published Sunday, July 6th, 2014

Run for life: And when you do, keep an eye on the odometer and your mind on your posture

Randy Whorton, with the Wild Trails organization, runs at Stringers Ridge early Monday afternoon.
Randy Whorton, with the Wild Trails organization, runs at Stringers Ridge early Monday afternoon.
Photo by Dan Henry.
  • photo
    Randy Whorton, with the Wild Trails organization, runs at Stringers Ridge early Monday afternoon.
    Photo by Dan Henry.
    enlarge photo

HEALTHY RUNNING TOP 5

According to RunnersWorld.com, following these five tips to healthy running can keep you on the road instead of off your feet:

• Avoid the terrible too's: Give your body time to adapt to increases in speed or distance and allow your muscles and joins a chance to recover to the new demands. Add no more than 10 percent to your mileage every week.

• Listen to your body: Pay attention to warning signs from your body such as aches, soreness or persistent pain that could indicate a more serious injury is imminent.

• Get good shoes: Find a shoe that supports your foot properly and that suits your running stride. Visit a specialty running store to have your gait analyzed and then make sure you replace your pair every 300 to 500 miles.

• Take good notes: Keep a log of your miles, run duration and how you felt afterward to help motivate yourself and to help detect when a problem may be brewing. This will help refine your schedule to allow for enough downtime between runs and make the daunting days seem less insurmountable.

• Cross train: Don't just run. Change up your exercise regimen to improve your balance and overall strength and to shore up your aerobic fitness, all of which will make you a better, healthier runner. Certain activities, such as elliptical training, stationary bike or rowing machine are also safe ways to remain physically active if you do injure yourself while running.

Decades worth of research into the physiological benefits of running say it's a boon to cardiovascular health. And the prevailing opinion all along has been that the more miles logged, the healthier the runner.

The conclusion of a recent study, however, flies in the face of that theory by demonstrating a link between regular participation in extreme distance running -- which includes events of marathon length (26.2 miles) or longer -- and the buildup of coronary artery plaque, a leading cause of heart disease.

"As with any potent drug, establishing the safe and effective dose range is critically important. ... An inadequately low dose may not confer full benefits, whereas an excessive dose may produce adverse effects that outweigh its benefits," reads the introduction to the study, which was published in the March/April issue of Missouri Medicine, the journal of the Missouri State Medical Association.

The study by researchers at the Minneapolis Heart Institute Foundation compared 50 male participants of 25 consecutive marathons and 23 self-reported "sedentary" men with similar coronary disease risk factors, such as age, resting blood pressure, smoking history and total cholesterol. The marathon runners consistently had lower resting heart rates, weight and body mass indexes compared to the sedentary control group but also were found to have about 60 percent more total plaque in their arteries, according to the article.

Local runners and exercise physiologists were surprised by the report, but called researchers' methodology into question, citing the small study group and a lack of consideration for critical factors such as participants' diet or how much and how frequently they ran every week.

"That's important because there's a real dose-response effect to training," says Dr. Gary Liguori, the head of the health and human performances department at the University of Tennessee at Chattanooga.

Liguori says the preponderance of evidence still suggests running longer and more frequently improves overall health.

"Someone who ran five or 10 miles a week would certainly accrue health benefits over a sedentary person, but not nearly as much as someone who ran 40 miles a week," Liguori says. "We see across-the-board lower LDL ["bad cholesterol"] levels, higher HTL ["good cholesterol"] levels, much lower incidence of heart attack, high blood pressure and all-across mortality."

Although they weren't willing to accept that running could be bad for the heart, many extreme distance runners acknowledge that there are health risks associated with putting in too many miles.

Chattanooga Track Club President Bill Brock, 56, has completed more than 40 marathons in the last 17 years and logs about 45 miles of running every week. After a recent checkup, he says his doctor gave him a clean bill of health, which gives him even more cause to dismiss the Missouri Medicine article.

"My numbers are really good," he says. "I ... am pretty much in balance on everything."

Brock says he doesn't take that condition for granted. When he's running, he's conscious not only of how much ground he's covering but of how he's covering it.

"Absolutely, proper posture and form is essential," he says. "If you run with improper posture and form, you can absolutely cause injury. If you run with shoes that are bad for you or totally worn out, you can do damage that way.

"It's not just running. The issue is how you run. That stuff does matter, and I do pay attention to it."

According to a 2011 study published in the British Journal of Sports Medicine, the most common injuries among long-distance runners were knee pain and inflammation, tearing or inflammation of the Achilles tendon, heel pain and shin splints, many of which can be caused by running improperly or on worn-out or ill-fitting footwear.

Another contributor to musculoskeletal injuries is the surface being run on, says Randy Whorton, 53, director of Wild Trails, a local nonprofit promoting trail running in Chattanooga. In the last 30 years, he's completed about 120 long-distance road and trail runs that are ultra-marathon length. Ultra marathons are defined as any race longer than marathon's traditional 26.2 miles and include double marathons, 100-mile races and extended trail races.

As a result of his experience -- and from eating well, Whorton says -- his heart is in tip-top shape. In fact, during a recent physical, the physician had to double-check his resting heart rate of 51 beats per minute because it seemed preternaturally low.

Whorton says diet is just as big a contributor to overall health as remaining physically active, but many veteran marathoners assume the miles they put in will excuse pigging out on foods that are high in cholesterol and fat.

"I've heard the statement a lot that, 'The fire is burning so hot. I can cook anything in it,'" he says. "That's bull. On the same [crummy] diet, the running group and the sedentary group will both have bad health.

"Total health is just misconceived when it comes to exercise. It has to be in correlation with a good diet."

Another consideration is where the miles are being put in, he says.

Running on the uneven surfaces of trails constantly forces him to consider how his foot is hitting the ground, Whorton says. And after reading books on the topic of foot plant -- the foot's motion when it strikes the ground -- and viewing recordings of himself running, he's made efforts to adjust his posture to be as efficient and healthy as possible.

Every week, Whorton logs about 40 to 50 miles, but if he'd spent his entire career running on asphalt, instead of splitting his time between on- and off-road events, his body might have suffered for it.

"A trail run of 50 kilometers that takes six hours is going to be far better on your body than a road marathon that takes 3 1/2 hours," he says. "I don't think a human body is made for road marathons. The consistency of the running form [on roads] that propagates up your leg exactly the same with every step is not healthy."

Despite defending the many recognized health benefits of running, physiologists agree with at least one finding of the Missouri Medicine study: Moderation is key.

"I would agree with the authors' term of 'cardiac overuse injury,'" writes Dr. Nicholas Boer, an associate professor of exercise science at UTC. "We were not designed to have our heart rate elevated for extended periods of time."

If they find themselves longing for the "runner's high," Boer says enthusiasts may need to ask themselves why they're putting in so many miles and consider adding variety to their regimen instead to condition complimentary aspects of their body such as flexibility and strength training.

"[Long-distance running] becomes similar to an addiction -- a mainly good addiction, but an addiction nonetheless," he says. "You need to keep the behavior in check, even though it is largely a healthful one.

"Everything in moderation ... as far as healthy habits are concerned. Nothing in extremes."

Contact Casey Phillips at cphillips@timesfreepress.com or 423-757-6205. Follow him on Twitter at @PhillipsCTFP.

about Casey Phillips...

Casey Phillips has worked as a features reporter in the Life department since May 2007. He writes about entertainment, young adults, technology and people of interest. Casey hails from Knoxville and earned a bachelor of science degree in journalism and a bachelor of arts in German. He previously worked as the features editor for Sidelines at Middle Tennessee State University. Casey received the East Tennessee Society of Professional Journalists Award of Excellence for Reviewing/Criticism in ...

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