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- Training Young Distance Runners
As the best-selling guide in the sport, Training Young Distance Runners has helped countless runners achieve their best times, avoid injuries, and improve their performance progressively from season to season. Updated, expanded, and enhanced, this new edition further solidifies its standing as a must-have for athletes and coaches in cross country, track and field, and road racing.
Running experts Larry Greene and Russ Pate combine the latest research with training, development, and conditioning plans from the most successful high school and college programs in the world. You’ll learn to optimize performance through tempo running, interval training, and technique work to improve form. You’ll gain a competitive advantage with expert advice and strategies for event-specific training, avoiding injuries, and overcoming setbacks.
With guidelines for designing customized daily, weekly, and seasonal programs—as well as coverage of hot topics including nutritional supplements, barefoot running and minimalist shoes, and gearing training to the specific needs of girls and boys—Training Young Distance Runners is the most complete and current training guide for the sport. Essential reading for coaches, parents, and young runners, this book has everything you need to get and stay ahead of the pack.
Part I: Running Fundamentals
Chapter 1 Peak Development
Chapter 2 Teen Physiology
Chapter 3 Optimal Nutrition
Chapter 4 Champion Psyche
Chapter 5 Form Fundamentals
Part II: Training and Racing Programs
Chapter 6 General Training
Chapter 7 Race-Specific Training
Chapter 8 Program Building
Chapter 9 Planning Training
Chapter 10 Dealing with Setbacks
Larry Greene knows all about the challenges facing young distance runners. He won state championships in high school cross country and track, becoming a Florida state champion in cross country and the 2-mile run and finishing 10th in the national Junior Olympic Cross Country Meet as a senior. Greene’s high school accomplishments earned him a scholarship to Florida State University, where he set the school record for the indoor 3,000-meter run and qualified for the NCAA championship meet three times. After college, Greene excelled as a distance runner. In 1984, he ran the fastest half marathon in the world (1:01:27) and finished 4th in the 10,000-meter run at the U.S. Track and Field Championships. In 1987, he finished 3rd in the half marathon at the U.S. Olympic Festival.
Greene is a scientific and medical writer in South Florida. He received an MS in movement science from Florida State University and a PhD in exercise science from the University of South Carolina. He has coached distance runners at the youth, university, and professional levels. He has also served as the director of the Carolina Marathon Youth Cross Country Run. His leisure interests include running, cycling, and cross-country skiing.
Russ Pate has been an exercise science instructor and researcher since 1972. He serves as a professor in the department of exercise science at the University of South Carolina, where his research is focused on the relationship between physical activity and health in children and adolescents. Pate is a lifelong distance runner. He has a personal best time of 2:15:20 in the marathon and competed in three U.S. Olympic Trials Marathons.
Pate has served as president of the American College of Sports Medicine (ACSM), the National Coalition for Promoting Physical Activity, and the National Physical Activity Plan Alliance. He has been recognized with awards by the American Alliance for Health, Physical Education, Recreation and Dance; the American College of Sports Medicine; the National Fitness Leaders Association; and the President’s Council on Physical Fitness and Sports. He has also directed two U.S. Olympic Trials Women’s Marathons.
Pate received a PhD in exercise physiology from the University of Oregon in 1974. In his free time, he enjoys running, reading, theater, traveling, and spending time with his family.
“It's all here! Science you can understand, nutrition that makes sense, how to race, and how to train, all spelled out for coach, parent, or aspiring young runner.”
Tom Heinonen-- Coach of University of Oregon Running Club, 2004-2014, University of Oregon Women's Track Coach, 1977-2003
“Authors Larry Greene and Russell Pate, in their acclaimed book Training Young Distance Runners, provide coaches with the latest scientific information to maximize individual potential in teen distance runners.”
Mel Williams-- Participant in More Than 100 marathons, Author of Nutrition for Health, Fitness & Sport
“Training Young Distance Runners skillfully integrates sport science into the specific, age-appropriate design of youth endurance training programs. I resoundingly recommend this book as a ‘must read’ resource for all coaches of young runners.”
Dr. Jeffrey I. Messer-- Girls’ Cross-Country Coach and Track-&-Field Coach, Desert Vista High School
Professor of Exercise Physiology
When to start training children for distance running
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week.
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week. The view that young children are physiologically capable of running long distances is backed by world age-group records for races as long as the marathon (26.2 miles, or 41.2 km). The records for 8-year-olds are 3:34:30 for boys and 3:13:24 for girls; for 11-year-olds the records are 2:47:17 for boys and 2:49:21 for girls. Many adult marathoners have trained at high levels for years without reaching these marks. Research also shows that young children adapt physiologically to endurance training in ways that improve running performance. Before puberty, for example, children who perform moderate levels of endurance training experience about a 10 percent increase in V\od\O2max, slightly less than the 15 percent increase observed, on average, in adults.
From this information, you might conclude that young children are indeed capable of training for and competing in long-distance races. Before you start planning programs for 8-year-olds, however, consider the following other important points:
- Neither scientific nor anecdotal evidence suggests that distance runners must start training at a young age to reach their greatest potential. Most world-class runners did not begin training until they were in their mid to late teens. And, with very few exceptions, the children who held age-group records for the 5K through the marathon did not develop into elite adult runners.
- Research consistently shows that, before puberty, physiological adaptations to training aren't always correlated with performance in long-distance events. For prepubescent children, the factors that best predict distance running performance are simply related to physical maturity: taller, stronger, and faster children lead the pack in distance races, just as they excel in other sports such as basketball, baseball, and soccer.
- Although many children have naturally high levels of aerobic fitness, making them physiologically capable of performing low-intensity endurance activities, they are limited in their capacity to generate energy for high-intensity activities. The body has two primary systems for producing energy during exercise: the aerobic system, which operates when a sufficient amount of oxygen is available to the muscles, and the anaerobic system, which operates when the oxygen supply cannot keep up with the muscles' demand during high-intensity activity. One of the most consistent findings in pediatric exercise science is that the anaerobic system is not fully developed until children have passed through puberty.
- Physically immature youth who undertake high volumes of intense training are at relatively high risk for injuries, abnormal growth and maturation, and psychological burnout.
Considering these points, we recommend that children not begin regular and specialized training for distance running at least until the early stages of puberty, around ages 11 to 13 (see table 1.1). By no means are we saying that kids under 11 shouldn't participate in running events such as 1- or 2-mile fun runs at school or in community races. We encourage children of all ages to run for fun and health. Instead, we advise holding off on regular training, which we define as more than three days a week over periods of several months, and specialized training, which means focusing only on running as opposed to other sports and physical activities.
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While children are experiencing major physical changes during puberty, we recommend limiting the volume and intensity of training. One reason is that normal pubertal development can improve running performance on its own. For example, the growth spurt of the lungs and heart, which occurs at an average age of 11.5 years in girls and 13.5 years in boys, boosts the delivery of oxygen-rich blood to the muscles, which naturally increases V\od\O2max. Another example is the elevated level of growth hormone, which enables stronger muscle contractions, increasing running speed and efficiency.
Not all developmental changes automatically improve running performance, a point that also supports curbing early training. Consider rapid growth in height. At the average age of 10.5 for girls and 12.5 for boys, the growth rate increases dramatically from approximately 2.2 inches (5.5 cm) per year to approximately 4.1 to 4.7 inches (10.5 to 12 cm) per year. The highest rate of growth, which is called peak height velocity, occurs at around age 11.5 for girls and 13.5 for boys. Now consider the 13-year-old boy who grows 2 inches (5 cm) over a single summer - suddenly he's all legs. The growth spurt should improve his running by increasing leg length and thus stride length. However, he now has trouble coordinating his longer legs because the nervous system, which controls movement, doesn't immediately adapt to changes in limb length. Also, during the growth spurt body parts grow at different rates. The feet and legs, for example, usually lengthen faster than the trunk, making many teenagers seem gangly or awkward in their movements. These developmental changes may actually cause the runner to temporarily perform worse because his uncoordinated stride wastes energy and leads to fatigue.
Rapid limb growth also means that children who train intensely for distance running are at risk for muscular and skeletal injury. Bones lengthen at each end in soft tissue called epiphyseal growth plates. During puberty, the growth plates are weaker than hardened bone and susceptible to fractures under the heavy, repetitive stresses experienced in long-distance running. The growing athlete's joints and muscles are also susceptible to injury because muscle mass and strength develop more slowly than bone. Eventually, the epiphyseal growth plates ossify, or harden, and muscle mass increases. Until these two critical growth processes are complete, however, children are at increased risk of injury from excessive training.
Excessive training before puberty can also affect hormones in ways that may interfere with normal maturation and optimal health. Estrogen, for example, is a hormone that ensures healthy growth and development in girls. This hormone plays a major role in menstruation, which is a normal process of maturation in girls and young women. Under certain conditions, including suboptimal nutrition, estrogen is not produced at regular levels during puberty in female runners. As a result, they may experience delayed menarche or irregular menstrual cycles. In chapter 3 we discuss a major health problem called the female athlete triad, which encompasses suboptimal nutrition, abnormal menstrual function, and weakened bones. Compared with normally active girls, those who train excessively for distance running are at risk for this condition.
Fortunately, most young runners avoid harmful levels of training. They naturally stop pushing themselves before reaching their limits. However, we've known at least a few young runners who were self-motivated to push to extremes, and we've known coaches and parents who pushed young runners too far. For these children, running injuries are fairly common.
Another concern for those who specialize in running at a young age is psychological burnout. Take the 10-year-old who's running 40 miles (64 km) a week and racing 10Ks on a regular basis. Eventually, she may grow tired of running, especially because improvement depends on increasing training loads over time. If a child is running 40 miles (64 km) a week at age 10, at age 16 she'll need to run 70 (113km), or maybe even 90 or 100 miles (145 or 161 km), to keep improving. That much running leaves little time for activities other than school, sleeping, and eating. When training becomes that consuming, it isn't fun anymore, and most young people drop out of running.
Most girls and boys, by the ages of 12 and 14, respectively, have experienced key developmental changes that enable them to safely begin a low-mileage, low-intensity training program, leaving lots of room for gradual improvement over time. Again, we're not saying that younger children should avoid participating in distance running altogether. Instead, our advice is to delay specialized training on a year-round basis. Beginning at age 7 or 8, children who enjoy running may participate in fun runs and organized track and field programs that last a few months each year. Future distance runners will benefit from participating not only in middle-distance races (up to 1 mile, or 1,600 meters), but also in sprinting, jumping, and throwing events. When track season is over, they should participate in soccer, basketball, and other youth sports they enjoy. We recommend multisport participation because it's important to develop all-around physical fitness before beginning specialized training for track and cross country (see developmental principle 3).
Learn more about Training Young Distance Runners, 3rd Edition.
Stretch to develop flexibility and mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally.
Developing Flexibility and Mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally. Of course, running doesn't demand the extensive flexibility of sports such as gymnastics and figure skating, and the runner's limbs move mostly in one plane - in line with the forward direction. For these reasons, some distance coaches don't include training for flexibility and mobility. These capacities, however, are actually essential for young runners, especially for preventing injuries.
Distance running strengthens and tightens different muscle groups, sometimes causing imbalances on opposing sides of limbs and joints. Consider, for example, that runners don't lift their knees very high when covering long distances at relatively slow speeds. As a result, their hamstrings don't stretch much. Repetitive movement through such a limited range of motion can tighten the hamstrings, leading to strains and tears when athletes extend their stride for faster running in workouts and races. In addition, some runners have very tight calf muscles and experience calf strains and tears, as well as Achilles tendon injuries. These examples point to the need for stretching as a fundamental training method.
The stretching exercises in this chapter focus on muscle groups, such as the hamstrings, calves, and hip flexors, that tend to be tight in distance runners. Keep in mind, however, that athletes differ in terms of muscle tightness and the need for stretching. Some runners with loose joints and muscles can even injure their muscles and connective tissues by overstretching. Ideally, runners should be assessed for specific areas of tightness and imbalances by a qualified athletic trainer, physical therapist, or physician who specializes in sports medicine.
Dynamic and Static Stretching
Following is a routine of 13 stretching exercises for maintaining or improving flexibility. The first section shows dynamic stretches, which involve continuous movement of the limbs through sweeping ranges of motion around a joint. The second section shows static stretching exercises, which involve holding the position without movement. Follow these guidelines for performing the stretching exercises:
- Always warm up the muscles by jogging for 5 to 15 minutes before stretching.
- Perform dynamic stretches before static stretches. We recommend performing the stretching exercises in this book in the order they appear. The dynamic stretching exercises loosen up the joints and prepare the muscles for static stretching. The movements in dynamic stretching should be slow and gentle rather than fast and ballistic. Do 10 to 15 repetitions of each dynamic exercise.
- When performing static stretching, hold the position for 20 to 60 seconds, without rocking or bouncing. Stretching should never be so vigorous that it causes quivering or pain in the muscles.
- Use the same stretching routine for both training and racing. A familiar stretching routine helps you stay comfortable and relaxed during the prerace warm-up, when competitive anxiety can make it difficult to concentrate on proper preparation. Spend at least 10 minutes stretching, and never rush the routine.
- Stretch before and after training. Many runners think of stretching only as a pretraining and prerace activity, but stretching after training and racing is essential for maintaining flexibility and preventing injuries.
Dynamic Stretches
Arm Reach and Swing
Extend the arms above the head and then swing them downward in a wide, sweeping action.
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Head Roll
Slowly roll the head in a circle, gently stretching the neck muscles. Perform repetitions clockwise, and then switch to counterclockwise.
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Learn more about Training Young Distance Runners, 3rd Edition.
Running injuries, treatment and prevention
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it’s important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries.
Dealing With Injuries
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it's important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries. Common causes of injuries include the following:
- Training errors: Sudden, sharp increases in training volume and intensity; overuse (running more miles or kilometers than the body can handle); failure to take sufficient recovery time between demanding workouts; running too much on very hard or very soft surfaces
- Anatomical abnormalities: Flat feet, high arches, excessive pronation or supination, knock knees, bowed legs, inwardly rotated thigh bones, unequal leg lengths
- Muscle imbalances: Differences in the strength of opposing muscle groups (hamstrings and quadriceps, calf and tibialis anterior, hip flexors and hip extensors), differences in the flexibility of opposing muscle groups, excessively tight or loose muscles
- Poor technique: Excessive turning and twisting motions, overstriding, striking too hard on the heel or forefoot
- Inappropriate footwear: Insufficient cushioning, inadequate control for excessive pronation or supination, insufficient arch support, overly worn shoes
- Suboptimal nutrition: Insufficient intake of calories, fluids, calcium, electrolytes, or other nutrients
By considering the causes of running injuries, coaches might find that some aspect of their training programs increases injury risk. By eliminating the risk factor or adding training methods that counteract it, they can prevent injuries. For example, impact-related injuries, such as shinsplints and stress fractures, are often caused by running long distances on hard surfaces such as asphalt roads. Runners can reduce their risk for these injuries by training on dirt roads and trails.
To effectively deal with injuries, both athletes and coaches must heed their symptoms and understand the best approaches to treatment and rehabilitation (see the Common Running Injuries sidebar later in this chapter). Although some injuries require immediate medical treatment, others, especially those caused by chronic overuse, may not pose an immediate danger. In some cases runners can self-treat these injuries, ideally under the supervision of a sports doctor or certified athletic trainer. Self-treatment of many running injuries involves RICE, which stands for rest, ice, compression, and elevation. Rest can mean a complete cessation of all training for at least a few days, but for many injuries it's possible to keep training with supplemental methods to maintain fitness. For example, runners with knee pain will make their injuries worse if they continue to run, but they can maintain a high level of cardiorespiratory and muscle fitness by swimming and doing upper-body circuit training.
Some leg and foot injuries that keep athletes from running are not affected by activities such as cycling and deep-water running. In deep-water running, the athlete mimics the running action while suspended in a pool by a flotation vest. Because cycling and deep-water running can elevate the heart rate for prolonged periods, they're great for maintaining cardiorespiratory fitness. The duration of supplemental training depends on the injured runner's familiarity with the exercise. For example, injured runners who have never done deep-water running might start out with only 10 or 15 minutes a day and gradually build up to a duration that approaches their longest continuous aerobic run. Runners who are accustomed to riding bicycles can start cycling at 45 minutes or more.
The second component of RICE, applying ice to the injured area, is often very effective for reducing swelling and pain as well as for promoting healing. Injuries that involve chronic inflammation, such as plantar fasciitis and Achilles tendinitis, respond especially well to ice treatment. The protocol is to simply apply a plastic bag filled with crushed ice to the injured area. To avoid freezing the skin, the runner should place a thin cloth between the bag and the injured area. Freezing water in a paper cup and using it to perform an ice massage is another option. A general guideline is to apply ice two or three times a day for 10 to 20 minutes each time. We strongly recommend that runners consult a sports doctor or athletic trainer for an injury-specific icing protocol.
Compression of the affected area is also often an effective treatment for injuries that cause swelling. The most common method of compression is applying an elastic bandage. The placement of the bandage depends on the injury and the person. Athletic trainers know the proper techniques for wrapping injuries.
The fourth component of RICE, elevation, involves raising the injured area to reduce blood flow to it, thereby reducing swelling. A runner who has a knee injury, for example, should lie on a bed or couch and elevate the affected leg with a pillow or two. The leg should be raised slightly above the heart.
Common Running Injuries
To prevent and treat running injuries, coaches and runners benefit from knowing their causes, symptoms, and rehabilitation methods. Following are descriptions of some common running injuries; an extensive discussion of running injuries is beyond the scope of this book.
Stress fractures are tiny breaks that occur in the bones of the feet, shins, thighs, and hips. The symptoms include localized pain and tenderness on the surface of the affected bone. This injury is commonly caused by overuse, or the excessive loading of the bones from the repetitive stress of running on hard surfaces. Stress fractures tend to occur in girls who, as a result of inadequate caloric intake and excessive training, experience athletic amenorrhea, or cessation of normal menstruation. Cyclical increases in estrogen levels, which occur with regular menstruation, are necessary for maintaining bone density. Diagnosing a stress fracture is typically complicated because the fracture may not show up on X-rays for several weeks after the onset of symptoms. To avoid serious bone damage and to promote healing, athletes who experience the symptoms of stress fractures should stop running and see a sports doctor. If a stress fracture is diagnosed, rehabilitation involves alterations in training and diet, a change in footwear or the use of orthotics, and cardiorespiratory training methods such as swimming, pool running, and cycling that don't stress the affected bone.
Plantar fasciitis is an inflammation of the band of connective tissue that runs along the insole of the foot from the heel to the arch. This injury is characterized by gripping pain and tenderness in the arch, close to the fleshy part of the heel. The pain is especially intense in the morning and during running. Plantar fasciitis is common in runners who have flat feet and who overpronate. Recovery time from this injury can often require several weeks or months of reduced or no running. Doctors may prescribe exercises for strengthening muscles in the feet, orthotics, anti-inflammatory medication, and steroid injections.
Achilles tendinitis is the degeneration and inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. The main symptoms of this overuse injury are pain, tenderness, and swelling along the tendon. The pain is especially severe when athletes run on their toes, up hills, and in low-heeled racing flats or spikes. Runners with tight calf muscles are at particular risk, so they should regularly stretch these muscles. In some cases, rehabilitation time can be lengthy because the Achilles tendon receives limited blood flow and is stressed in daily activities such as walking. The main treatments - icing, anti-inflammatory medication, and ultrasound - increase blood flow to the tendon to reduce inflammation and promote healing. Swimming and deep-water running are good training methods for maintaining fitness while the tendon heals.
Patellofemoral pain syndrome results from cartilage degeneration behind the kneecap. Runners with this syndrome experience stiffness and grinding pain in the knee, especially after sitting for long periods and bending the knee in activities such as squatting and stair climbing. Patellofemoral pain syndrome occurs most often in runners with knock knees, bowed legs, and flat feet. Another cause is strength imbalances between the hamstrings and quadriceps. Doctors recommend anti-inflammatory medicine and exercises that strengthen the quadriceps and stretch the hamstrings.
Osgood- Schlatter syndrome refers to inflammation, tenderness, and pain where the patellar tendon (in front of the knee) attaches to the tibia, or shin bone. This syndrome, which is unique to young athletes, develops as a result of a combination of rapid bone growth and repetitive stress. During the adolescent growth spurt, the bones grow faster than the muscles and connective tissue. When the growth of the tibia outstrips that of the patellar tendon, the tendon pulls hard on its attachment site at the top of the shin. The excessive tugging causes irritation and pain. In addition, the force can lead to small bony formations and fractures. In most cases, the swelling and pain go away with reduced running and skeletal maturation.
Iliotibial band syndrome refers to inflammation and pain caused by the rubbing of the iliotibial band tendon against the lateral side (outside) of the knee. The iliotibial band runs along the lateral side of the thigh from the hip to the knee. In adult runners the syndrome is typically caused by a combination of repetitive stress from running and tightness of the iliotibial band and the muscles around it. In young runners an additional cause is rapid growth of the femur. Runners should cease running, ice the injured area, and stretch the iliotibial band (see chapter 6) and hamstring muscles (see chapter 6).
Shinsplints is a term referring to pain and tenderness along the shin bone. When the pain runs along the inner side of the shin from a few inches (around 5 or 6 cm) below the knee to the ankle, doctors refer to the injury as medial tibial pain syndrome. The pain associated with this syndrome is caused by inflammation of the tissue that lines the bone. When the pain is on the outer side of the shin, the cause may be compartment syndrome - swelling of the muscles in the lower leg, which overstretches the elastic sheath that covers the muscles and creates pressure on nerve endings in the muscles. Runners with shin pain should consult a sports doctor because appropriate treatment depends on the cause, which is difficult to self-diagnose, and because continuing to run without appropriate treatment can result in stress fractures.
Risk Factors for Running Injuries
To prevent injuries, coaches and runners benefit from knowing factors that increase their risk. This was the aim of a study conducted by Dr. Adam Tenforde and colleagues at Stanford University (Tenforde et al., 2011). The researchers surveyed 748 high school distance runners (442 girls and 306 boys) between 13 and 18 years old, asking them to report previous injuries, training mileage, and performance bests in the mile and 5K. Most of these young runners, 68 percent of the girls and 59 percent of the boys, reported at least one injury from a list that included Achilles tendinitis, ankle sprains, iliotibial band syndrome, knee pain, plantar fasciitis, and shinsplints. The proportion of these injuries was greater for girls. For example, 41 percent of the girls and 34 percent of the boys had experienced shinsplints. Around 6 percent of the girls and 3 percent of the boys had had at least one stress fracture. Compared with noninjured runners, those who reported injuries were older and covered more miles in their weekly training. For girls, significant risk factors for injury included greater amounts of running on pavement and faster performance times in the mile and 5K.
Based on their findings and other related research, Tenforde and coauthors concluded that high school runners can reduce injury risks by limiting running on hard surfaces and by performing injury-specific strength training and balancing exercises. The researchers' recommendations are summarized in table 10.3.
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Learn more about Training Young Distance Runners, 3rd Edition.
When to start training children for distance running
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week.
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week. The view that young children are physiologically capable of running long distances is backed by world age-group records for races as long as the marathon (26.2 miles, or 41.2 km). The records for 8-year-olds are 3:34:30 for boys and 3:13:24 for girls; for 11-year-olds the records are 2:47:17 for boys and 2:49:21 for girls. Many adult marathoners have trained at high levels for years without reaching these marks. Research also shows that young children adapt physiologically to endurance training in ways that improve running performance. Before puberty, for example, children who perform moderate levels of endurance training experience about a 10 percent increase in V\od\O2max, slightly less than the 15 percent increase observed, on average, in adults.
From this information, you might conclude that young children are indeed capable of training for and competing in long-distance races. Before you start planning programs for 8-year-olds, however, consider the following other important points:
- Neither scientific nor anecdotal evidence suggests that distance runners must start training at a young age to reach their greatest potential. Most world-class runners did not begin training until they were in their mid to late teens. And, with very few exceptions, the children who held age-group records for the 5K through the marathon did not develop into elite adult runners.
- Research consistently shows that, before puberty, physiological adaptations to training aren't always correlated with performance in long-distance events. For prepubescent children, the factors that best predict distance running performance are simply related to physical maturity: taller, stronger, and faster children lead the pack in distance races, just as they excel in other sports such as basketball, baseball, and soccer.
- Although many children have naturally high levels of aerobic fitness, making them physiologically capable of performing low-intensity endurance activities, they are limited in their capacity to generate energy for high-intensity activities. The body has two primary systems for producing energy during exercise: the aerobic system, which operates when a sufficient amount of oxygen is available to the muscles, and the anaerobic system, which operates when the oxygen supply cannot keep up with the muscles' demand during high-intensity activity. One of the most consistent findings in pediatric exercise science is that the anaerobic system is not fully developed until children have passed through puberty.
- Physically immature youth who undertake high volumes of intense training are at relatively high risk for injuries, abnormal growth and maturation, and psychological burnout.
Considering these points, we recommend that children not begin regular and specialized training for distance running at least until the early stages of puberty, around ages 11 to 13 (see table 1.1). By no means are we saying that kids under 11 shouldn't participate in running events such as 1- or 2-mile fun runs at school or in community races. We encourage children of all ages to run for fun and health. Instead, we advise holding off on regular training, which we define as more than three days a week over periods of several months, and specialized training, which means focusing only on running as opposed to other sports and physical activities.
http://www.humankinetics.com/AcuCustom/Sitename/DAM/133/E6148_503161_ebook_Main.png
While children are experiencing major physical changes during puberty, we recommend limiting the volume and intensity of training. One reason is that normal pubertal development can improve running performance on its own. For example, the growth spurt of the lungs and heart, which occurs at an average age of 11.5 years in girls and 13.5 years in boys, boosts the delivery of oxygen-rich blood to the muscles, which naturally increases V\od\O2max. Another example is the elevated level of growth hormone, which enables stronger muscle contractions, increasing running speed and efficiency.
Not all developmental changes automatically improve running performance, a point that also supports curbing early training. Consider rapid growth in height. At the average age of 10.5 for girls and 12.5 for boys, the growth rate increases dramatically from approximately 2.2 inches (5.5 cm) per year to approximately 4.1 to 4.7 inches (10.5 to 12 cm) per year. The highest rate of growth, which is called peak height velocity, occurs at around age 11.5 for girls and 13.5 for boys. Now consider the 13-year-old boy who grows 2 inches (5 cm) over a single summer - suddenly he's all legs. The growth spurt should improve his running by increasing leg length and thus stride length. However, he now has trouble coordinating his longer legs because the nervous system, which controls movement, doesn't immediately adapt to changes in limb length. Also, during the growth spurt body parts grow at different rates. The feet and legs, for example, usually lengthen faster than the trunk, making many teenagers seem gangly or awkward in their movements. These developmental changes may actually cause the runner to temporarily perform worse because his uncoordinated stride wastes energy and leads to fatigue.
Rapid limb growth also means that children who train intensely for distance running are at risk for muscular and skeletal injury. Bones lengthen at each end in soft tissue called epiphyseal growth plates. During puberty, the growth plates are weaker than hardened bone and susceptible to fractures under the heavy, repetitive stresses experienced in long-distance running. The growing athlete's joints and muscles are also susceptible to injury because muscle mass and strength develop more slowly than bone. Eventually, the epiphyseal growth plates ossify, or harden, and muscle mass increases. Until these two critical growth processes are complete, however, children are at increased risk of injury from excessive training.
Excessive training before puberty can also affect hormones in ways that may interfere with normal maturation and optimal health. Estrogen, for example, is a hormone that ensures healthy growth and development in girls. This hormone plays a major role in menstruation, which is a normal process of maturation in girls and young women. Under certain conditions, including suboptimal nutrition, estrogen is not produced at regular levels during puberty in female runners. As a result, they may experience delayed menarche or irregular menstrual cycles. In chapter 3 we discuss a major health problem called the female athlete triad, which encompasses suboptimal nutrition, abnormal menstrual function, and weakened bones. Compared with normally active girls, those who train excessively for distance running are at risk for this condition.
Fortunately, most young runners avoid harmful levels of training. They naturally stop pushing themselves before reaching their limits. However, we've known at least a few young runners who were self-motivated to push to extremes, and we've known coaches and parents who pushed young runners too far. For these children, running injuries are fairly common.
Another concern for those who specialize in running at a young age is psychological burnout. Take the 10-year-old who's running 40 miles (64 km) a week and racing 10Ks on a regular basis. Eventually, she may grow tired of running, especially because improvement depends on increasing training loads over time. If a child is running 40 miles (64 km) a week at age 10, at age 16 she'll need to run 70 (113km), or maybe even 90 or 100 miles (145 or 161 km), to keep improving. That much running leaves little time for activities other than school, sleeping, and eating. When training becomes that consuming, it isn't fun anymore, and most young people drop out of running.
Most girls and boys, by the ages of 12 and 14, respectively, have experienced key developmental changes that enable them to safely begin a low-mileage, low-intensity training program, leaving lots of room for gradual improvement over time. Again, we're not saying that younger children should avoid participating in distance running altogether. Instead, our advice is to delay specialized training on a year-round basis. Beginning at age 7 or 8, children who enjoy running may participate in fun runs and organized track and field programs that last a few months each year. Future distance runners will benefit from participating not only in middle-distance races (up to 1 mile, or 1,600 meters), but also in sprinting, jumping, and throwing events. When track season is over, they should participate in soccer, basketball, and other youth sports they enjoy. We recommend multisport participation because it's important to develop all-around physical fitness before beginning specialized training for track and cross country (see developmental principle 3).
Learn more about Training Young Distance Runners, 3rd Edition.
Stretch to develop flexibility and mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally.
Developing Flexibility and Mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally. Of course, running doesn't demand the extensive flexibility of sports such as gymnastics and figure skating, and the runner's limbs move mostly in one plane - in line with the forward direction. For these reasons, some distance coaches don't include training for flexibility and mobility. These capacities, however, are actually essential for young runners, especially for preventing injuries.
Distance running strengthens and tightens different muscle groups, sometimes causing imbalances on opposing sides of limbs and joints. Consider, for example, that runners don't lift their knees very high when covering long distances at relatively slow speeds. As a result, their hamstrings don't stretch much. Repetitive movement through such a limited range of motion can tighten the hamstrings, leading to strains and tears when athletes extend their stride for faster running in workouts and races. In addition, some runners have very tight calf muscles and experience calf strains and tears, as well as Achilles tendon injuries. These examples point to the need for stretching as a fundamental training method.
The stretching exercises in this chapter focus on muscle groups, such as the hamstrings, calves, and hip flexors, that tend to be tight in distance runners. Keep in mind, however, that athletes differ in terms of muscle tightness and the need for stretching. Some runners with loose joints and muscles can even injure their muscles and connective tissues by overstretching. Ideally, runners should be assessed for specific areas of tightness and imbalances by a qualified athletic trainer, physical therapist, or physician who specializes in sports medicine.
Dynamic and Static Stretching
Following is a routine of 13 stretching exercises for maintaining or improving flexibility. The first section shows dynamic stretches, which involve continuous movement of the limbs through sweeping ranges of motion around a joint. The second section shows static stretching exercises, which involve holding the position without movement. Follow these guidelines for performing the stretching exercises:
- Always warm up the muscles by jogging for 5 to 15 minutes before stretching.
- Perform dynamic stretches before static stretches. We recommend performing the stretching exercises in this book in the order they appear. The dynamic stretching exercises loosen up the joints and prepare the muscles for static stretching. The movements in dynamic stretching should be slow and gentle rather than fast and ballistic. Do 10 to 15 repetitions of each dynamic exercise.
- When performing static stretching, hold the position for 20 to 60 seconds, without rocking or bouncing. Stretching should never be so vigorous that it causes quivering or pain in the muscles.
- Use the same stretching routine for both training and racing. A familiar stretching routine helps you stay comfortable and relaxed during the prerace warm-up, when competitive anxiety can make it difficult to concentrate on proper preparation. Spend at least 10 minutes stretching, and never rush the routine.
- Stretch before and after training. Many runners think of stretching only as a pretraining and prerace activity, but stretching after training and racing is essential for maintaining flexibility and preventing injuries.
Dynamic Stretches
Arm Reach and Swing
Extend the arms above the head and then swing them downward in a wide, sweeping action.
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Head Roll
Slowly roll the head in a circle, gently stretching the neck muscles. Perform repetitions clockwise, and then switch to counterclockwise.
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Learn more about Training Young Distance Runners, 3rd Edition.
Running injuries, treatment and prevention
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it’s important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries.
Dealing With Injuries
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it's important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries. Common causes of injuries include the following:
- Training errors: Sudden, sharp increases in training volume and intensity; overuse (running more miles or kilometers than the body can handle); failure to take sufficient recovery time between demanding workouts; running too much on very hard or very soft surfaces
- Anatomical abnormalities: Flat feet, high arches, excessive pronation or supination, knock knees, bowed legs, inwardly rotated thigh bones, unequal leg lengths
- Muscle imbalances: Differences in the strength of opposing muscle groups (hamstrings and quadriceps, calf and tibialis anterior, hip flexors and hip extensors), differences in the flexibility of opposing muscle groups, excessively tight or loose muscles
- Poor technique: Excessive turning and twisting motions, overstriding, striking too hard on the heel or forefoot
- Inappropriate footwear: Insufficient cushioning, inadequate control for excessive pronation or supination, insufficient arch support, overly worn shoes
- Suboptimal nutrition: Insufficient intake of calories, fluids, calcium, electrolytes, or other nutrients
By considering the causes of running injuries, coaches might find that some aspect of their training programs increases injury risk. By eliminating the risk factor or adding training methods that counteract it, they can prevent injuries. For example, impact-related injuries, such as shinsplints and stress fractures, are often caused by running long distances on hard surfaces such as asphalt roads. Runners can reduce their risk for these injuries by training on dirt roads and trails.
To effectively deal with injuries, both athletes and coaches must heed their symptoms and understand the best approaches to treatment and rehabilitation (see the Common Running Injuries sidebar later in this chapter). Although some injuries require immediate medical treatment, others, especially those caused by chronic overuse, may not pose an immediate danger. In some cases runners can self-treat these injuries, ideally under the supervision of a sports doctor or certified athletic trainer. Self-treatment of many running injuries involves RICE, which stands for rest, ice, compression, and elevation. Rest can mean a complete cessation of all training for at least a few days, but for many injuries it's possible to keep training with supplemental methods to maintain fitness. For example, runners with knee pain will make their injuries worse if they continue to run, but they can maintain a high level of cardiorespiratory and muscle fitness by swimming and doing upper-body circuit training.
Some leg and foot injuries that keep athletes from running are not affected by activities such as cycling and deep-water running. In deep-water running, the athlete mimics the running action while suspended in a pool by a flotation vest. Because cycling and deep-water running can elevate the heart rate for prolonged periods, they're great for maintaining cardiorespiratory fitness. The duration of supplemental training depends on the injured runner's familiarity with the exercise. For example, injured runners who have never done deep-water running might start out with only 10 or 15 minutes a day and gradually build up to a duration that approaches their longest continuous aerobic run. Runners who are accustomed to riding bicycles can start cycling at 45 minutes or more.
The second component of RICE, applying ice to the injured area, is often very effective for reducing swelling and pain as well as for promoting healing. Injuries that involve chronic inflammation, such as plantar fasciitis and Achilles tendinitis, respond especially well to ice treatment. The protocol is to simply apply a plastic bag filled with crushed ice to the injured area. To avoid freezing the skin, the runner should place a thin cloth between the bag and the injured area. Freezing water in a paper cup and using it to perform an ice massage is another option. A general guideline is to apply ice two or three times a day for 10 to 20 minutes each time. We strongly recommend that runners consult a sports doctor or athletic trainer for an injury-specific icing protocol.
Compression of the affected area is also often an effective treatment for injuries that cause swelling. The most common method of compression is applying an elastic bandage. The placement of the bandage depends on the injury and the person. Athletic trainers know the proper techniques for wrapping injuries.
The fourth component of RICE, elevation, involves raising the injured area to reduce blood flow to it, thereby reducing swelling. A runner who has a knee injury, for example, should lie on a bed or couch and elevate the affected leg with a pillow or two. The leg should be raised slightly above the heart.
Common Running Injuries
To prevent and treat running injuries, coaches and runners benefit from knowing their causes, symptoms, and rehabilitation methods. Following are descriptions of some common running injuries; an extensive discussion of running injuries is beyond the scope of this book.
Stress fractures are tiny breaks that occur in the bones of the feet, shins, thighs, and hips. The symptoms include localized pain and tenderness on the surface of the affected bone. This injury is commonly caused by overuse, or the excessive loading of the bones from the repetitive stress of running on hard surfaces. Stress fractures tend to occur in girls who, as a result of inadequate caloric intake and excessive training, experience athletic amenorrhea, or cessation of normal menstruation. Cyclical increases in estrogen levels, which occur with regular menstruation, are necessary for maintaining bone density. Diagnosing a stress fracture is typically complicated because the fracture may not show up on X-rays for several weeks after the onset of symptoms. To avoid serious bone damage and to promote healing, athletes who experience the symptoms of stress fractures should stop running and see a sports doctor. If a stress fracture is diagnosed, rehabilitation involves alterations in training and diet, a change in footwear or the use of orthotics, and cardiorespiratory training methods such as swimming, pool running, and cycling that don't stress the affected bone.
Plantar fasciitis is an inflammation of the band of connective tissue that runs along the insole of the foot from the heel to the arch. This injury is characterized by gripping pain and tenderness in the arch, close to the fleshy part of the heel. The pain is especially intense in the morning and during running. Plantar fasciitis is common in runners who have flat feet and who overpronate. Recovery time from this injury can often require several weeks or months of reduced or no running. Doctors may prescribe exercises for strengthening muscles in the feet, orthotics, anti-inflammatory medication, and steroid injections.
Achilles tendinitis is the degeneration and inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. The main symptoms of this overuse injury are pain, tenderness, and swelling along the tendon. The pain is especially severe when athletes run on their toes, up hills, and in low-heeled racing flats or spikes. Runners with tight calf muscles are at particular risk, so they should regularly stretch these muscles. In some cases, rehabilitation time can be lengthy because the Achilles tendon receives limited blood flow and is stressed in daily activities such as walking. The main treatments - icing, anti-inflammatory medication, and ultrasound - increase blood flow to the tendon to reduce inflammation and promote healing. Swimming and deep-water running are good training methods for maintaining fitness while the tendon heals.
Patellofemoral pain syndrome results from cartilage degeneration behind the kneecap. Runners with this syndrome experience stiffness and grinding pain in the knee, especially after sitting for long periods and bending the knee in activities such as squatting and stair climbing. Patellofemoral pain syndrome occurs most often in runners with knock knees, bowed legs, and flat feet. Another cause is strength imbalances between the hamstrings and quadriceps. Doctors recommend anti-inflammatory medicine and exercises that strengthen the quadriceps and stretch the hamstrings.
Osgood- Schlatter syndrome refers to inflammation, tenderness, and pain where the patellar tendon (in front of the knee) attaches to the tibia, or shin bone. This syndrome, which is unique to young athletes, develops as a result of a combination of rapid bone growth and repetitive stress. During the adolescent growth spurt, the bones grow faster than the muscles and connective tissue. When the growth of the tibia outstrips that of the patellar tendon, the tendon pulls hard on its attachment site at the top of the shin. The excessive tugging causes irritation and pain. In addition, the force can lead to small bony formations and fractures. In most cases, the swelling and pain go away with reduced running and skeletal maturation.
Iliotibial band syndrome refers to inflammation and pain caused by the rubbing of the iliotibial band tendon against the lateral side (outside) of the knee. The iliotibial band runs along the lateral side of the thigh from the hip to the knee. In adult runners the syndrome is typically caused by a combination of repetitive stress from running and tightness of the iliotibial band and the muscles around it. In young runners an additional cause is rapid growth of the femur. Runners should cease running, ice the injured area, and stretch the iliotibial band (see chapter 6) and hamstring muscles (see chapter 6).
Shinsplints is a term referring to pain and tenderness along the shin bone. When the pain runs along the inner side of the shin from a few inches (around 5 or 6 cm) below the knee to the ankle, doctors refer to the injury as medial tibial pain syndrome. The pain associated with this syndrome is caused by inflammation of the tissue that lines the bone. When the pain is on the outer side of the shin, the cause may be compartment syndrome - swelling of the muscles in the lower leg, which overstretches the elastic sheath that covers the muscles and creates pressure on nerve endings in the muscles. Runners with shin pain should consult a sports doctor because appropriate treatment depends on the cause, which is difficult to self-diagnose, and because continuing to run without appropriate treatment can result in stress fractures.
Risk Factors for Running Injuries
To prevent injuries, coaches and runners benefit from knowing factors that increase their risk. This was the aim of a study conducted by Dr. Adam Tenforde and colleagues at Stanford University (Tenforde et al., 2011). The researchers surveyed 748 high school distance runners (442 girls and 306 boys) between 13 and 18 years old, asking them to report previous injuries, training mileage, and performance bests in the mile and 5K. Most of these young runners, 68 percent of the girls and 59 percent of the boys, reported at least one injury from a list that included Achilles tendinitis, ankle sprains, iliotibial band syndrome, knee pain, plantar fasciitis, and shinsplints. The proportion of these injuries was greater for girls. For example, 41 percent of the girls and 34 percent of the boys had experienced shinsplints. Around 6 percent of the girls and 3 percent of the boys had had at least one stress fracture. Compared with noninjured runners, those who reported injuries were older and covered more miles in their weekly training. For girls, significant risk factors for injury included greater amounts of running on pavement and faster performance times in the mile and 5K.
Based on their findings and other related research, Tenforde and coauthors concluded that high school runners can reduce injury risks by limiting running on hard surfaces and by performing injury-specific strength training and balancing exercises. The researchers' recommendations are summarized in table 10.3.
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When to start training children for distance running
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week.
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week. The view that young children are physiologically capable of running long distances is backed by world age-group records for races as long as the marathon (26.2 miles, or 41.2 km). The records for 8-year-olds are 3:34:30 for boys and 3:13:24 for girls; for 11-year-olds the records are 2:47:17 for boys and 2:49:21 for girls. Many adult marathoners have trained at high levels for years without reaching these marks. Research also shows that young children adapt physiologically to endurance training in ways that improve running performance. Before puberty, for example, children who perform moderate levels of endurance training experience about a 10 percent increase in V\od\O2max, slightly less than the 15 percent increase observed, on average, in adults.
From this information, you might conclude that young children are indeed capable of training for and competing in long-distance races. Before you start planning programs for 8-year-olds, however, consider the following other important points:
- Neither scientific nor anecdotal evidence suggests that distance runners must start training at a young age to reach their greatest potential. Most world-class runners did not begin training until they were in their mid to late teens. And, with very few exceptions, the children who held age-group records for the 5K through the marathon did not develop into elite adult runners.
- Research consistently shows that, before puberty, physiological adaptations to training aren't always correlated with performance in long-distance events. For prepubescent children, the factors that best predict distance running performance are simply related to physical maturity: taller, stronger, and faster children lead the pack in distance races, just as they excel in other sports such as basketball, baseball, and soccer.
- Although many children have naturally high levels of aerobic fitness, making them physiologically capable of performing low-intensity endurance activities, they are limited in their capacity to generate energy for high-intensity activities. The body has two primary systems for producing energy during exercise: the aerobic system, which operates when a sufficient amount of oxygen is available to the muscles, and the anaerobic system, which operates when the oxygen supply cannot keep up with the muscles' demand during high-intensity activity. One of the most consistent findings in pediatric exercise science is that the anaerobic system is not fully developed until children have passed through puberty.
- Physically immature youth who undertake high volumes of intense training are at relatively high risk for injuries, abnormal growth and maturation, and psychological burnout.
Considering these points, we recommend that children not begin regular and specialized training for distance running at least until the early stages of puberty, around ages 11 to 13 (see table 1.1). By no means are we saying that kids under 11 shouldn't participate in running events such as 1- or 2-mile fun runs at school or in community races. We encourage children of all ages to run for fun and health. Instead, we advise holding off on regular training, which we define as more than three days a week over periods of several months, and specialized training, which means focusing only on running as opposed to other sports and physical activities.
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While children are experiencing major physical changes during puberty, we recommend limiting the volume and intensity of training. One reason is that normal pubertal development can improve running performance on its own. For example, the growth spurt of the lungs and heart, which occurs at an average age of 11.5 years in girls and 13.5 years in boys, boosts the delivery of oxygen-rich blood to the muscles, which naturally increases V\od\O2max. Another example is the elevated level of growth hormone, which enables stronger muscle contractions, increasing running speed and efficiency.
Not all developmental changes automatically improve running performance, a point that also supports curbing early training. Consider rapid growth in height. At the average age of 10.5 for girls and 12.5 for boys, the growth rate increases dramatically from approximately 2.2 inches (5.5 cm) per year to approximately 4.1 to 4.7 inches (10.5 to 12 cm) per year. The highest rate of growth, which is called peak height velocity, occurs at around age 11.5 for girls and 13.5 for boys. Now consider the 13-year-old boy who grows 2 inches (5 cm) over a single summer - suddenly he's all legs. The growth spurt should improve his running by increasing leg length and thus stride length. However, he now has trouble coordinating his longer legs because the nervous system, which controls movement, doesn't immediately adapt to changes in limb length. Also, during the growth spurt body parts grow at different rates. The feet and legs, for example, usually lengthen faster than the trunk, making many teenagers seem gangly or awkward in their movements. These developmental changes may actually cause the runner to temporarily perform worse because his uncoordinated stride wastes energy and leads to fatigue.
Rapid limb growth also means that children who train intensely for distance running are at risk for muscular and skeletal injury. Bones lengthen at each end in soft tissue called epiphyseal growth plates. During puberty, the growth plates are weaker than hardened bone and susceptible to fractures under the heavy, repetitive stresses experienced in long-distance running. The growing athlete's joints and muscles are also susceptible to injury because muscle mass and strength develop more slowly than bone. Eventually, the epiphyseal growth plates ossify, or harden, and muscle mass increases. Until these two critical growth processes are complete, however, children are at increased risk of injury from excessive training.
Excessive training before puberty can also affect hormones in ways that may interfere with normal maturation and optimal health. Estrogen, for example, is a hormone that ensures healthy growth and development in girls. This hormone plays a major role in menstruation, which is a normal process of maturation in girls and young women. Under certain conditions, including suboptimal nutrition, estrogen is not produced at regular levels during puberty in female runners. As a result, they may experience delayed menarche or irregular menstrual cycles. In chapter 3 we discuss a major health problem called the female athlete triad, which encompasses suboptimal nutrition, abnormal menstrual function, and weakened bones. Compared with normally active girls, those who train excessively for distance running are at risk for this condition.
Fortunately, most young runners avoid harmful levels of training. They naturally stop pushing themselves before reaching their limits. However, we've known at least a few young runners who were self-motivated to push to extremes, and we've known coaches and parents who pushed young runners too far. For these children, running injuries are fairly common.
Another concern for those who specialize in running at a young age is psychological burnout. Take the 10-year-old who's running 40 miles (64 km) a week and racing 10Ks on a regular basis. Eventually, she may grow tired of running, especially because improvement depends on increasing training loads over time. If a child is running 40 miles (64 km) a week at age 10, at age 16 she'll need to run 70 (113km), or maybe even 90 or 100 miles (145 or 161 km), to keep improving. That much running leaves little time for activities other than school, sleeping, and eating. When training becomes that consuming, it isn't fun anymore, and most young people drop out of running.
Most girls and boys, by the ages of 12 and 14, respectively, have experienced key developmental changes that enable them to safely begin a low-mileage, low-intensity training program, leaving lots of room for gradual improvement over time. Again, we're not saying that younger children should avoid participating in distance running altogether. Instead, our advice is to delay specialized training on a year-round basis. Beginning at age 7 or 8, children who enjoy running may participate in fun runs and organized track and field programs that last a few months each year. Future distance runners will benefit from participating not only in middle-distance races (up to 1 mile, or 1,600 meters), but also in sprinting, jumping, and throwing events. When track season is over, they should participate in soccer, basketball, and other youth sports they enjoy. We recommend multisport participation because it's important to develop all-around physical fitness before beginning specialized training for track and cross country (see developmental principle 3).
Learn more about Training Young Distance Runners, 3rd Edition.
Stretch to develop flexibility and mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally.
Developing Flexibility and Mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally. Of course, running doesn't demand the extensive flexibility of sports such as gymnastics and figure skating, and the runner's limbs move mostly in one plane - in line with the forward direction. For these reasons, some distance coaches don't include training for flexibility and mobility. These capacities, however, are actually essential for young runners, especially for preventing injuries.
Distance running strengthens and tightens different muscle groups, sometimes causing imbalances on opposing sides of limbs and joints. Consider, for example, that runners don't lift their knees very high when covering long distances at relatively slow speeds. As a result, their hamstrings don't stretch much. Repetitive movement through such a limited range of motion can tighten the hamstrings, leading to strains and tears when athletes extend their stride for faster running in workouts and races. In addition, some runners have very tight calf muscles and experience calf strains and tears, as well as Achilles tendon injuries. These examples point to the need for stretching as a fundamental training method.
The stretching exercises in this chapter focus on muscle groups, such as the hamstrings, calves, and hip flexors, that tend to be tight in distance runners. Keep in mind, however, that athletes differ in terms of muscle tightness and the need for stretching. Some runners with loose joints and muscles can even injure their muscles and connective tissues by overstretching. Ideally, runners should be assessed for specific areas of tightness and imbalances by a qualified athletic trainer, physical therapist, or physician who specializes in sports medicine.
Dynamic and Static Stretching
Following is a routine of 13 stretching exercises for maintaining or improving flexibility. The first section shows dynamic stretches, which involve continuous movement of the limbs through sweeping ranges of motion around a joint. The second section shows static stretching exercises, which involve holding the position without movement. Follow these guidelines for performing the stretching exercises:
- Always warm up the muscles by jogging for 5 to 15 minutes before stretching.
- Perform dynamic stretches before static stretches. We recommend performing the stretching exercises in this book in the order they appear. The dynamic stretching exercises loosen up the joints and prepare the muscles for static stretching. The movements in dynamic stretching should be slow and gentle rather than fast and ballistic. Do 10 to 15 repetitions of each dynamic exercise.
- When performing static stretching, hold the position for 20 to 60 seconds, without rocking or bouncing. Stretching should never be so vigorous that it causes quivering or pain in the muscles.
- Use the same stretching routine for both training and racing. A familiar stretching routine helps you stay comfortable and relaxed during the prerace warm-up, when competitive anxiety can make it difficult to concentrate on proper preparation. Spend at least 10 minutes stretching, and never rush the routine.
- Stretch before and after training. Many runners think of stretching only as a pretraining and prerace activity, but stretching after training and racing is essential for maintaining flexibility and preventing injuries.
Dynamic Stretches
Arm Reach and Swing
Extend the arms above the head and then swing them downward in a wide, sweeping action.
http://www.humankinetics.com/AcuCustom/Sitename/DAM/133/E6148_0755P_0471_ebook_Main.jpg
Head Roll
Slowly roll the head in a circle, gently stretching the neck muscles. Perform repetitions clockwise, and then switch to counterclockwise.
http://www.humankinetics.com/AcuCustom/Sitename/DAM/133/E6148_0755P_0475_ebook_Main.jpg
Learn more about Training Young Distance Runners, 3rd Edition.
Running injuries, treatment and prevention
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it’s important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries.
Dealing With Injuries
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it's important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries. Common causes of injuries include the following:
- Training errors: Sudden, sharp increases in training volume and intensity; overuse (running more miles or kilometers than the body can handle); failure to take sufficient recovery time between demanding workouts; running too much on very hard or very soft surfaces
- Anatomical abnormalities: Flat feet, high arches, excessive pronation or supination, knock knees, bowed legs, inwardly rotated thigh bones, unequal leg lengths
- Muscle imbalances: Differences in the strength of opposing muscle groups (hamstrings and quadriceps, calf and tibialis anterior, hip flexors and hip extensors), differences in the flexibility of opposing muscle groups, excessively tight or loose muscles
- Poor technique: Excessive turning and twisting motions, overstriding, striking too hard on the heel or forefoot
- Inappropriate footwear: Insufficient cushioning, inadequate control for excessive pronation or supination, insufficient arch support, overly worn shoes
- Suboptimal nutrition: Insufficient intake of calories, fluids, calcium, electrolytes, or other nutrients
By considering the causes of running injuries, coaches might find that some aspect of their training programs increases injury risk. By eliminating the risk factor or adding training methods that counteract it, they can prevent injuries. For example, impact-related injuries, such as shinsplints and stress fractures, are often caused by running long distances on hard surfaces such as asphalt roads. Runners can reduce their risk for these injuries by training on dirt roads and trails.
To effectively deal with injuries, both athletes and coaches must heed their symptoms and understand the best approaches to treatment and rehabilitation (see the Common Running Injuries sidebar later in this chapter). Although some injuries require immediate medical treatment, others, especially those caused by chronic overuse, may not pose an immediate danger. In some cases runners can self-treat these injuries, ideally under the supervision of a sports doctor or certified athletic trainer. Self-treatment of many running injuries involves RICE, which stands for rest, ice, compression, and elevation. Rest can mean a complete cessation of all training for at least a few days, but for many injuries it's possible to keep training with supplemental methods to maintain fitness. For example, runners with knee pain will make their injuries worse if they continue to run, but they can maintain a high level of cardiorespiratory and muscle fitness by swimming and doing upper-body circuit training.
Some leg and foot injuries that keep athletes from running are not affected by activities such as cycling and deep-water running. In deep-water running, the athlete mimics the running action while suspended in a pool by a flotation vest. Because cycling and deep-water running can elevate the heart rate for prolonged periods, they're great for maintaining cardiorespiratory fitness. The duration of supplemental training depends on the injured runner's familiarity with the exercise. For example, injured runners who have never done deep-water running might start out with only 10 or 15 minutes a day and gradually build up to a duration that approaches their longest continuous aerobic run. Runners who are accustomed to riding bicycles can start cycling at 45 minutes or more.
The second component of RICE, applying ice to the injured area, is often very effective for reducing swelling and pain as well as for promoting healing. Injuries that involve chronic inflammation, such as plantar fasciitis and Achilles tendinitis, respond especially well to ice treatment. The protocol is to simply apply a plastic bag filled with crushed ice to the injured area. To avoid freezing the skin, the runner should place a thin cloth between the bag and the injured area. Freezing water in a paper cup and using it to perform an ice massage is another option. A general guideline is to apply ice two or three times a day for 10 to 20 minutes each time. We strongly recommend that runners consult a sports doctor or athletic trainer for an injury-specific icing protocol.
Compression of the affected area is also often an effective treatment for injuries that cause swelling. The most common method of compression is applying an elastic bandage. The placement of the bandage depends on the injury and the person. Athletic trainers know the proper techniques for wrapping injuries.
The fourth component of RICE, elevation, involves raising the injured area to reduce blood flow to it, thereby reducing swelling. A runner who has a knee injury, for example, should lie on a bed or couch and elevate the affected leg with a pillow or two. The leg should be raised slightly above the heart.
Common Running Injuries
To prevent and treat running injuries, coaches and runners benefit from knowing their causes, symptoms, and rehabilitation methods. Following are descriptions of some common running injuries; an extensive discussion of running injuries is beyond the scope of this book.
Stress fractures are tiny breaks that occur in the bones of the feet, shins, thighs, and hips. The symptoms include localized pain and tenderness on the surface of the affected bone. This injury is commonly caused by overuse, or the excessive loading of the bones from the repetitive stress of running on hard surfaces. Stress fractures tend to occur in girls who, as a result of inadequate caloric intake and excessive training, experience athletic amenorrhea, or cessation of normal menstruation. Cyclical increases in estrogen levels, which occur with regular menstruation, are necessary for maintaining bone density. Diagnosing a stress fracture is typically complicated because the fracture may not show up on X-rays for several weeks after the onset of symptoms. To avoid serious bone damage and to promote healing, athletes who experience the symptoms of stress fractures should stop running and see a sports doctor. If a stress fracture is diagnosed, rehabilitation involves alterations in training and diet, a change in footwear or the use of orthotics, and cardiorespiratory training methods such as swimming, pool running, and cycling that don't stress the affected bone.
Plantar fasciitis is an inflammation of the band of connective tissue that runs along the insole of the foot from the heel to the arch. This injury is characterized by gripping pain and tenderness in the arch, close to the fleshy part of the heel. The pain is especially intense in the morning and during running. Plantar fasciitis is common in runners who have flat feet and who overpronate. Recovery time from this injury can often require several weeks or months of reduced or no running. Doctors may prescribe exercises for strengthening muscles in the feet, orthotics, anti-inflammatory medication, and steroid injections.
Achilles tendinitis is the degeneration and inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. The main symptoms of this overuse injury are pain, tenderness, and swelling along the tendon. The pain is especially severe when athletes run on their toes, up hills, and in low-heeled racing flats or spikes. Runners with tight calf muscles are at particular risk, so they should regularly stretch these muscles. In some cases, rehabilitation time can be lengthy because the Achilles tendon receives limited blood flow and is stressed in daily activities such as walking. The main treatments - icing, anti-inflammatory medication, and ultrasound - increase blood flow to the tendon to reduce inflammation and promote healing. Swimming and deep-water running are good training methods for maintaining fitness while the tendon heals.
Patellofemoral pain syndrome results from cartilage degeneration behind the kneecap. Runners with this syndrome experience stiffness and grinding pain in the knee, especially after sitting for long periods and bending the knee in activities such as squatting and stair climbing. Patellofemoral pain syndrome occurs most often in runners with knock knees, bowed legs, and flat feet. Another cause is strength imbalances between the hamstrings and quadriceps. Doctors recommend anti-inflammatory medicine and exercises that strengthen the quadriceps and stretch the hamstrings.
Osgood- Schlatter syndrome refers to inflammation, tenderness, and pain where the patellar tendon (in front of the knee) attaches to the tibia, or shin bone. This syndrome, which is unique to young athletes, develops as a result of a combination of rapid bone growth and repetitive stress. During the adolescent growth spurt, the bones grow faster than the muscles and connective tissue. When the growth of the tibia outstrips that of the patellar tendon, the tendon pulls hard on its attachment site at the top of the shin. The excessive tugging causes irritation and pain. In addition, the force can lead to small bony formations and fractures. In most cases, the swelling and pain go away with reduced running and skeletal maturation.
Iliotibial band syndrome refers to inflammation and pain caused by the rubbing of the iliotibial band tendon against the lateral side (outside) of the knee. The iliotibial band runs along the lateral side of the thigh from the hip to the knee. In adult runners the syndrome is typically caused by a combination of repetitive stress from running and tightness of the iliotibial band and the muscles around it. In young runners an additional cause is rapid growth of the femur. Runners should cease running, ice the injured area, and stretch the iliotibial band (see chapter 6) and hamstring muscles (see chapter 6).
Shinsplints is a term referring to pain and tenderness along the shin bone. When the pain runs along the inner side of the shin from a few inches (around 5 or 6 cm) below the knee to the ankle, doctors refer to the injury as medial tibial pain syndrome. The pain associated with this syndrome is caused by inflammation of the tissue that lines the bone. When the pain is on the outer side of the shin, the cause may be compartment syndrome - swelling of the muscles in the lower leg, which overstretches the elastic sheath that covers the muscles and creates pressure on nerve endings in the muscles. Runners with shin pain should consult a sports doctor because appropriate treatment depends on the cause, which is difficult to self-diagnose, and because continuing to run without appropriate treatment can result in stress fractures.
Risk Factors for Running Injuries
To prevent injuries, coaches and runners benefit from knowing factors that increase their risk. This was the aim of a study conducted by Dr. Adam Tenforde and colleagues at Stanford University (Tenforde et al., 2011). The researchers surveyed 748 high school distance runners (442 girls and 306 boys) between 13 and 18 years old, asking them to report previous injuries, training mileage, and performance bests in the mile and 5K. Most of these young runners, 68 percent of the girls and 59 percent of the boys, reported at least one injury from a list that included Achilles tendinitis, ankle sprains, iliotibial band syndrome, knee pain, plantar fasciitis, and shinsplints. The proportion of these injuries was greater for girls. For example, 41 percent of the girls and 34 percent of the boys had experienced shinsplints. Around 6 percent of the girls and 3 percent of the boys had had at least one stress fracture. Compared with noninjured runners, those who reported injuries were older and covered more miles in their weekly training. For girls, significant risk factors for injury included greater amounts of running on pavement and faster performance times in the mile and 5K.
Based on their findings and other related research, Tenforde and coauthors concluded that high school runners can reduce injury risks by limiting running on hard surfaces and by performing injury-specific strength training and balancing exercises. The researchers' recommendations are summarized in table 10.3.
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When to start training children for distance running
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week.
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week. The view that young children are physiologically capable of running long distances is backed by world age-group records for races as long as the marathon (26.2 miles, or 41.2 km). The records for 8-year-olds are 3:34:30 for boys and 3:13:24 for girls; for 11-year-olds the records are 2:47:17 for boys and 2:49:21 for girls. Many adult marathoners have trained at high levels for years without reaching these marks. Research also shows that young children adapt physiologically to endurance training in ways that improve running performance. Before puberty, for example, children who perform moderate levels of endurance training experience about a 10 percent increase in V\od\O2max, slightly less than the 15 percent increase observed, on average, in adults.
From this information, you might conclude that young children are indeed capable of training for and competing in long-distance races. Before you start planning programs for 8-year-olds, however, consider the following other important points:
- Neither scientific nor anecdotal evidence suggests that distance runners must start training at a young age to reach their greatest potential. Most world-class runners did not begin training until they were in their mid to late teens. And, with very few exceptions, the children who held age-group records for the 5K through the marathon did not develop into elite adult runners.
- Research consistently shows that, before puberty, physiological adaptations to training aren't always correlated with performance in long-distance events. For prepubescent children, the factors that best predict distance running performance are simply related to physical maturity: taller, stronger, and faster children lead the pack in distance races, just as they excel in other sports such as basketball, baseball, and soccer.
- Although many children have naturally high levels of aerobic fitness, making them physiologically capable of performing low-intensity endurance activities, they are limited in their capacity to generate energy for high-intensity activities. The body has two primary systems for producing energy during exercise: the aerobic system, which operates when a sufficient amount of oxygen is available to the muscles, and the anaerobic system, which operates when the oxygen supply cannot keep up with the muscles' demand during high-intensity activity. One of the most consistent findings in pediatric exercise science is that the anaerobic system is not fully developed until children have passed through puberty.
- Physically immature youth who undertake high volumes of intense training are at relatively high risk for injuries, abnormal growth and maturation, and psychological burnout.
Considering these points, we recommend that children not begin regular and specialized training for distance running at least until the early stages of puberty, around ages 11 to 13 (see table 1.1). By no means are we saying that kids under 11 shouldn't participate in running events such as 1- or 2-mile fun runs at school or in community races. We encourage children of all ages to run for fun and health. Instead, we advise holding off on regular training, which we define as more than three days a week over periods of several months, and specialized training, which means focusing only on running as opposed to other sports and physical activities.
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While children are experiencing major physical changes during puberty, we recommend limiting the volume and intensity of training. One reason is that normal pubertal development can improve running performance on its own. For example, the growth spurt of the lungs and heart, which occurs at an average age of 11.5 years in girls and 13.5 years in boys, boosts the delivery of oxygen-rich blood to the muscles, which naturally increases V\od\O2max. Another example is the elevated level of growth hormone, which enables stronger muscle contractions, increasing running speed and efficiency.
Not all developmental changes automatically improve running performance, a point that also supports curbing early training. Consider rapid growth in height. At the average age of 10.5 for girls and 12.5 for boys, the growth rate increases dramatically from approximately 2.2 inches (5.5 cm) per year to approximately 4.1 to 4.7 inches (10.5 to 12 cm) per year. The highest rate of growth, which is called peak height velocity, occurs at around age 11.5 for girls and 13.5 for boys. Now consider the 13-year-old boy who grows 2 inches (5 cm) over a single summer - suddenly he's all legs. The growth spurt should improve his running by increasing leg length and thus stride length. However, he now has trouble coordinating his longer legs because the nervous system, which controls movement, doesn't immediately adapt to changes in limb length. Also, during the growth spurt body parts grow at different rates. The feet and legs, for example, usually lengthen faster than the trunk, making many teenagers seem gangly or awkward in their movements. These developmental changes may actually cause the runner to temporarily perform worse because his uncoordinated stride wastes energy and leads to fatigue.
Rapid limb growth also means that children who train intensely for distance running are at risk for muscular and skeletal injury. Bones lengthen at each end in soft tissue called epiphyseal growth plates. During puberty, the growth plates are weaker than hardened bone and susceptible to fractures under the heavy, repetitive stresses experienced in long-distance running. The growing athlete's joints and muscles are also susceptible to injury because muscle mass and strength develop more slowly than bone. Eventually, the epiphyseal growth plates ossify, or harden, and muscle mass increases. Until these two critical growth processes are complete, however, children are at increased risk of injury from excessive training.
Excessive training before puberty can also affect hormones in ways that may interfere with normal maturation and optimal health. Estrogen, for example, is a hormone that ensures healthy growth and development in girls. This hormone plays a major role in menstruation, which is a normal process of maturation in girls and young women. Under certain conditions, including suboptimal nutrition, estrogen is not produced at regular levels during puberty in female runners. As a result, they may experience delayed menarche or irregular menstrual cycles. In chapter 3 we discuss a major health problem called the female athlete triad, which encompasses suboptimal nutrition, abnormal menstrual function, and weakened bones. Compared with normally active girls, those who train excessively for distance running are at risk for this condition.
Fortunately, most young runners avoid harmful levels of training. They naturally stop pushing themselves before reaching their limits. However, we've known at least a few young runners who were self-motivated to push to extremes, and we've known coaches and parents who pushed young runners too far. For these children, running injuries are fairly common.
Another concern for those who specialize in running at a young age is psychological burnout. Take the 10-year-old who's running 40 miles (64 km) a week and racing 10Ks on a regular basis. Eventually, she may grow tired of running, especially because improvement depends on increasing training loads over time. If a child is running 40 miles (64 km) a week at age 10, at age 16 she'll need to run 70 (113km), or maybe even 90 or 100 miles (145 or 161 km), to keep improving. That much running leaves little time for activities other than school, sleeping, and eating. When training becomes that consuming, it isn't fun anymore, and most young people drop out of running.
Most girls and boys, by the ages of 12 and 14, respectively, have experienced key developmental changes that enable them to safely begin a low-mileage, low-intensity training program, leaving lots of room for gradual improvement over time. Again, we're not saying that younger children should avoid participating in distance running altogether. Instead, our advice is to delay specialized training on a year-round basis. Beginning at age 7 or 8, children who enjoy running may participate in fun runs and organized track and field programs that last a few months each year. Future distance runners will benefit from participating not only in middle-distance races (up to 1 mile, or 1,600 meters), but also in sprinting, jumping, and throwing events. When track season is over, they should participate in soccer, basketball, and other youth sports they enjoy. We recommend multisport participation because it's important to develop all-around physical fitness before beginning specialized training for track and cross country (see developmental principle 3).
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Stretch to develop flexibility and mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally.
Developing Flexibility and Mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally. Of course, running doesn't demand the extensive flexibility of sports such as gymnastics and figure skating, and the runner's limbs move mostly in one plane - in line with the forward direction. For these reasons, some distance coaches don't include training for flexibility and mobility. These capacities, however, are actually essential for young runners, especially for preventing injuries.
Distance running strengthens and tightens different muscle groups, sometimes causing imbalances on opposing sides of limbs and joints. Consider, for example, that runners don't lift their knees very high when covering long distances at relatively slow speeds. As a result, their hamstrings don't stretch much. Repetitive movement through such a limited range of motion can tighten the hamstrings, leading to strains and tears when athletes extend their stride for faster running in workouts and races. In addition, some runners have very tight calf muscles and experience calf strains and tears, as well as Achilles tendon injuries. These examples point to the need for stretching as a fundamental training method.
The stretching exercises in this chapter focus on muscle groups, such as the hamstrings, calves, and hip flexors, that tend to be tight in distance runners. Keep in mind, however, that athletes differ in terms of muscle tightness and the need for stretching. Some runners with loose joints and muscles can even injure their muscles and connective tissues by overstretching. Ideally, runners should be assessed for specific areas of tightness and imbalances by a qualified athletic trainer, physical therapist, or physician who specializes in sports medicine.
Dynamic and Static Stretching
Following is a routine of 13 stretching exercises for maintaining or improving flexibility. The first section shows dynamic stretches, which involve continuous movement of the limbs through sweeping ranges of motion around a joint. The second section shows static stretching exercises, which involve holding the position without movement. Follow these guidelines for performing the stretching exercises:
- Always warm up the muscles by jogging for 5 to 15 minutes before stretching.
- Perform dynamic stretches before static stretches. We recommend performing the stretching exercises in this book in the order they appear. The dynamic stretching exercises loosen up the joints and prepare the muscles for static stretching. The movements in dynamic stretching should be slow and gentle rather than fast and ballistic. Do 10 to 15 repetitions of each dynamic exercise.
- When performing static stretching, hold the position for 20 to 60 seconds, without rocking or bouncing. Stretching should never be so vigorous that it causes quivering or pain in the muscles.
- Use the same stretching routine for both training and racing. A familiar stretching routine helps you stay comfortable and relaxed during the prerace warm-up, when competitive anxiety can make it difficult to concentrate on proper preparation. Spend at least 10 minutes stretching, and never rush the routine.
- Stretch before and after training. Many runners think of stretching only as a pretraining and prerace activity, but stretching after training and racing is essential for maintaining flexibility and preventing injuries.
Dynamic Stretches
Arm Reach and Swing
Extend the arms above the head and then swing them downward in a wide, sweeping action.
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Head Roll
Slowly roll the head in a circle, gently stretching the neck muscles. Perform repetitions clockwise, and then switch to counterclockwise.
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Running injuries, treatment and prevention
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it’s important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries.
Dealing With Injuries
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it's important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries. Common causes of injuries include the following:
- Training errors: Sudden, sharp increases in training volume and intensity; overuse (running more miles or kilometers than the body can handle); failure to take sufficient recovery time between demanding workouts; running too much on very hard or very soft surfaces
- Anatomical abnormalities: Flat feet, high arches, excessive pronation or supination, knock knees, bowed legs, inwardly rotated thigh bones, unequal leg lengths
- Muscle imbalances: Differences in the strength of opposing muscle groups (hamstrings and quadriceps, calf and tibialis anterior, hip flexors and hip extensors), differences in the flexibility of opposing muscle groups, excessively tight or loose muscles
- Poor technique: Excessive turning and twisting motions, overstriding, striking too hard on the heel or forefoot
- Inappropriate footwear: Insufficient cushioning, inadequate control for excessive pronation or supination, insufficient arch support, overly worn shoes
- Suboptimal nutrition: Insufficient intake of calories, fluids, calcium, electrolytes, or other nutrients
By considering the causes of running injuries, coaches might find that some aspect of their training programs increases injury risk. By eliminating the risk factor or adding training methods that counteract it, they can prevent injuries. For example, impact-related injuries, such as shinsplints and stress fractures, are often caused by running long distances on hard surfaces such as asphalt roads. Runners can reduce their risk for these injuries by training on dirt roads and trails.
To effectively deal with injuries, both athletes and coaches must heed their symptoms and understand the best approaches to treatment and rehabilitation (see the Common Running Injuries sidebar later in this chapter). Although some injuries require immediate medical treatment, others, especially those caused by chronic overuse, may not pose an immediate danger. In some cases runners can self-treat these injuries, ideally under the supervision of a sports doctor or certified athletic trainer. Self-treatment of many running injuries involves RICE, which stands for rest, ice, compression, and elevation. Rest can mean a complete cessation of all training for at least a few days, but for many injuries it's possible to keep training with supplemental methods to maintain fitness. For example, runners with knee pain will make their injuries worse if they continue to run, but they can maintain a high level of cardiorespiratory and muscle fitness by swimming and doing upper-body circuit training.
Some leg and foot injuries that keep athletes from running are not affected by activities such as cycling and deep-water running. In deep-water running, the athlete mimics the running action while suspended in a pool by a flotation vest. Because cycling and deep-water running can elevate the heart rate for prolonged periods, they're great for maintaining cardiorespiratory fitness. The duration of supplemental training depends on the injured runner's familiarity with the exercise. For example, injured runners who have never done deep-water running might start out with only 10 or 15 minutes a day and gradually build up to a duration that approaches their longest continuous aerobic run. Runners who are accustomed to riding bicycles can start cycling at 45 minutes or more.
The second component of RICE, applying ice to the injured area, is often very effective for reducing swelling and pain as well as for promoting healing. Injuries that involve chronic inflammation, such as plantar fasciitis and Achilles tendinitis, respond especially well to ice treatment. The protocol is to simply apply a plastic bag filled with crushed ice to the injured area. To avoid freezing the skin, the runner should place a thin cloth between the bag and the injured area. Freezing water in a paper cup and using it to perform an ice massage is another option. A general guideline is to apply ice two or three times a day for 10 to 20 minutes each time. We strongly recommend that runners consult a sports doctor or athletic trainer for an injury-specific icing protocol.
Compression of the affected area is also often an effective treatment for injuries that cause swelling. The most common method of compression is applying an elastic bandage. The placement of the bandage depends on the injury and the person. Athletic trainers know the proper techniques for wrapping injuries.
The fourth component of RICE, elevation, involves raising the injured area to reduce blood flow to it, thereby reducing swelling. A runner who has a knee injury, for example, should lie on a bed or couch and elevate the affected leg with a pillow or two. The leg should be raised slightly above the heart.
Common Running Injuries
To prevent and treat running injuries, coaches and runners benefit from knowing their causes, symptoms, and rehabilitation methods. Following are descriptions of some common running injuries; an extensive discussion of running injuries is beyond the scope of this book.
Stress fractures are tiny breaks that occur in the bones of the feet, shins, thighs, and hips. The symptoms include localized pain and tenderness on the surface of the affected bone. This injury is commonly caused by overuse, or the excessive loading of the bones from the repetitive stress of running on hard surfaces. Stress fractures tend to occur in girls who, as a result of inadequate caloric intake and excessive training, experience athletic amenorrhea, or cessation of normal menstruation. Cyclical increases in estrogen levels, which occur with regular menstruation, are necessary for maintaining bone density. Diagnosing a stress fracture is typically complicated because the fracture may not show up on X-rays for several weeks after the onset of symptoms. To avoid serious bone damage and to promote healing, athletes who experience the symptoms of stress fractures should stop running and see a sports doctor. If a stress fracture is diagnosed, rehabilitation involves alterations in training and diet, a change in footwear or the use of orthotics, and cardiorespiratory training methods such as swimming, pool running, and cycling that don't stress the affected bone.
Plantar fasciitis is an inflammation of the band of connective tissue that runs along the insole of the foot from the heel to the arch. This injury is characterized by gripping pain and tenderness in the arch, close to the fleshy part of the heel. The pain is especially intense in the morning and during running. Plantar fasciitis is common in runners who have flat feet and who overpronate. Recovery time from this injury can often require several weeks or months of reduced or no running. Doctors may prescribe exercises for strengthening muscles in the feet, orthotics, anti-inflammatory medication, and steroid injections.
Achilles tendinitis is the degeneration and inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. The main symptoms of this overuse injury are pain, tenderness, and swelling along the tendon. The pain is especially severe when athletes run on their toes, up hills, and in low-heeled racing flats or spikes. Runners with tight calf muscles are at particular risk, so they should regularly stretch these muscles. In some cases, rehabilitation time can be lengthy because the Achilles tendon receives limited blood flow and is stressed in daily activities such as walking. The main treatments - icing, anti-inflammatory medication, and ultrasound - increase blood flow to the tendon to reduce inflammation and promote healing. Swimming and deep-water running are good training methods for maintaining fitness while the tendon heals.
Patellofemoral pain syndrome results from cartilage degeneration behind the kneecap. Runners with this syndrome experience stiffness and grinding pain in the knee, especially after sitting for long periods and bending the knee in activities such as squatting and stair climbing. Patellofemoral pain syndrome occurs most often in runners with knock knees, bowed legs, and flat feet. Another cause is strength imbalances between the hamstrings and quadriceps. Doctors recommend anti-inflammatory medicine and exercises that strengthen the quadriceps and stretch the hamstrings.
Osgood- Schlatter syndrome refers to inflammation, tenderness, and pain where the patellar tendon (in front of the knee) attaches to the tibia, or shin bone. This syndrome, which is unique to young athletes, develops as a result of a combination of rapid bone growth and repetitive stress. During the adolescent growth spurt, the bones grow faster than the muscles and connective tissue. When the growth of the tibia outstrips that of the patellar tendon, the tendon pulls hard on its attachment site at the top of the shin. The excessive tugging causes irritation and pain. In addition, the force can lead to small bony formations and fractures. In most cases, the swelling and pain go away with reduced running and skeletal maturation.
Iliotibial band syndrome refers to inflammation and pain caused by the rubbing of the iliotibial band tendon against the lateral side (outside) of the knee. The iliotibial band runs along the lateral side of the thigh from the hip to the knee. In adult runners the syndrome is typically caused by a combination of repetitive stress from running and tightness of the iliotibial band and the muscles around it. In young runners an additional cause is rapid growth of the femur. Runners should cease running, ice the injured area, and stretch the iliotibial band (see chapter 6) and hamstring muscles (see chapter 6).
Shinsplints is a term referring to pain and tenderness along the shin bone. When the pain runs along the inner side of the shin from a few inches (around 5 or 6 cm) below the knee to the ankle, doctors refer to the injury as medial tibial pain syndrome. The pain associated with this syndrome is caused by inflammation of the tissue that lines the bone. When the pain is on the outer side of the shin, the cause may be compartment syndrome - swelling of the muscles in the lower leg, which overstretches the elastic sheath that covers the muscles and creates pressure on nerve endings in the muscles. Runners with shin pain should consult a sports doctor because appropriate treatment depends on the cause, which is difficult to self-diagnose, and because continuing to run without appropriate treatment can result in stress fractures.
Risk Factors for Running Injuries
To prevent injuries, coaches and runners benefit from knowing factors that increase their risk. This was the aim of a study conducted by Dr. Adam Tenforde and colleagues at Stanford University (Tenforde et al., 2011). The researchers surveyed 748 high school distance runners (442 girls and 306 boys) between 13 and 18 years old, asking them to report previous injuries, training mileage, and performance bests in the mile and 5K. Most of these young runners, 68 percent of the girls and 59 percent of the boys, reported at least one injury from a list that included Achilles tendinitis, ankle sprains, iliotibial band syndrome, knee pain, plantar fasciitis, and shinsplints. The proportion of these injuries was greater for girls. For example, 41 percent of the girls and 34 percent of the boys had experienced shinsplints. Around 6 percent of the girls and 3 percent of the boys had had at least one stress fracture. Compared with noninjured runners, those who reported injuries were older and covered more miles in their weekly training. For girls, significant risk factors for injury included greater amounts of running on pavement and faster performance times in the mile and 5K.
Based on their findings and other related research, Tenforde and coauthors concluded that high school runners can reduce injury risks by limiting running on hard surfaces and by performing injury-specific strength training and balancing exercises. The researchers' recommendations are summarized in table 10.3.
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Learn more about Training Young Distance Runners, 3rd Edition.
When to start training children for distance running
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week.
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week. The view that young children are physiologically capable of running long distances is backed by world age-group records for races as long as the marathon (26.2 miles, or 41.2 km). The records for 8-year-olds are 3:34:30 for boys and 3:13:24 for girls; for 11-year-olds the records are 2:47:17 for boys and 2:49:21 for girls. Many adult marathoners have trained at high levels for years without reaching these marks. Research also shows that young children adapt physiologically to endurance training in ways that improve running performance. Before puberty, for example, children who perform moderate levels of endurance training experience about a 10 percent increase in V\od\O2max, slightly less than the 15 percent increase observed, on average, in adults.
From this information, you might conclude that young children are indeed capable of training for and competing in long-distance races. Before you start planning programs for 8-year-olds, however, consider the following other important points:
- Neither scientific nor anecdotal evidence suggests that distance runners must start training at a young age to reach their greatest potential. Most world-class runners did not begin training until they were in their mid to late teens. And, with very few exceptions, the children who held age-group records for the 5K through the marathon did not develop into elite adult runners.
- Research consistently shows that, before puberty, physiological adaptations to training aren't always correlated with performance in long-distance events. For prepubescent children, the factors that best predict distance running performance are simply related to physical maturity: taller, stronger, and faster children lead the pack in distance races, just as they excel in other sports such as basketball, baseball, and soccer.
- Although many children have naturally high levels of aerobic fitness, making them physiologically capable of performing low-intensity endurance activities, they are limited in their capacity to generate energy for high-intensity activities. The body has two primary systems for producing energy during exercise: the aerobic system, which operates when a sufficient amount of oxygen is available to the muscles, and the anaerobic system, which operates when the oxygen supply cannot keep up with the muscles' demand during high-intensity activity. One of the most consistent findings in pediatric exercise science is that the anaerobic system is not fully developed until children have passed through puberty.
- Physically immature youth who undertake high volumes of intense training are at relatively high risk for injuries, abnormal growth and maturation, and psychological burnout.
Considering these points, we recommend that children not begin regular and specialized training for distance running at least until the early stages of puberty, around ages 11 to 13 (see table 1.1). By no means are we saying that kids under 11 shouldn't participate in running events such as 1- or 2-mile fun runs at school or in community races. We encourage children of all ages to run for fun and health. Instead, we advise holding off on regular training, which we define as more than three days a week over periods of several months, and specialized training, which means focusing only on running as opposed to other sports and physical activities.
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While children are experiencing major physical changes during puberty, we recommend limiting the volume and intensity of training. One reason is that normal pubertal development can improve running performance on its own. For example, the growth spurt of the lungs and heart, which occurs at an average age of 11.5 years in girls and 13.5 years in boys, boosts the delivery of oxygen-rich blood to the muscles, which naturally increases V\od\O2max. Another example is the elevated level of growth hormone, which enables stronger muscle contractions, increasing running speed and efficiency.
Not all developmental changes automatically improve running performance, a point that also supports curbing early training. Consider rapid growth in height. At the average age of 10.5 for girls and 12.5 for boys, the growth rate increases dramatically from approximately 2.2 inches (5.5 cm) per year to approximately 4.1 to 4.7 inches (10.5 to 12 cm) per year. The highest rate of growth, which is called peak height velocity, occurs at around age 11.5 for girls and 13.5 for boys. Now consider the 13-year-old boy who grows 2 inches (5 cm) over a single summer - suddenly he's all legs. The growth spurt should improve his running by increasing leg length and thus stride length. However, he now has trouble coordinating his longer legs because the nervous system, which controls movement, doesn't immediately adapt to changes in limb length. Also, during the growth spurt body parts grow at different rates. The feet and legs, for example, usually lengthen faster than the trunk, making many teenagers seem gangly or awkward in their movements. These developmental changes may actually cause the runner to temporarily perform worse because his uncoordinated stride wastes energy and leads to fatigue.
Rapid limb growth also means that children who train intensely for distance running are at risk for muscular and skeletal injury. Bones lengthen at each end in soft tissue called epiphyseal growth plates. During puberty, the growth plates are weaker than hardened bone and susceptible to fractures under the heavy, repetitive stresses experienced in long-distance running. The growing athlete's joints and muscles are also susceptible to injury because muscle mass and strength develop more slowly than bone. Eventually, the epiphyseal growth plates ossify, or harden, and muscle mass increases. Until these two critical growth processes are complete, however, children are at increased risk of injury from excessive training.
Excessive training before puberty can also affect hormones in ways that may interfere with normal maturation and optimal health. Estrogen, for example, is a hormone that ensures healthy growth and development in girls. This hormone plays a major role in menstruation, which is a normal process of maturation in girls and young women. Under certain conditions, including suboptimal nutrition, estrogen is not produced at regular levels during puberty in female runners. As a result, they may experience delayed menarche or irregular menstrual cycles. In chapter 3 we discuss a major health problem called the female athlete triad, which encompasses suboptimal nutrition, abnormal menstrual function, and weakened bones. Compared with normally active girls, those who train excessively for distance running are at risk for this condition.
Fortunately, most young runners avoid harmful levels of training. They naturally stop pushing themselves before reaching their limits. However, we've known at least a few young runners who were self-motivated to push to extremes, and we've known coaches and parents who pushed young runners too far. For these children, running injuries are fairly common.
Another concern for those who specialize in running at a young age is psychological burnout. Take the 10-year-old who's running 40 miles (64 km) a week and racing 10Ks on a regular basis. Eventually, she may grow tired of running, especially because improvement depends on increasing training loads over time. If a child is running 40 miles (64 km) a week at age 10, at age 16 she'll need to run 70 (113km), or maybe even 90 or 100 miles (145 or 161 km), to keep improving. That much running leaves little time for activities other than school, sleeping, and eating. When training becomes that consuming, it isn't fun anymore, and most young people drop out of running.
Most girls and boys, by the ages of 12 and 14, respectively, have experienced key developmental changes that enable them to safely begin a low-mileage, low-intensity training program, leaving lots of room for gradual improvement over time. Again, we're not saying that younger children should avoid participating in distance running altogether. Instead, our advice is to delay specialized training on a year-round basis. Beginning at age 7 or 8, children who enjoy running may participate in fun runs and organized track and field programs that last a few months each year. Future distance runners will benefit from participating not only in middle-distance races (up to 1 mile, or 1,600 meters), but also in sprinting, jumping, and throwing events. When track season is over, they should participate in soccer, basketball, and other youth sports they enjoy. We recommend multisport participation because it's important to develop all-around physical fitness before beginning specialized training for track and cross country (see developmental principle 3).
Learn more about Training Young Distance Runners, 3rd Edition.
Stretch to develop flexibility and mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally.
Developing Flexibility and Mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally. Of course, running doesn't demand the extensive flexibility of sports such as gymnastics and figure skating, and the runner's limbs move mostly in one plane - in line with the forward direction. For these reasons, some distance coaches don't include training for flexibility and mobility. These capacities, however, are actually essential for young runners, especially for preventing injuries.
Distance running strengthens and tightens different muscle groups, sometimes causing imbalances on opposing sides of limbs and joints. Consider, for example, that runners don't lift their knees very high when covering long distances at relatively slow speeds. As a result, their hamstrings don't stretch much. Repetitive movement through such a limited range of motion can tighten the hamstrings, leading to strains and tears when athletes extend their stride for faster running in workouts and races. In addition, some runners have very tight calf muscles and experience calf strains and tears, as well as Achilles tendon injuries. These examples point to the need for stretching as a fundamental training method.
The stretching exercises in this chapter focus on muscle groups, such as the hamstrings, calves, and hip flexors, that tend to be tight in distance runners. Keep in mind, however, that athletes differ in terms of muscle tightness and the need for stretching. Some runners with loose joints and muscles can even injure their muscles and connective tissues by overstretching. Ideally, runners should be assessed for specific areas of tightness and imbalances by a qualified athletic trainer, physical therapist, or physician who specializes in sports medicine.
Dynamic and Static Stretching
Following is a routine of 13 stretching exercises for maintaining or improving flexibility. The first section shows dynamic stretches, which involve continuous movement of the limbs through sweeping ranges of motion around a joint. The second section shows static stretching exercises, which involve holding the position without movement. Follow these guidelines for performing the stretching exercises:
- Always warm up the muscles by jogging for 5 to 15 minutes before stretching.
- Perform dynamic stretches before static stretches. We recommend performing the stretching exercises in this book in the order they appear. The dynamic stretching exercises loosen up the joints and prepare the muscles for static stretching. The movements in dynamic stretching should be slow and gentle rather than fast and ballistic. Do 10 to 15 repetitions of each dynamic exercise.
- When performing static stretching, hold the position for 20 to 60 seconds, without rocking or bouncing. Stretching should never be so vigorous that it causes quivering or pain in the muscles.
- Use the same stretching routine for both training and racing. A familiar stretching routine helps you stay comfortable and relaxed during the prerace warm-up, when competitive anxiety can make it difficult to concentrate on proper preparation. Spend at least 10 minutes stretching, and never rush the routine.
- Stretch before and after training. Many runners think of stretching only as a pretraining and prerace activity, but stretching after training and racing is essential for maintaining flexibility and preventing injuries.
Dynamic Stretches
Arm Reach and Swing
Extend the arms above the head and then swing them downward in a wide, sweeping action.
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Head Roll
Slowly roll the head in a circle, gently stretching the neck muscles. Perform repetitions clockwise, and then switch to counterclockwise.
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Running injuries, treatment and prevention
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it’s important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries.
Dealing With Injuries
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it's important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries. Common causes of injuries include the following:
- Training errors: Sudden, sharp increases in training volume and intensity; overuse (running more miles or kilometers than the body can handle); failure to take sufficient recovery time between demanding workouts; running too much on very hard or very soft surfaces
- Anatomical abnormalities: Flat feet, high arches, excessive pronation or supination, knock knees, bowed legs, inwardly rotated thigh bones, unequal leg lengths
- Muscle imbalances: Differences in the strength of opposing muscle groups (hamstrings and quadriceps, calf and tibialis anterior, hip flexors and hip extensors), differences in the flexibility of opposing muscle groups, excessively tight or loose muscles
- Poor technique: Excessive turning and twisting motions, overstriding, striking too hard on the heel or forefoot
- Inappropriate footwear: Insufficient cushioning, inadequate control for excessive pronation or supination, insufficient arch support, overly worn shoes
- Suboptimal nutrition: Insufficient intake of calories, fluids, calcium, electrolytes, or other nutrients
By considering the causes of running injuries, coaches might find that some aspect of their training programs increases injury risk. By eliminating the risk factor or adding training methods that counteract it, they can prevent injuries. For example, impact-related injuries, such as shinsplints and stress fractures, are often caused by running long distances on hard surfaces such as asphalt roads. Runners can reduce their risk for these injuries by training on dirt roads and trails.
To effectively deal with injuries, both athletes and coaches must heed their symptoms and understand the best approaches to treatment and rehabilitation (see the Common Running Injuries sidebar later in this chapter). Although some injuries require immediate medical treatment, others, especially those caused by chronic overuse, may not pose an immediate danger. In some cases runners can self-treat these injuries, ideally under the supervision of a sports doctor or certified athletic trainer. Self-treatment of many running injuries involves RICE, which stands for rest, ice, compression, and elevation. Rest can mean a complete cessation of all training for at least a few days, but for many injuries it's possible to keep training with supplemental methods to maintain fitness. For example, runners with knee pain will make their injuries worse if they continue to run, but they can maintain a high level of cardiorespiratory and muscle fitness by swimming and doing upper-body circuit training.
Some leg and foot injuries that keep athletes from running are not affected by activities such as cycling and deep-water running. In deep-water running, the athlete mimics the running action while suspended in a pool by a flotation vest. Because cycling and deep-water running can elevate the heart rate for prolonged periods, they're great for maintaining cardiorespiratory fitness. The duration of supplemental training depends on the injured runner's familiarity with the exercise. For example, injured runners who have never done deep-water running might start out with only 10 or 15 minutes a day and gradually build up to a duration that approaches their longest continuous aerobic run. Runners who are accustomed to riding bicycles can start cycling at 45 minutes or more.
The second component of RICE, applying ice to the injured area, is often very effective for reducing swelling and pain as well as for promoting healing. Injuries that involve chronic inflammation, such as plantar fasciitis and Achilles tendinitis, respond especially well to ice treatment. The protocol is to simply apply a plastic bag filled with crushed ice to the injured area. To avoid freezing the skin, the runner should place a thin cloth between the bag and the injured area. Freezing water in a paper cup and using it to perform an ice massage is another option. A general guideline is to apply ice two or three times a day for 10 to 20 minutes each time. We strongly recommend that runners consult a sports doctor or athletic trainer for an injury-specific icing protocol.
Compression of the affected area is also often an effective treatment for injuries that cause swelling. The most common method of compression is applying an elastic bandage. The placement of the bandage depends on the injury and the person. Athletic trainers know the proper techniques for wrapping injuries.
The fourth component of RICE, elevation, involves raising the injured area to reduce blood flow to it, thereby reducing swelling. A runner who has a knee injury, for example, should lie on a bed or couch and elevate the affected leg with a pillow or two. The leg should be raised slightly above the heart.
Common Running Injuries
To prevent and treat running injuries, coaches and runners benefit from knowing their causes, symptoms, and rehabilitation methods. Following are descriptions of some common running injuries; an extensive discussion of running injuries is beyond the scope of this book.
Stress fractures are tiny breaks that occur in the bones of the feet, shins, thighs, and hips. The symptoms include localized pain and tenderness on the surface of the affected bone. This injury is commonly caused by overuse, or the excessive loading of the bones from the repetitive stress of running on hard surfaces. Stress fractures tend to occur in girls who, as a result of inadequate caloric intake and excessive training, experience athletic amenorrhea, or cessation of normal menstruation. Cyclical increases in estrogen levels, which occur with regular menstruation, are necessary for maintaining bone density. Diagnosing a stress fracture is typically complicated because the fracture may not show up on X-rays for several weeks after the onset of symptoms. To avoid serious bone damage and to promote healing, athletes who experience the symptoms of stress fractures should stop running and see a sports doctor. If a stress fracture is diagnosed, rehabilitation involves alterations in training and diet, a change in footwear or the use of orthotics, and cardiorespiratory training methods such as swimming, pool running, and cycling that don't stress the affected bone.
Plantar fasciitis is an inflammation of the band of connective tissue that runs along the insole of the foot from the heel to the arch. This injury is characterized by gripping pain and tenderness in the arch, close to the fleshy part of the heel. The pain is especially intense in the morning and during running. Plantar fasciitis is common in runners who have flat feet and who overpronate. Recovery time from this injury can often require several weeks or months of reduced or no running. Doctors may prescribe exercises for strengthening muscles in the feet, orthotics, anti-inflammatory medication, and steroid injections.
Achilles tendinitis is the degeneration and inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. The main symptoms of this overuse injury are pain, tenderness, and swelling along the tendon. The pain is especially severe when athletes run on their toes, up hills, and in low-heeled racing flats or spikes. Runners with tight calf muscles are at particular risk, so they should regularly stretch these muscles. In some cases, rehabilitation time can be lengthy because the Achilles tendon receives limited blood flow and is stressed in daily activities such as walking. The main treatments - icing, anti-inflammatory medication, and ultrasound - increase blood flow to the tendon to reduce inflammation and promote healing. Swimming and deep-water running are good training methods for maintaining fitness while the tendon heals.
Patellofemoral pain syndrome results from cartilage degeneration behind the kneecap. Runners with this syndrome experience stiffness and grinding pain in the knee, especially after sitting for long periods and bending the knee in activities such as squatting and stair climbing. Patellofemoral pain syndrome occurs most often in runners with knock knees, bowed legs, and flat feet. Another cause is strength imbalances between the hamstrings and quadriceps. Doctors recommend anti-inflammatory medicine and exercises that strengthen the quadriceps and stretch the hamstrings.
Osgood- Schlatter syndrome refers to inflammation, tenderness, and pain where the patellar tendon (in front of the knee) attaches to the tibia, or shin bone. This syndrome, which is unique to young athletes, develops as a result of a combination of rapid bone growth and repetitive stress. During the adolescent growth spurt, the bones grow faster than the muscles and connective tissue. When the growth of the tibia outstrips that of the patellar tendon, the tendon pulls hard on its attachment site at the top of the shin. The excessive tugging causes irritation and pain. In addition, the force can lead to small bony formations and fractures. In most cases, the swelling and pain go away with reduced running and skeletal maturation.
Iliotibial band syndrome refers to inflammation and pain caused by the rubbing of the iliotibial band tendon against the lateral side (outside) of the knee. The iliotibial band runs along the lateral side of the thigh from the hip to the knee. In adult runners the syndrome is typically caused by a combination of repetitive stress from running and tightness of the iliotibial band and the muscles around it. In young runners an additional cause is rapid growth of the femur. Runners should cease running, ice the injured area, and stretch the iliotibial band (see chapter 6) and hamstring muscles (see chapter 6).
Shinsplints is a term referring to pain and tenderness along the shin bone. When the pain runs along the inner side of the shin from a few inches (around 5 or 6 cm) below the knee to the ankle, doctors refer to the injury as medial tibial pain syndrome. The pain associated with this syndrome is caused by inflammation of the tissue that lines the bone. When the pain is on the outer side of the shin, the cause may be compartment syndrome - swelling of the muscles in the lower leg, which overstretches the elastic sheath that covers the muscles and creates pressure on nerve endings in the muscles. Runners with shin pain should consult a sports doctor because appropriate treatment depends on the cause, which is difficult to self-diagnose, and because continuing to run without appropriate treatment can result in stress fractures.
Risk Factors for Running Injuries
To prevent injuries, coaches and runners benefit from knowing factors that increase their risk. This was the aim of a study conducted by Dr. Adam Tenforde and colleagues at Stanford University (Tenforde et al., 2011). The researchers surveyed 748 high school distance runners (442 girls and 306 boys) between 13 and 18 years old, asking them to report previous injuries, training mileage, and performance bests in the mile and 5K. Most of these young runners, 68 percent of the girls and 59 percent of the boys, reported at least one injury from a list that included Achilles tendinitis, ankle sprains, iliotibial band syndrome, knee pain, plantar fasciitis, and shinsplints. The proportion of these injuries was greater for girls. For example, 41 percent of the girls and 34 percent of the boys had experienced shinsplints. Around 6 percent of the girls and 3 percent of the boys had had at least one stress fracture. Compared with noninjured runners, those who reported injuries were older and covered more miles in their weekly training. For girls, significant risk factors for injury included greater amounts of running on pavement and faster performance times in the mile and 5K.
Based on their findings and other related research, Tenforde and coauthors concluded that high school runners can reduce injury risks by limiting running on hard surfaces and by performing injury-specific strength training and balancing exercises. The researchers' recommendations are summarized in table 10.3.
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When to start training children for distance running
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week.
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week. The view that young children are physiologically capable of running long distances is backed by world age-group records for races as long as the marathon (26.2 miles, or 41.2 km). The records for 8-year-olds are 3:34:30 for boys and 3:13:24 for girls; for 11-year-olds the records are 2:47:17 for boys and 2:49:21 for girls. Many adult marathoners have trained at high levels for years without reaching these marks. Research also shows that young children adapt physiologically to endurance training in ways that improve running performance. Before puberty, for example, children who perform moderate levels of endurance training experience about a 10 percent increase in V\od\O2max, slightly less than the 15 percent increase observed, on average, in adults.
From this information, you might conclude that young children are indeed capable of training for and competing in long-distance races. Before you start planning programs for 8-year-olds, however, consider the following other important points:
- Neither scientific nor anecdotal evidence suggests that distance runners must start training at a young age to reach their greatest potential. Most world-class runners did not begin training until they were in their mid to late teens. And, with very few exceptions, the children who held age-group records for the 5K through the marathon did not develop into elite adult runners.
- Research consistently shows that, before puberty, physiological adaptations to training aren't always correlated with performance in long-distance events. For prepubescent children, the factors that best predict distance running performance are simply related to physical maturity: taller, stronger, and faster children lead the pack in distance races, just as they excel in other sports such as basketball, baseball, and soccer.
- Although many children have naturally high levels of aerobic fitness, making them physiologically capable of performing low-intensity endurance activities, they are limited in their capacity to generate energy for high-intensity activities. The body has two primary systems for producing energy during exercise: the aerobic system, which operates when a sufficient amount of oxygen is available to the muscles, and the anaerobic system, which operates when the oxygen supply cannot keep up with the muscles' demand during high-intensity activity. One of the most consistent findings in pediatric exercise science is that the anaerobic system is not fully developed until children have passed through puberty.
- Physically immature youth who undertake high volumes of intense training are at relatively high risk for injuries, abnormal growth and maturation, and psychological burnout.
Considering these points, we recommend that children not begin regular and specialized training for distance running at least until the early stages of puberty, around ages 11 to 13 (see table 1.1). By no means are we saying that kids under 11 shouldn't participate in running events such as 1- or 2-mile fun runs at school or in community races. We encourage children of all ages to run for fun and health. Instead, we advise holding off on regular training, which we define as more than three days a week over periods of several months, and specialized training, which means focusing only on running as opposed to other sports and physical activities.
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While children are experiencing major physical changes during puberty, we recommend limiting the volume and intensity of training. One reason is that normal pubertal development can improve running performance on its own. For example, the growth spurt of the lungs and heart, which occurs at an average age of 11.5 years in girls and 13.5 years in boys, boosts the delivery of oxygen-rich blood to the muscles, which naturally increases V\od\O2max. Another example is the elevated level of growth hormone, which enables stronger muscle contractions, increasing running speed and efficiency.
Not all developmental changes automatically improve running performance, a point that also supports curbing early training. Consider rapid growth in height. At the average age of 10.5 for girls and 12.5 for boys, the growth rate increases dramatically from approximately 2.2 inches (5.5 cm) per year to approximately 4.1 to 4.7 inches (10.5 to 12 cm) per year. The highest rate of growth, which is called peak height velocity, occurs at around age 11.5 for girls and 13.5 for boys. Now consider the 13-year-old boy who grows 2 inches (5 cm) over a single summer - suddenly he's all legs. The growth spurt should improve his running by increasing leg length and thus stride length. However, he now has trouble coordinating his longer legs because the nervous system, which controls movement, doesn't immediately adapt to changes in limb length. Also, during the growth spurt body parts grow at different rates. The feet and legs, for example, usually lengthen faster than the trunk, making many teenagers seem gangly or awkward in their movements. These developmental changes may actually cause the runner to temporarily perform worse because his uncoordinated stride wastes energy and leads to fatigue.
Rapid limb growth also means that children who train intensely for distance running are at risk for muscular and skeletal injury. Bones lengthen at each end in soft tissue called epiphyseal growth plates. During puberty, the growth plates are weaker than hardened bone and susceptible to fractures under the heavy, repetitive stresses experienced in long-distance running. The growing athlete's joints and muscles are also susceptible to injury because muscle mass and strength develop more slowly than bone. Eventually, the epiphyseal growth plates ossify, or harden, and muscle mass increases. Until these two critical growth processes are complete, however, children are at increased risk of injury from excessive training.
Excessive training before puberty can also affect hormones in ways that may interfere with normal maturation and optimal health. Estrogen, for example, is a hormone that ensures healthy growth and development in girls. This hormone plays a major role in menstruation, which is a normal process of maturation in girls and young women. Under certain conditions, including suboptimal nutrition, estrogen is not produced at regular levels during puberty in female runners. As a result, they may experience delayed menarche or irregular menstrual cycles. In chapter 3 we discuss a major health problem called the female athlete triad, which encompasses suboptimal nutrition, abnormal menstrual function, and weakened bones. Compared with normally active girls, those who train excessively for distance running are at risk for this condition.
Fortunately, most young runners avoid harmful levels of training. They naturally stop pushing themselves before reaching their limits. However, we've known at least a few young runners who were self-motivated to push to extremes, and we've known coaches and parents who pushed young runners too far. For these children, running injuries are fairly common.
Another concern for those who specialize in running at a young age is psychological burnout. Take the 10-year-old who's running 40 miles (64 km) a week and racing 10Ks on a regular basis. Eventually, she may grow tired of running, especially because improvement depends on increasing training loads over time. If a child is running 40 miles (64 km) a week at age 10, at age 16 she'll need to run 70 (113km), or maybe even 90 or 100 miles (145 or 161 km), to keep improving. That much running leaves little time for activities other than school, sleeping, and eating. When training becomes that consuming, it isn't fun anymore, and most young people drop out of running.
Most girls and boys, by the ages of 12 and 14, respectively, have experienced key developmental changes that enable them to safely begin a low-mileage, low-intensity training program, leaving lots of room for gradual improvement over time. Again, we're not saying that younger children should avoid participating in distance running altogether. Instead, our advice is to delay specialized training on a year-round basis. Beginning at age 7 or 8, children who enjoy running may participate in fun runs and organized track and field programs that last a few months each year. Future distance runners will benefit from participating not only in middle-distance races (up to 1 mile, or 1,600 meters), but also in sprinting, jumping, and throwing events. When track season is over, they should participate in soccer, basketball, and other youth sports they enjoy. We recommend multisport participation because it's important to develop all-around physical fitness before beginning specialized training for track and cross country (see developmental principle 3).
Learn more about Training Young Distance Runners, 3rd Edition.
Stretch to develop flexibility and mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally.
Developing Flexibility and Mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally. Of course, running doesn't demand the extensive flexibility of sports such as gymnastics and figure skating, and the runner's limbs move mostly in one plane - in line with the forward direction. For these reasons, some distance coaches don't include training for flexibility and mobility. These capacities, however, are actually essential for young runners, especially for preventing injuries.
Distance running strengthens and tightens different muscle groups, sometimes causing imbalances on opposing sides of limbs and joints. Consider, for example, that runners don't lift their knees very high when covering long distances at relatively slow speeds. As a result, their hamstrings don't stretch much. Repetitive movement through such a limited range of motion can tighten the hamstrings, leading to strains and tears when athletes extend their stride for faster running in workouts and races. In addition, some runners have very tight calf muscles and experience calf strains and tears, as well as Achilles tendon injuries. These examples point to the need for stretching as a fundamental training method.
The stretching exercises in this chapter focus on muscle groups, such as the hamstrings, calves, and hip flexors, that tend to be tight in distance runners. Keep in mind, however, that athletes differ in terms of muscle tightness and the need for stretching. Some runners with loose joints and muscles can even injure their muscles and connective tissues by overstretching. Ideally, runners should be assessed for specific areas of tightness and imbalances by a qualified athletic trainer, physical therapist, or physician who specializes in sports medicine.
Dynamic and Static Stretching
Following is a routine of 13 stretching exercises for maintaining or improving flexibility. The first section shows dynamic stretches, which involve continuous movement of the limbs through sweeping ranges of motion around a joint. The second section shows static stretching exercises, which involve holding the position without movement. Follow these guidelines for performing the stretching exercises:
- Always warm up the muscles by jogging for 5 to 15 minutes before stretching.
- Perform dynamic stretches before static stretches. We recommend performing the stretching exercises in this book in the order they appear. The dynamic stretching exercises loosen up the joints and prepare the muscles for static stretching. The movements in dynamic stretching should be slow and gentle rather than fast and ballistic. Do 10 to 15 repetitions of each dynamic exercise.
- When performing static stretching, hold the position for 20 to 60 seconds, without rocking or bouncing. Stretching should never be so vigorous that it causes quivering or pain in the muscles.
- Use the same stretching routine for both training and racing. A familiar stretching routine helps you stay comfortable and relaxed during the prerace warm-up, when competitive anxiety can make it difficult to concentrate on proper preparation. Spend at least 10 minutes stretching, and never rush the routine.
- Stretch before and after training. Many runners think of stretching only as a pretraining and prerace activity, but stretching after training and racing is essential for maintaining flexibility and preventing injuries.
Dynamic Stretches
Arm Reach and Swing
Extend the arms above the head and then swing them downward in a wide, sweeping action.
http://www.humankinetics.com/AcuCustom/Sitename/DAM/133/E6148_0755P_0471_ebook_Main.jpg
Head Roll
Slowly roll the head in a circle, gently stretching the neck muscles. Perform repetitions clockwise, and then switch to counterclockwise.
http://www.humankinetics.com/AcuCustom/Sitename/DAM/133/E6148_0755P_0475_ebook_Main.jpg
Learn more about Training Young Distance Runners, 3rd Edition.
Running injuries, treatment and prevention
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it’s important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries.
Dealing With Injuries
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it's important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries. Common causes of injuries include the following:
- Training errors: Sudden, sharp increases in training volume and intensity; overuse (running more miles or kilometers than the body can handle); failure to take sufficient recovery time between demanding workouts; running too much on very hard or very soft surfaces
- Anatomical abnormalities: Flat feet, high arches, excessive pronation or supination, knock knees, bowed legs, inwardly rotated thigh bones, unequal leg lengths
- Muscle imbalances: Differences in the strength of opposing muscle groups (hamstrings and quadriceps, calf and tibialis anterior, hip flexors and hip extensors), differences in the flexibility of opposing muscle groups, excessively tight or loose muscles
- Poor technique: Excessive turning and twisting motions, overstriding, striking too hard on the heel or forefoot
- Inappropriate footwear: Insufficient cushioning, inadequate control for excessive pronation or supination, insufficient arch support, overly worn shoes
- Suboptimal nutrition: Insufficient intake of calories, fluids, calcium, electrolytes, or other nutrients
By considering the causes of running injuries, coaches might find that some aspect of their training programs increases injury risk. By eliminating the risk factor or adding training methods that counteract it, they can prevent injuries. For example, impact-related injuries, such as shinsplints and stress fractures, are often caused by running long distances on hard surfaces such as asphalt roads. Runners can reduce their risk for these injuries by training on dirt roads and trails.
To effectively deal with injuries, both athletes and coaches must heed their symptoms and understand the best approaches to treatment and rehabilitation (see the Common Running Injuries sidebar later in this chapter). Although some injuries require immediate medical treatment, others, especially those caused by chronic overuse, may not pose an immediate danger. In some cases runners can self-treat these injuries, ideally under the supervision of a sports doctor or certified athletic trainer. Self-treatment of many running injuries involves RICE, which stands for rest, ice, compression, and elevation. Rest can mean a complete cessation of all training for at least a few days, but for many injuries it's possible to keep training with supplemental methods to maintain fitness. For example, runners with knee pain will make their injuries worse if they continue to run, but they can maintain a high level of cardiorespiratory and muscle fitness by swimming and doing upper-body circuit training.
Some leg and foot injuries that keep athletes from running are not affected by activities such as cycling and deep-water running. In deep-water running, the athlete mimics the running action while suspended in a pool by a flotation vest. Because cycling and deep-water running can elevate the heart rate for prolonged periods, they're great for maintaining cardiorespiratory fitness. The duration of supplemental training depends on the injured runner's familiarity with the exercise. For example, injured runners who have never done deep-water running might start out with only 10 or 15 minutes a day and gradually build up to a duration that approaches their longest continuous aerobic run. Runners who are accustomed to riding bicycles can start cycling at 45 minutes or more.
The second component of RICE, applying ice to the injured area, is often very effective for reducing swelling and pain as well as for promoting healing. Injuries that involve chronic inflammation, such as plantar fasciitis and Achilles tendinitis, respond especially well to ice treatment. The protocol is to simply apply a plastic bag filled with crushed ice to the injured area. To avoid freezing the skin, the runner should place a thin cloth between the bag and the injured area. Freezing water in a paper cup and using it to perform an ice massage is another option. A general guideline is to apply ice two or three times a day for 10 to 20 minutes each time. We strongly recommend that runners consult a sports doctor or athletic trainer for an injury-specific icing protocol.
Compression of the affected area is also often an effective treatment for injuries that cause swelling. The most common method of compression is applying an elastic bandage. The placement of the bandage depends on the injury and the person. Athletic trainers know the proper techniques for wrapping injuries.
The fourth component of RICE, elevation, involves raising the injured area to reduce blood flow to it, thereby reducing swelling. A runner who has a knee injury, for example, should lie on a bed or couch and elevate the affected leg with a pillow or two. The leg should be raised slightly above the heart.
Common Running Injuries
To prevent and treat running injuries, coaches and runners benefit from knowing their causes, symptoms, and rehabilitation methods. Following are descriptions of some common running injuries; an extensive discussion of running injuries is beyond the scope of this book.
Stress fractures are tiny breaks that occur in the bones of the feet, shins, thighs, and hips. The symptoms include localized pain and tenderness on the surface of the affected bone. This injury is commonly caused by overuse, or the excessive loading of the bones from the repetitive stress of running on hard surfaces. Stress fractures tend to occur in girls who, as a result of inadequate caloric intake and excessive training, experience athletic amenorrhea, or cessation of normal menstruation. Cyclical increases in estrogen levels, which occur with regular menstruation, are necessary for maintaining bone density. Diagnosing a stress fracture is typically complicated because the fracture may not show up on X-rays for several weeks after the onset of symptoms. To avoid serious bone damage and to promote healing, athletes who experience the symptoms of stress fractures should stop running and see a sports doctor. If a stress fracture is diagnosed, rehabilitation involves alterations in training and diet, a change in footwear or the use of orthotics, and cardiorespiratory training methods such as swimming, pool running, and cycling that don't stress the affected bone.
Plantar fasciitis is an inflammation of the band of connective tissue that runs along the insole of the foot from the heel to the arch. This injury is characterized by gripping pain and tenderness in the arch, close to the fleshy part of the heel. The pain is especially intense in the morning and during running. Plantar fasciitis is common in runners who have flat feet and who overpronate. Recovery time from this injury can often require several weeks or months of reduced or no running. Doctors may prescribe exercises for strengthening muscles in the feet, orthotics, anti-inflammatory medication, and steroid injections.
Achilles tendinitis is the degeneration and inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. The main symptoms of this overuse injury are pain, tenderness, and swelling along the tendon. The pain is especially severe when athletes run on their toes, up hills, and in low-heeled racing flats or spikes. Runners with tight calf muscles are at particular risk, so they should regularly stretch these muscles. In some cases, rehabilitation time can be lengthy because the Achilles tendon receives limited blood flow and is stressed in daily activities such as walking. The main treatments - icing, anti-inflammatory medication, and ultrasound - increase blood flow to the tendon to reduce inflammation and promote healing. Swimming and deep-water running are good training methods for maintaining fitness while the tendon heals.
Patellofemoral pain syndrome results from cartilage degeneration behind the kneecap. Runners with this syndrome experience stiffness and grinding pain in the knee, especially after sitting for long periods and bending the knee in activities such as squatting and stair climbing. Patellofemoral pain syndrome occurs most often in runners with knock knees, bowed legs, and flat feet. Another cause is strength imbalances between the hamstrings and quadriceps. Doctors recommend anti-inflammatory medicine and exercises that strengthen the quadriceps and stretch the hamstrings.
Osgood- Schlatter syndrome refers to inflammation, tenderness, and pain where the patellar tendon (in front of the knee) attaches to the tibia, or shin bone. This syndrome, which is unique to young athletes, develops as a result of a combination of rapid bone growth and repetitive stress. During the adolescent growth spurt, the bones grow faster than the muscles and connective tissue. When the growth of the tibia outstrips that of the patellar tendon, the tendon pulls hard on its attachment site at the top of the shin. The excessive tugging causes irritation and pain. In addition, the force can lead to small bony formations and fractures. In most cases, the swelling and pain go away with reduced running and skeletal maturation.
Iliotibial band syndrome refers to inflammation and pain caused by the rubbing of the iliotibial band tendon against the lateral side (outside) of the knee. The iliotibial band runs along the lateral side of the thigh from the hip to the knee. In adult runners the syndrome is typically caused by a combination of repetitive stress from running and tightness of the iliotibial band and the muscles around it. In young runners an additional cause is rapid growth of the femur. Runners should cease running, ice the injured area, and stretch the iliotibial band (see chapter 6) and hamstring muscles (see chapter 6).
Shinsplints is a term referring to pain and tenderness along the shin bone. When the pain runs along the inner side of the shin from a few inches (around 5 or 6 cm) below the knee to the ankle, doctors refer to the injury as medial tibial pain syndrome. The pain associated with this syndrome is caused by inflammation of the tissue that lines the bone. When the pain is on the outer side of the shin, the cause may be compartment syndrome - swelling of the muscles in the lower leg, which overstretches the elastic sheath that covers the muscles and creates pressure on nerve endings in the muscles. Runners with shin pain should consult a sports doctor because appropriate treatment depends on the cause, which is difficult to self-diagnose, and because continuing to run without appropriate treatment can result in stress fractures.
Risk Factors for Running Injuries
To prevent injuries, coaches and runners benefit from knowing factors that increase their risk. This was the aim of a study conducted by Dr. Adam Tenforde and colleagues at Stanford University (Tenforde et al., 2011). The researchers surveyed 748 high school distance runners (442 girls and 306 boys) between 13 and 18 years old, asking them to report previous injuries, training mileage, and performance bests in the mile and 5K. Most of these young runners, 68 percent of the girls and 59 percent of the boys, reported at least one injury from a list that included Achilles tendinitis, ankle sprains, iliotibial band syndrome, knee pain, plantar fasciitis, and shinsplints. The proportion of these injuries was greater for girls. For example, 41 percent of the girls and 34 percent of the boys had experienced shinsplints. Around 6 percent of the girls and 3 percent of the boys had had at least one stress fracture. Compared with noninjured runners, those who reported injuries were older and covered more miles in their weekly training. For girls, significant risk factors for injury included greater amounts of running on pavement and faster performance times in the mile and 5K.
Based on their findings and other related research, Tenforde and coauthors concluded that high school runners can reduce injury risks by limiting running on hard surfaces and by performing injury-specific strength training and balancing exercises. The researchers' recommendations are summarized in table 10.3.
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When to start training children for distance running
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week.
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week. The view that young children are physiologically capable of running long distances is backed by world age-group records for races as long as the marathon (26.2 miles, or 41.2 km). The records for 8-year-olds are 3:34:30 for boys and 3:13:24 for girls; for 11-year-olds the records are 2:47:17 for boys and 2:49:21 for girls. Many adult marathoners have trained at high levels for years without reaching these marks. Research also shows that young children adapt physiologically to endurance training in ways that improve running performance. Before puberty, for example, children who perform moderate levels of endurance training experience about a 10 percent increase in V\od\O2max, slightly less than the 15 percent increase observed, on average, in adults.
From this information, you might conclude that young children are indeed capable of training for and competing in long-distance races. Before you start planning programs for 8-year-olds, however, consider the following other important points:
- Neither scientific nor anecdotal evidence suggests that distance runners must start training at a young age to reach their greatest potential. Most world-class runners did not begin training until they were in their mid to late teens. And, with very few exceptions, the children who held age-group records for the 5K through the marathon did not develop into elite adult runners.
- Research consistently shows that, before puberty, physiological adaptations to training aren't always correlated with performance in long-distance events. For prepubescent children, the factors that best predict distance running performance are simply related to physical maturity: taller, stronger, and faster children lead the pack in distance races, just as they excel in other sports such as basketball, baseball, and soccer.
- Although many children have naturally high levels of aerobic fitness, making them physiologically capable of performing low-intensity endurance activities, they are limited in their capacity to generate energy for high-intensity activities. The body has two primary systems for producing energy during exercise: the aerobic system, which operates when a sufficient amount of oxygen is available to the muscles, and the anaerobic system, which operates when the oxygen supply cannot keep up with the muscles' demand during high-intensity activity. One of the most consistent findings in pediatric exercise science is that the anaerobic system is not fully developed until children have passed through puberty.
- Physically immature youth who undertake high volumes of intense training are at relatively high risk for injuries, abnormal growth and maturation, and psychological burnout.
Considering these points, we recommend that children not begin regular and specialized training for distance running at least until the early stages of puberty, around ages 11 to 13 (see table 1.1). By no means are we saying that kids under 11 shouldn't participate in running events such as 1- or 2-mile fun runs at school or in community races. We encourage children of all ages to run for fun and health. Instead, we advise holding off on regular training, which we define as more than three days a week over periods of several months, and specialized training, which means focusing only on running as opposed to other sports and physical activities.
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While children are experiencing major physical changes during puberty, we recommend limiting the volume and intensity of training. One reason is that normal pubertal development can improve running performance on its own. For example, the growth spurt of the lungs and heart, which occurs at an average age of 11.5 years in girls and 13.5 years in boys, boosts the delivery of oxygen-rich blood to the muscles, which naturally increases V\od\O2max. Another example is the elevated level of growth hormone, which enables stronger muscle contractions, increasing running speed and efficiency.
Not all developmental changes automatically improve running performance, a point that also supports curbing early training. Consider rapid growth in height. At the average age of 10.5 for girls and 12.5 for boys, the growth rate increases dramatically from approximately 2.2 inches (5.5 cm) per year to approximately 4.1 to 4.7 inches (10.5 to 12 cm) per year. The highest rate of growth, which is called peak height velocity, occurs at around age 11.5 for girls and 13.5 for boys. Now consider the 13-year-old boy who grows 2 inches (5 cm) over a single summer - suddenly he's all legs. The growth spurt should improve his running by increasing leg length and thus stride length. However, he now has trouble coordinating his longer legs because the nervous system, which controls movement, doesn't immediately adapt to changes in limb length. Also, during the growth spurt body parts grow at different rates. The feet and legs, for example, usually lengthen faster than the trunk, making many teenagers seem gangly or awkward in their movements. These developmental changes may actually cause the runner to temporarily perform worse because his uncoordinated stride wastes energy and leads to fatigue.
Rapid limb growth also means that children who train intensely for distance running are at risk for muscular and skeletal injury. Bones lengthen at each end in soft tissue called epiphyseal growth plates. During puberty, the growth plates are weaker than hardened bone and susceptible to fractures under the heavy, repetitive stresses experienced in long-distance running. The growing athlete's joints and muscles are also susceptible to injury because muscle mass and strength develop more slowly than bone. Eventually, the epiphyseal growth plates ossify, or harden, and muscle mass increases. Until these two critical growth processes are complete, however, children are at increased risk of injury from excessive training.
Excessive training before puberty can also affect hormones in ways that may interfere with normal maturation and optimal health. Estrogen, for example, is a hormone that ensures healthy growth and development in girls. This hormone plays a major role in menstruation, which is a normal process of maturation in girls and young women. Under certain conditions, including suboptimal nutrition, estrogen is not produced at regular levels during puberty in female runners. As a result, they may experience delayed menarche or irregular menstrual cycles. In chapter 3 we discuss a major health problem called the female athlete triad, which encompasses suboptimal nutrition, abnormal menstrual function, and weakened bones. Compared with normally active girls, those who train excessively for distance running are at risk for this condition.
Fortunately, most young runners avoid harmful levels of training. They naturally stop pushing themselves before reaching their limits. However, we've known at least a few young runners who were self-motivated to push to extremes, and we've known coaches and parents who pushed young runners too far. For these children, running injuries are fairly common.
Another concern for those who specialize in running at a young age is psychological burnout. Take the 10-year-old who's running 40 miles (64 km) a week and racing 10Ks on a regular basis. Eventually, she may grow tired of running, especially because improvement depends on increasing training loads over time. If a child is running 40 miles (64 km) a week at age 10, at age 16 she'll need to run 70 (113km), or maybe even 90 or 100 miles (145 or 161 km), to keep improving. That much running leaves little time for activities other than school, sleeping, and eating. When training becomes that consuming, it isn't fun anymore, and most young people drop out of running.
Most girls and boys, by the ages of 12 and 14, respectively, have experienced key developmental changes that enable them to safely begin a low-mileage, low-intensity training program, leaving lots of room for gradual improvement over time. Again, we're not saying that younger children should avoid participating in distance running altogether. Instead, our advice is to delay specialized training on a year-round basis. Beginning at age 7 or 8, children who enjoy running may participate in fun runs and organized track and field programs that last a few months each year. Future distance runners will benefit from participating not only in middle-distance races (up to 1 mile, or 1,600 meters), but also in sprinting, jumping, and throwing events. When track season is over, they should participate in soccer, basketball, and other youth sports they enjoy. We recommend multisport participation because it's important to develop all-around physical fitness before beginning specialized training for track and cross country (see developmental principle 3).
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Stretch to develop flexibility and mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally.
Developing Flexibility and Mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally. Of course, running doesn't demand the extensive flexibility of sports such as gymnastics and figure skating, and the runner's limbs move mostly in one plane - in line with the forward direction. For these reasons, some distance coaches don't include training for flexibility and mobility. These capacities, however, are actually essential for young runners, especially for preventing injuries.
Distance running strengthens and tightens different muscle groups, sometimes causing imbalances on opposing sides of limbs and joints. Consider, for example, that runners don't lift their knees very high when covering long distances at relatively slow speeds. As a result, their hamstrings don't stretch much. Repetitive movement through such a limited range of motion can tighten the hamstrings, leading to strains and tears when athletes extend their stride for faster running in workouts and races. In addition, some runners have very tight calf muscles and experience calf strains and tears, as well as Achilles tendon injuries. These examples point to the need for stretching as a fundamental training method.
The stretching exercises in this chapter focus on muscle groups, such as the hamstrings, calves, and hip flexors, that tend to be tight in distance runners. Keep in mind, however, that athletes differ in terms of muscle tightness and the need for stretching. Some runners with loose joints and muscles can even injure their muscles and connective tissues by overstretching. Ideally, runners should be assessed for specific areas of tightness and imbalances by a qualified athletic trainer, physical therapist, or physician who specializes in sports medicine.
Dynamic and Static Stretching
Following is a routine of 13 stretching exercises for maintaining or improving flexibility. The first section shows dynamic stretches, which involve continuous movement of the limbs through sweeping ranges of motion around a joint. The second section shows static stretching exercises, which involve holding the position without movement. Follow these guidelines for performing the stretching exercises:
- Always warm up the muscles by jogging for 5 to 15 minutes before stretching.
- Perform dynamic stretches before static stretches. We recommend performing the stretching exercises in this book in the order they appear. The dynamic stretching exercises loosen up the joints and prepare the muscles for static stretching. The movements in dynamic stretching should be slow and gentle rather than fast and ballistic. Do 10 to 15 repetitions of each dynamic exercise.
- When performing static stretching, hold the position for 20 to 60 seconds, without rocking or bouncing. Stretching should never be so vigorous that it causes quivering or pain in the muscles.
- Use the same stretching routine for both training and racing. A familiar stretching routine helps you stay comfortable and relaxed during the prerace warm-up, when competitive anxiety can make it difficult to concentrate on proper preparation. Spend at least 10 minutes stretching, and never rush the routine.
- Stretch before and after training. Many runners think of stretching only as a pretraining and prerace activity, but stretching after training and racing is essential for maintaining flexibility and preventing injuries.
Dynamic Stretches
Arm Reach and Swing
Extend the arms above the head and then swing them downward in a wide, sweeping action.
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Head Roll
Slowly roll the head in a circle, gently stretching the neck muscles. Perform repetitions clockwise, and then switch to counterclockwise.
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Running injuries, treatment and prevention
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it’s important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries.
Dealing With Injuries
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it's important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries. Common causes of injuries include the following:
- Training errors: Sudden, sharp increases in training volume and intensity; overuse (running more miles or kilometers than the body can handle); failure to take sufficient recovery time between demanding workouts; running too much on very hard or very soft surfaces
- Anatomical abnormalities: Flat feet, high arches, excessive pronation or supination, knock knees, bowed legs, inwardly rotated thigh bones, unequal leg lengths
- Muscle imbalances: Differences in the strength of opposing muscle groups (hamstrings and quadriceps, calf and tibialis anterior, hip flexors and hip extensors), differences in the flexibility of opposing muscle groups, excessively tight or loose muscles
- Poor technique: Excessive turning and twisting motions, overstriding, striking too hard on the heel or forefoot
- Inappropriate footwear: Insufficient cushioning, inadequate control for excessive pronation or supination, insufficient arch support, overly worn shoes
- Suboptimal nutrition: Insufficient intake of calories, fluids, calcium, electrolytes, or other nutrients
By considering the causes of running injuries, coaches might find that some aspect of their training programs increases injury risk. By eliminating the risk factor or adding training methods that counteract it, they can prevent injuries. For example, impact-related injuries, such as shinsplints and stress fractures, are often caused by running long distances on hard surfaces such as asphalt roads. Runners can reduce their risk for these injuries by training on dirt roads and trails.
To effectively deal with injuries, both athletes and coaches must heed their symptoms and understand the best approaches to treatment and rehabilitation (see the Common Running Injuries sidebar later in this chapter). Although some injuries require immediate medical treatment, others, especially those caused by chronic overuse, may not pose an immediate danger. In some cases runners can self-treat these injuries, ideally under the supervision of a sports doctor or certified athletic trainer. Self-treatment of many running injuries involves RICE, which stands for rest, ice, compression, and elevation. Rest can mean a complete cessation of all training for at least a few days, but for many injuries it's possible to keep training with supplemental methods to maintain fitness. For example, runners with knee pain will make their injuries worse if they continue to run, but they can maintain a high level of cardiorespiratory and muscle fitness by swimming and doing upper-body circuit training.
Some leg and foot injuries that keep athletes from running are not affected by activities such as cycling and deep-water running. In deep-water running, the athlete mimics the running action while suspended in a pool by a flotation vest. Because cycling and deep-water running can elevate the heart rate for prolonged periods, they're great for maintaining cardiorespiratory fitness. The duration of supplemental training depends on the injured runner's familiarity with the exercise. For example, injured runners who have never done deep-water running might start out with only 10 or 15 minutes a day and gradually build up to a duration that approaches their longest continuous aerobic run. Runners who are accustomed to riding bicycles can start cycling at 45 minutes or more.
The second component of RICE, applying ice to the injured area, is often very effective for reducing swelling and pain as well as for promoting healing. Injuries that involve chronic inflammation, such as plantar fasciitis and Achilles tendinitis, respond especially well to ice treatment. The protocol is to simply apply a plastic bag filled with crushed ice to the injured area. To avoid freezing the skin, the runner should place a thin cloth between the bag and the injured area. Freezing water in a paper cup and using it to perform an ice massage is another option. A general guideline is to apply ice two or three times a day for 10 to 20 minutes each time. We strongly recommend that runners consult a sports doctor or athletic trainer for an injury-specific icing protocol.
Compression of the affected area is also often an effective treatment for injuries that cause swelling. The most common method of compression is applying an elastic bandage. The placement of the bandage depends on the injury and the person. Athletic trainers know the proper techniques for wrapping injuries.
The fourth component of RICE, elevation, involves raising the injured area to reduce blood flow to it, thereby reducing swelling. A runner who has a knee injury, for example, should lie on a bed or couch and elevate the affected leg with a pillow or two. The leg should be raised slightly above the heart.
Common Running Injuries
To prevent and treat running injuries, coaches and runners benefit from knowing their causes, symptoms, and rehabilitation methods. Following are descriptions of some common running injuries; an extensive discussion of running injuries is beyond the scope of this book.
Stress fractures are tiny breaks that occur in the bones of the feet, shins, thighs, and hips. The symptoms include localized pain and tenderness on the surface of the affected bone. This injury is commonly caused by overuse, or the excessive loading of the bones from the repetitive stress of running on hard surfaces. Stress fractures tend to occur in girls who, as a result of inadequate caloric intake and excessive training, experience athletic amenorrhea, or cessation of normal menstruation. Cyclical increases in estrogen levels, which occur with regular menstruation, are necessary for maintaining bone density. Diagnosing a stress fracture is typically complicated because the fracture may not show up on X-rays for several weeks after the onset of symptoms. To avoid serious bone damage and to promote healing, athletes who experience the symptoms of stress fractures should stop running and see a sports doctor. If a stress fracture is diagnosed, rehabilitation involves alterations in training and diet, a change in footwear or the use of orthotics, and cardiorespiratory training methods such as swimming, pool running, and cycling that don't stress the affected bone.
Plantar fasciitis is an inflammation of the band of connective tissue that runs along the insole of the foot from the heel to the arch. This injury is characterized by gripping pain and tenderness in the arch, close to the fleshy part of the heel. The pain is especially intense in the morning and during running. Plantar fasciitis is common in runners who have flat feet and who overpronate. Recovery time from this injury can often require several weeks or months of reduced or no running. Doctors may prescribe exercises for strengthening muscles in the feet, orthotics, anti-inflammatory medication, and steroid injections.
Achilles tendinitis is the degeneration and inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. The main symptoms of this overuse injury are pain, tenderness, and swelling along the tendon. The pain is especially severe when athletes run on their toes, up hills, and in low-heeled racing flats or spikes. Runners with tight calf muscles are at particular risk, so they should regularly stretch these muscles. In some cases, rehabilitation time can be lengthy because the Achilles tendon receives limited blood flow and is stressed in daily activities such as walking. The main treatments - icing, anti-inflammatory medication, and ultrasound - increase blood flow to the tendon to reduce inflammation and promote healing. Swimming and deep-water running are good training methods for maintaining fitness while the tendon heals.
Patellofemoral pain syndrome results from cartilage degeneration behind the kneecap. Runners with this syndrome experience stiffness and grinding pain in the knee, especially after sitting for long periods and bending the knee in activities such as squatting and stair climbing. Patellofemoral pain syndrome occurs most often in runners with knock knees, bowed legs, and flat feet. Another cause is strength imbalances between the hamstrings and quadriceps. Doctors recommend anti-inflammatory medicine and exercises that strengthen the quadriceps and stretch the hamstrings.
Osgood- Schlatter syndrome refers to inflammation, tenderness, and pain where the patellar tendon (in front of the knee) attaches to the tibia, or shin bone. This syndrome, which is unique to young athletes, develops as a result of a combination of rapid bone growth and repetitive stress. During the adolescent growth spurt, the bones grow faster than the muscles and connective tissue. When the growth of the tibia outstrips that of the patellar tendon, the tendon pulls hard on its attachment site at the top of the shin. The excessive tugging causes irritation and pain. In addition, the force can lead to small bony formations and fractures. In most cases, the swelling and pain go away with reduced running and skeletal maturation.
Iliotibial band syndrome refers to inflammation and pain caused by the rubbing of the iliotibial band tendon against the lateral side (outside) of the knee. The iliotibial band runs along the lateral side of the thigh from the hip to the knee. In adult runners the syndrome is typically caused by a combination of repetitive stress from running and tightness of the iliotibial band and the muscles around it. In young runners an additional cause is rapid growth of the femur. Runners should cease running, ice the injured area, and stretch the iliotibial band (see chapter 6) and hamstring muscles (see chapter 6).
Shinsplints is a term referring to pain and tenderness along the shin bone. When the pain runs along the inner side of the shin from a few inches (around 5 or 6 cm) below the knee to the ankle, doctors refer to the injury as medial tibial pain syndrome. The pain associated with this syndrome is caused by inflammation of the tissue that lines the bone. When the pain is on the outer side of the shin, the cause may be compartment syndrome - swelling of the muscles in the lower leg, which overstretches the elastic sheath that covers the muscles and creates pressure on nerve endings in the muscles. Runners with shin pain should consult a sports doctor because appropriate treatment depends on the cause, which is difficult to self-diagnose, and because continuing to run without appropriate treatment can result in stress fractures.
Risk Factors for Running Injuries
To prevent injuries, coaches and runners benefit from knowing factors that increase their risk. This was the aim of a study conducted by Dr. Adam Tenforde and colleagues at Stanford University (Tenforde et al., 2011). The researchers surveyed 748 high school distance runners (442 girls and 306 boys) between 13 and 18 years old, asking them to report previous injuries, training mileage, and performance bests in the mile and 5K. Most of these young runners, 68 percent of the girls and 59 percent of the boys, reported at least one injury from a list that included Achilles tendinitis, ankle sprains, iliotibial band syndrome, knee pain, plantar fasciitis, and shinsplints. The proportion of these injuries was greater for girls. For example, 41 percent of the girls and 34 percent of the boys had experienced shinsplints. Around 6 percent of the girls and 3 percent of the boys had had at least one stress fracture. Compared with noninjured runners, those who reported injuries were older and covered more miles in their weekly training. For girls, significant risk factors for injury included greater amounts of running on pavement and faster performance times in the mile and 5K.
Based on their findings and other related research, Tenforde and coauthors concluded that high school runners can reduce injury risks by limiting running on hard surfaces and by performing injury-specific strength training and balancing exercises. The researchers' recommendations are summarized in table 10.3.
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Learn more about Training Young Distance Runners, 3rd Edition.
When to start training children for distance running
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week.
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week. The view that young children are physiologically capable of running long distances is backed by world age-group records for races as long as the marathon (26.2 miles, or 41.2 km). The records for 8-year-olds are 3:34:30 for boys and 3:13:24 for girls; for 11-year-olds the records are 2:47:17 for boys and 2:49:21 for girls. Many adult marathoners have trained at high levels for years without reaching these marks. Research also shows that young children adapt physiologically to endurance training in ways that improve running performance. Before puberty, for example, children who perform moderate levels of endurance training experience about a 10 percent increase in V\od\O2max, slightly less than the 15 percent increase observed, on average, in adults.
From this information, you might conclude that young children are indeed capable of training for and competing in long-distance races. Before you start planning programs for 8-year-olds, however, consider the following other important points:
- Neither scientific nor anecdotal evidence suggests that distance runners must start training at a young age to reach their greatest potential. Most world-class runners did not begin training until they were in their mid to late teens. And, with very few exceptions, the children who held age-group records for the 5K through the marathon did not develop into elite adult runners.
- Research consistently shows that, before puberty, physiological adaptations to training aren't always correlated with performance in long-distance events. For prepubescent children, the factors that best predict distance running performance are simply related to physical maturity: taller, stronger, and faster children lead the pack in distance races, just as they excel in other sports such as basketball, baseball, and soccer.
- Although many children have naturally high levels of aerobic fitness, making them physiologically capable of performing low-intensity endurance activities, they are limited in their capacity to generate energy for high-intensity activities. The body has two primary systems for producing energy during exercise: the aerobic system, which operates when a sufficient amount of oxygen is available to the muscles, and the anaerobic system, which operates when the oxygen supply cannot keep up with the muscles' demand during high-intensity activity. One of the most consistent findings in pediatric exercise science is that the anaerobic system is not fully developed until children have passed through puberty.
- Physically immature youth who undertake high volumes of intense training are at relatively high risk for injuries, abnormal growth and maturation, and psychological burnout.
Considering these points, we recommend that children not begin regular and specialized training for distance running at least until the early stages of puberty, around ages 11 to 13 (see table 1.1). By no means are we saying that kids under 11 shouldn't participate in running events such as 1- or 2-mile fun runs at school or in community races. We encourage children of all ages to run for fun and health. Instead, we advise holding off on regular training, which we define as more than three days a week over periods of several months, and specialized training, which means focusing only on running as opposed to other sports and physical activities.
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While children are experiencing major physical changes during puberty, we recommend limiting the volume and intensity of training. One reason is that normal pubertal development can improve running performance on its own. For example, the growth spurt of the lungs and heart, which occurs at an average age of 11.5 years in girls and 13.5 years in boys, boosts the delivery of oxygen-rich blood to the muscles, which naturally increases V\od\O2max. Another example is the elevated level of growth hormone, which enables stronger muscle contractions, increasing running speed and efficiency.
Not all developmental changes automatically improve running performance, a point that also supports curbing early training. Consider rapid growth in height. At the average age of 10.5 for girls and 12.5 for boys, the growth rate increases dramatically from approximately 2.2 inches (5.5 cm) per year to approximately 4.1 to 4.7 inches (10.5 to 12 cm) per year. The highest rate of growth, which is called peak height velocity, occurs at around age 11.5 for girls and 13.5 for boys. Now consider the 13-year-old boy who grows 2 inches (5 cm) over a single summer - suddenly he's all legs. The growth spurt should improve his running by increasing leg length and thus stride length. However, he now has trouble coordinating his longer legs because the nervous system, which controls movement, doesn't immediately adapt to changes in limb length. Also, during the growth spurt body parts grow at different rates. The feet and legs, for example, usually lengthen faster than the trunk, making many teenagers seem gangly or awkward in their movements. These developmental changes may actually cause the runner to temporarily perform worse because his uncoordinated stride wastes energy and leads to fatigue.
Rapid limb growth also means that children who train intensely for distance running are at risk for muscular and skeletal injury. Bones lengthen at each end in soft tissue called epiphyseal growth plates. During puberty, the growth plates are weaker than hardened bone and susceptible to fractures under the heavy, repetitive stresses experienced in long-distance running. The growing athlete's joints and muscles are also susceptible to injury because muscle mass and strength develop more slowly than bone. Eventually, the epiphyseal growth plates ossify, or harden, and muscle mass increases. Until these two critical growth processes are complete, however, children are at increased risk of injury from excessive training.
Excessive training before puberty can also affect hormones in ways that may interfere with normal maturation and optimal health. Estrogen, for example, is a hormone that ensures healthy growth and development in girls. This hormone plays a major role in menstruation, which is a normal process of maturation in girls and young women. Under certain conditions, including suboptimal nutrition, estrogen is not produced at regular levels during puberty in female runners. As a result, they may experience delayed menarche or irregular menstrual cycles. In chapter 3 we discuss a major health problem called the female athlete triad, which encompasses suboptimal nutrition, abnormal menstrual function, and weakened bones. Compared with normally active girls, those who train excessively for distance running are at risk for this condition.
Fortunately, most young runners avoid harmful levels of training. They naturally stop pushing themselves before reaching their limits. However, we've known at least a few young runners who were self-motivated to push to extremes, and we've known coaches and parents who pushed young runners too far. For these children, running injuries are fairly common.
Another concern for those who specialize in running at a young age is psychological burnout. Take the 10-year-old who's running 40 miles (64 km) a week and racing 10Ks on a regular basis. Eventually, she may grow tired of running, especially because improvement depends on increasing training loads over time. If a child is running 40 miles (64 km) a week at age 10, at age 16 she'll need to run 70 (113km), or maybe even 90 or 100 miles (145 or 161 km), to keep improving. That much running leaves little time for activities other than school, sleeping, and eating. When training becomes that consuming, it isn't fun anymore, and most young people drop out of running.
Most girls and boys, by the ages of 12 and 14, respectively, have experienced key developmental changes that enable them to safely begin a low-mileage, low-intensity training program, leaving lots of room for gradual improvement over time. Again, we're not saying that younger children should avoid participating in distance running altogether. Instead, our advice is to delay specialized training on a year-round basis. Beginning at age 7 or 8, children who enjoy running may participate in fun runs and organized track and field programs that last a few months each year. Future distance runners will benefit from participating not only in middle-distance races (up to 1 mile, or 1,600 meters), but also in sprinting, jumping, and throwing events. When track season is over, they should participate in soccer, basketball, and other youth sports they enjoy. We recommend multisport participation because it's important to develop all-around physical fitness before beginning specialized training for track and cross country (see developmental principle 3).
Learn more about Training Young Distance Runners, 3rd Edition.
Stretch to develop flexibility and mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally.
Developing Flexibility and Mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally. Of course, running doesn't demand the extensive flexibility of sports such as gymnastics and figure skating, and the runner's limbs move mostly in one plane - in line with the forward direction. For these reasons, some distance coaches don't include training for flexibility and mobility. These capacities, however, are actually essential for young runners, especially for preventing injuries.
Distance running strengthens and tightens different muscle groups, sometimes causing imbalances on opposing sides of limbs and joints. Consider, for example, that runners don't lift their knees very high when covering long distances at relatively slow speeds. As a result, their hamstrings don't stretch much. Repetitive movement through such a limited range of motion can tighten the hamstrings, leading to strains and tears when athletes extend their stride for faster running in workouts and races. In addition, some runners have very tight calf muscles and experience calf strains and tears, as well as Achilles tendon injuries. These examples point to the need for stretching as a fundamental training method.
The stretching exercises in this chapter focus on muscle groups, such as the hamstrings, calves, and hip flexors, that tend to be tight in distance runners. Keep in mind, however, that athletes differ in terms of muscle tightness and the need for stretching. Some runners with loose joints and muscles can even injure their muscles and connective tissues by overstretching. Ideally, runners should be assessed for specific areas of tightness and imbalances by a qualified athletic trainer, physical therapist, or physician who specializes in sports medicine.
Dynamic and Static Stretching
Following is a routine of 13 stretching exercises for maintaining or improving flexibility. The first section shows dynamic stretches, which involve continuous movement of the limbs through sweeping ranges of motion around a joint. The second section shows static stretching exercises, which involve holding the position without movement. Follow these guidelines for performing the stretching exercises:
- Always warm up the muscles by jogging for 5 to 15 minutes before stretching.
- Perform dynamic stretches before static stretches. We recommend performing the stretching exercises in this book in the order they appear. The dynamic stretching exercises loosen up the joints and prepare the muscles for static stretching. The movements in dynamic stretching should be slow and gentle rather than fast and ballistic. Do 10 to 15 repetitions of each dynamic exercise.
- When performing static stretching, hold the position for 20 to 60 seconds, without rocking or bouncing. Stretching should never be so vigorous that it causes quivering or pain in the muscles.
- Use the same stretching routine for both training and racing. A familiar stretching routine helps you stay comfortable and relaxed during the prerace warm-up, when competitive anxiety can make it difficult to concentrate on proper preparation. Spend at least 10 minutes stretching, and never rush the routine.
- Stretch before and after training. Many runners think of stretching only as a pretraining and prerace activity, but stretching after training and racing is essential for maintaining flexibility and preventing injuries.
Dynamic Stretches
Arm Reach and Swing
Extend the arms above the head and then swing them downward in a wide, sweeping action.
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Head Roll
Slowly roll the head in a circle, gently stretching the neck muscles. Perform repetitions clockwise, and then switch to counterclockwise.
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Learn more about Training Young Distance Runners, 3rd Edition.
Running injuries, treatment and prevention
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it’s important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries.
Dealing With Injuries
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it's important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries. Common causes of injuries include the following:
- Training errors: Sudden, sharp increases in training volume and intensity; overuse (running more miles or kilometers than the body can handle); failure to take sufficient recovery time between demanding workouts; running too much on very hard or very soft surfaces
- Anatomical abnormalities: Flat feet, high arches, excessive pronation or supination, knock knees, bowed legs, inwardly rotated thigh bones, unequal leg lengths
- Muscle imbalances: Differences in the strength of opposing muscle groups (hamstrings and quadriceps, calf and tibialis anterior, hip flexors and hip extensors), differences in the flexibility of opposing muscle groups, excessively tight or loose muscles
- Poor technique: Excessive turning and twisting motions, overstriding, striking too hard on the heel or forefoot
- Inappropriate footwear: Insufficient cushioning, inadequate control for excessive pronation or supination, insufficient arch support, overly worn shoes
- Suboptimal nutrition: Insufficient intake of calories, fluids, calcium, electrolytes, or other nutrients
By considering the causes of running injuries, coaches might find that some aspect of their training programs increases injury risk. By eliminating the risk factor or adding training methods that counteract it, they can prevent injuries. For example, impact-related injuries, such as shinsplints and stress fractures, are often caused by running long distances on hard surfaces such as asphalt roads. Runners can reduce their risk for these injuries by training on dirt roads and trails.
To effectively deal with injuries, both athletes and coaches must heed their symptoms and understand the best approaches to treatment and rehabilitation (see the Common Running Injuries sidebar later in this chapter). Although some injuries require immediate medical treatment, others, especially those caused by chronic overuse, may not pose an immediate danger. In some cases runners can self-treat these injuries, ideally under the supervision of a sports doctor or certified athletic trainer. Self-treatment of many running injuries involves RICE, which stands for rest, ice, compression, and elevation. Rest can mean a complete cessation of all training for at least a few days, but for many injuries it's possible to keep training with supplemental methods to maintain fitness. For example, runners with knee pain will make their injuries worse if they continue to run, but they can maintain a high level of cardiorespiratory and muscle fitness by swimming and doing upper-body circuit training.
Some leg and foot injuries that keep athletes from running are not affected by activities such as cycling and deep-water running. In deep-water running, the athlete mimics the running action while suspended in a pool by a flotation vest. Because cycling and deep-water running can elevate the heart rate for prolonged periods, they're great for maintaining cardiorespiratory fitness. The duration of supplemental training depends on the injured runner's familiarity with the exercise. For example, injured runners who have never done deep-water running might start out with only 10 or 15 minutes a day and gradually build up to a duration that approaches their longest continuous aerobic run. Runners who are accustomed to riding bicycles can start cycling at 45 minutes or more.
The second component of RICE, applying ice to the injured area, is often very effective for reducing swelling and pain as well as for promoting healing. Injuries that involve chronic inflammation, such as plantar fasciitis and Achilles tendinitis, respond especially well to ice treatment. The protocol is to simply apply a plastic bag filled with crushed ice to the injured area. To avoid freezing the skin, the runner should place a thin cloth between the bag and the injured area. Freezing water in a paper cup and using it to perform an ice massage is another option. A general guideline is to apply ice two or three times a day for 10 to 20 minutes each time. We strongly recommend that runners consult a sports doctor or athletic trainer for an injury-specific icing protocol.
Compression of the affected area is also often an effective treatment for injuries that cause swelling. The most common method of compression is applying an elastic bandage. The placement of the bandage depends on the injury and the person. Athletic trainers know the proper techniques for wrapping injuries.
The fourth component of RICE, elevation, involves raising the injured area to reduce blood flow to it, thereby reducing swelling. A runner who has a knee injury, for example, should lie on a bed or couch and elevate the affected leg with a pillow or two. The leg should be raised slightly above the heart.
Common Running Injuries
To prevent and treat running injuries, coaches and runners benefit from knowing their causes, symptoms, and rehabilitation methods. Following are descriptions of some common running injuries; an extensive discussion of running injuries is beyond the scope of this book.
Stress fractures are tiny breaks that occur in the bones of the feet, shins, thighs, and hips. The symptoms include localized pain and tenderness on the surface of the affected bone. This injury is commonly caused by overuse, or the excessive loading of the bones from the repetitive stress of running on hard surfaces. Stress fractures tend to occur in girls who, as a result of inadequate caloric intake and excessive training, experience athletic amenorrhea, or cessation of normal menstruation. Cyclical increases in estrogen levels, which occur with regular menstruation, are necessary for maintaining bone density. Diagnosing a stress fracture is typically complicated because the fracture may not show up on X-rays for several weeks after the onset of symptoms. To avoid serious bone damage and to promote healing, athletes who experience the symptoms of stress fractures should stop running and see a sports doctor. If a stress fracture is diagnosed, rehabilitation involves alterations in training and diet, a change in footwear or the use of orthotics, and cardiorespiratory training methods such as swimming, pool running, and cycling that don't stress the affected bone.
Plantar fasciitis is an inflammation of the band of connective tissue that runs along the insole of the foot from the heel to the arch. This injury is characterized by gripping pain and tenderness in the arch, close to the fleshy part of the heel. The pain is especially intense in the morning and during running. Plantar fasciitis is common in runners who have flat feet and who overpronate. Recovery time from this injury can often require several weeks or months of reduced or no running. Doctors may prescribe exercises for strengthening muscles in the feet, orthotics, anti-inflammatory medication, and steroid injections.
Achilles tendinitis is the degeneration and inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. The main symptoms of this overuse injury are pain, tenderness, and swelling along the tendon. The pain is especially severe when athletes run on their toes, up hills, and in low-heeled racing flats or spikes. Runners with tight calf muscles are at particular risk, so they should regularly stretch these muscles. In some cases, rehabilitation time can be lengthy because the Achilles tendon receives limited blood flow and is stressed in daily activities such as walking. The main treatments - icing, anti-inflammatory medication, and ultrasound - increase blood flow to the tendon to reduce inflammation and promote healing. Swimming and deep-water running are good training methods for maintaining fitness while the tendon heals.
Patellofemoral pain syndrome results from cartilage degeneration behind the kneecap. Runners with this syndrome experience stiffness and grinding pain in the knee, especially after sitting for long periods and bending the knee in activities such as squatting and stair climbing. Patellofemoral pain syndrome occurs most often in runners with knock knees, bowed legs, and flat feet. Another cause is strength imbalances between the hamstrings and quadriceps. Doctors recommend anti-inflammatory medicine and exercises that strengthen the quadriceps and stretch the hamstrings.
Osgood- Schlatter syndrome refers to inflammation, tenderness, and pain where the patellar tendon (in front of the knee) attaches to the tibia, or shin bone. This syndrome, which is unique to young athletes, develops as a result of a combination of rapid bone growth and repetitive stress. During the adolescent growth spurt, the bones grow faster than the muscles and connective tissue. When the growth of the tibia outstrips that of the patellar tendon, the tendon pulls hard on its attachment site at the top of the shin. The excessive tugging causes irritation and pain. In addition, the force can lead to small bony formations and fractures. In most cases, the swelling and pain go away with reduced running and skeletal maturation.
Iliotibial band syndrome refers to inflammation and pain caused by the rubbing of the iliotibial band tendon against the lateral side (outside) of the knee. The iliotibial band runs along the lateral side of the thigh from the hip to the knee. In adult runners the syndrome is typically caused by a combination of repetitive stress from running and tightness of the iliotibial band and the muscles around it. In young runners an additional cause is rapid growth of the femur. Runners should cease running, ice the injured area, and stretch the iliotibial band (see chapter 6) and hamstring muscles (see chapter 6).
Shinsplints is a term referring to pain and tenderness along the shin bone. When the pain runs along the inner side of the shin from a few inches (around 5 or 6 cm) below the knee to the ankle, doctors refer to the injury as medial tibial pain syndrome. The pain associated with this syndrome is caused by inflammation of the tissue that lines the bone. When the pain is on the outer side of the shin, the cause may be compartment syndrome - swelling of the muscles in the lower leg, which overstretches the elastic sheath that covers the muscles and creates pressure on nerve endings in the muscles. Runners with shin pain should consult a sports doctor because appropriate treatment depends on the cause, which is difficult to self-diagnose, and because continuing to run without appropriate treatment can result in stress fractures.
Risk Factors for Running Injuries
To prevent injuries, coaches and runners benefit from knowing factors that increase their risk. This was the aim of a study conducted by Dr. Adam Tenforde and colleagues at Stanford University (Tenforde et al., 2011). The researchers surveyed 748 high school distance runners (442 girls and 306 boys) between 13 and 18 years old, asking them to report previous injuries, training mileage, and performance bests in the mile and 5K. Most of these young runners, 68 percent of the girls and 59 percent of the boys, reported at least one injury from a list that included Achilles tendinitis, ankle sprains, iliotibial band syndrome, knee pain, plantar fasciitis, and shinsplints. The proportion of these injuries was greater for girls. For example, 41 percent of the girls and 34 percent of the boys had experienced shinsplints. Around 6 percent of the girls and 3 percent of the boys had had at least one stress fracture. Compared with noninjured runners, those who reported injuries were older and covered more miles in their weekly training. For girls, significant risk factors for injury included greater amounts of running on pavement and faster performance times in the mile and 5K.
Based on their findings and other related research, Tenforde and coauthors concluded that high school runners can reduce injury risks by limiting running on hard surfaces and by performing injury-specific strength training and balancing exercises. The researchers' recommendations are summarized in table 10.3.
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Learn more about Training Young Distance Runners, 3rd Edition.
When to start training children for distance running
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week.
Research shows that, pound for pound, normally active 6- to 8-year-olds have V\od\O2max values as high as, or sometimes even higher than, recreational adult runners who train 30 to 40 miles (about 48 to 64 km) a week. The view that young children are physiologically capable of running long distances is backed by world age-group records for races as long as the marathon (26.2 miles, or 41.2 km). The records for 8-year-olds are 3:34:30 for boys and 3:13:24 for girls; for 11-year-olds the records are 2:47:17 for boys and 2:49:21 for girls. Many adult marathoners have trained at high levels for years without reaching these marks. Research also shows that young children adapt physiologically to endurance training in ways that improve running performance. Before puberty, for example, children who perform moderate levels of endurance training experience about a 10 percent increase in V\od\O2max, slightly less than the 15 percent increase observed, on average, in adults.
From this information, you might conclude that young children are indeed capable of training for and competing in long-distance races. Before you start planning programs for 8-year-olds, however, consider the following other important points:
- Neither scientific nor anecdotal evidence suggests that distance runners must start training at a young age to reach their greatest potential. Most world-class runners did not begin training until they were in their mid to late teens. And, with very few exceptions, the children who held age-group records for the 5K through the marathon did not develop into elite adult runners.
- Research consistently shows that, before puberty, physiological adaptations to training aren't always correlated with performance in long-distance events. For prepubescent children, the factors that best predict distance running performance are simply related to physical maturity: taller, stronger, and faster children lead the pack in distance races, just as they excel in other sports such as basketball, baseball, and soccer.
- Although many children have naturally high levels of aerobic fitness, making them physiologically capable of performing low-intensity endurance activities, they are limited in their capacity to generate energy for high-intensity activities. The body has two primary systems for producing energy during exercise: the aerobic system, which operates when a sufficient amount of oxygen is available to the muscles, and the anaerobic system, which operates when the oxygen supply cannot keep up with the muscles' demand during high-intensity activity. One of the most consistent findings in pediatric exercise science is that the anaerobic system is not fully developed until children have passed through puberty.
- Physically immature youth who undertake high volumes of intense training are at relatively high risk for injuries, abnormal growth and maturation, and psychological burnout.
Considering these points, we recommend that children not begin regular and specialized training for distance running at least until the early stages of puberty, around ages 11 to 13 (see table 1.1). By no means are we saying that kids under 11 shouldn't participate in running events such as 1- or 2-mile fun runs at school or in community races. We encourage children of all ages to run for fun and health. Instead, we advise holding off on regular training, which we define as more than three days a week over periods of several months, and specialized training, which means focusing only on running as opposed to other sports and physical activities.
http://www.humankinetics.com/AcuCustom/Sitename/DAM/133/E6148_503161_ebook_Main.png
While children are experiencing major physical changes during puberty, we recommend limiting the volume and intensity of training. One reason is that normal pubertal development can improve running performance on its own. For example, the growth spurt of the lungs and heart, which occurs at an average age of 11.5 years in girls and 13.5 years in boys, boosts the delivery of oxygen-rich blood to the muscles, which naturally increases V\od\O2max. Another example is the elevated level of growth hormone, which enables stronger muscle contractions, increasing running speed and efficiency.
Not all developmental changes automatically improve running performance, a point that also supports curbing early training. Consider rapid growth in height. At the average age of 10.5 for girls and 12.5 for boys, the growth rate increases dramatically from approximately 2.2 inches (5.5 cm) per year to approximately 4.1 to 4.7 inches (10.5 to 12 cm) per year. The highest rate of growth, which is called peak height velocity, occurs at around age 11.5 for girls and 13.5 for boys. Now consider the 13-year-old boy who grows 2 inches (5 cm) over a single summer - suddenly he's all legs. The growth spurt should improve his running by increasing leg length and thus stride length. However, he now has trouble coordinating his longer legs because the nervous system, which controls movement, doesn't immediately adapt to changes in limb length. Also, during the growth spurt body parts grow at different rates. The feet and legs, for example, usually lengthen faster than the trunk, making many teenagers seem gangly or awkward in their movements. These developmental changes may actually cause the runner to temporarily perform worse because his uncoordinated stride wastes energy and leads to fatigue.
Rapid limb growth also means that children who train intensely for distance running are at risk for muscular and skeletal injury. Bones lengthen at each end in soft tissue called epiphyseal growth plates. During puberty, the growth plates are weaker than hardened bone and susceptible to fractures under the heavy, repetitive stresses experienced in long-distance running. The growing athlete's joints and muscles are also susceptible to injury because muscle mass and strength develop more slowly than bone. Eventually, the epiphyseal growth plates ossify, or harden, and muscle mass increases. Until these two critical growth processes are complete, however, children are at increased risk of injury from excessive training.
Excessive training before puberty can also affect hormones in ways that may interfere with normal maturation and optimal health. Estrogen, for example, is a hormone that ensures healthy growth and development in girls. This hormone plays a major role in menstruation, which is a normal process of maturation in girls and young women. Under certain conditions, including suboptimal nutrition, estrogen is not produced at regular levels during puberty in female runners. As a result, they may experience delayed menarche or irregular menstrual cycles. In chapter 3 we discuss a major health problem called the female athlete triad, which encompasses suboptimal nutrition, abnormal menstrual function, and weakened bones. Compared with normally active girls, those who train excessively for distance running are at risk for this condition.
Fortunately, most young runners avoid harmful levels of training. They naturally stop pushing themselves before reaching their limits. However, we've known at least a few young runners who were self-motivated to push to extremes, and we've known coaches and parents who pushed young runners too far. For these children, running injuries are fairly common.
Another concern for those who specialize in running at a young age is psychological burnout. Take the 10-year-old who's running 40 miles (64 km) a week and racing 10Ks on a regular basis. Eventually, she may grow tired of running, especially because improvement depends on increasing training loads over time. If a child is running 40 miles (64 km) a week at age 10, at age 16 she'll need to run 70 (113km), or maybe even 90 or 100 miles (145 or 161 km), to keep improving. That much running leaves little time for activities other than school, sleeping, and eating. When training becomes that consuming, it isn't fun anymore, and most young people drop out of running.
Most girls and boys, by the ages of 12 and 14, respectively, have experienced key developmental changes that enable them to safely begin a low-mileage, low-intensity training program, leaving lots of room for gradual improvement over time. Again, we're not saying that younger children should avoid participating in distance running altogether. Instead, our advice is to delay specialized training on a year-round basis. Beginning at age 7 or 8, children who enjoy running may participate in fun runs and organized track and field programs that last a few months each year. Future distance runners will benefit from participating not only in middle-distance races (up to 1 mile, or 1,600 meters), but also in sprinting, jumping, and throwing events. When track season is over, they should participate in soccer, basketball, and other youth sports they enjoy. We recommend multisport participation because it's important to develop all-around physical fitness before beginning specialized training for track and cross country (see developmental principle 3).
Learn more about Training Young Distance Runners, 3rd Edition.
Stretch to develop flexibility and mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally.
Developing Flexibility and Mobility
Flexibility is the capacity to move the limbs through a range of motion for optimally performing a given activity. Mobility is the skill of making coordinated movements in various planes, such as forward, sideways, and diagonally. Of course, running doesn't demand the extensive flexibility of sports such as gymnastics and figure skating, and the runner's limbs move mostly in one plane - in line with the forward direction. For these reasons, some distance coaches don't include training for flexibility and mobility. These capacities, however, are actually essential for young runners, especially for preventing injuries.
Distance running strengthens and tightens different muscle groups, sometimes causing imbalances on opposing sides of limbs and joints. Consider, for example, that runners don't lift their knees very high when covering long distances at relatively slow speeds. As a result, their hamstrings don't stretch much. Repetitive movement through such a limited range of motion can tighten the hamstrings, leading to strains and tears when athletes extend their stride for faster running in workouts and races. In addition, some runners have very tight calf muscles and experience calf strains and tears, as well as Achilles tendon injuries. These examples point to the need for stretching as a fundamental training method.
The stretching exercises in this chapter focus on muscle groups, such as the hamstrings, calves, and hip flexors, that tend to be tight in distance runners. Keep in mind, however, that athletes differ in terms of muscle tightness and the need for stretching. Some runners with loose joints and muscles can even injure their muscles and connective tissues by overstretching. Ideally, runners should be assessed for specific areas of tightness and imbalances by a qualified athletic trainer, physical therapist, or physician who specializes in sports medicine.
Dynamic and Static Stretching
Following is a routine of 13 stretching exercises for maintaining or improving flexibility. The first section shows dynamic stretches, which involve continuous movement of the limbs through sweeping ranges of motion around a joint. The second section shows static stretching exercises, which involve holding the position without movement. Follow these guidelines for performing the stretching exercises:
- Always warm up the muscles by jogging for 5 to 15 minutes before stretching.
- Perform dynamic stretches before static stretches. We recommend performing the stretching exercises in this book in the order they appear. The dynamic stretching exercises loosen up the joints and prepare the muscles for static stretching. The movements in dynamic stretching should be slow and gentle rather than fast and ballistic. Do 10 to 15 repetitions of each dynamic exercise.
- When performing static stretching, hold the position for 20 to 60 seconds, without rocking or bouncing. Stretching should never be so vigorous that it causes quivering or pain in the muscles.
- Use the same stretching routine for both training and racing. A familiar stretching routine helps you stay comfortable and relaxed during the prerace warm-up, when competitive anxiety can make it difficult to concentrate on proper preparation. Spend at least 10 minutes stretching, and never rush the routine.
- Stretch before and after training. Many runners think of stretching only as a pretraining and prerace activity, but stretching after training and racing is essential for maintaining flexibility and preventing injuries.
Dynamic Stretches
Arm Reach and Swing
Extend the arms above the head and then swing them downward in a wide, sweeping action.
http://www.humankinetics.com/AcuCustom/Sitename/DAM/133/E6148_0755P_0471_ebook_Main.jpg
Head Roll
Slowly roll the head in a circle, gently stretching the neck muscles. Perform repetitions clockwise, and then switch to counterclockwise.
http://www.humankinetics.com/AcuCustom/Sitename/DAM/133/E6148_0755P_0475_ebook_Main.jpg
Learn more about Training Young Distance Runners, 3rd Edition.
Running injuries, treatment and prevention
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it’s important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries.
Dealing With Injuries
Given the physical demands of distance running, a fine line separates peak performance and injury risk. Over a long career, despite following a sound training program, few runners will completely avoid getting hurt, so it's important for coaches, parents, and runners to know the causes, symptoms, and approaches to treating and rehabilitating running injuries. Common causes of injuries include the following:
- Training errors: Sudden, sharp increases in training volume and intensity; overuse (running more miles or kilometers than the body can handle); failure to take sufficient recovery time between demanding workouts; running too much on very hard or very soft surfaces
- Anatomical abnormalities: Flat feet, high arches, excessive pronation or supination, knock knees, bowed legs, inwardly rotated thigh bones, unequal leg lengths
- Muscle imbalances: Differences in the strength of opposing muscle groups (hamstrings and quadriceps, calf and tibialis anterior, hip flexors and hip extensors), differences in the flexibility of opposing muscle groups, excessively tight or loose muscles
- Poor technique: Excessive turning and twisting motions, overstriding, striking too hard on the heel or forefoot
- Inappropriate footwear: Insufficient cushioning, inadequate control for excessive pronation or supination, insufficient arch support, overly worn shoes
- Suboptimal nutrition: Insufficient intake of calories, fluids, calcium, electrolytes, or other nutrients
By considering the causes of running injuries, coaches might find that some aspect of their training programs increases injury risk. By eliminating the risk factor or adding training methods that counteract it, they can prevent injuries. For example, impact-related injuries, such as shinsplints and stress fractures, are often caused by running long distances on hard surfaces such as asphalt roads. Runners can reduce their risk for these injuries by training on dirt roads and trails.
To effectively deal with injuries, both athletes and coaches must heed their symptoms and understand the best approaches to treatment and rehabilitation (see the Common Running Injuries sidebar later in this chapter). Although some injuries require immediate medical treatment, others, especially those caused by chronic overuse, may not pose an immediate danger. In some cases runners can self-treat these injuries, ideally under the supervision of a sports doctor or certified athletic trainer. Self-treatment of many running injuries involves RICE, which stands for rest, ice, compression, and elevation. Rest can mean a complete cessation of all training for at least a few days, but for many injuries it's possible to keep training with supplemental methods to maintain fitness. For example, runners with knee pain will make their injuries worse if they continue to run, but they can maintain a high level of cardiorespiratory and muscle fitness by swimming and doing upper-body circuit training.
Some leg and foot injuries that keep athletes from running are not affected by activities such as cycling and deep-water running. In deep-water running, the athlete mimics the running action while suspended in a pool by a flotation vest. Because cycling and deep-water running can elevate the heart rate for prolonged periods, they're great for maintaining cardiorespiratory fitness. The duration of supplemental training depends on the injured runner's familiarity with the exercise. For example, injured runners who have never done deep-water running might start out with only 10 or 15 minutes a day and gradually build up to a duration that approaches their longest continuous aerobic run. Runners who are accustomed to riding bicycles can start cycling at 45 minutes or more.
The second component of RICE, applying ice to the injured area, is often very effective for reducing swelling and pain as well as for promoting healing. Injuries that involve chronic inflammation, such as plantar fasciitis and Achilles tendinitis, respond especially well to ice treatment. The protocol is to simply apply a plastic bag filled with crushed ice to the injured area. To avoid freezing the skin, the runner should place a thin cloth between the bag and the injured area. Freezing water in a paper cup and using it to perform an ice massage is another option. A general guideline is to apply ice two or three times a day for 10 to 20 minutes each time. We strongly recommend that runners consult a sports doctor or athletic trainer for an injury-specific icing protocol.
Compression of the affected area is also often an effective treatment for injuries that cause swelling. The most common method of compression is applying an elastic bandage. The placement of the bandage depends on the injury and the person. Athletic trainers know the proper techniques for wrapping injuries.
The fourth component of RICE, elevation, involves raising the injured area to reduce blood flow to it, thereby reducing swelling. A runner who has a knee injury, for example, should lie on a bed or couch and elevate the affected leg with a pillow or two. The leg should be raised slightly above the heart.
Common Running Injuries
To prevent and treat running injuries, coaches and runners benefit from knowing their causes, symptoms, and rehabilitation methods. Following are descriptions of some common running injuries; an extensive discussion of running injuries is beyond the scope of this book.
Stress fractures are tiny breaks that occur in the bones of the feet, shins, thighs, and hips. The symptoms include localized pain and tenderness on the surface of the affected bone. This injury is commonly caused by overuse, or the excessive loading of the bones from the repetitive stress of running on hard surfaces. Stress fractures tend to occur in girls who, as a result of inadequate caloric intake and excessive training, experience athletic amenorrhea, or cessation of normal menstruation. Cyclical increases in estrogen levels, which occur with regular menstruation, are necessary for maintaining bone density. Diagnosing a stress fracture is typically complicated because the fracture may not show up on X-rays for several weeks after the onset of symptoms. To avoid serious bone damage and to promote healing, athletes who experience the symptoms of stress fractures should stop running and see a sports doctor. If a stress fracture is diagnosed, rehabilitation involves alterations in training and diet, a change in footwear or the use of orthotics, and cardiorespiratory training methods such as swimming, pool running, and cycling that don't stress the affected bone.
Plantar fasciitis is an inflammation of the band of connective tissue that runs along the insole of the foot from the heel to the arch. This injury is characterized by gripping pain and tenderness in the arch, close to the fleshy part of the heel. The pain is especially intense in the morning and during running. Plantar fasciitis is common in runners who have flat feet and who overpronate. Recovery time from this injury can often require several weeks or months of reduced or no running. Doctors may prescribe exercises for strengthening muscles in the feet, orthotics, anti-inflammatory medication, and steroid injections.
Achilles tendinitis is the degeneration and inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. The main symptoms of this overuse injury are pain, tenderness, and swelling along the tendon. The pain is especially severe when athletes run on their toes, up hills, and in low-heeled racing flats or spikes. Runners with tight calf muscles are at particular risk, so they should regularly stretch these muscles. In some cases, rehabilitation time can be lengthy because the Achilles tendon receives limited blood flow and is stressed in daily activities such as walking. The main treatments - icing, anti-inflammatory medication, and ultrasound - increase blood flow to the tendon to reduce inflammation and promote healing. Swimming and deep-water running are good training methods for maintaining fitness while the tendon heals.
Patellofemoral pain syndrome results from cartilage degeneration behind the kneecap. Runners with this syndrome experience stiffness and grinding pain in the knee, especially after sitting for long periods and bending the knee in activities such as squatting and stair climbing. Patellofemoral pain syndrome occurs most often in runners with knock knees, bowed legs, and flat feet. Another cause is strength imbalances between the hamstrings and quadriceps. Doctors recommend anti-inflammatory medicine and exercises that strengthen the quadriceps and stretch the hamstrings.
Osgood- Schlatter syndrome refers to inflammation, tenderness, and pain where the patellar tendon (in front of the knee) attaches to the tibia, or shin bone. This syndrome, which is unique to young athletes, develops as a result of a combination of rapid bone growth and repetitive stress. During the adolescent growth spurt, the bones grow faster than the muscles and connective tissue. When the growth of the tibia outstrips that of the patellar tendon, the tendon pulls hard on its attachment site at the top of the shin. The excessive tugging causes irritation and pain. In addition, the force can lead to small bony formations and fractures. In most cases, the swelling and pain go away with reduced running and skeletal maturation.
Iliotibial band syndrome refers to inflammation and pain caused by the rubbing of the iliotibial band tendon against the lateral side (outside) of the knee. The iliotibial band runs along the lateral side of the thigh from the hip to the knee. In adult runners the syndrome is typically caused by a combination of repetitive stress from running and tightness of the iliotibial band and the muscles around it. In young runners an additional cause is rapid growth of the femur. Runners should cease running, ice the injured area, and stretch the iliotibial band (see chapter 6) and hamstring muscles (see chapter 6).
Shinsplints is a term referring to pain and tenderness along the shin bone. When the pain runs along the inner side of the shin from a few inches (around 5 or 6 cm) below the knee to the ankle, doctors refer to the injury as medial tibial pain syndrome. The pain associated with this syndrome is caused by inflammation of the tissue that lines the bone. When the pain is on the outer side of the shin, the cause may be compartment syndrome - swelling of the muscles in the lower leg, which overstretches the elastic sheath that covers the muscles and creates pressure on nerve endings in the muscles. Runners with shin pain should consult a sports doctor because appropriate treatment depends on the cause, which is difficult to self-diagnose, and because continuing to run without appropriate treatment can result in stress fractures.
Risk Factors for Running Injuries
To prevent injuries, coaches and runners benefit from knowing factors that increase their risk. This was the aim of a study conducted by Dr. Adam Tenforde and colleagues at Stanford University (Tenforde et al., 2011). The researchers surveyed 748 high school distance runners (442 girls and 306 boys) between 13 and 18 years old, asking them to report previous injuries, training mileage, and performance bests in the mile and 5K. Most of these young runners, 68 percent of the girls and 59 percent of the boys, reported at least one injury from a list that included Achilles tendinitis, ankle sprains, iliotibial band syndrome, knee pain, plantar fasciitis, and shinsplints. The proportion of these injuries was greater for girls. For example, 41 percent of the girls and 34 percent of the boys had experienced shinsplints. Around 6 percent of the girls and 3 percent of the boys had had at least one stress fracture. Compared with noninjured runners, those who reported injuries were older and covered more miles in their weekly training. For girls, significant risk factors for injury included greater amounts of running on pavement and faster performance times in the mile and 5K.
Based on their findings and other related research, Tenforde and coauthors concluded that high school runners can reduce injury risks by limiting running on hard surfaces and by performing injury-specific strength training and balancing exercises. The researchers' recommendations are summarized in table 10.3.
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