"Only those who risk failing greatly can ever succeed greatly." –RFK
Sunday, May 31, 2009
What I did and didn't do this week
Well, we didn't get to run around this mountain.
But the week was yet filled with all sorts of goodies!
I headed to Seattle Tuesday for the American College of Sports Medicine conference. The kick-off speaker was Dr. Dan Lieberman. I first heard him speak in Chicago in 2006 at the LaSalle Bank Chicago Marathon 2006 World Congress: Science and Medicine of the Marathon, which was presented by American Road Race Medical Society (ARRMS)and the ACSM.
This 2006 conference was IMO the BEST conference ever on running medicine. I admit I get totally geeked out about this stuff, so please bear with me....if there are any running medicine geeks out there other than me, here are the topics that were presented and discussed at that outstanding conference. You may notice that these are the world's most prominent researchers on these topics. So, if you ever want to look up information on these topics, you should start with names from this list. If you're not interested, I'm not at all offended if you just scroll on down....or just check out the pictures below.
Demographics of modern marathon running 1) An overview of the 1976 New York Academy of Sciences Meeting – Dave Costill 2) The Marathon Race: Historical perspective – Amby Burfoot 3) Endurance running and the evolution of man as a marathon runner - Daniel Lieberman 4) Marathon Medical Care: Historical Perspective – Dan Tunstall Pedoe 5) American women in the marathon - Russ Pate 6) Can children and adolescents run marathons? - William Roberts 7) Marathon Runners: How do they age? – Scott Trappe
Physiology 8) Physiological limits to marathon performance - Ed Coyle 9) Thermoregulatory function during the marathon - Mike Sawka 10) Running economy and body dimensions - Carl Foster
Marathon performance 11) Elite marathon performance: How fast can they go? – Ed Coyle 12) Marathon Performance in Thermally Stressing Conditions – Scott Montain 13) Strategies for optimizing marathon performance in the heat – David Martin
Energy Metabolism 1) Metabolic adaptations to marathon training and racing – John Hawley 2) Regulation of substrate use during the marathon - Lawrence Spriet 3) Protein turnover in endurance activity and dietary requirements - Marty Gibala 4) The role of the lactate shuttle in marathon energy metabolism – George Brooks
Nutrition and fluid balance 5) Nutritional strategies for marathon training and racing - Louise Burke 6) The effects of negative energy balance on women in the marathon – Anne Loukes 7) Fluid replacement during the marathon – Sam Cheuvront 8) The role of salt and glucose replacement drinks in the marathon – Bob Murray
Muscle Damage 9) Muscle adaptation and rhabdomyolysis in the marathon: “Normal” findings and potential pathophysiology – Priscilla Clarkson 10) Muscle cramping in the marathon – Martin Schwellnus 11) The role of sodium in muscle cramping during and after the marathon – Randy Eichner
Exercise tolerance and collapse during and after a marathon 12) Hyperthermia impairs brain, heart and muscle function – Jose Gonzalez-Alonso 13) The central governor model of exercise regulation applied to the marathon – Tim Noakes 14) Heat exhaustion, exhaustion, and dehydration as causes of marathon collapse – Sawka 15) Reduced peripheral resistance and other factors in marathon collapse - Tim Noakes
Doping issues 1) History and prevalence of doping in marathon competitors – John Hoberman 2) Blood doping in the marathon: infusions, EPO and artificial oxygen carriers – Randy Eichner 3) Customized androgens: Fooling drug testing – Don Catlin
Environmental issues 4) Altitude training for marathon performance – Ben Levine 5) Heat and cold: what does environment do to marathon performance? – Ron Maughan 6) Heat and cold: what does environment do to marathon injury? – William Roberts
Psychology 7) Psychological characteristics of elite marathon runners - John S. Raglin 8) Monitoring and titrating symptoms of anger, fatigue, depression and pain: A science-based approach to using your brain to improve marathon performance - Patrick J. O'Connor
Immunology and Hematology 9) Marathon training and immune function – David Nieman 10) Strategies to enhance immune function for marathon runners – Thorbjørn Åkerstrøm
Biomechanics 11) Biomechanical factors contributing to marathon race success - Keith Williams
Genetics 12) Genotypes and marathon performance – Yannis Pitsiladis
Race day medical care Marathon medical care and planning 1) Marathon race medical administration – Greg Ewert 2) Exercise associated collapse care matrix in the marathon – William Roberts 3) Intravenous fluids post marathon: when and why? – Scott Pyne 4) Marathon running injuries: epidemiology and etiology – Michael Fredericson 5) Exertional Heat Stroke in the Marathon – William Roberts
Cardiovascular medical issues 7) Cardiovascular adaptations to marathon running – Paul Thompson 8) Cardiac arrest and sudden death in the marathon – Dan Tunstall Pedoe
Hyponatremia in the marathon 9) Hyponatremia: Identification and Evaluation in the Marathon Medical Tent – Joe Chorley 10) Renal function and vasopressin during marathon running – Joe Verbalis 11) Hypertonic saline to treat hypervolemic hyponatremia: The Boston Experience – Art Siegel 12) Hydration in the marathon: too little or too much – zeroing in on safe replacement? – Tim Noakes
So, when I heard that Dr. Lieberman was giving the opening lecture at this year's ACSM, I was thrilled. He spoke on "Human Evolution, Endurance Running and Injury." I am now convinced that we were adapted to run and that only in modern times have we started "de-evolutionizing" our feet with treatments such as orthotics and motion control shoes and thick soles that prohibit us from sensing the ground. Interestingly, all the various models of expensive running shoes have NOT decreased the incidence of injury one bit!
Coincidentally, while I was staying at my friend Glenn's house (eating yummy healthy food made by Glenn), I got a call from Chris McDougall, author of the new best seller "Born to Run: A Hidden Tribe, Superathletes, and the Greatest Race the World Has Never Seen." I had the opportunity to tell him personally that I am reading his book and find it a highly compelling read. I am quite the book critic and have started and put down many books half-way through. Born to Run however is engaging, entertaining and thought-provoking. McDougall starts with the question of "Why does my foot hurt?" and by way of history and mystery, humor and appreciation of the reclusive Tarahumara Tribe, he proposes the answers. When I mentioned Dan Lieberman's spectacular lecture on the evolution and endurance running to Chris, I was not at all surprised to learn that the two are friends.
I chose to spend most of the conference in lectures on endurance training, hamstring strains, stress fractures, supplements, and immunology. I even FINALLY regrouped enough to readdress some research data we collected at the Badwater Ultramarathon a couple years ago, and we are going to get those data published. Yes, finally! (This is a difficult task when research is a hobby and happens only in "spare" time and with the money in our pockets.)
And just when I thought the conference was good enough, I wedged myself into the packed auditorium to hear Dr. Barbara Drinkwater of WomenSport International and the first female President of the ACSM in the 1980s talk about "Evolution of the Female Athlete: Myth Versus Reality." All I can say is Wow! She was outstanding, highly inspirational. Her talk was interrupted several times by the audience bursting into applause. There were even tears, yes. Even me. She received a never-ending standing ovation. It was the most poignant and inspirational talk on the history of women in sports I have ever heard. Oh, and in case you were wondering...we are for real!
So, after all that geeked-up good stuff, I left the conference early and headed to Cougar, WA to meet Tim and eight other friends for a run around Mt. St. Helens Saturday morning. Well, unfortunately, Tim's MRI results came back still showing the femoral neck stress fracture, so we decided instead to just hike on our own while the others attempted to make it around the mountain before dusk. We all hoped that the snow would not be a significant problem. Sure enough however, they made it only a few miles into the trail before they were forced to turn back due to the inability to locate the trail in the high snow conditions.
While everyone else was making his or her attempt at the mountain, Tim and I hiked 6 miles out and back along the Lewis River. It was nice to move slowly and be able to really look around. The trees were so tall and the air was thick with fragrance. I have some pictures, which I'll post here.
(pic: tree parasite)
(pic: Tim races a slug and barely wins by a toe-box)
(pic: Bolt Camp still standing since 1930)
(pic: Tim and I shimmied up this downed tree, and then had to figure out how to get back down!)
(pic: Tim bushwacks back down)
(pic: look how strong I am!)
(pic: sufficient clearance for hikers but not for mountain bikers. Doh!)
Next up is another adventure...just not sure what yet.
I am an ultra runner, physician and have been medical director of some of the toughest ultras. I tend to be a mover and a shaker and louder than my size suggests. However, my Gemini twin is gentler and contemplative, an artist, a writer, and a poet. I am a dog lover, a believer in souls, and have a special affinity for those who struggle because I have been there.
This is my crazy lovable huggable Weimaraner, Steely Dan. I call him Steely. He left us in January of this year at only 6 years from lymphoma that did not respond to chemotherapy treatments. Steely was a total goof. He loved trail running, road running, treadmill running, new experiences, making eye contact, sleeping on his back, me, kids, and liver treats. He was Zappa's best friend. We miss him dearly.
This is Stella. A rescue from the shelter. She's about 6 months old and a Border Collie. She is a joyous bundle of energy and curiosity and now also Zappa best friend. She will make a nice running partner when she grows up.
This is the now the big brother of my family - a rescued Greyhound. His name is Frank Zappa. I call him Zappa. He's 7 years old and has learned all about life beyond the track and crate from Steely when he was with us. It was very rewarding to watch his personality bloom as he settled into the family. And yes, he runs like the wind!
This is Natasha, my dearest friend. She was with me through college, medical school, residency, and she moved with me from Chicago to Spokane several years ago. She was my best running partner for 10 years. My sweet Natasha died from bone cancer in 2006. I miss her still. I hung a windchimes over the deck outside. When it chimes, I smile and think she has finally -- wherever she is now -- caught a squirrel!