The Run Smarter Podcast

Episode Title: Unraveling the Mystery of Muscle Cramping with Jeff Sankoff

Guest:
Today's guest is Jeff Sankoff, an emergency physician and seasoned triathlete with over 50 finishes at the 70.3 distance, six Ironman completions, and six 70.3 World Championships under his belt. Jeff is also the host of the Tri-Doc Podcast and a coach who specializes in guiding triathletes, runners, and cyclists through his Tri-Doc coaching business. His unique combination of medical expertise and extensive experience in endurance sports makes him the perfect guest to discuss the complexities of muscle cramping.

Episode Summary:
In this episode, Brodie Sharpe and Jeff Sankoff delve into the elusive and often frustrating topic of muscle cramping. Jeff shares his personal experiences with cramping, particularly during his endurance races, and discusses the scientific theories behind what causes muscle cramps. The conversation covers potential causes such as dehydration, electrolyte imbalances, and the newer theory of neuromuscular imbalances. They also touch on the related condition of hyponatremia, exploring its dangers and how to prevent it during long endurance events. Throughout the discussion, Jeff emphasizes the multifactorial nature of cramping and the importance of personalized strategies for prevention and treatment.

Key Talking Points:

• Personal Experiences with Cramping: Jeff shares how cramping has affected his races, sometimes costing him podium finishes, and the frustration of managing cramps throughout his athletic career.
• Causes of Muscle Cramping: Exploration of the two main theories behind muscle cramping: dehydration/electrolyte imbalance and neuromuscular dysfunction due to an imbalance between excitatory and inhibitory nerve impulses.
• Hyponatremia: Understanding the dangers of hyponatremia, how it can be mistaken for heat stroke, and the importance of balancing water and electrolyte intake during long endurance events.
• Prevention and Treatment: Discussion on the effectiveness of various cramp remedies, such as electrolyte supplements, spicy drinks like pickle juice, and the importance of training at race intensity to prevent cramps.
• The Role of Fitness and Strength Training: How better fitness and strength in targeted muscle groups might reduce the risk of cramping during high-intensity efforts.

Key Takeaways for Runners:

• Experimentation is Key: If you’re prone to cramping, try different strategies such as electrolyte replacement or spicy liquids to find what works best for you.
• Listen to Your Body: Pay attention to how your body reacts in different conditions and intensities. Adjust your training and race strategies accordingly to minimize the risk of cramping.
• Stay Hydrated, but Smartly: In hot conditions, ensure you're not just drinking plain water but also replenishing your sodium levels to avoid hyponatremia.
• Strength Training: Incorporate strength training into your routine to enhance muscle endurance and potentially reduce the risk of cramping during races.
• Know the Warning Signs of Hyponatremia: Be aware of the symptoms like confusion and imbalance, and ensure you're adequately replacing sodium if you’re sweating heavily during long races.

Where to Find Jeff Sankoff:

• Website: Tri-Doc Coaching
• Instagram: @tridoccoaching
• Podcast: The Tri-Doc Podcast available on Apple Podcasts, Stitcher, Spotify, and more.

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These are the paper titles discussed in today's episode:

Paper 1: The Effects of Nordic Hamstring Exercise on Performance and Injury in the Lower Extremities: An Umbrella Review
Paper 2: Running Shoes of the Post-modern Footwear Era: A Narrative Overview of Advanced Footwear Technology
Paper 3: Comparison of Bone Mineral Density of Runners with Inactive Males: A Cross-Sectional Study

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Guest: Patrick McGilvray, Weight Loss Coach for Runners, Host of the Running Lean Podcast, Certified Sports Nutritionist, and Personal Trainer

Episode Overview: In this episode of the Run Smarter Podcast, we welcome back Patrick McGilvray for an in-depth Q&A session on nutrition for runners. Patrick is a seasoned coach who specializes in helping runners achieve weight loss, optimize performance, and navigate the often confusing world of sports nutrition. Whether you're struggling with weight fluctuations during marathon training or curious about intermittent fasting, Patrick offers valuable insights tailored to the everyday runner.

Key Topics Discussed:

• Intermittent Fasting for Runners:
  • What is intermittent fasting, and how can it be effectively implemented during marathon training?
  • Understanding the benefits and challenges of fasting while maintaining training intensity.
  • Practical tips for runners on managing hunger and energy levels.
• Nutrition for Fat Adaptation:
  • The importance of low-carb diets in enhancing fat oxidation and overall endurance performance.
  • How to become fat-adapted and why it’s crucial for runners aiming to lose weight without sacrificing performance.
• Managing Weight Fluctuations:
  • Why some runners gain weight during marathon training and how to counteract it.
  • The role of carbohydrates in weight management and how to adjust your diet to stay lean.
• Cravings and Sugar Addiction:
  • Strategies to reduce cravings for sweets and understand the addictive nature of sugar.
  • Practical methods like the 15-minute rule to regain control over your diet.
• Balanced Diets and Sustainable Eating:
  • Why it's essential to find a diet that works for your body and lifestyle, whether it’s plant-based, paleo, or something else.
  • How Patrick’s own journey from plant-based eating to a more balanced diet improved his health and performance.

Key Takeaways:

1. Intermittent Fasting Can Be Beneficial for Runners: When done correctly, intermittent fasting can help with weight loss and fat adaptation, even during marathon training. The key is not cutting calories but focusing on nutrient-dense, low-carb foods.
2. Fat Adaptation is a Game-Changer: Transitioning to a low-carb diet and becoming fat-adapted can significantly improve endurance and make running easier over time, though it requires patience through the initial adjustment period.
3. Mindful Eating Reduces Sugar Cravings: Understanding the psychological and physiological aspects of sugar addiction can help you make better dietary choices. Taking a break from sugar and using strategies like the 15-minute rule can curb cravings effectively.
4. Strength Training is Essential: Incorporating regular resistance training into your routine is crucial for injury prevention and improving overall running performance. Don’t skip the weights!
5. Personalization is Key: There’s no one-size-fits-all diet for runners. What works for one person may not work for another, so it’s essential to experiment and find a nutritional approach that suits your individual needs and goals.

Links Mentioned:

• Running Lean Podcast
• Running Lean Coach Website
• Dr. Mindy Pelz Book - Fast Like a Girl

Follow Patrick McGilvray:

• Instagram

Tune in to learn more about optimizing your nutrition as a runner and making informed dietary choices that support your training and weight loss goals.

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Episode Summary: In this insightful episode, we dive deep into the science of breath control and its impact on running performance with James Fletcher—a physiotherapist, exercise physiologist, university lecturer, Olympic trainer, and freedive instructor. James shares his journey from treating world-class athletes to helping his mother manage COPD, leading him to discover the untapped potential of breath training in both health and athletic performance.

Key Topics Covered:

1. The Science Behind Breathlessness:
   • James explains the complex neurophysiology of breathlessness and how carbon dioxide buildup, over-breathing, and inefficient breathing patterns can limit a runner's performance.
   • Fascinating insights into how breath-holding techniques and even simple actions like tapping your chest can extend your breath-hold capacity by tricking the body.
2. Breath Training for Runners:
   • Discover the importance of training your respiratory muscles, just as you would train your legs, to delay the onset of breathlessness and improve running efficiency.
   • James outlines simple yet effective techniques like nasal breathing and the "fist breath" method to strengthen your breathing muscles without the need for expensive equipment.
3. Practical Tests and Tips:
   • Test your breathing efficiency by running for 10 minutes using only nasal breathing or see if you can hold your breath for over two minutes. These benchmarks help determine if you're over-breathing during runs.
   • Learn the importance of syncing your breath with your foot strike to reduce the work of breathing and improve running rhythm.
4. Debunking Common Myths:
   • James challenges the outdated belief that the respiratory system isn't a limiting factor in performance, showing how proper breath training can significantly enhance your endurance and speed.
   • The importance of maintaining a balance of carbon dioxide in the body for optimal oxygen delivery to muscles during running.
5. The Respiratory Muscle Metaboreflex:
   • Understanding how fatigue in the breathing muscles can divert blood from the exercising limbs to the respiratory system, and how strengthening these muscles can prevent this, allowing for better performance.

Connect with James Fletcher:

• Instagram: @allaboutbreathing

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Running Technique Insight for Injury Prevention and Performance with Chris Brammer

Episode Highlights:

• Guest Introduction: Chris Brammer, a physiotherapist and researcher in biomechanics with a focus on running technique, injury prevention, and performance. Based in Manchester, UK, he has worked with British Athletics and Team GB, utilizing advanced biomechanics technology.
• Key Insights: Chris shares his extensive knowledge on how subtle changes in running technique can significantly impact performance and injury risk. He emphasizes the importance of understanding the individual runner's biomechanics and training routine.
• Assessment Process: Chris outlines a comprehensive approach to assessing running technique, starting with a detailed conversation about the runner's history and routine, followed by a treadmill analysis. Key focus areas include:
  • Pelvis and Trunk Rotation: Excessive rotation can indicate braking forces or rotational instability.
  • Trunk Lean: The "Goldilocks effect" - finding the right amount of forward lean to avoid overloading the knees or risking a fall.
  • Overstride and Ground Contact: Critical for minimizing braking forces and optimizing running efficiency.
• Cadence and Biomechanics: Chris discusses the role of cadence in running efficiency and injury prevention, debunking the myth of the "perfect" cadence and explaining how slight adjustments can enhance performance.
• Practical Advice: Chris offers actionable tips for runners to assess their technique using simple tools like smartphones and wearables, and emphasizes the importance of focusing on major biomechanical factors rather than getting lost in minor details.
• Strength and Running Economy: The episode explores the relationship between muscle strength and running mechanics, highlighting the importance of a well-rounded strength training routine for injury prevention and performance enhancement.

Take-Home Messages:

• Focus on obvious biomechanical issues and avoid overcomplicating assessments.
• Pronation is not inherently harmful and can actually aid in energy return.
• Changing foot strike patterns can increase injury risk and should be approached cautiously.
• Consult with a specialist running physio for personalized advice and accurate assessments.

Connect with Chris Brammer:

• Website: Extra Mile Health
• Twitter: @ChrisBrammer

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Running Research Papers for this episode:
Paper 1: Consensus Statements and guideline for the diagnosis and management of plantar fasciitis in Singapore
Paper 2: Effects of high-intensity interval training and resistance training on physiological parameters and performance of well-trained runners: A randomized controlled trial
Paper 3: Predicting Musculoskeletal Loading at Common Running Injury Locations using Machine Learning and Instrumented Insoles

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Episode Description: In this powerful episode, we share Emily's inspiring journey from chronic pain to recovery through the discovery and treatment of Tension Myoneural Syndrome (TMS). Emily opens up about her struggle with pain over the past few years, the emotional and psychological battles she faced, and the transformative strategies that helped her reclaim her life.

Key Discussion Points:

• 00:00 - Introduction: Meet Emily and learn about her battle with chronic pain and her breakthrough with TMS.
• 00:54 - Understanding TMS: What is Tension Myoneural Syndrome? Emily and the host explain the connection between emotions, personality, and pain manifestation.
• 01:22 - Journey Through Pain: Emily recounts her four-year struggle with various misdiagnoses, including seronegative peripheral spondyloarthritis and Raynaud’s, and her eventual diagnosis with TMS.
• 04:07 - The Onset of Injuries: From cubital tunnel syndrome to sciatica, Emily describes the series of injuries that compounded her pain.
• 07:44 - Psychological and Emotional Factors: The impact of emotional repression and personality traits on chronic pain.
• 08:13 - Finding Relief: How reading "Think Away Your Pain" by Dr. David Schechter and other resources helped Emily start her recovery journey.
• 11:27 - What is TMS?: A deeper dive into the science behind TMS and how the brain creates and amplifies pain.
• 17:13 - Emily’s Recovery Tools: Journaling, meditation, positive self-talk, and visualization—practical strategies Emily used to overcome TMS.
• 22:41 - Breaking the Cycle: Overcoming the fear of pain and rebuilding a normal life.
• 30:05 - The Role of Positive Thinking: How shifting from negative to positive thinking played a crucial role in Emily's recovery.
• 33:35 - Early Signs of Improvement: The initial glimpses of relief and how they motivated Emily to continue her journey.
• 36:54 - Overcoming Setbacks: Advice for those struggling with belief and persistence in their recovery.
• 45:39 - Current Life: Emily shares her current state, pain-free and living a fulfilling life.
• 47:35 - Resources and Recommendations: Books, YouTube videos, quizzes, and other resources to help listeners explore and address TMS.

Resources Mentioned:

• Book: "Think Away Your Pain" by Dr. David Schechter
• YouTube Meditation: "Powerful Chronic Pain Healing Meditation for TMS Mind Body, Dr. John Sarno"
• Quiz: isthistms.com – To help determine if you have TMS.

Emily's email: [email protected]
Follow Emily on Instagram: @painexplained_tms

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Zach Bitter is a record ultra runner, coach and podcast host. In this episode, he answers your questions on training, fueling, recovery and much more!

Find Zach Bitter via his website, Instagram or podcast

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On today's episode, Brodie reflects on his recent Hyrox event and discusses how you should reflect on your own races. 

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Guest: Dr. Peter Malliaris, a leading expert in tendinopathy research and clinical practice for over 15 years.

Here is what we will cover today:

Effective Management of Tendinopathy:

• Exercise and Education:
  • Importance of progressive exercise to build tendon tolerance.
  • Education on managing symptoms and avoiding aggravating activities.
• Isometrics and Loading:
  • Isometrics were initially thought to reduce pain but recent studies show progressive loading is equally effective.

Adjunct Therapies:

• Shockwave and PRP:
  • Evidence on their effectiveness is mixed; more placebo-controlled studies needed.
• Scans and Imaging:
  • Not necessary for diagnosis; used if initial treatments fail to identify other possible issues.

Pain and Function Management:

• Mechanisms of Pain:
  • Pain is multifactorial; education should address beliefs and neuromuscular factors.
• Loading and Tolerance:
  • Gradual increase in load is crucial for rehabilitation.
• Individualized Education:
  • Tailored education interventions for conditions like rotator cuff pain.

Then I answer your Facebook Group Questions

To visit Peter's website head to:  https://www.tendinopathyrehab.com/

For Peter's twitter go to: https://twitter.com/DrPeteMalliaras

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