Walking Into The Fog: Shoes For When We Aren't Running

Monday night's workout was my first setback, more-accurately defined as a speed bump, on the road to racing fitness.

There are some runs which just don't feel right from the first strides, but you suck it up and hope things normalize after a mile, or at least a mile and a quarter. Fifteen minutes, two pit stops, and an aching achilles tendon later I got the memo: Stop, silly. You're not helping your cause. I jumped on the elliptical trainer for 30 minutes, then ambled home to dinner.

The first steps on Monday, and even the day after, were achy and tight. Naturally, being the "cause and effect" guy, I asked myself what changes I made in the past few days. It all fell back on a pair of shoes, not the trainers I ran in on Sunday evening, but the loafers I wore last week.

Unless you're one of those persons who races in a very neutral pair of racing flats or wears a "minimalist" shoe, both shoes with very little heel lift, you're probably wearing a shoe for work/recovery which may adversely affect your running. Ladies who run are probably in a worse position than most guys. I've seen stiletto-heeled devices which I know could not have been designed by a woman; no woman in their right mind would EVER wear something that damaging to their feet and legs...in public.

I wore slip-on loafers at work and school for many years until seven years ago, when I ran my second marathon. Climbing and descending stairs after a marathon is painful; a (recovery) shoe with insufficient support only adds insult to injury. In desperation I made a road trip to the San Diego-based brick-and-mortar location of a popular on-line running shoe store. I considered a pair of black leather walking shoes, but decided against them because they STILL looked too much like a running shoe. I eventually picked up a pair of shoes made by Dunham, the parent company of New Balance. Black leather, American-made, and comfortable for standing and walking.

My wife bought her son a pair of shoes from a walking shoe store a couple of years ago, and she suggested I replace mine. Seven years of hiking through parking lots, walking through hallways, and standing in classrooms around the world had taken its toll by that time. Heels wear along the outer corner; midsoles break down, and soles wear thin. While blue jeans seem to improve with age, a good walking shoe - like a running shoe - has a limited lifespan. And, silly me, I didn't want to invest in another pair when I felt I had a few more years left in these.

But one morning you wake up and look in horror at the condition of those "old reliable" shoes. It's the "Come to Jesus" talk, so to speak. Before I made a buyers' decision and replaced this pair I thought I'd take a look at what shoes were recommended by podiatrists.

Darned if the American Association of Podiatric Sports Medicine (AAPSM) didn't go and quit the "shoe recommendation" business in 2010. Yes, there was a short list of walking shoes which they had evaluated, but no single brand or model was tapped by the evaluators as the best shoe...which really shouldn't have surprised me.

I've always recommended visiting with an experienced shoe fitter when it comes to running shoes. Naturally, because we're all unique it stands to reason we all will have different responses or results when using a single particular shoe.

AAPSM recommends individuals be fit by a reputable footwear retailer and seek out a sports medicine podiatrist for concerns on injury or footwear. An individual’s gait pattern, range of motion, biomechanical profile and foot type, injury history, body mass index, weekly miles or hours of training, training goals, training philosophy, and training surface are all important in selecting the right shoe...whether it be one for running or walking.

So, if you're having those aches and pains when you aren't running it might be what's on your feet that's causing it. A visit with a trained professional might save you from the error of "trying this at home." Remember, when you aren't running, you're recovering.

ISO A Guy With Initials After His Name

(EDITORIAL COMMENT: MY USE OF THE MASCULINE FORM DOES NOT MEAN I AM A MALE CHAUVINIST - USE OF MALE FORM ONLY MAKES FOR EASIER WRITING.)

Spent a few minutes after getting my weekly Six at Six beat-down talking to Mark. He asked me what I knew about chiropractic, & whether I had ever been treated by a doctor of chiropractic. I had to admit a certain degree of ignorance about the benefits of chiropractic; while I've read much in the running world about athletes being adjusted on a regular basis, I also had to look past some formerly/deeply-held (religion-based) convictions. I'm not in the mood to get into the theological side of this, so I'll stay with the semi-scientific side.

I spent 14 years working in the medical field, as an administrative person (transcribing doctors' orders), a file maintainer/receptionist & a transcriber (history/physical examinations, ER visits, progress notes, discharge orders, treatment notes, and so on). During that time I had close working/personal relationships with most of the relevant medical professions (doctors are willing to engage in some back-scratching to get their work expedited), which gave me the chance on many occasions to ask 'what's the difference between...?'

So, if I were to place the three forms of medicine on a spectrum, I would consider osteopathic medicine (practiced by doctors of osteopathic, or D.O.'s) at the center of the spectrum. Chiropractic, Homeopathic, Chinese and Ayurvedic would be on the left side; allopathic medicine (practiced by doctors of medicine, M.D.'s) would be on the right.

A V.A. friend of mine is a D.O. I would visit him on occasion in the Rehab Medicine department when I had an issue, or just to ask 'what would you do in this situation?' I always found his approach to medical issues to be pragmatic & holistic. He was more likely to try something outside the box than fall back on more traditional methods of treatment. I decided to see what Wikipedia had to say about osteopathic medicine, and whether I had gone far afield with my description to Mark.

Wiki says: "...osteopathy has been considered a form of complementary medicine, emphasizing a holistic approach and the skilled use of a range of manual and physical treatment interventions in the prevention and treatment of disease. In practice, this most commonly relates to musculoskeletal problems such as back and neck pain. Osteopathic principles teach that treatment of the musculoskeletal system (bones, muscles and joints) facilitates the recuperative powers of the body."There's a time & place for pharmaceuticals in the treatment of medical issues, but I'm always amenable to something a little more on the natural side. Mind you, the most important issue is not so much the type of initials after the name as much as whether they are compatible to your needs.

I have spent more time over the past two years in dental offices than doctor's offices, so it wasn't that important to me. However, after my episode in Panama City I knew I did not want to visit the general practitioner near my home. There's nothing worse than being an athlete who has a medical issue; a physician's visit usually leads to the typical 'stop running/cycling/swimming altogether' advice. I also could tell from the first visit the practice would not be compatible; contemporary religious background muzak & copies of Christianity Today are not preferred waiting room material for a recovering fundamentalist.

Fortunately for me, I was able to get the contact information for the physician my friend Steven sees. The guy's a masters' swimmer & does some of our long swim events, so he recognized me right away when he came into the examination room. Right away, I knew this would be a fairly comfortable fit.

And when it comes to your life, your health & your avocation, comfort is darn near everything.

Take A Number

"...the stars might lie but the numbers never do." -- Mary-Chapin Carpenter

The orthopedic consultant gave me the green light of sorts about two weeks ago. I have his permission to engage in easy running or bicycling. My first guess was that he thought I was one of those people who do the bare minimum of exercise; once the sweat starts rolling it's time to quit. Ho, ho, now that's a funny one. Obviously, he's never seen me with that look like I got sprayed with a fire hose.

Then, he mentions three things: First, I have to come back and see him in six weeks.

Second, no lifting anything heavier than a can of soup. The bad news is that my left shoulder and arm strength is growing by leaps and bounds; my right shoulder muscle structure is almost nonexistent. The good news is that 12-to-16 ounces fall right within that weight range.

Third, he suspects I will be one of those patients he'll have to hold back rather than force to progress forward with rehabilitation.

So, how do you make certain not to push the envelope so much you delay achieving cardiovascular fitness, or you risk overtraining and injury, in the foundation period?

You can use the Borg scale to gauge how hard you're working. This scale ranges from 1 to 20, with 20 being the absolute maximal "oh, my goodness, my heart is going to explode any second" effort. Slowly walking is about a nine; a hard effort you can continue to hold for a while is about a 13 or 14, 17 is a very hard effort.

What's so good about the Borg scale? First, you're checking all of your body; heart, lungs, muscles, breathing, and so on, in order to determine your rate of perceived exertion. Second, it correlates quite strongly to your heart rate; multiply your Borg number times ten and you're probably going to be close to what your heart rate is at that moment. This is especially important for those persons who take drugs that affect their heart rate. Third, you don't have to depend on a heart rate monitor to help you tell when you're working too hard.

I like the heart rate monitor. It provides a relatively accurate picture of how hard I'm working. However, most folks who have heart rate monitors don't know their maximum heart rate, and therefore don't know how hard they are working.

Two, and maybe three, schools of thought persist on how to determine maximum heart rate, and the percentage of maximum heart rate a person is exercising:

First is the "220-minus-age" school. So, a 45 year-old would have a maximum heart rate of 175; his or her exercise at 50 percent of maximum would be half of that, or 87 to 88 beats per minute, which is the minimum someone coming back from injury, or just starting an exercise program would use.

The second school takes the "220-minus-age," then subtracts the heart rate you immediately after waking up, to give you the range. So the hypothetical 45 year-old who has a resting heart rate of 45 (not bad for a physically-fit individual; the average sedentary person ranges from 60 to 80) has a range of 130 beats between minimum and maximum. So, 50 percent of that "normal" range (65 beats) added to the resting rate, would give the hypothetical a target heart rate of 110 beats per minute...add another six or seven to give a window...is this getting crazy, or what?

The third school requires having a trained medical professional around to administer a maximal heart rate test. Slap a heart rate monitor or an electrocardiogram on the athlete and run them to exhaustion on a treadmill. The 1985 movie American Flyers has a guy doing this test; it's a scene I love, but my wife cannot stand to watch. The benefit of all the discomfort is obvious; you know what the maximal heart rate is, without question. All the other calculations are simple once you figure that first one out.

Whether you decide to use a perceived exertion scale, or a heart rate monitor, remember that these are tools to help you communicate to yourself and (if you have one) your coach how you are feeling and how your body is reacting to the training. I've met athletes who have set their heart rate monitor at a rate that's too low. It's not completely foolproof; some athletes can operate at higher maximum heart rates than the "220-minus-age" number, which is more of a guideline for that "three times a week, 20 minutes a day, and no more" crowd.

The Road Back

Fresh out of my second follow-up appointment/x-rays with the orthopedic consultant. While I was certain beyond a doubt he was not going to give me complete clearance (my range-of-motion is almost complete, but my strength is going to take quite some time to return), I'm pleased he considered me to be one of those rare patients he 'would have to slow down rather than speed up.' So, I have at least one more follow-up, in about six weeks time. In the meantime, I can get back on the bike and do some running; I guess that means spinning and running is good.

My doctor's counsel about the weight limitations was not too good, though...'nothing heavier than a can of soup' right now. What that means for swimming, I'm not certain. Guess it means lots of kicking drills and some gentle strokes in the meantime.

The road from injury back to fitness, and training, and competition is not a straight one. There's lots and lots of bends, vectors off the main course; sometimes you think you can see the "archway" of the finish as you're at what you feel is the hard part of the climb, but cannot see the route through the forest...where all of the twists and turns are hidden from plain view. Instead of being in the middle of base-building, I'm two weeks behind. It's all right. I think it means dropping one of the tune-up races this fall, or moving it one week further forward. I'll figure it out by Labor Day weekend.

I never thought I'd say I looked forward to going back to work. The seemingly arbitrary and capricious nature of my present employer is not conducive to workplace happiness. But at this particular time it will be better to have something meaningful to do. Telework and telecommuting would not be such a bad thing, but not when you have to have access to certain dot-whatever web sites.

My dog has been instrumental in making certain I spend no more than 90 minutes at my computer...that's not such a bad thing. I've had the Tour de France on the television over the past days...so I've been able to entertain myself. Given a little bit of entrepreneurial spirit, I could do the 'work from home' thing. This past month has given me the time to think about the positives and negatives of the whole concept.