Psychology of Recovery From Injuries

Injuries are inevitable. For any runner who as been at it long enough, becoming injured is only a matter of time. "How can I eliminate the likelihood of injury?", you ask. There is only one answer that can't fail: "Quit running!"

But the desire to run is infectious, and when your running is threatened because of injury, the desire becomes magnified. After all, humans have always had cravings for things they can have, but have been known to kill for those things they can't have. And when running is not in a runner's itinerary, the emotional controversy that takes place rock's the senses. "I've just got to run....".

Now, we all know, for every injury out there, there are inner-circle "surgeons general" who quickly and confidently diagnose the condition, outlining the do's and don'ts they'd recommend. From your neighbor to your brother-in-law to your therapist and spouse, everyone's an authority. The runner continues to hear all of these priceless (worthless?) recommendations, but still has to deal with that little voice in the back of the mind screaming to run. "Come on. Don't be a baby. Run through the pain. If it hurts, just stop. What do they know anyways? None of them even run!"

Six weeks of mild running (which the runner will tell you was total rest), and the injury is still there. More relatives and fellow employees have joined the list of "specialists" voicing their opinion and the hope for a future on the roads now seems near impossible. But before all hope is gone, STOP and LISTEN! There is a way. There are simple means which will get you back. Just as nature provides guidelines to live by, nature also provides guidelines to heal by. You just have to Follow The Rules! (that little clause in the contract we never see). Now they may sound simple, but the difficult part comes in applying them.

Rule #1

Ask yourself clearly - "What is my objective?". The answer, for most, is generally the same and pretty simple. "To get from point A (injured) to point B (able to run safely) as fast and inexpensively as possible".

Now, the most common reason runner's fail at the above rule is because they try to answer 2 objectives at once. They want to do as stated above, point A to point B, but they also want to run everyday to not lose their conditioning. "But, I go crazy if I don't run". Don't worry, that's only mental and you'll learn to get over it.

Keep in mind, nature usually doesn't give us the opportunity to have two wishes at the same time. If you want two, you usually end up without any. (You can't run comfortably or as much as you want, and you don't heal). This is when you start looking to pay money to that great specialist from afar. Believe me, keep your money. Most injuries are cumulative and no specialist can do any more than you can do, if you are disciplined.

Rule #2

At this time, sit down and re-define your goals. You may need to forget the marathon you've been training for. You may need to give up that "favorite" race this year if your body is not healthy. Nature doesn't care about your wants, so don't act totally robotic with your schedule. The only thing that stays the same is that everything is always changing. You may need to change your wish list to be more realistic.

Rule #3

Decide what you need to do to get from point A to point B the quickest and most cost effective. Generally, allowing the injured area the necessary time to heal is a good place to start. This doesn't mean minimal running or cross training, this means quality healing time. Again, keep in mind, the more you use an injured area, the longer the healing time takes. It is far wiser to do it right the first time, if your true objective is to get back to running pain free and safely. Ice, heat, massage (The Stick®) , rest, anti-inflammatories (Rehab-Plus), etc. are some of the complements you should use.

Rule #4

Understand, this is not supposed to be fun. Runners say, "This isn't what I want to do, I want to run". Hey, dying isn't fun either, but it happens. Show an ounce of discipline and intelligence. Quit whining. Shift your mindset during this period. As long as you pressure yourself mentally, your only setting yourself up to come back too soon. Relax and do something you never have time to do because of your running. Soon enough, you'll be back, so don't drive yourself crazy.

Rule #5

The lack of pain and swelling does not mean an injury is totally healed. Read that sentence again. Don't "attack" the first day you feel good. The longer you have had to lay off, the slower your comeback should be. Be willing to come back slowly enough. Write the word "RELAPSE" all around the house and office. Imagine going back to square one and starting over. Remember, do it right the first time.

Rule #6

Last but not least, keep in mind that being frustrated, yelling or screaming or even whining or complaining is wasted energy. As I said in the beginning, if you run, you will be injured. Save the theatrics. Immediately alter your mindset and go into the healing mode. Ask yourself, "What do I have to do to get back to running the quickest?". I'll guarantee you the answer does not include kicking the dog or yelling at your spouse. Conserve your energy for something worthwhile and have the discipline to correct the condition. It's really not that big a deal.

Now, once you've done the above, and you're still not better, look for the specialist who can help. But don't be weak in your discipline and think that if you pay money you'll get some magical cure. Somewhere along the way, you have to pay the price. These guidelines, hopefully, will keep you from paying double. Good luck.

Running—the Cure for All Ills It’s all about motion

By Dr. Tim Maggs

Those who don’t run can’t understand the big fuss. “Why would anyone run?”. Those who do run protect it like a fortune. “It’s the most important thing in my life.” And those poor souls who are former runners due to injury live on a pilgrimage back to youth. Their undying hope is “maybe, just maybe...”.

What is it that turns normal people into cult-like members once they learn what it’s like to finish their first 5k or do a long group run on a Saturday morning? What makes them convert into a “runner”?

I’ve pondered this question for years, and interestingly enough, my answer has evolved over time. I initially thought it was the joy of competition, the thrill of training to beat that nameless person you see at every race who always seems to outrun you at the end. As time passed, I saw running as a therapy, something to help me get through the tough times. And, as I’ve grown older, I now see it as a much bigger piece of the puzzle. My impression goes something like this;

Life is all about motion. In fact, I’m currently reading Robert Ringer’s new book Nothing Happens Until Something Moves. Great book. Ringer deals with the very basic universal laws of life, the laws that, if adhered to, would turn this crazy world into a balanced, respectful territory. But, the key to his entire message is motion. Motion is the very essence of life--the key to happiness & the ultimate therapy for the masses.

Running takes this message to a whole new level. Running is an organized, planned approach to insure that your life includes motion. It allows you to spend time with others who are important in your life. Without running, you’d hardly ever see such people.

Motionless

This is where everything starts getting sour on you. We have so many patients who are unable to move, with sprains, strains, arthritis and bloated schedules. I’ve come to the conclusion that lack of motion in your life is the beginning of the downhill. Think about it; weight gain, something in epidemic proportion in this country and getting worse, increased blood pressure, which should be treated with increased “motion” long before any prescription is recommended, blood sugar problems, as a result of weight gain, and most importantly, a frazzled psyche.

The psychological component is without a doubt the biggest reason people get hooked on running. Running is such an appropriate therapy for all of us, as most people have very little margin in their psychological world for any types of stresses. Yet, as we’ve written about so many times in the past, expect problems, as they are a constant part of life. Running seems to reduce the size of problems, but more importantly, gives us a quiet time to think them through and come up with better answers. I’m amazed how often I leave the house with “issues”, and come home with simple solutions. I can’t imagine how much it would have cost had I asked a professional to listen to me and then tell me what to do. Not to mention the fact, their answer could never be as valuable as mine.

Wisdom with Aging

As we get older, all of us truly recognize that mobility is so much better than immobility. I tell my geriatric patients “Keep going, as they can’t throw dirt on you as long as you’re moving”. They laugh, but they know I’m serious.

When younger, we feel like we’re bullet proof, and that youth will always be there. As we begin reaching middle age, we realize, aging happens to all of us. The aging process slows down the more active you are, not to mention the fact that life just seems to be a little less chaotic if we can include motion in our daily life.

I encourage all patients to increase their daily motion. If you can run, run. If you can’t run, walk. Combine the two. Jeff Galloway has done a phenomenal job of converting people into marathoners with the inclusion of walking. Die hard runners have a hard time walking during any training or racing event, but for those who wish to make it a lifetime activity, it only makes sense to do what you have to do to stay out on the road.

Conclusion

I was going through some old magazines the other day, when I came upon an article by the George Sheehan. It was in his later years, and he was telling the story of him out running, when some young runner approached him and asked him what his pace was. Sheehan always had a way of keeping everything in perspective. His response to the young man was “comfortable”, as he claimed he no longer checked for distance and time.

His joy of running was now at a different level, but one he felt was the best he’d ever experienced. Mimic Sheehan. Keep the fire burning by staying out there. Never give up, as any motion outdoors is mandatory for all of us. And, if you’re dream is anything like mine, you’ll also want to run to your funeral at the age of 105. I’ll drink to that.

Have a great month.

A Most Special Reunion

By Dr. Tim Maggs

I met Paul Mbugua in February, 1994. He was one of 17 Kenyans we had recruited to travel from Nairobi to New York to Tampa to compete in the 1994 Gasparilla 15k. I was already in Florida with my 2 sons (5 and 3), my wife Trudy, my mother in law, and 3 friends who traveled with us from New York when they arrived.

When we got to the airport for their arrival, we walked into 17 startled, bewildered and confused Kenyans. They had just traveled from Nairobi to London to New York to Tampa. While in London, they had an 8 hour layover, with no money for food. They didn’t eat until they got to New York when one of the members of our staff met them at JFK. He flew with them to Tampa, and this was the beginning of a new and interesting chapter in all our lives.

Team Stick

I met Joseph Nzau in Boulder, Co. in 1993 at the Boulder Boulder 10k. He and I hit it off, and decided on the creation of an American training program for young and talented Kenyans. Joseph went home at the end of the 1993 season, and selected talented runners who were ready to travel to the U.S. In retrospect, he did pretty good.

He chose Lazarus Nyakeraka, the Runner’s World #1 runner of the year in 1994. He chose John
Kagwe, the 2 time New York City Marathon winner. He chose Josphat Machuka, winner of the Carlsbad 5000 and Boulder Boulder 10k. And he chose Paul Mbugua.

We created the name Team Stick after The Stick, which was a newer product I had just been introduced to. The Stick was my salvation to get back to running after many years of injuries to my calves, and my goal was to find a way to introduce this great product to more runners. We travelled the country, participating in many races during the next few years, and meeting many people along the way. We even set a few world records. Can you imagine?

As I got to know the runners better, their individual stories were incredible. There was Philip Langat, who kept lions away from his cattle with a spear. There was Abraham Limo, who had 6 kids, and lived on $100. per month. And there was Paul Mbugua, who had 4 kids and a wife back home.

Paul was different than the rest of the runners. Not only was he a great runner, (13:45 in the 5k) but he also had a master plan for his kids and wife. Paul never went back to Kenya like all the others did. He stayed, and began working 3 jobs to provide for himself and his plan.

6 years ago, Paul was able to get his 4 kids into our country. It was a momentous occasion, and the beginning of his new life with his family again. They ranged from 11to 18 years old. The joy Paul experienced could be felt and heard everytime you spoke with him. They endured the difficult cultural shift with our school system. Paul became the ultimate father and parent by providing for their every need. The kids quickly became adjusted to the new life in America.


Quickly they made it through high school and were off to college. And, at every step, they excelled.

Then, about a year ago, I got the call from Paul that his wife had an opportunity to leave Kenya and join the family in the United States, six years after her children left. I was shocked at Paul’s announcement, asking him, “How would she adjust?, do you think you guys would still get along after 17 years apart?, and how will the kids handle you and Mary getting back together again?”. On a more comedic level, I asked Paul if he thought she’d take him, even after gaining all that American cooking weight.

Paul, the ever-so-wise person, simply told me, “we will all do well when Mary arrives”. Low and behold, Mary did arrive about 3 months ago, reuniting this family after so many years of being apart. They’d put many American family’s to shame by showing so much love, loyalty and devotion after so many years apart.

Paul told me in private, “Mary knows how hard I worked to take care of the kids before she was arrived, and that kind of love is the strongest ever. We are a strong and stable family.”

As I reflect on the many experiences my family enjoyed during the Team Stick years, the world records, the laughter, the cultural experiences, etc., I don’t think there is any greater joy than the thought that Joseph Nzau and I, in our craziest of dreams back in 1993, changed the lives of the Paul Mbugua family forever. And, with the success that this family has shown to date, the U.S. will be a better place because of it. I never could have imagined that the greatest feat of any of our runners would be Paul’s undying desire to reunite his family.

I’m proud to have been a small part of this miracle. Have a great month.

 

(From left-Dr. Tim Maggs, Paul Mbugua, Mary Mbugua and Trudy Maggs)

Running Barefoot with Nike Good or bad?

By Dr. Tim Maggs

Everytime a shoe company comes out with a new concept, I hold my breath wondering if it’s only to sell more shoes, or is there some semblance of logic involved.

Last year at the Boston Marathon expo, I visited the Nike booth, and watched closely as they had treadmills set up with video cameras filming the gait of runners who wanted to be “analyzed”. Once the video was completed, the Nike rep would play it back, showing the runner how their foot hit the ground, and then recommended the appropriate pair of shoes. For the average onlooker, Nike appeared to be using cutting edge technology. However, when you look at some of the facts, you realize how far short of the mark they actually are.

Do You Know Your Structural Fingerprint®?

What Nike, as well as the most of the sportsmed world, fails to identify is the fact that biomechanics exists above the ankles. Simply put, humans are a “bag of biomechanical sins”, and unless you examine each person biomechanically, you’ll never know the many specifics of that individual. The end result of these “sins” is the foot strike during the gait cycle. The strike is just an overall compensation for all of the undetected and uncorrected biomechanical flaws that are the result of many contributing factors, such as hereditary weaknesses, prior injuries, using the wrong shoe type, poor conditioning, height, weight, job, etc.

So, until you actually get a biomechanical exam, no one knows your specifics, such as your center of gravity, structural balance, joint restrictions, muscular imbalances, foot type, etc. And, these factors will determine what your life will be about.

The Structural Fingerprint® Exam

This exam first looks at foot type. The shoe industry has done a tremendous job of developing shoes for the different foot types, but most Dr.’s and the general public have no idea what their foot type is or how to test for it. Learning your foot type is critical, and it must be done in the standing, static position. Evaluating gaits during the running cycle should never be done until many of the biomechanical defects in the body have been improved, and that usually takes at least 6-12 months.

The Q angle of the knee, as well as leg length, range of motion of all joints and muscle balance, should all be tested. 75% of the information needed for a comprehensive biomechanical exam comes from standing x-rays of the low back and neck. And, you can’t ask most Dr.’s to read them, as most Dr.’s are only schooled in looking for pathology on x-rays, not biomechanics. This is why most x-rays come back “negative”. They are negative for pathology.

Once all these tests are performed, then a rehabilitative program is designed to allow time to re-educate and mobilize muscles and joints, improve habits, and perform the necessary rehab exercises. Our goal is threefold; to improve overall posture and balance, to increase joint mobility and to increase muscle flexibility. Much like the orthodontist who requires 2-3 years to alter the alignment of kids teeth, structural balancing is a process, and a tremendously worthwhile one.

Who needs this exam and correction? Everyone interested in getting the most out of their physical life while reducing the frequency and degree of breaking down. If getting a joint replacement isn’t on your “to do” list just yet, you may have in interest in learning how to preserve the joints you have, just in case you’ll want to use them later in life.

Final question; When can you stop working on this balance, joint mobility and muscle flexibility? Never. Just like any other mechanical machine you own, management and maintenance is required to keep it running well. The very thought that we should just let our bodies and joints degenerate and rot out until we can’t take it anymore borders on lunacy. Then, the very thought that drugs or joint replacements are the obvious answer is nothing more than modern medicine doing a great marketing job and keeping the masses ignorant.

So, Nike now comes out with the Nike Free shoe that “gets the hell out of your foot’s way”. They tell how studies have shown barefoot running allowed runners to get faster and have fewer injuries. “Add to that, research showed that runners in unshod populations like Africa or the Caribbean often have lower incidences of running injuries like Achilles tendonitis and plantar fascitis”, the marketing literature states.

So, is it worth a try? Hard to say. But what I can say is this; until these biomechanics labs at the running shoe companies begin examining biomechanics above the ankles, like the sacral base angle or Ferguson’s center of gravity line, they will always be too uninformed to make the statements they make. Until they recognize the importance of a balanced knee and mobility in the spine at all levels, the relationship between foot type and full body biomechanics, and the importance of educating the masses on foot type and appropriate shoe type, with custom orthotics when needed, that’s when it’ll be time to then congratulate a new shoe and explore new concepts.

The downside of the current state is that most runners will wear the wrong shoes, end their running careers prematurely on the disabled list and use their primary Dr.’s as their fitness/injury guru’s. Oh my, what a shame.

Have a great month.

Tribute to a Running Partner

By Dr. Tim Maggs
© 2002

I’ve had the enjoyment over the past 25 years of having very special training partners. In our complicated and busy lives, a training partner becomes our other self. They listen to us, talk to us, live through us and share our aches, pains and joys.

Two years ago I gave a running clinic at the Olympic Training Center in Lake Placid. Mary Peck was there. A short time later, Mary came in as a patient and, as a result, we began to train together. Once, twice and even three times a week for the next two years, we ran together. We had so much not in common, but we also had a need for each other. She was 18, I was 46. She was totally driven, I was laid back. She didn’t like to talk, I loved to tell all. Opposites attract, evidently. And with each and every run, Mary’s grandmother would drive her to my office and sit and wait for us to return. I don’t know if Mary ever really understood how blessed she was.

In May, 2001, I needed Mary to help me reach a goal I thought was virtually impossible. I had gone 14 years without running a marathon. I had no confidence I would ever get back to running marathons, while Mary’s youthful optimism had me running marathons and her running in the 2004 Olympics. I stole this fire from Mary each and every run. I was the benefactor.

I finished that marathon, my first in 14 years, and wildly celebrated this improbable accomplishment. Mary deserved much of the credit because she believed when I didn’t. But, I believed in her. Not once in 2 years did Mary ever fail to show for a run. She also pushed every step of every run. I finished my first marathon in over 14 years. Mary helped my life get so much better.

Another Road Traveled

While Mary helped me reach improbable successes, her life continued to suffer. Although her back problem certainly played a part in her training, she also suffered with other issues, and much of our energy was spent on helping her get well. Mary worked obsessively every day of her life, one hour at a time. There were many days I wanted to cancel due to my busy schedule, but she’d patiently sit in my waiting room, and I wouldn’t have the guts to not run with her.

After finishing 3 marathons since my return back, with the latest being this year’s Vermont City Marathon on May 26, 2002, Mary was always the first to congratulate and celebrate with me. She may have even lived through my successes.

Fast forward to June 10th of this year. Mary waited longer than usual this day to do our 4-mile run through the woods. Never a complaint, as this was not a part of her make-up. Before treating her that day, I asked her how she felt, and it was the first time in a long time she replied, “better”. Mary ran that day as well as she had in the prior 6 months. Several times during the run, I’d ask, “Are you okay Mary?”. “Yup”. That day was a great run. The best we’d had in weeks. She was starting to feel good again.

For me, that day’s routine continued as usual. The next morning, my life changed forever. I sat at my computer reading e mails. My wife, Trudy, was reading the morning paper, and let out a horrible sound; “Where does Mary live?”. I told her, and she froze. There in the paper, in bold, clear and horrible, horrible print were the words that would change my life forever---“Mary Peck killed in a cycling accident”. As simple as that, Mary had died. She died. Mary was gone. That simple. The 4 miles we ran the day before would be the last I’d ever run with her. Almost 2 years of together, and now, just like that, we were apart. A short 25 minutes after leaving my office, Mary was hit by a dump truck while riding her bike home and killed almost instantly. Where do you go when something like this happens? Can life ever be the same?

As hard as this loss has been for me, I live with unconditional faith in God’s plan. There is some larger purpose for what I see as a senseless death, but in time, I’m sure I’ll better understand why this happened.

Mary’s grandmother, who took total care of her, is relieved to know that Mary is now out of pain. I’m saddened by the fact that Mary took such good care of me and I was helpless when she needed me most. I cherish the opportunity to have spent so much time over the past couple years with her, and hope I gave as much as possible whenever possible.

In reflecting back over the many runs we had together, one common question would always be, “Mary, are you okay?”. She never answered anything but “yeah”. She was one of the most focused, determined people I’d ever met. I wonder if I have the ability to train and run a marathon without her help.

Life is a fragile and perilous trip, and the loss of someone so close, so fast is difficult. Mary represents all of our training partners. Please realize the value of all of them, before it’s too late. I run most of my runs alone now, and I’ll continue to do so, as running is still the answer, not the problem. All of us have had troubles in our lives, and running should be part of the reason we’re able to handle them better than those who don’t run. We know the price, the pain, the lessons of life. That’s what it’s all about. Mary’s death taught me more than any life experience I’ve ever had.

As a representative of all training partners, please consider giving to the Mary C. Peck Scholarship Fund to help provide support to 5 female athletes with Olympic aspirations. If interested, donations can be sent to my office, with checks made out to The Mary C. Peck Foundation. My office address is 1310 Union St., Schenectady, New York 12308. Never take your partner for granted.

Herniated Disc - The end of running?

By Dr. Tim Maggs, © July 2000

Q: I was diagnosed with a herniated disc in my neck which caused "pinching" of my C7 nerve resulting in numbness of my thumb and first 2 fingers (along with a great deal of pain). I am being treated with Vicodin, Skelaxin and Prednisone. The doctor said my x-rays were normal, but he said we needed to do an MRI. My questions; Could this be from running? Could it be from stress or poor mattress/pillow? When can I begin running again? The doctor said he wanted me to learn some neck strengthening exercises, but didn't mention anything about my running.

I was diagnosed with a herniated disc in my neck that caused "pinching" of my C7 nerve resulting in numbness of my thumb and first 2 fingers.

This is not uncommon for someone to suffer with a herniated disc at this level. The symptoms described are quite common.

I am being treated with Vicodin, Skelaxin and Prednisone.

These drugs are certainly common and are designed to help reduce symptoms, such as inflammation, muscle tightness and pain. But, by no means, is a chemical treatment a cure for a physical problem.

The doctor said my x-rays were normal, but he said we needed to do an MRI.

Typically, if you suffer with a true herniated disc, your spinal biomechanics are abnormal, suggesting your spine is either imbalanced, locked at certain levels or twisted out of its normal position. Unfortunately, most doctors don't know how to read x-rays from a biomechanical perspective. First of all, you need your x-rays taken in a standing position. Secondly, the doctor must know how to interpret them from an athletic and biomechanical viewpoint. If the first comment is, "The x-rays are normal and you need an MRI", you must at least consider the fact that the doctor might not be capable of interpreting biomechanical information from your x-rays. X-rays show alignment, curvature and positioning of the spine, while an MRI will better highlight soft tissue problems as well as disc herniations.

Could this be from running?

Running, and the compression associated with it, could certainly be a contributor to the problem, but it is highly unlikely that running alone could cause such a problem. In most cases of herniated discs, joints will lock up due to a prolonged, ongoing stress to a certain area of the spine, thus producing increased demands on a specific disc. This demand will eventually produce a bulging and ultimate herniation of this disc. If, however, an underlying problem exists, running can certainly aggravate the problem and prevent the necessary healing process from taking place.

When can I begin running again?

This can only be answered by your treating doctor. If he or she isn't experienced in biomechanics, then you need to find someone who is. The release to allow you to resume running is one that must be done at the right time and only after corrective rehabilitation. Each and every person who has a problem such as yours needs to have specific guidance with regard to when running can be resumed.

The doctor said he wanted me to learn some neck strengthening exercises, but didn't mention anything about my running.

Your doctor is correct about neck strengthening exercises, but your return to running requires a very sophisticated effort for full return. Typically, most herniated discs in the neck are a result of restricted motion in the spine. This restriction can be in the low back, mid-back or neck. Once complete motion is restored in all joints of the spine, the likelihood of recovery in the injured area goes up. This is with or without surgery. If a surgeon feels surgery is not in your best interest, complete motion is still your objective in all joints of the spine. Proper exercises, which facilitate improved motion and muscular activity, improve the status of the neck and help to prevent future flare-ups. Proper neck exercises in a condition such as this are critical.

Conclusion

Whenever a structural problem presents itself, whether it be pain, spasm or limited range of motion, a thorough biomechanical exam is indicated. This can only be done by someone skilled in that area. The difficulty is finding someone who understands full biomechanics and how to help you get better with your condition. Once you find the right person, the objective for all of your body's imbalances, lockings, restrictions and abnormalities will be to work towards correction and balance. Once the body improves in motion and balance, everything begins to improve.

In the future, never let pain and restriction be your motivation for finding someone skilled in this area. Start today, as all of us will have some type of biomechanical problems at some point in the future. The body wears out with abnormal wear and tear, and once it's worn out, there's no hope for recovery. But, with a little foresight and preparation, longevity and health are certainly well within the grasps of all of us.

Case History of an Injured Runner

by Dr. Tim Maggs, © 2000

Mary Peck is a 19 year old girl. She's also a runner. A good runner. Maybe a great runner. She dreams of the 2004 Olympics.

Mary ran a 3:11 in Boston 2000, and this past November, ran a 58:00 plus 15k in cold, hilly upstate New York. Very promising. Until her back gave out. With no warning, her entire back ceased up on her. She could barely walk let alone run. She couldn't get beyond 4 miles without the back going into a full spasm. Her sole identity had become that of a young, promising runner, and now, she was unable to run. Mary's success has been a result of her commitment to hard work. It was now out of her hands. The situation was beyond her control.

Seeking Answers

Mary went the normal route, seeing several doctors, looking for solutions that would allow her to keep training. Tests, treatments and hopes didn't produce the results she needed. Mary was now an injured runner with no "program". This feeling was foreign and unacceptable to her.

I first met Mary at a clinic I gave last August at the Olympic Training Center in Lake Placid. Mary spoke to me after the clinic, and there was no doubt she was a focused and committed runner.

It was now mid-December, and Mary Peck was on the phone. She briefly explained her situation. We set up an appointment. After going through her history, a couple things jumped out at me; first, no doctor had convinced Mary they knew what her problem was, and second, she was still as bad as the day it started, almost 30 days prior. Mary was living in a freeze-frame and unable to run.

One of the doctors Mary had seen was a chiropractor. She'd been seeing him for several months. Mary liked him. He was a sportsmedicine expert. His treatments were once per week before she became injured, and once injured, he re-took her x-rays to see if there was anything "seriously" wrong. He found nothing, so his treatment continued at once per week. Even Mary recognized the illogic here, and decided to look elsewhere.

Using the x-rays that were taken at his office, I immediately noticed Mary's sacral base angle, which is normally 36°-42°, was 50°. An increased sacral base angle will cause the low back to cease up prematurely under stress (such as in running). Ceasing up equates to spasms in the low back. The muscles go into a defensive mode to protect any stressed areas in the body. Typically, this is a cumulative condition, the result of many influencing factors. Simply put, once a person's workload reaches a certain level and their body mechanics are imbalanced, problems occur.

The abnormal sacral base angle was the most telling finding in Mary's structural exam. Coupled with her other findings, a corrective program was set up. Although it was met with discouragement on Mary's part, I reminded her that 19 is a very young age and life is a very long time, so let's be willing to give up 6-10 weeks of training in an effort to create a successful future. She agreed to the plan.

Conclusion

Mary turned into the perfect patient. She complied 100% to the restrictions, guidelines and treatments that were prescribed. Improvements came quickly and re-x-rays were taken approximately 8 weeks after treatment began. Her 50° sacral base angle was reduced to 40° and she was now able to increase the demands on her back. He symptoms were pretty much gone by now, and Mary was well into returning to a full running schedule.

A combination of specific treatments, spinal exercises, improved habits, our Muscle Management Program, a slow and deliberate return to running and her vision on the long term has helped Mary to come back strong. She is now training up to 40 miles per week with no setbacks. Her back feels strong, her spirit feels impenetrable and the road ahead looks bright.

The key to it all is to locate the cause of the problem through a Structural Fingerprint® exam, and to pay the necessary rehabilitative price to correct that cause. There are so many reasons runners don't do this, from being impatient to having a hard time finding a doctor who thinks biomechanically. But, the benefits are so grand when approaching back, neck, hip and other structural problems this way, that the price you pay to do it right is minimal compared to the price you pay if you don't. Simply put, the sooner you learn your "Structural Fingerprint", as Mary finally did, the sooner you can begin to improve any imbalances or defects that may be preventing you from reaching your full potential. Not to mention, the elimination of many nagging symptoms that have bothered you for years.

Why Kenyans Run So Fast

by Dr. Tim Maggs, © 2000

Guess what? Another Kenyan won the Boston Marathon this year. Calm down from the disbelief.

When Elijah Langat crossed the finish line first this year, he kept the string of Kenyan victories going. But then, did anyone ever suspect the string would be broken? Hardly.

Many would probably expect to read my in depth discussion as to the physiological differences between the Kenyans and the Americans. Sorry. Although Kenyans are built for success in running, the true answer goes beyond their structural efficiencies.

Living With Kenyans

If I've been asked once I've been asked a thousand times. "Why are the Kenyans so fast"? Ironically, the more you know, the more you realize there may be no simple answer to this question. My experience all began in mid-1993 when a small group of Kenyans came to my hometown to begin a training program in Upstate New York. By early 1994, we had a total of 16 Kenyans living in our small, close-knit community. The first thing I did was go to our local police station and warn them they'd be getting reports of many black men running a lot. I told them not to presume robbery or some other crime. It was just a group of world class runners doing what they do best.

Kenyans are different. I don't think anyone of them could ever become American by culture no matter how long they lived here. Thomas Osano, Paul Mbugua, John Kagwe, Lazarus Nyakeraka and Gideon Mutisya certainly have developed a lot of American ways, but their heritage and lifestyle is so different, it would be similar to changing your fingerprint. Can't happen. When Thomas Osano, Josphat Machuka and William Sigei all ran under the 10-Mile world record at the 1994 Cherry Blossom, I stood close to Thomas and Josphat after the race. They quietly stood there with hardly a smile. That was their celebration. On the trip home, you would think they DNF'd.

Their diets tell a huge story. They all eat the same. We'd go shopping once a week and the cart would be filled with things like cabbage, chicken, steaks, cans of tomatoes, tea, white corn meal and whole-wheat flour. No matter how much of this stuff you buy, it still never amounts to much money. And, they all ate the same thing. I never heard one of them say "I don't like that". Different runners would prepare meals each night, but a simple system was developed and multiple cooks took over. Preparation, cooking, cleaning and a cup of tea before bed.

We had two houses with approximately 8 runners in each house. Showers were usually taken by 2 runners at a time. Conserve water. Running clothes would be hanging everywhere, as two, and sometimes three runs per day took place. In between runs, the runners would relax by going for a walk, reading the bible or visiting some neighbors. The activity was never what you'd call stressful.

One night when I came down to the house for some particular reason, I heard a lot of screaming inside the living room. As I rounded the corner, I saw all of them huddled and cheering over 2 who were seated on the floor. The two on the floor were playing a game of checkers, with the board and the checkers made from a running shoe box. Nike pays millions to have such excitement from their shoes. I'll bet they never anticipated such excitement from their boxes.

Another time, we traveled 3 hours to run a 20k in New Jersey. 15 Kenyans, my wife, my 2 sons and myself made the trip. All in a 15 seat van. A little crowded maybe, but not a word of complaint. And the aroma on the return trip certainly deserved some complaints.

Finally, they are suited for running. From their structures to their altitude training to their constitutional courage, the Kenyan has become the Lion of the roads. There are now so many Kenyan heroes; young Kenyans have these leaders to emulate while growing up. I remember Abraham Limo, father of 4, tell me how $100. would last him and his family over one month. He was shocked how quickly it could be spent here.

Paying The Price

The Kenyan runner has sacrificed more than most of us would. They leave their families and travel halfway around the world for nothing more than an opportunity. No guarantees. I remember when my wife and I first met 12 of them in Tampa in 1994, and from there, they would be traveling to Upstate New York with us (it was late February). They stood there with t-shirts on and only a small handbag with their possessions. I take more than that to the bathroom with me in the morning. I questioned whether they knew how cold our weather was. They didn't, but it didn't matter. The only thing that mattered was the opportunity.

As soon as we arrived in New York, we quickly gathered coats for all of them. Alfornce Muindi came over one day wearing a woman's jacket. He didn't even know. He was smiling and happy as could be. Fashion wasn't part of his make-up. He was only one of the best runners in the world. I remember when Nike hired Alfornce to rabbit for the New York Marathon in 1993. At dinner the night before, I asked Alfornce if he knew how many people would be behind him the next morning. He smiled and sheepishly asked, "2,000?". I still love Alfornce for his innocence.

My sons learned so much from our involvement with these great people. When asked why Kenyans run faster than we do, the answer is really kind of simple. Just live with them for awhile. You'll quickly understand.

Headaches Runners Need to Know: "Why?"

by Dr. Timothy J. Maggs, © 1999

Of the many maladies runners suffer with, none should get the level of sympathy that chronic headaches command. The perfect punishment for a worst enemy, who happens to suffer with headaches, is to make them run step after pounding step for 5 miles a day, as their head explodes with each and every stride.

Many runners today suffer with both constant and intermittent headaches, and unfortunately, many doctors seem to miss the boat with regard to accurate or beneficial diagnoses. Any doctor who just writes a prescription in the absence of proper testing should----well, should be injected with headache juice and forced to run 5 miles per day.

Know the Cause

If any treatment is ever recommended for your headache without a full description of the cause of the headache, feel free to exit quickly and go to Doctor #2. Headaches can be caused by a host of problems, and to ignore the exact cause for "relief only" borders on lunacy. You must know why you have your headache before you can ever work to correct the cause. Some doctors out there forgot that "cause" matters. And for many Americans, they've never thought in terms of "cause". But, if symptomatic relief is the level your bar is at, you stand the distinct possibility of getting worse with time and finding that the level of medication you take today won't even begin to touch your pain tomorrow.

There are several common causes of headaches. Most people who suffer with headaches suffer with one or more of these conditions. You must use a doctor who is skilled in the following areas to hope for an accurate diagnosis and treatment; blood sugar, hormonal imbalances, stress and subluxations of the joints of the cervical spine (neck). Although there are more severe disease processes which can cause headaches, such as brain tumors and aneurysms, it is most common to have the more correctable causes listed above as the underlying criminal

With blood sugar and hormonal imbalances as the cause, diet plays a significant role in improving the condition. Although it is very difficult to eat a great diet these days, (a great diet consists of whole grains, seasonal vegetables, fruits, legumes and nuts), it is much easier to supplement your diet with nutritional supplementation specific for your needs. In this situation, there are dietary tests which can be given to determine what hormonal imbalances exist or what specific blood sugar problem is present. For example, blood sugar involves the liver, adrenal glands, pancreas and digestive organs. Many, many people suffer with imbalances in the blood sugar system and will never find resolution until they nutritionally balance their diets. The answer is to do as well as you can with your diet and then be willing to supplement for specific weaknesses.

If any testing is needed, a 5 hour glucose tolerance test (GTT) is the most accurate test to give the specific information needed. Most medical doctors frown on the 5 hour GTT as the only information you'll find after the 3rd hour is that your blood sugar drops significantly. This is critical information, but, if low blood sugar is found, the only effective treatment is dietary. Most M.D.'s are not trained to think nutritionally, so their interest in finding low blood sugar is minimal. A 3 hour GTT or a 2 hour post-prandial is virtually worthless unless you have diabetes.

Now, if blood sugar or hormonal imbalances aren't the cause, then think in terms of your neck and the base of the skull, especially if you've suffered with some prior neck trauma, like a whiplash injury. This area of the body has a tremendous influence over all of the body, and any misalignment or fixation of the joints at the top of the spine can pinch nerves that will cause headaches. In fact, many migraines are a result of the atlas (the top bone of the spine) being in an abnormal position. If the headache occurs over one or both eyes, think in terms of the 2nd bone, the axis, as being out of position, as there is a nerve that exits near the axis and affects this area. Any mis-alignment of that bone will produce an irritation of that nerve.

Solutions

For the majority of headaches, I would recommend two providers, a nutrition oriented health care provider and a chiropractor familiar with runners. Make sure whoever you go to gives you a specific cause and treatment schedule. If it's nutritional, get an idea of what you can expect. If it's structural, make sure you can see the misalignment on the x-ray. If it's blood sugar, make sure you see the 5 hour GTT results that show a drop in blood sugar (below 70 at any point). Be careful with anyone who recommends symptomatic treatment without verification of your condition.

And last but not least, never stop searching for the answer to life. It is out there.

Herbs For Runners?

by Dr. Timothy J. Maggs, © 1999

I recently read an article in the L. A. Times about herbal products and the popularity they were gaining in this country. I've always been a proponent of nutritional therapy, and the thought that the "trend" is all of a sudden catching up with my beliefs of 20 years or more is, well, heartwarming.

According to this article, a national survey was done 2 years ago and found that 45% of Americans were aware of or had tried herbal products and 16% used them regularly. The same study, just completed, found that 70% are now aware of or have tried herbs while 40 percent use them regularly. Not only are these products gaining popularity amongst the masses, but staid medical journals recently published scientific studies on herbs and indicate the conventional medical community is also beginning to take notice.

"It's no longer a fringe movement," said Mark Blumenthal, executive director of the American Botanical Council. "Herbs are no longer folklore. People are finding out there is research to support the scientific side of it."

Herbal History

Herbs have been used by many groups and countries for many years. Authorities believe the future of herbal medicine will depend on ethical collection, organic cultivation and the protection of the natural environment. Ethical collection of wild plants was first taught by the Native Americans. Their reverence for plant life was symbolized in the prayer of gratitude offered before collection. It was their practice to only collect every third plant, knowing this would ensure a continued supply. Early medicine, in fact, used practices which today might be confused with those of herbalists or homeopaths.

Modern medicine, along with the pharmaceutical industry, grew significantly about the same time our country transformed from an agricultural nation into an industrial nation. As we entered the 1940's and 50's and farmers began moving to the cities, society accepted"artificial" in their trade for convenience in both food preparation and healthcare. The use of drugs and artificial food ingredients rose dramatically. Flavorings, colorings and preservatives were on the rise. As we entered the 60's, 70's and into the 80's, Americans began to recognize that, although they were living longer, they now led the world in degenerative disease and their quality of life was declining. Moving into the 90's with the baby boomers at the helm, they decided "enough was enough". They would have nothing to do with anything less than the best, including healthier foods and more natural medical care. Wrinkles, aches and pains once again have brought people back to herbs, and the cycle continues.

Most Popular Herbs

Now that herbs and other natural remedies have gone mainstream and are no longer the sole domain of health food purists, which are the most popular and what do they do for you?

Whole Foods Magazine recently surveyed a group of retailers and consumers to find out what the most popular herbs being sold today were:

1. Echinacea. There are different forms of echinacea, but all of them provide relief for cold and flu symptoms. In fact, this is the third year echinacea was ranked number one.
2. Garlic. This boasts a host of benefits, including reducing blood pressure and cholesterol and helping to prevent colds and other infectious diseases.
3. Ginkgo Biloba. This reportedly improves circulation to the brain and lessens ringing in the ears.
4. Goldenseal. This, too, is a popular remedy for cold and flu symptoms.
5. Saw Palmetto. A truly interesting herb, saw palmetto has shown to dramatically improve benign prostatic hyperplasia, or enlarged prostate. This condition plagues men 40 years old and above. Traditional lore surrounding the plant also includes a prolific reputation as an aphrodisiac.
6. Aloe. This acts as a laxative taken internally and a skin treatment externally.
7. Ginseng. This increases resistance to stress and provides endurance energy.
8. Cat's Claw. This reportedly boosts the immune system.
9. Astragalus. This is supposed to have immune enhancing properties.
10. Cayenne. This relieves pain.

The survey also found that St. John's Wort is expected by retailers to be the hottest selling herb this coming year as the media touts it as "Natures Prozac".

Conclusion

When all is said and done, keep in mind there are no miracles in health care. Yes, herbs can offer a better and more natural approach to wellness, but they cannot override poor health habits. Exercise, quality sleep, good nutrition and a good attitude are still necessary to ever capture all that life has to offer. As I tell my kids, "The Dirt Road" is the only way. Pay now rather than later. Herbs do offer relief of symptoms and a more natural approach, but they need to be a complement rather than a cure.