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1.
Foundational Health for Runners: Is it the Key to Minimizing Injury?
Silva, M, Ready, LV, Etzel, CM
Rhode Island medical journal (2013). 2020;(7):54-58
Abstract
BACKGROUND Injury rates in runners are as high as 80%. Here, we focus on the concept of foundational health including sleep, recovery, nutrition, stress and physical health and how it can reduce injuries. METHODS The literature was reviewed to find papers linking running injuries and athletic performance to the foundational health topics discussed. RESULTS There are many factors that can improve athletic performance and reduce injuries in runners other than the often-discussed topics: training philosophies, footwear, and running form. This paper shows how a multidisciplinary approach including education on sleep, rest, stress, nutrition, strength, and mobility all can improve performance and reduce injuries. CONCLUSIONS The care and management of an injured runner is multifactorial and the treatment should be as well. By optimizing foundational health, the sports medicine professional will not only reduce injury risk, but also improve performance and overall health.
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2.
Contemporary Nutrition Strategies to Optimize Performance in Distance Runners and Race Walkers.
Burke, LM, Jeukendrup, AE, Jones, AM, Mooses, M
International journal of sport nutrition and exercise metabolism. 2019;(2):117-129
Abstract
Distance events in Athletics include cross country, 10,000-m track race, half-marathon and marathon road races, and 20- and 50-km race walking events over different terrain and environmental conditions. Race times for elite performers span ∼26 min to >4 hr, with key factors for success being a high aerobic power, the ability to exercise at a large fraction of this power, and high running/walking economy. Nutrition-related contributors include body mass and anthropometry, capacity to use fuels, particularly carbohydrate (CHO) to produce adenosine triphosphate economically over the duration of the event, and maintenance of reasonable hydration status in the face of sweat losses induced by exercise intensity and the environment. Race nutrition strategies include CHO-rich eating in the hours per days prior to the event to store glycogen in amounts sufficient for event fuel needs, and in some cases, in-race consumption of CHO and fluid to offset event losses. Beneficial CHO intakes range from small amounts, including mouth rinsing, in the case of shorter events to high rates of intake (75-90 g/hr) in the longest races. A personalized and practiced race nutrition plan should balance the benefits of fluid and CHO consumed within practical opportunities, against the time, cost, and risk of gut discomfort. In hot environments, prerace hyperhydration or cooling strategies may provide a small but useful offset to the accrued thermal challenge and fluid deficit. Sports foods (drinks, gels, etc.) may assist in meeting training/race nutrition plans, with caffeine, and, perhaps nitrate being used as evidence-based performance supplements.
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3.
Contemporary Nutrition Interventions to Optimize Performance in Middle-Distance Runners.
Stellingwerff, T, Bovim, IM, Whitfield, J
International journal of sport nutrition and exercise metabolism. 2019;(2):106-116
Abstract
Middle-distance runners utilize the full continuum of energy systems throughout training, and given the infinite competition tactical scenarios, this event group is highly complex from a performance intervention point of view. However, this complexity results in numerous potential periodized nutrition interventions to optimize middle-distance training adaptation and competition performance. Middle-distance race intensity is extreme, with 800- to 5,000-m races being at ∼95% to 130% of VO2max. Accordingly, elite middle-distance runners have primarily Type IIa/IIx fiber morphology and rely almost exclusively on carbohydrate (primarily muscle glycogen) metabolic pathways for producing adenosine triphosphate. Consequently, the principle nutritional interventions that should be emphasized are those that optimize muscle glycogen contents to support high glycolytic flux (resulting in very high lactate values, of >20 mmol/L in some athletes) with appropriate buffering capabilities, while optimizing power to weight ratios, all in a macro- and microperiodized manner. From youth to elite level, middle-distance athletes have arduous racing schedules (10-25 races/year), coupled with excessive global travel, which can take a physical and emotional toll. Accordingly, proactive and integrated nutrition planning can have a profound recovery effect over a long race season, as well as optimizing recovery during rounds of championship racing. Finally, with evidence-based implementation and an appropriate risk/reward assessment, several ergogenic aids may have an adaptive and/or performance-enhancing effect in the middle-distance athlete. Given that elite middle-distance athletes undertake ∼400 to 800 training sessions with 10-25 races/year, there are countless opportunities to implement various periodized acute and chronic nutrition-based interventions to optimize performance.
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4.
SPRINTING. . . Dietary Approaches to Optimize Training Adaptation and Performance.
Slater, GJ, Sygo, J, Jorgensen, M
International journal of sport nutrition and exercise metabolism. 2019;(2):85-94
Abstract
Although sprint athletes are assumed to primarily be interested in promoting muscle hypertrophy, it is the ability to generate explosive muscle power, optimization of power-to-weight ratio, and enhancement of anaerobic energy generation that are key outcomes of sprint training. This reflects the physique of track sprinters, being characterized as ecto-mesomorphs. Although there is little contemporary data on sprinters dietary habits, given their moderate energy requirements relative to body mass, a carbohydrate intake within the range of 3-6 g·kg-1·day-1 appears reasonable, while ensuring carbohydrate availability is optimized around training. Similarly, although protein needs may be twice general population recommendations, sprint athletes should consume meals containing ∼0.4 g/kg high biological value protein (i.e., easily digested, rich in essential amino acids) every 3-5 hr. Despite the short duration of competitions and relative long-recovery periods between races, nutrition still plays an important role in sprint performance. As energy expenditure moderates during competition, so too should intake of energy and macronutrients to prevent unwanted weight gain. Further adjustments in macronutrient intake may be warranted among athletes contemplating optimization of power-to-weight ratio through reductions in body fat prior to the competitive season. Other novel acute methods of weight loss have also been proposed to enhance power-to-weight ratio, but their implementation should only be considered under professional guidance. Given the metabolic demands of sprinting, a few supplements may be of benefit to athletes in training and/or competition. Their use in competition should be preceded with trialing in training to confirm tolerance and perceived ergogenic potential.
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5.
Conservative Management and Rehabilitation in the Older Runner With Knee Osteoarthritis: An Evidence-Based Review.
Castillo, B, Sepúlveda, F, Micheo, W
American journal of physical medicine & rehabilitation. 2019;(5):416-421
Abstract
Osteoarthritis is an age-related condition that commonly affects the middle-aged and elderly population including individuals who continue to pursue an active and athletic lifestyle. Running is an easily accessible activity with many health benefits; thus, it is becoming a popular form of exercise, even in older individuals. Studies evaluating the correlation between running and osteoarthritis show conflicting results; however, most studies show an increased risk of osteoarthritis in runners with a combination of modifiable and nonmodifiable risk factors. This study reviews the current literature to provide an overview of conservative (nonpharmacological and pharmacological) management strategies including patient education, therapeutic modalities and exercises, mechanical measures, dietary factors, oral and injectable pharmacotherapies, and orthobiologics. Rehabilitation considerations and return-to-sport guidelines are discussed, emphasizing the notion that a return to running activity requires reduction in mileage and formulation of a structured exercise program that includes strengthening, flexibility, and stability exercises, as well as modifications in the running technique.
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6.
Nutrition for Ultramarathon Running: Trail, Track, and Road.
Costa, RJS, Knechtle, B, Tarnopolsky, M, Hoffman, MD
International journal of sport nutrition and exercise metabolism. 2019;(2):130-140
Abstract
Ultramarathon running events and participation numbers have increased progressively over the past three decades. Besides the exertion of prolonged running with or without a loaded pack, such events are often associated with challenging topography, environmental conditions, acute transient lifestyle discomforts, and/or event-related health complications. These factors create a scenario for greater nutritional needs, while predisposing ultramarathon runners to multiple nutritional intake barriers. The current review aims to explore the physiological and nutritional demands of ultramarathon running and provide general guidance on nutritional requirements for ultramarathon training and competition, including aspects of race nutrition logistics. Research outcomes suggest that daily dietary carbohydrates (up to 12 g·kg-1·day-1) and multiple-transportable carbohydrate intake (∼90 g·hr-1 for running distances ≥3 hr) during exercise support endurance training adaptations and enhance real-time endurance performance. Whether these intake rates are tolerable during ultramarathon competition is questionable from a practical and gastrointestinal perspective. Dietary protocols, such as glycogen manipulation or low-carbohydrate high-fat diets, are currently popular among ultramarathon runners. Despite the latter dietary manipulation showing increased total fat oxidation rates during submaximal exercise, the role in enhancing ultramarathon running performance is currently not supported. Ultramarathon runners may develop varying degrees of both hypohydration and hyperhydration (with accompanying exercise-associated hyponatremia), dependent on event duration, and environmental conditions. To avoid these two extremes, euhydration can generally be maintained through "drinking to thirst." A well practiced and individualized nutrition strategy is required to optimize training and competition performance in ultramarathon running events, whether they are single stage or multistage.
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7.
Integration of Wearable Sensors Into the Evaluation of Running Economy and Foot Mechanics in Elite Runners.
Muniz-Pardos, B, Sutehall, S, Gellaerts, J, Falbriard, M, Mariani, B, Bosch, A, Asrat, M, Schaible, J, Pitsiladis, YP
Current sports medicine reports. 2018;(12):480-488
Abstract
Running economy, known as the steady-state oxygen consumption at a given submaximal intensity, has been proposed as one of the key factors differentiating East African runners from other running communities around the world. Kenyan runners have dominated middle- and long-distance running events and this phenomenon has been attributed, in part at least, to their exceptional running economy. Despite such speculation, there are no data on running mechanics during real-life situations such as during training or competition. The use of innovative wearable devices together with real-time analysis of data will represent a paradigm shift in the study of running biomechanics and could potentially help explain the outstanding performances of certain athletes. For example, the integration of foot worn inertial sensors into the training and racing of athletes will enable coaches and researchers to investigate foot mechanics (e.g., an accurate set of variables such as pitch and eversion angles, cadence, symmetry, contact and flight times or swing times) during real-life activities and facilitate feedback in real-time. The same technological approach also can be used to help the athlete, coach, sports physician, and sport scientist make better informed decisions in terms of performance and efficacy of interventions, treatments or injury prevention; a kind of "telesport" equivalent to "telemedicine." There also is the opportunity to use this real-time technology to advance broadcasting of sporting events with the transmission of real-time performance metrics and in doing so enhance the level of entertainment, interest, and engagement of enthusiasts in the broadcast and the sport. Such technological advances that are able to unobtrusively augment personal experience and interaction, represent an unprecedented opportunity to transform the world of sport for participants, spectators, and all relevant stakeholders.
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8.
Exercise physiology and nutritional perspectives of elite soccer refereeing.
Schenk, K, Bizzini, M, Gatterer, H
Scandinavian journal of medicine & science in sports. 2018;(3):782-793
Abstract
Referees are an integral part of soccer, and their performance is fundamental for regular match flow, irrespective of the competition level or age classes. So far, scientific interest was mainly limited to aspects of exercise physiology and match performance of soccer referees, whereas recommendations for nutrition were adopted from active professional soccer. In contrast to elite soccer players, most referees are non-professional and engaged in different occupations. Furthermore, elite referees and soccer players differ in regard to age, body composition, aerobic capacity, and training load. Thus, referees' caloric needs and recommended daily carbohydrate intake may generally be lower compared to active soccer players, with higher intakes limited to periods of increased training load and match days or for referees engaged in physical demanding occupations. With respect to fluid intake, pre-match and in-match hydration strategies generally valid in sports are recommended also for referees to avoid cognitive and physical performance loss, especially when officiating in extreme climates and altitude. In contrast to elite soccer, professional assistance concerning nutrition and training is rarely available for national elite referees of most countries. Therefore, special attention on education about adequate nutrition and fluid intake, about the dietary prevention of deficiencies (iron in female referees, vitamin D irrespective of sex and age), and basic precautions for travels abroad is warranted. In conclusion, the simple adoption of nutritional considerations from active soccer for referees may not be appropriate. Recommendations should respect gender differences, population-specific physical characteristics, and demands just as well as individual characteristics and special needs.
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9.
Hamstring Injury Prevention Practices in Elite Sport: Evidence for Eccentric Strength vs. Lumbo-Pelvic Training.
Shield, AJ, Bourne, MN
Sports medicine (Auckland, N.Z.). 2018;(3):513-524
Abstract
Hamstring strain injuries are endemic in running-based sports. Given the economic and performance implications of these injuries, a significant body of research has emerged in recent years in an attempt to identify risk factors and develop or optimise injury prevention strategies. Surveys of injury prevention practices among medical and conditioning staff in elite sport suggest that many sporting clubs invest significant efforts in eccentric hamstring conditioning and lumbo-pelvic or trunk stability programmes. The purpose of this narrative review was to critically evaluate the evidence underpinning these practices. Single-exercise eccentric training interventions have proven effective in the prevention of primary and recurrent hamstring strains, when compliance is adequate. However, despite its almost universal acceptance, the authors are aware of only one, very recent, prospective risk factor study examining the effect of lumbo-pelvic motion during sprinting on hamstring injury risk. Furthermore, the interventions exploring the effect of lumbo-pelvic training on hamstring injury rates have not measured stability in any way. An improved understanding of the evidence underpinning commonly employed hamstring injury prevention practices may enable clinicians and coaches to better prioritise effective strategies in the increasingly complex environment of elite sport.
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10.
Zinc status at baseline is not related to acute changes in serum zinc concentration following bouts of running or cycling.
Chu, A, Petocz, P, Samman, S
Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS). 2018;:105-110
Abstract
Zinc status is implicated in physiological functions related to exercise performance and physical activity. We have previously demonstrated significant changes in serum zinc concentrations following a bout of aerobic exercise, suggestive of a relationship between zinc metabolism and exercise-related functions. In the present study, we aim to determine the association between pre-exercise serum zinc concentration and immediate changes in serum zinc concentration following an aerobic exercise bout. We have previously conducted a systematic literature search of PubMed, Web of Science, Scopus and SPORTDiscus, for studies that investigated the acute effects of aerobic exercise on zinc biomarkers. In the current study, we undertook a secondary analysis using mixed effects meta-regression modelling to determine the relationship between baseline serum zinc concentration and the change in serum zinc concentration immediately after exercise. Meta-regression models revealed no significant relationship between baseline serum zinc concentration and the change in serum zinc concentration following a bout of exercise when all comparisons were included (slope -0.11 ± 0.07 [standard error]; P > 0.05). When comparisons were stratified by exercise modality, no significant relationships were observed for exercise bouts involving cycling or running. The current analyses were limited by the available literature and low statistical power of the meta-regression models. Based on the current available data, the present analysis revealed limited evidence for a relationship between pre-exercise serum zinc concentration and immediate changes in serum zinc levels following a bout of aerobic exercise. Subgroup meta-regression analyses stratified by the mode of exercise bouts did not differ from the overall results. This suggests that zinc status at baseline is not related to acute changes in serum zinc concentration following bouts of aerobic exercise.