Muscle Cramps in Runners

Introduction

Muscle cramping is probably an inevitable experience for most runners and other endurance athletes and has to be one of the more common questions asked by patients in our sports medicine clinic. I'll cover the basics about the causes of the typical type of muscle cramps, as well review some of the medical literature regarding current concepts in treatment and prevention and try to explain some of the myths and misinformation about cramps.

What is a muscle cramp?

Muscle cramps or cramping is a condition that most runners have experienced. It is usually defined as a spontaneous and painful contraction or spasm of a muscle or a muscle group such as the calf muscles or hamstrings.

Are there different types of muscle cramps?

Yes, and also a number of different causes of muscle cramps. Muscle cramps occur in the well-trained athlete, the elderly and is also more common in women during pregnancy. Severe electrolyte or chemical deficiencies or imbalances may also cause muscle cramping, in addition to underlying neuromuscular disorders. The wide variety of people whom experience muscle cramps suggest that there are multiple or different factors or triggers for cramps.

The most common type of muscle cramp seen in athletes is exercise-associated muscle cramps (EAMC). Surveys of marathon runners and Ironman triathletes have reported a prevalence of muscle cramps of 30-50% and 67% respectively (Schewellnus).

What are the causes of muscle cramps?

Schwellnus and others have suggested that EAMC is actually a result of muscle fatigue and not due to other causes such as dehydration or electrolyte imbalance. Their current concept for the source or etiology of EAMC is that an altered or abnormal spinal reflex activity produces muscle cramping. As the muscle fatigues, the amount of relaxation time in between muscle contractions lengthens. If the relaxation time is too long, or a high rate of muscle contraction is required, such as during running, then muscle cramping may result. Cramping may also be a protective mechanism to prevent further injury to fatiguing or damaged muscle tissue.

What about sodium and other electrolytes?

Sodium and other electrolytes such as potassium and magnesium have been mentioned in the past as possibly causing exercise-induced muscle cramps, although there is little evidence to support electrolyte imbalance as a cause. The original work looked at miners and other workers exposed to high-heat environment. Two more recent studies by Nicol and Maughan have looked specifically at endurance athletes and were not able to identify an association between muscle cramps and changes in the blood levels of specific electrolytes. However, in some cases, runners and other athletes that have an excessively high sodium sweat rate combined with a low-sodium intake may suffer from cramps due to low sodium levels.

Who is more likely to cramp?

Which athletes are more at risk for EAMC? Manjra studied over 1300 marathon runners and found the following risk factors for EAMC among the runners:

• Older age of the athlete
• Longer running history
• Higher Body-Mass Index (BMI)
• Less time spent stretching, or irregular stretching habits
• Family history of muscle cramps

Manjra also found that the marathon runners were able to identify certain conditions that either appeared to aggravate or precipitate EAMC. These conditions included:

• Duration (or distance) of running
• Increased intensity of running
• Running hills
• Subjective feelings of muscle fatigue or poor race performance.

What are effective treatments for muscle cramps?

Treatment for exercise-induced muscle cramps primarily focuses upon passive stretching of the affected muscle groups, as well as correcting any identifiable muscle imbalances and weaknesses. Proper nutrition and hydration during competition and training are also important by preventing early fatigue and susceptibility to muscle cramping.

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Orthopaedic Clinic Cape Town

South African Journal of Sports Medicine

The South African Journal of Sports Medicine is an international, 
refereed journal published for professionals with a primary interest 
in sports medicine and exercise science practice.

The journal publishes original research and reviews covering 
diagnostics, therapeutics and rehabilitation in healthy and 
physically challenged individuals of all ages and levels of sport and 
exercise participation. Original manuscripts, i.e., those that have 
not been published elsewhere except in abstract form, will be 
accepted from all countries and subject to peer review by the Editors 
and Editorial Board.

The South African Journal of Sports Medicine invites articles for 
submission from the areas of: (1) diagnosis, treatment, and 
rehabilitation of sport- and exercise-related injuries, (2) medical 
illnesses induced by or exacerbated by exercise, (3) the relationship 
between exercise and health, including exercise physiology, (4) the 
medical care of physically active individuals, (5) sports psychology, 
(6) sports nutrition, and (7) biomechanics related to sport.

Articles are invited from within the following categories:

Original Research: Clinical research and basic science articles that 
are clinically relevant.
Brief Reports: Clinical studies that are limited in depth or scope 
but with important findings to report.
Case Reports: Reports of clinical observations that have been 
carefully documented are particularly instructive.

Additional manuscripts may be submitted, after consulting with the 
Editor-in-Chief, in the following categories:

Letters to the Editor:
Lead Editorials: These are short syntheses of data and current 
thought on topical issues in the field of sports medicine.
Review Articles: These should be concise, in-depth, and well 
referenced; they should use the principles of critical appraisal 
(evidence-based medicine).
Position Statements: These succinct but comprehensive documents are 
typically prepared by a recognised society for the purpose of 
providing clinical guidelines in important areas of sports medicine.

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Orthopaedic Clinic South Africa

Back2Sports Organises Shoulder Seminar for Swimmers and Water-Polo Players

Unravelling the Complexities of Shoulder Injuries - Management and Prevention for Competitive Swimmers

PRLog (Press Release) – Jul 02, 2008 – Shoulder injuries are perhaps amongst the most complex of sports injuries. As the most heavily stressed joint in the sport, it is prevalent amongst competitive swimmers and water-polo players. Managing and preventing shoulder injuries are critical components in high performance training. Back2Sports is organizing a seminar to shed some light on this complex area for swimmers and water-polo players with an overview of the type of shoulder injuries, preventative and recovery measures available.

The seminar, “Swimmers’

Shoulders”, will provide an overview of the types of injuries amongst swimmers and water-polo players, its management and prevention. The three topics covered are:

1.Types of Shoulder Injuries in Swimmers and Water Polo Players by Dr Patrick Goh, a Sports Physician from SportsMed Central

2.Management and Prevention of Shoulder Injuries by Mr. Calvin Sim, a Senior Physiotherapist from Back2Sports

3.Surgical Intervention for Shoulder Injuries by Dr Lim Jit Kheng, a Consultant Orthopaedic Surgeon from Minimally Invasive Orthopaedic Surgery.

Back2Sports, a division of Core Concept, is the official physiotherapist for the Pre-Olympics Water Polo Invitational 2008 held here in Singapore from 30th July till 6th August 2008. The event hosted by Singapore Water Polo will see nine Men’s and Women’s Olympic water polo teams competing in a four-day tournament before heading off to Beijing for the 2008 Olympics.

The seminar will be held on the 26th of July 2008 at the Singapore Management University. For details on registration, visit www.back2sports.com.sg/shoulder.htm

Notes to Editors

1.Dr. Patrick Goh is a Sports Physician with SportsMed Central. He was formerly the Deputy Director (Sports Medicine) with the Singapore Sports Council's (SSC) Sports Medicine and Research Centre until he left for private practice in 2005. His patients have included many of Singapore's top athletes, and he was chief medical officer for the Singapore Contingent for two Olympic Games (Sydney 2000 and Athens 2004), and two Commonwealth Games (1998 and 2002). He was team physician for Singapore's national soccer team during their victorious 1994 Malaysia Cup season, and team physician in numerous South-East-Asian games.

2.Calvin Sim is a Senior Sports Physiotherapist with Back2Sports. He graduated with a Master of Manual Therapy from UWA. He has always been actively involved in sports, being the team physiotherapist for the National Football Academy Under-18 team, National Soccer Team, and was part of the team of physiotherapists providing coverage for the SCC International Rugby 7s, to name a few. Being a former school track and field athlete, he strongly believes in strengthening to prevent injury.

3.Dr Lim Jit Kheng is a fellowship-trained Consultant Orthopaedic Surgeon with Minimally Invasive Orthopaedic Surgery at Mount Elizabeth Hospital. His special interests are arthroscopic and reconstructive surgery for disorders of the knee and shoulder. Specialized operations performed include arthroscopic ligament reconstruction, treatment of meniscus and cartilage injuries, computer-aided surgery, and joint replacement of the shoulder, knee and hip joints. He also specializes in general sports injuries, as well as sporting injuries to the elbow, hip and ankle joints. Dr Lim is one of only a few orthopaedic surgeons in Singapore with a postgraduate Masters degree in the field of Sports Medicine.

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Orthopaedic Clinic Cape Town

Sports Medicine

Sport's medicine encompasses the following elements: preparation and training, prevention of injuries and illness, diagnosis and treatment of injuries and illness, rehabilitation and return to active participation in sport.

As can be seen, sport's medicine covers a large area; however, for this section we will concentrate mainly on topics relating to athlete health with the occasional articles covering the broader outline of sport's medicine. In the exercise physiology (the ABC) section and physiotherapy section there will be various areas of sports medicine that will be covered. Such is the development of sports medicine that it is becoming increasingly important for the sports doctor to concentrate on the problems affecting the athlete from the waist to the head. The head is another area altogether (smile).

Although many millions of people participate in sports their is a relatively low incidence of fatalities and catastrophic injuries. There is however, a problem resulting from participants who incur injuries or illness as a result from training and competing who allow the problem to develop into more serious chronic conditions. For this reason it is of major importance that the athlete creates a good medical team around his needs and works with a doctor who works more in the direction of sports medicine.

Sports Doctor

The Sport's doctor plays an ever important role in that he is the direct link between you and the specialist treatment you may need at some stage in your running experiences.

The doctor has to get to know you on a personal basis so that he can prescribe the correct treatment when it comes to all the ailments you may come across on a day to day basis. It is best to start with an overall check-up with the sports doctor you are going to working with, this medicall check-up should cover everything including 'blood screening'.

Such is the development of sports medicine that it is becoming increasingly important for the sports doctor to concentrate on the problems affecting the athlete from the waist to the head. The head is another area altogether (smile).

Although many millions of people participate in sports their is a relatively low incidence of fatalities and catastrophic injuries. There is however, a problem resulting from participants who incur injuries or illness as a result from training and competing who allow the problem to develop into more serious chronic conditions. For this reason it is of major importance that the athlete creates a good medical team around his needs and works with a doctor who works more in the direction of sports medicine. <more>

A number of years ago athletes were told to stop running because of the 'abnormality' in their heart-beats however with the science of sports medicine developing it was found it was all too often not necessary for the athletes to retire. The various subjects of athlete anemia, exercise induced asthma (EIA) as well as the dreaded influenza have become the norm in sports medicine and it is with this in mind that we venture into the world of the sports doctor.

Best Spine Surgeons

Unfortunately the process of finding a spine surgeon is still fairly archaic. Because there is no real data base on who is a good spine surgeon or who isn’t, you are going to have to trust that your physician is referring you to the best spine surgeon possible.

Seeing as medicine is a business just like anything else, a lot of the referrals are based on business tie-ins. A lot of professionals in the medical business don’t really have any way of telling who is a good surgeon or not. Most times they refer to the people that are inside their system without having a lot of data to go off of.

there are some good questions you can ask them at the time of the interview. These questions are taken directly from an interview that I read on spine-health’s website.

What their experience is in spine surgery, the number of cases they do, does it make up a large part of their practice or just a small part of their practice and they do a lot of general orthopedic or other types of cases. Another important thing, especially if you are considering a fusion, is fellowship training. Fusion surgery is difficult enough and it seems that people who do fellowships in it have lower complication rates. Paul McAfee out of Baltimore wrote a good article a number of years ago about especially with inter-body fusions a fellowship-trained spine surgeon had four times less complications than a non-fellowship-trained surgeon.

Let’s take a look at a few spine surgeons I have read good things about.
Dr. James St. Louis
• 2007 Distinguished physician, Florida Medical Association
• Board Certified in Orthopaedic Surgery
• Diplomat American Academy of Neurologic and Orthopaedic Surgeons
• Fellow International College of Surgeons
• Fellow American Academy of Neurological and Orthopaedic Surgeons
2005 Physician of the Year for Orthopaedic Surgery American Association of Physician Specialists.

A Native of Niagara, Wisconsin, Dr. James St. Louis received his bachelor of science with Sigma Zeta honors from The University of Wisconsin La Crosse. This was followed by a Masters of Science degree. He was then named Director of Cardiac Rehabilitation and Research Coordinator. Dr. St. Louis was involved with the National Lopressor Intervention Trial at Brooke Army Medical Center. His many accomplishments include the publication of an article entitled ‘Exercise Prescription for Cardiac Patients’.

In 1983, Dr. St. Louis started medical school at the University of Health Sciences in Kansas City, Mo., during which time he received the Student Doctor Award for his publication entitled ‘Exercise Prescription for Cardiac Patients’. Medical school was followed by the completion of internship and residency. During this training he presented papers on metastatic tumors of the spine and published ‘Orthopaedic Manifestation of Hyperlipidemia.

He then began a distinguished career as an Orthopaedic Surgeon, developing and owning the Pensacola Clinic, Bone and Joint Center and the Alabama clinic, Bone and Joint Center. At that time, Dr. St. Louis was also appointed as Medical Director of Health South and was Chief of Surgery at Woodlawn Medical Center in Cullman, Alabama.

After completing further work on the development of minimally invasive spine surgery, Dr St. Louis started the spine surgery department at the Laser Spine Institute in Tampa, Florida.

Peter F. Ullrich, Jr., MD
Institution: NeuroSpine Center of Wisconsin
Specialty: Orthopedic Surgeon
Information: Fellowship trained spine surgeon whose practice is limited to the care of patients with spinal disorders. Care is delivered within the framework of a comprehensive, integrated spine center.
Professional Affiliations: American Academy of Orthopedic Surgeons
North American Spine Society
Certifications: Board Certified in Orthopedic Surgery, 1997
Professional Distinctions: Spine Fellowship, University of Utah 1994-1995
Medical Director, Spine-health.com
Medical Director, NeuroSpine Center of Wisconsin

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The Sports Science Orthopaedic Clinic

International sport stars praise SA healthcare expertise

To be fit and match-ready is critical to the careers of all professional sportsmen and -women. Any injury sustained is a danger to their livelihood, and the time spent whilst fully recovering should be kept to a minimum.

It is exactly because of these reasons that the Centre for Sports Medicine and Orthopaedics at Netcare’s Rosebank Hospital has become first choice for many top South African and international sport stars.

Two professional sportsmen who recently sought the expertise of the medical specialists at this Centre is Indian bowler Zaheer Khan and Springbok centre Jaque Fourie.

Khan, India’s left arm seamer, was proclaimed a doubtful starter for the upcoming test series between South Africa and India because of an injury to his left heel, sustained during the Sydney test in early January this year. After being told that he would probably have to wait six to ten months before being able to play again, he sought treatment from the Centre for Sports Medicine and Orthopaedics at Netcare Rosebank Hospital. The specialist team at the Centre helped him to heal faster than anyone anticipated.

“In the past the Centre has been very helpful with injuries sustained by the Indian cricket team. The differentiating factor is the multidisciplinary approach used that even include rehabilitation and conditioning after treatment. They have given me hope and early indications are that I will be able to play again within two month’s instead of the projected six to ten months,” says Khan.

Although he needs to take it slow at first he is already running and bowling again. Khan believes that he will be able to start playing domestic games in India within three to four weeks, with the hope of being drafted back into the Indian side soon after.

Netcare Rosebank Hospital’s Centre for Sport Medicine and Orthopaedics has also recently treated Springbok and Golden Lions centre Jaque Fourie. He suffered a sports hernia injury, also referred to as a Gilmore’s Groin.

“In the past a player would be out of action for at least ten weeks after undergoing surgery to repair a Gilmore’s Groin. With the latest technology used by the Centre however, I will be able to start practicing again by next week, only six weeks after the surgery,” says Fourie.

He describes the Centre as being the best place in Johannesburg for treatment of any kind of sports injury. “I have been using the Centre since 2004 and have only ever received the best treatment from the specialists and staff there. All the doctors and physiotherapists are extremely knowledgeable. If, for instance, your usual physio is not available to help you, any of the others in the team can help you immediately with professional, friendly treatment. They’re a great bunch of people.

”Lucas Radebe, former captain of Bafana Bafana and Leeds Football Club, previously praised the sophisticated orthopaedic surgery practiced at this Centre as being responsible for extending his soccer career by several years. He was a long-time patron of the Centre.

All surgery takes place at Netcare Rosebank Hospital whose facilities include a Digital Operating Room (DOR) and a CAS enabled operating room. The hospital was the first in the country to use this groundbreaking technology.

Surgery in the DOR involves the use of fiber optic lenses and digital video cameras in certain orthopaedic procedures. The CAS system enables physicians to perform knee, artificial joint and hip replacement surgeries with great precision, resulting in improved prognoses in terms of longer lasting results for patients.

The Centre also offers a multi-disciplinary sports centre recovery clinic with expertise in the treatment and non-surgical management of sports injuries, treatment of exercise-related medical conditions and advice for athletes. Other services include physiotherapy, podiatry, biokinetics, clinical and sports dietician, radiology, and a pathology laboratory.

First established in 1996 by Drs Mark Ferguson, Clive Noble and Evan Speechley, the centre catered primarily for elite athletes but it soon became evident that there was a need for a wider range of orthopaedic specialists. Today the centre is in a unique position to meet the medical needs of both professional and leisure sportsmen and women.

“We realised that the ‘weekend warriors’, or non-professional, sports people in South Africa were very much in need of orthopaedic care and began to develop the centre into a full spectrum treatment facility,” says Dr Ferguson. “Anyone can utilise the expertise of our large team of orthopaedic surgeons who can handle anything from general to specialised procedures. Patient care, facilitated by means of a coordinated healthcare team, state-of-the-art facilities, as well as co-operation and information sharing between patient and doctor, is our primary concern.”

The science of sport

Noakes will also be signing his book, co-written with Bob Woolmer, Discovering Cricket: The Art and Science of the Game.

Topics of discussion will include "The strategy on uniting African broadcasters for 2010 and Africa's development at large", "2010: Migration of technology -- tele­communications and broadcast", "2010: Municipalities and sports technical teams", "Gender lens" and "Introducing IKS into sports", as well as "Creating indigenous models of producing winning sportsmen in South Africa".

There will also be contributions from Dr Mike Bruton, who will host demonstrations on the science of cricket, football and golf, and from Dr Tony Kirkbride, head: CSIR technology centre, who will host a demonstration on the CSIR's science and technology sports research

The SABC will broadcast live from the Sandton Convention Centre through Radio 2000. A panel discussion will also take place at the exhibition and will be broadcast on SABC Sport.

Sizwe Nzimande, head of sports at the SABC, says the broadcaster is embarking on a campaign highlighting its readiness for broadcasting the 2010 Soccer World Cup. "As part of this, we are adopting innovative technologies such as our outside broadcast high definition vans. As we are the official broadcaster for 2010, we are tasked to bring the highest quality of broadcasting to the nation through these technologies. The objectives of Insite 2008 and the Science and Technology in Sport conference fall squarely within our goal to bring the best technologies to 2010, and we are pleased to be the media partner for this important event."

Demystifying science and technology for South Africa's youth through sport and recreation is the objective of a Science and Technology in Sport conference, which takes place at Insite 2008.

A joint initiative by the Department of Science and Technology, the Department of Sport and Recreation and Pambili Productions, the conference will take place on September 16 and will highlight the role science and technology plays in sport, focusing on the youth and the 2010 World Cup.

Dr Phil Mjwara, Science and Technology Director General, says his department has identified the need for science and technology to be made accessible to the country's youth and to recognise sport and recreation as a platform for this to be achieved. "The objectives of the Science and Technology in Sport conference align perfectly with Insite 2008, where the youth will be targeted in order to address the critical skills shortage in the science and technology sectors," says Mjwara.

Dr Phil Mjwara, Science and Technology Director General, says his department has identified the need for science and technology to be made accessible to the country's youth and to recognise sport and recreation as a platform for this to be achieved. "The objectives of the Science and Technology in Sport conference align perfectly with Insite 2008, where the youth will be targeted in order to address the critical skills shortage in the science and technology sectors," says Mjwara.

His thoughts are echoed by Xoliswa Sibeko, Director General in the Department of Sport and Recreation.
"There's no doubt that first class sport scientific support makes the difference between winning on the playing field and ending up with no medals. South Africa is blessed with a tertiary education [system] and, inter alia, a sport science infrastructure that is on par with the best in the world," she says.

"However, we still see a gap between science and sport. Opportunities presented by the Science and Technology in Sport conference, are therefore welcomed. As a department responsible for sport and recreation, we see our involvement as a necessary contribution to the development of sport in our country and hope that our sport people will take advantage of this opportunity."

Sibeko says the department's core interest in this endeavour is that science in sport must be linked to the national development programme of massifying sport participation among previously disadvantaged communities.

"It should be one of the programmes linked to the 2010 World Cup legacy initiatives we will showcase to the world in 2010," she says.

The conference also aims to grow the culture of research in science and technology for sports in Africa and export the indigenous knowledge systems (IKS) in sports to foreign markets.

A drawcard will be an address by world-renowned sports academic Professor Tim Noakes and former Springbok rugby coach Jake White titled "Why the Springboks won the Rugby World Cup 2007 and lessons for Bafana Bafana toward 2010".

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Sports Science Orthopaedic Clinic

Sports Science & Improving Sporting Performance

Sport science is a collection of scientific disciplines that work together to improve the performance of a given athlete. This can cover the way an athlete sleeps to the food they eat and when they eat it. It can also cover the cloth they wear and the manner in which they train and how often they train. Sport science covers the facilities that they perform in and how they are designed and built.

Finally, sport science also includes the mental needs of the athlete. There can be great strides on the physical front to allow the athlete to go beyond what they think they can. The mental barriers also have to be moved to allow the athlete to move that imaginary point they see as their limit.

Top consultants in the worldCurrently the following people are listed as the top consultants in the world on the subject of sports science. They are Dr. Filippo Ongaro (Italy), who works with endurance performance enhancements for elite athletes and astronauts, Dr. Jacques Dallaire (USA/Canada), who works with mental and physical testing and performance for athletes and professional racecar drivers and Ric Charlesworth (New Zealand), who works with high-performance management.

Each of these people brings to the field of sport science a wide range of experience and techniques that help to increase athletes abilities to perform at their peak. They have, in fact, worked to keep moving the point at which the athlete reaches their peak. This effort allows the athlete to perform faster, better and for longer periods of time. They have addressed the mental challenges to endurance as well as the physical challenges to endurance.

Qualifications involved with sports scienceThe people that are involved in sport science are all professionals at what they do. They may be doctors of various clinical specializations. They can also be dietitians, physical therapists, psychologists and physiologists.

Many will be engineers that focus on different areas of the athletes performance and find ways to get a little bit more out of the athletes efforts. Some will design the training equipment or the actual equipment used to compete with or the facilities they compete in. The one thing that all these professionals have in common is a love for the sport they are involved in and a desire to see it go to the next level

Benefited from sports scienceThere have been many benefits for the general public because of sports science. Some of these advances have included the way shoes are designed and the way they are built. We have seen changes in bicycle designs that have made them lighter and stronger. We have even seen changes in the types of snacks that have been made popular over the years.

The benefits of sport science have also impacted the way our every day injuries are treated. There are new methods for physical therapy that were developed to help elite athletes heal faster and better. The cloths we wear are warmer, lighter and brighter because of the advances in sports science.

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The Peak Performance index of back issues

We are often asked for help in tracing an article or subject, and the purpose of this Back Issue Index is to help you do just that. The last index was published in our September 2003 issue (no 186), but from now on the index will appear annually in every January issue. Here, then, are the contents of the last 21 issues at a glance. You can order any of these issues at a cost of £5 each (inc p&p), reduced to £3 each for quantities of five or more. A complete set of all issues published to date would cost you £1,030. But, for a limited period, you can recieve all issues for £499. Please note, though, that some issues are sold out, so we can only supply high-quality photocopies of these. Please send orders, listing issue number(s) to Peak Performance, Freepost Lon7447, London, EC1P 1PD, with cheques made payable to Peak Performance, or credit card (Mastercard or Visa) details: number of the card, date of expiry and your name and address. Credit card orders can also be placed on our Hotline: 0845 450 4202. The complete set of back issues is available on CD, please indicate whether you would prefer to recieve the CD.

186:Tendon training – how to work on both parts of your muscle tendon units; Nutrition – can ALA and ALC reverse the ageing process? Exercise of the month – the single arm row; Injury risks of older runners; The truth about pre-competition tapering; Hill training for endurance; Zinc – do athletes really need supplements?

187: Strength or power – which matters most for peak performane? Fluid balance – are dehydration risks exaggerated? Exercise of the month – the straight arm pullover; Nutrition – why magnesium matters; Carbo-loading – when it works for women; Ankle sprains in footballers.

188: Drugs in sport – the risks of ‘harmless’ supplements; Pre-cooling – year-round tactics for boosting performance; Sports vision for that extra edge; Eating disorders – when athletes are too thin to win; Ergogenic effects of ephedrine; Performance and the Pill; Carbo-loading during recovery.

189 (Marathon Special): The London marathon – illness, injury and death; From couch potato to international marathoner – one man’s journey; Training programme for the non-specialist; Metabolic adaptations to endurance training; Risks for marathon ‘virgins’; Carbohydrate as ergogenic aid.

190: Essential fats – the answer to most athletes’ prayers; Exercise of the month – the single-legged Romanian deadlift; Speed development – tried and tested boosters; Exercise and the heart – what causes cardiac fatigue? Ethiopian runners – nature or nurture? Warm-ups in golfing; Sauna weight loss risks.

191: Psychology – develop the confidence of a winner; Human growth hormone – how to make your own; 10k performance – what elite Kenyan runners have to teach us; Performance effects of oral contraceptives; Exercise addiction; Drafting in triathlon swimming; Long-term detraining risks; How steroids raise blood pressure.

192 (Ageing and Performance Special): Speed – how sprinters can maintain it with age; Nutrition – foods and supplements to protect joints from degeneration; Detraining – its role in the ageing process; How fitness protects the ageing brain and improves memory; Power and endurance – which diminishes first?

193: Exercise-induced asthma – drug and other treatments; World consensus on sport nutrition; Cycling – biomechanics of safe and effective performance; Exercise of the month – ‘hamstrings of steel’; Creatine for vegetarians; Aero position for untrained cyclists; ADHD in sport.

194: Coaching – underperformance in young rugby players; Stereotype threat – an explanation for East African dominance of distance running; Nutritional medicine – strategies to boost immunity; Exercise in childhood – the key to adult fitness.

195: Psychology – raise your game through goalsetting; Exercise of the month – the ab curl-up; Weight and endurance training – how well do they work together? Inspiratory stridor – a new threat to athletes; Delayed menstruation in rhythmic gymnasts; How aerobic exercise controls blood pressure; Persistent fatigue and infection in athletes; Rapid weight loss in young wrestlers; Circulatory risk of steroids; Exercise-related sudden death.

196 (Football Special): Nutrition – the Premiership approach to science; Sudden cardiac death – assessing risk in young players; Hydration – why one size doesn’t fit all; Psychology – who’s there for the manager? Dehydration problems for refs; Personal fitness and team success; Hamstring strains – the commonest injury; Research void on injury prevention.

197: Psychology – how imagery can enhance performance; Speed training – rotational power for zippy turns; Nutrition – why ribose is not ‘the new creatine’; Chinese supplements don’t work for cyclists; Asthma in amateur athletes; Bodybuilding dependence – not just for men.

198: Periodisation – pace yourself to a peak; Respiratory problems – risks for 2004 Olympians; Exercise of the month – the side raise; Conditioning – sport specific agility boosters; GACIK – can it rival creatine? Stretching no help to footballers.

199: Perceptual training – gain an advantage through faster reactions; Periodisation – sport specific requirements; Antioxidants – could they do more harm than good? Recovery – the best strategy; Child protection in sport.

200 (200th Issue Special): Sport science – has the knowledge explosion improved performance? Drugs in sport – the ceaseless quest for the ‘magic bullet’; Distance running – the inexorable decline in Northern European performance; Nutrition – the growing sophistication of strategies in sport; Futurology – the two-hour marathon.

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Sports Science Orthopaedic Clinic

“THE WONDERS OF WALKING ”

The Sports Science Orthopaedic Clinic

By Kathleen Mc Quaide
(Sports Scientist, Health Promotions Manager of Sports Science Institute of SA)
Walking is how us humans get around and perhaps for this reason, many disregard it as a “real”
form of exercise. New and trendy must be better we think as we head off to our Tae-Bo, Kata-
Box, Tai Chi, Pilates, spinning or core-strengthening classes! Not necessarily so – research on
walking shows that it improves your circulation and cardiovascular function, strengthens your
bones, helps to build and maintain muscle mass, eases stress and anxiety, improves your sense
of well-being and done correctly, is a nifty way to shed extra kilos.
Evidence of the change in perception of walking are the tens of thousands of people seen on the
start line of many 10km national walking races every year.
One of the pleasures of walking is that little equipment or skill is required. However, a good pair of
walking shoes is essential. Here are a few tips to consider when shopping for shoes:
• Buy good quality walking shoes that offer comfort and support.
• Purchase the right type of shoe for your foot strike. A salesman at a reputable sports
store, should be able to advise you.
• Shop later in the day when your feet are a little swollen, since feet swell with exercise,
and wear the socks you’ll use when walking.
• One foot is bigger than the other, so try on both shoes to accommodate this- your walking
shoes might be one size bigger than your “day” shoes.
• Try out a variety of brands, walk around the store and choose the most comfortable pair.
Before you can fine-tune your walking programme and maximise the benefits you get from it, also
consider your walking technique. Ensure your back is straight, although a slight forward lean is
acceptable. “Zip up” your abs and squeeze in those glutes; this will help you to maintain a straight
back. Keep your chest out, your shoulders back, down and relaxed. Let your arms, which are
bent at the elbows, swing naturally from the shoulders. As you speed up, you might find it easier
to bend your arms at 90 degrees and use a stronger arm movement. Your foot strike action is
important. After you land on the outer side of your heel, your foot rolls inwards, which is essential
for adequate shock absorption and the final phase is a push off with your toes. Beware of
pounding your heels down when walking briskly; this generates unnecessary forces on your
joints. Pick your feet up, rather than shuffling along and tripping over them! Breathe rhythmically,
for example inhale for 3 steps and exhale for the next 3 or at a rate that feels right. Finally, keep
your head up, eyes looking forward and focused about 20m ahead and smile – this is fun!
Walking for weight loss
As summer approaches, we are especially conscious of the extra kilos that have crept on during
Winter. To lose weight, you need to create an imbalance between the calories you take in and
your energy expenditure (calories burned). To achieve this, combine a healthy, low-fat, caloriecontrolled
diet with a regular moderate-to-vigorous intensity exercise programme. Walking offers
a wide range of wonderful opportunities to shape up and here are 4 ways to achieve a fit and
healthy body.
1. Invest more time
The easiest and safest way for beginner walkers to lose more weight through walking is to walk
further, more often. One burns approximately 50 calories for every kilometer walked, so
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