several text messages and emails about those comments.  Ranging anywhere from "Ya Wolf!  Good takedown of stupid jogging!"  to "That was unexpected," to "What in the name of Kahn are you talking about?!?" to "I am a jogger.  Didn't you see the commercial?  Joggers, we're different.  I'm coming for you.  And you won't be able to run away from me, either, cause I'm a jogger.  I'll catch you."

Ok, so I made the last one up, but there was plenty of agreement, surprise, and disagreement engendered by that post.  Which makes sense, because for some reason, the discussion on how best to do conditioning work is one that a lot of people get riled up about.   In this post, I will explore the issue in greater detail than I previously have, explain my own position, and hopefully clarify once and for all my position on long distance running/"cardio."

Why am I not a huge fan of this?
Because it's generally less effective at increasing
fitness than THIS!
(Gratuitous bathing suit pic acknowledged)
The key to this discussion is understanding why most people are jogging.  I haven't taken a formal survey, but from 9 years in the fitness industry and generally being a social human being, I've gathered that most people jog because of one of the following reasons, or a combination of some or all:
1. They want to "get in shape" or "stay in shape."
2. Their doctor told them to
3. It's the only form of fitness they know how to do
4. They want to lose weight and think jogging is the best way to do so
5. They believe jogging is good for heart health

I list those reasons, because I specifically want to exclude one group from this discussion: actual endurance athletes.  Defining that term very accurately is a longer, tedious discussion I don't want to get in to here, so for our purposes we'll simplify it.  In the context of this article, an endurance athlete is anyone who participates in endurance/aerobic dominant sports at a high level.  So I'm not only including olympians or professionals, but anyone who both takes their endurance training seriously AND is good at it.

I realize this is a somewhat vague definition, since "high level" and "good at it" are somewhat subjective. This definition doesn't draw a clear line of distinction, but for our purposes, this is ok.  The point is that this definition EXCLUDES the vast majority of people who "do cardio," jog, participate recreationally in marathons, 1/2 marathons, triathlons, iron man, etc...

I'll also very briefly point out that reason #1: "to get in shape" is the most common reason I've heard.  It's also complete and utter BS.  It's too vague to mean anything, and the question always is: get in shape FOR WHAT?  Unless the answer is "for a long distance race," then long distance training doesn't do that.  It's not often in any normal life situation that the need to repeat an extremely easy (in terms of strength, power, balance, coordination, and agility demands) activity for thousands of identical and linear repetitions presents itself.  General strength training much better provides a "getting in shape" training effect than does 30 minutes of jogging.  In any case, getting in shape is so meaningless as to render it a useless goal.   Strength is general, metabolic/energy system training is more specific, and becomes even more specific the longer time/distances you do.   This is because there's a trickle DOWN effect from high to low intensity, but there isn't, and can't be, a trickle UP effect from low to high intensity.  End segue.
Getting in shape for this... different than for this...
...which is different from the needs
of this...

...which is different than being in shape for this.

Anyway, why am I OK with endurance athletes doing long bouts of cardio, when I don't recommend it for others (for reasons we shall explore below)?  Listen closely, because this may come as a surprise to many of you:  high level competitive athletics is in no way, shape, or form about long term general health and fitness.  It's about competition and winning and pushing yourself to the limit.  And those two things are very often at odds with one another.  Training for recreation, health and fitness always prioritizes long term health over short term gains.  Competitive athletics often does the opposite.

In this respect, marathon runners and other endurance athletes are no different than football or rugby players.  They give their bodies a serious and severe pounding because that's what they need to do in order to excel at their sport.  The main difference is that in football/rugby or other contact sports, the injuries sustained are much more likely to be acute, whereas in endurance sports, the injuries and issues are much more likely to be chronic.  And this gets to the heart of why long distance training isn't as good an option for the general (non endurance athlete) population.

To clarify: An acute injury is usually the result of a specific impact or traumatic event that occurs in one specific area of the body, such as a muscle, bone, or joint.   An example would be an ankle sprain when a player comes down from a jump on an opponents foot and rolls his ankle, or an ACL tear when a basketball player tries to make a sharp cut and the deceleration forces overwhelm the knee joint integrity.

Whereas a chronic injuries develop slowly and are persistent and often long-lasting, or constantly recur over time.  Many chronic injuries have mild symptoms and low-grade pain, and are often ignored or simply overlooked until the pain increases and forces a training stoppage.  Chronic injuries are sometimes referred to as cumulative trauma or overuse injuries.  Example are tendinitis, stress fractures, shin splints, plantar fasciitis (in many cases), ITB Syndrome (in many cases), and others.

If something looks familiar about the examples of chronic injuries, that's because it's the same list of injuries that long distance cardio participants have on a regular basis.  It's not because I cherry-picked the list to turn out that way either.  Google search "chronic injury," "chronic injury examples," and other similar keywords, and these are the issues that come up most often.

So endurance athletes deal with chronic injuries, such as _____itis, while strength/power and most team sport athletes have to deal with acute injuries like sprains, pulls, tears, etc...

What about recreational participants?  Well, if you play basketball once a week at the recreational level, you don't accumulate enough participation hours to be at a high risk of an acute injury.  Sure, you might get one - everyone knows someone who's sprained an ankle in a pickup game - but the chances are a lot lower.  This is further mitigated by the fact that recreational games move at a MUCH slower, relaxed pace compared to pro games.  So the mechanisms involved in injury are less likely to occur, since the impacts and direction changes occur at lower speeds.  And if they do occur, it's more likely that the injury won't be as severe.  Again, we're talking about risk factor here.  Don't come yelling at me "WELL I TORE MY ACL PLAYING BASKETBALL ONE TIME, BUT HAVE BEEN RUNNING FOR 7 YEARS WITH NO PROBLEM, SO YOU'RE WRONG!"  There will always be outlying situations at the end of the statistical line on both sides.  But in terms of odds, where to place your bet, so to speak, this is what we're discussing.

Contrast that to endurance sports done recreationally.  Though you'll be going slower, you still have to put in nearly the same total training volume as the pros and elites, because you still have to finish the damn race.  You're probably not as good at absorbing the force and shock when running, because if you were, you'd probably BE an elite or pro.  Each step, or cycle cadence, etc... is probably done with slightly imperfect form - you're an over-pronator or your knees buckle in just slightly each step, etc etc etc...   So you're compounding your less than perfect ability to absorb force and shock with your small form imperfections.  Multiply this by 15,000 steps/7,500 per leg (approximate steps in a 10 mile run) and you take a serious pounding when doing long distance stuff.  Each tiny minute form error is magnified at a force of 2-3 times your bodyweight (since you're running) and repeated 15,000 times!!!!  Is it any wonder that long distance stuff is almost guaranteed to cause overuse injury?

Run a lot?  Better get used to this.

Now, if we go back to the beginning of this article and check what we now know against the 5 main reasons why MOST people do endurance training - does it still make any sense to do so, knowing the endurance training is almost certain to cause injury?   Recreational sports are also an injury risk, but as noted above, probably not as big a risk as endurance sport training.

To add to the list of long distance training woes, even if injuries weren't an issue, research and empirical observation has consistently shown that steady-state long distance training is simply less effective than various types of interval training at increasing cardiovascular/respiratory fitness.  Here's a short article (aptly titled "Death to Long Slow Distance") by Mike Boyle, one of the most respected S&C Coaches in the industry today, that touches on this point in greater detail: Death to Long Slow Distance.  Boyle cites a study that shows an hour, total, of interval work per week (including the rest periods!!) gave the same aerobic benefits as a long distance group who did 4-6 hours a week of standard cardio.  If 20% of the work yields the same or better results, why in the world would you choose to do all that extra work?
Further, if all that extra work is proven to be a HUGE risk factor for developing overuse injuries, then you've really got to ask yourself if it makes any sense at all to not switch to exclusively interval type training!  Unless, as I and Boyle and others have said, your actual EVENT is a long distance event.

Boyle has written another article on this topic as well, addressing trainers who train people who are recreational endurance athletes.  I can't link to it because it's available only on his pay-for site, but here's a long chunk of it, that I have found both disturbing and accurate:
In order to train the endurance athete you need to understand how he or she thinks. This involves something I have decided to call The Endurance Cycle. The cycle is illustrated below. 
The Endurance Cycle
-Train---> Injury---> Rehab/PT---->
-Train---> Injury---> Rehab/PT---->
-Train---> Injury---> Rehab/PT---->
-Train---> Injury---> Rehab/PT---->
The cycle is simple. Train hard until you get hurt. Call your PT (who by now is like a family friend) rest and repeat. This is so prevalent that I have coined another term "The Endurance Conversation". This is a typical conversation overheard between two endurance athletes. 
Endurance athlete 1 Question- "Are you training or injured?"
Endurance athlete 2 Answer - " Well I just got over _ _ _ itis and I've being running in the pool..."
To you or I, this may seem like a strange conversation but, between two endurance athletes, this is a "how's the weather?" conversation. Endurance athletes view injury as a reasonable expectation and are not surprised when it happens. In fact, my theory is that the entire physical therapy profession owes a great debt to the early aerobic proponents of the seventies. As a kid growing up playing sports I had never heard of a physical therapist. Physical therapists were put on the map by endurance athletes and their "itises". Endurance athletes fueled the physical therapy boom and today they continue to provide some of physical therapies best patients. To be honest, PT's love these guys. They are like crack addicts to them. 
Another thing that has become very common in the endurance world is the revolving door of what I like to call "The Injury Progression". The injury progression is illustrated below. 
The Injury Progression- The Three I's
Ingestion- oral anti-inflammatories, no change in training
Injection- anti-inflammatories like cortisone, no change in training
Incision- surgery, the "lets take a look" conversation. This is followed by a mandatory long layoff.
I like to call these the three "I's" of endurance athletes because not only are the endurance athletes the PT's best friend, they may also be the orthopedic surgeons best source of income. 
When dealing with endurance athletes the truth may be hard to tell them and even harder for them to accept. The truth is that all non-traumatic injuries are training related. All "itises" are overuse. If you didn't fall off something or get hit by something you did something wrong in training. Again, talk to an endurance athlete. Rarely will they admit they just plain did too much too soon. Instead, they will blame their shoes or some other inanimate object. 

Boyle hits uncomfortably close to the mark here.  Surely not all, but many PTs and Orthopods don't want to discourage this obviously injurious behavior, because it's likely one of their best sources of income.  The participants themselves are driven by a "More is Better" mentality, and in the case of long distance events, that type of training is almost sure to lead to further injury.

To conclude, I offer this anecdote:
Two friends, separately, recently sent me this article from the NYT health section, which was interesting.  It discussed studies that show that HIIT, or even not so high intensity intervals have equal or greater benefits compared to LSD (long slow distance, like traditional jogging).

My quick-take on it, as sent in a reply email to one of the friends who sent it my way:
While the modified version is definitely not HIIT anymore (HIIT, by definition, requires HI), it still does put one more point on the board to show that even lower intensity interval training is a lot more useful in a lot less time than LSDC (Long Slow Distance Cardio).  Funny how the person at the end hemmed and hawed “Oh but you really should still do the slow 30 minute stuff…”  Ummmmmmm WHY?!?!?   Why would you choose to do something that’s more boring, less effective, and takes longer?  Oh, and reduces strength and muscle, and increases catabolic hormones?  Oh wait, cause you’ve been recommending it for decades, so let’s keep doing that.
On the skeptical side, if you study untrained people, ANYTHING will make them fitter.  But since all the subjects were untrained, it’s valid because we can see which works better.

The only need I see to ever do anything except relatively short, hard intervals is with a SEVERELY deconditioned person, or if you’re training for a race/event that requires longer distances.  But the question again remains: Why are you doing a race/event that requires longer distances?  If you’re actually an endurance athlete, then that’s perfectly reasonable and go kick some endurance butt!   But if you’re doing it for weight loss, general fitness and health, etc… there are far more effective, less time consuming, and strength sapping ways.  You should probably start doing them.  

1 comment:

  1. Mike,

    Excellent points! It always puts a smile on my face to have more reasons not to run long distances, and ammo to fire back at people who look at me cross-eyed for never doing it. 2 things:

    1) I especially liked the way you phrased the distinction between exercising for long term health benefits and exercising for a specific athletic competition.
    "Listen closely, because this may come as a surprise to many of you: high level competitive athletics is in no way, shape, or form about long term general health and fitness. It's about competition and winning and pushing yourself to the limit. And those two things are very often at odds with one another. Training for recreation, health and fitness always prioritizes long term health over short term gains. Competitive athletics often does the opposite."

    People don't understand the trade-off that high level athletes frequently have to make between being a successful competitor and having a pain/problem-free musculoskeletal system, and how this might not apply to their particular fitness goals. Well said...

    2) I would argue that some of the acute injuries you mention (sprains, strains) are actually the endpoint of chronic issues and overuse. Even ACL tears can be the result of repeated microtears that finally cause a failure of the tissue. I'm not talking about the impact traumas (contusions, fractures, concussions) that are clearly fresh, acute injuries. I'm talking about faulty mechanics causing repeated microtrauma resulting in what appears to be an acute muscle/tendon/ligament tear. Yet another reason to learn and practice proper form and biomechanics!