Sunday, November 13, 2011

Dr. Phil Maffetone's "Big Book of Endurance Training and Racing" Review

Thanks to some of the participants on Barefoot Ted's Google group, I recently became aware of the work of Dr. Phil Maffetone.  We spend a good bit of discussing a various topics on that group, but a most of it concerns barefoot and barefoot-style running, and peripheral topics to running.  Diet comes up very often, because runners are either concerned with increasing performance or losing weight. A good diet is obviously important on either front.

Given my personal history, diet is of particular concern, and over the last 2+ years, researching diet and barefoot-style running have become my intellectual hobby.  So I've spent quite a bit of time learning about the science behind barefoot-style running and the paleo diet, since, respectively, reading Born to Run and discovering that I'm acutely wheat-intolerant.
So with that background, and my skeptical nature, I'm pretty impressed with Dr. Phil's book.  (As he's known in his online posts.)

The cons of this book are: Dr. Phil's credentials.  He's not a medical doctor, and he comes from an "alternative" medicine background [update: see the P.P.S. below].  That said, based on the reading I've done, he's pretty spot on for almost all of his suggestions.  And for whatever strange reason, most of the "alternative" doctors seem to be more open to diet as a cause for common medical maladies.  Examining the reasons behind that fact are fodder for another long post, but I will say that if the suggestions seem scientifically sound, you shouldn't discard them just because they come from a chiropractor.  That said, I'd recommend this book to anyone, with the following caveat (and the second con):

It's not well-sourced.  One of the compelling aspects of the Jaminet's Perfect Health Diet is that there book is well-footnoted with online resources that you can look up to learn more about why they make a specific recommendation.  Dr. Phil's book is not well footnoted.  You've got to take him on faith if you're not familiar with the research behind it.  The fact that the foreword is written by Mark Allen, the famed triathlete, and the afterword is written by Dr. Timothy Noakes, the famed exercise physiologist, should give you skeptical types some comfort.  For myself, I've already done enough reading to realize that Dr. Phil's work is well-founded, and don't have to rely solely on the testimonials.  But it would be good if he presented better evidence, as some of his ideas are pretty out there; while being correct, in my view.

The pros of the book are pretty simple.  You can save yourself my two years of diligent reading to achieve a much healthier approach to fitness and health just by following the recommendations of this book. 

I've been following most of the recommendations on diet and barefoot-style running for long enough (and before reading the book) that I'm a big fan.  The one part the book added for me was a detailed explanation of Dr. Phil's 180-formula for training intensity.  I'm now using this as my guide, and have definitely noticed benefits so far.  It's not magic, but it's definitely improved my training in the few months I've been using it.  I hope to continue through the winter, and start seeing the benefits of this approach come spring.

In a nutshell, Dr. Phil argues that you should train for most of your miles by keeping your heart rate low enough that you're primarily burning fat, and not carbohydrates, as fuel.  Dr. Noakes observes that following this approach helped Mark Allen to become one of the most fit and successful athletes in the world.  It's a pretty well-tested, if counter-intuitive, approach.  The formula is simply 180 - your age = the heart rate at which you should do most of your training.  (There are some complications based on fitness and injury status, but that's the basics.)  In my opinion, this is a training program for broken humans, who've been following the bad diet advice of the modern era, and not getting the sort of vigorous exercise that our bodies evolved to expect.

So I would highly recommend this book to anyone looking to get a better and comprehensive view of how to be fitter and healthier.  Or if you don't feel like poking around on this or any other blog that covers healthy diets and barefoot-style running, you can just buy Dr. Phil's book and be done with it.  I've already loaned my copy out to a good friend, along with Mark Sisson's The Primal Blueprint and the afore-mentioned The Perfect Health Diet.  (Happily I also got the Kindle version.)

Here are a bunch of segments that I highlighted in my Kindle and manually typed in here, since the Kindle doesn't allow copying [update: see the P.S.].  Sigh.
"Aspirin, ibuprofen (such as Advil), naproxen (such as Aleve), and other non-steroidal anti-inflammatory drugs (NSAIDSs) are commonly used for pain relief. If taking NSAIDs lessens your pain, it probably indicates your fats are not balanced."
Makes a lot of sense to me.  Excess omega-6 intake and insufficient omega-3 are pretty obivously indicated in a lot of maladies, most especially joint pain and weak cartilage.
"The most popular shoe in this category is the basketball sneaker.  Plain high-top sneakers were popular for many years, but today they have become fancy over-supported, overpriced high-top shoes. Supposedly, the added ankle support, the key feature of this shoe, protects against ankle sprain and other injuries. But studies don't verify this. Actually, these shoes can do just the opposite, as basketball players may have the highest rates of ankle sprains of any sport. When the ankle, or any area of the body, is supported, we run the risk of weakening that area. This is the result of muscles that sense the support and no longer have to work as much; the result is loss of some of their strength."
Again, makes perfect sense to me.  I think basketball players, and most other athletes, have been sold a bill of goods by the sneaker companies.  There's no evidence for any of the sneaker-company claims, except lots of injuries.
"Perhaps the first published scientific evidence describing the harm from shoes came in 1954 when researchers Basmajian and Bentzon measured the electrical activity in foot muscles using an electromyographic (EMG) device. This study showed that when shoes were placed on the feet, certain muscles lost significant function."
Well, Dr. Munson predates this by quite a stretch, as The Soldier's Foot and the Military Shoe was published in 1912, and tested on millions of feet by 1954.
"This is because shock absorption in the feet occurs at the same level of intensity whether we wear shoes or not."
It's even worse than that: shock absorption is worse when wearing shoes, not better, or even equal.
"For acute foot problems - recent injuries such as a fall, twisted ankle, or stubbed toe - the traditional RICE remedy of rest, ice (or cold), compression, and elevation can be very effective."
I'm not a big fan of RICE.  It's been tested, and found to be ineffective.  But if it makes you happy, or keeps your mind off your pain, go for it.  I never take pain killers or use RICE for my frequent falls and stubbed toes.  And I don't miss it.  (Twisted ankles are a thing of the past since going barefoot-style.)
"Other important factors included balancing fats, eating ten servings of vegetables and fruits each day, and controlling stress."
OK, sorry.  Ten servings of fruit and vegetables a day?  I think this is ridiculous.  I generally eat three meals a day, and may have a snack.  I think that if you eat more frequently you're probably doing something wrong.  This is one area where Dr. Phil is conveying ill-considered conventional wisdom.
He also has a chapter on oral pH, which is interesting, but about which I know very little...  But given the solid character of the rest of the book, something I will take into consideration.

So I have a couple of quibbles with Dr. Phil.  Big deal. I highly recommend this book.

P.S. Sean points out that one can access highlights via the Kindle web site.  I was using the Kindle for PC software to try to copy the text.  Live and learn.  This will make my next review a lot easier, as I love using the Kindle highlight functionality.

P.P.S. Luis notes this page where Dr. Phil describes himself thusly:
"While Tim’s essay seemed to focus on so-called alternative medicine, my practice style was not alternative. Instead, it was a physiologically based approach of evaluating and treating an athlete in an individual way rather than a cookbook style that is still common today. Properly stated, I practiced complementary sports medicine. Alternative medicine is an alternative to this approach, and especially one departing from more traditional or conventional medicine. (Many in the alternative medicine community say that I’m too scientific.)"
I like this description, and think it's 100% accurate.  Lots of reasonable practices are decribed as "alternative", complementary is a much better term for what Dr. Phil does.

P.P.P.S.  Sean has some additional thoughts.

P.P.P.P.S. Here's an update. Pretty remarkable improvements, IMHO. In addition, I did a regular warmup at the gym. I found a speed on the treadmill that would reliably keep my HR under the MAF rate (137 at the time), and then did my warmup run at that speed. I initially had trouble keeping it below 137. Now, I don't even get close to 137, and have finished my warmup run with HRs as low as 121. Pretty incredible. The treadmill warmup is a part of my gym routine that I've been doing for about 4 years prior, but I would also try to run fast. So this recent improvement in HR is not simply because I've started doing a warmup run, my routine was pretty consistent for years prior to starting Maffetone.

Blogger Wonderfulness

I can't comment on my own posts from Blogger while on my home computer. I get this idiocy:
"Your current account (xxx@gmail.com) does not have access to view this page. Click here to logout and change accounts."
Needless to say, following the instructions doesn't get me anywhere, and of course there's no real "help". I've been having login problems from this computer on Blogger for months. All of my software is up to date.

You do get what you pay for. Google is pretty lame when in comes to software, in my experience.

So if you've posted a comment, and I've not responded, it's because Google won't let me. Sorry...

P.S.  Of course Blogger's post editor ate all of my paragraph breaks.  The post editor truly stinks.

P.P.S. Jan. 12, 2012: It works now.  No idea when it started working.  The post editor still truly stinks.

Saturday, November 12, 2011

Runner's Knee

As I detailed in this post, I had a bout with Runner's Knee (patellofemoral syndrome, to address it formally) a couple of years ago.  I attributed it in part to the shoes I was wearing at the time.  What I've since come to realize is that those overly-cushioned shoes merely exaggerated poor form.

Well, RK is back.  This time, however, I've been doing most of my miles in minimalist shoes like the Vibram FiveFingers Speeds, or barefoot.  I've had many successful miles in the Speeds, in the VivoBarefoot Ultra, and barefoot this summer.  I've increased my mileage, as I did the last time RK appeared, and this time I think it's safe to say that while the shoes, even minimalist shoes, accentuate the conditions that lead to RK, they're not the cause.  RK re-appeared on a 10k run in the Speeds, by the way.

When RK first appeared switching to Vibrams from the NB MT100s was enough to make it go away.  That's clearly not going to work this time.  So what could it be?

It's got to be form.  Today I went for a 10 mile Maffetone run, 5 on road, and 5 on trail.  I wore the Speeds, as it was in the low 30s F at the beginning of the run.  RK appeared almost immediately on the road stretch, but went away when I got on the rougher trail sections, only to reappear on the flat parts of the trail.

As I've posted before, I've been working on form issues on my weaker right leg.  While that leg is not 100%, it's much improved, and running on the trails I ran today is where those issues first appeared.  The right leg was good to go today.  One of the key suggestions Lee Saxby gave me was to press down on the big toe while running.  This resolved the metatarsal-cuboid joint pain I was having almost immediately.

So once I got back to the road section (after stubbing my second toe on my right foot nicely on the trail: blood from the nail, but no break: thank Heavens for shoes sometimes...), I took off my shoes for the 2.7 mile run home.  RK continued to bother me, even barefoot.  So finally what I decided to do, as an experiment, was to exaggerate the toe-press.  Basically, I was running on my big toes.  This forced my left foot inward.  My right big toe and foot have straightened much more than my left, and I have much more trouble flexing the left big toe down, so this seemed like a pretty good approach to take.  My hypothesis is that the feet should be doing pretty much the same thing, so if one leg hurts and is working differently from the other, try to make it the same.

Running on the big toes was kind of an odd feeling, and a bit of a strain on the calves, including a nasty pull in my left calf I suffered a few weeks ago while mountain biking.  I probably ran about 1.2 miles on my big toes, until I got home.

RK is completely gone in the left knee.  It feels great.

Your mileage may vary. :)

P.S.  I forgot to mention one of the key hints: I've been getting pain in the tendon under the second toe on the left foot during runs.  Lee had said that people often put too much pressure down on the second toe, which is why pressing down on the big toe makes a difference.  You're shifting the pressure to where it ought to be.

Monday, November 7, 2011

Altra Adam Review

Interesting.

I don't mind the toes.  In fact, the forthcoming Altra Sampson (the Adam with laces) sounds like my favorite shoe, the Vibram Fivefinger Speed, without toes.

I like the toes...

Saturday, November 5, 2011

Barefoot At The New York Marathon

Good luck, guys.

"...That’s right. Wood, a 35-year-old programmer, is running the entire 26.2 miles completely barefoot.

“I’ve been running through a lot of back streets where sometimes it’s all rubble and glass,” says Wood, whose long training runs take him through Brooklyn, over the Manhattan Bridge and up the West Side of Manhattan. 
"Wood isn’t participating in some sort of monastic self-flagellation.
"Rather, he’s part of a growing number of New Yorkers who’ve said bon voyage to their sneakers and embraced the idea that running barefoot promotes proper form, thereby preventing most injuries that plague long-distance runners.

"“I think a lot of people are under the impression that someone has stolen my shoes, and I’m running after them,” quips the second-time marathoner who ditched his running shoes about a year ago because his knees began to bother him.

"He began his barefoot odyssey with funky “five-finger” wetsuit shoes that are made by Vibram, then went the full monty.

"After a recent 19-mile barefoot run through the city, Wood didn’t need to ice his body or stretch out thoroughly. “The knees feel great. I feel a complete difference,” he swears...."

Good luck to all the folks running the marathon shod, also.

Back from a long hiatus, this story features the popular Obligatory Ding-Bat Podiatrist quote!
"...Though running barefoot is increasingly popular in the running community, there are experts who say sole-to-pavement jogging is playing with fire.
"“Some people say the caveman is a perfect example of how walking barefoot is safe and not harmful to the body,” says Dr. Rock Positano, director of non-surgical foot and ankle service at the Hospital for Special Surgery.
"“What they don’t mention is that the average caveman didn’t live past age 20. It’s not a very good comparison.”
"Running a marathon barefoot is a “nightmare in the making,” he says. “The feet will be screaming for mercy — [as will] the shins, knees, hips and back.”..."
Thanks Doc!  Another podiatrist ignorantly spreading fear, uncertainty, and doubt.  Gotta love that.  Read the literature, Doc. We do.

Friday, November 4, 2011

Omega-3 Fats and Dental Health

Fascinating:

"...To be fair, professional researchers are starting to figure this out. A 2010 study of 9000 people found that “participants in the middle and upper third for omega-3 fatty acid consumption were between 23 percent and 30 percent less likely to have gum disease than those who consumed the least amount of omega-3 fatty acids.” With the right dose, I believe gum disease becomes 100% less likely...."

My gums used to bleed at every brushing, like clockwork.  Since fixing my diet, gum bleeding has become a rare event.  I never take flax seed oil, but do eat pastured meat, salmon, and macadamia nuts, all of which are good sources of omega-3 fats.  I also avoid seed oils diligently.

The only time I've noticed the same sort of bleeding I used to get is after eating wheat, however.  I wonder if the lectins in wheat affect the gums, as they do mucus membranes...

Wednesday, November 2, 2011

Fila Skeletoes Amp and Skeletoes Voltage First Impressions

Hilarious:

"What do you think? Am I being too harsh?"

Not harsh enough.  It's the Vibram/Nike Free.  What a horror.