The Question:

Ok fellow runners…ever since I took a week off post 1/2 marathon I can’t run more than 2.5 miles without excruciating pain in my knees. Never once happened before. This is bullshit! Help!!!

My Response:

Knee pain is a postural issue. It has less to do with a problem at the knee and more to do with mobility and stability dysfunction at the hips, feet, upper back and shoulders. For any adjustment to be effective, the entire biomechanical chain must be addressed.  Not just the knees.

I work on postural dysfunction in four (4) stages:

1. Pain: Your range of motion must be, first and foremost, PAIN FREE! This means, if it hurts to do… DON’T DO IT!!! If it hurts to run, squat, or lunge, etc… hold off on these exercises until you can do them without pain.  What to do about the pain?  I address the pain through massage and foam roller therapy. I recommend finding a highly skilled fascial therapist who has experience successfully treating these types of injuries. I typically see a significant reduction in pain within 2-4 treatments. Then follow it up with foam roller therapy exercises (see link below).

Foam Roller for Beginners

2. Mobility: Once the pain is reduced, you will need to work on improving your functional range of motion, such as the ability to perform a functional deep squat or lunge. IN MY OPINION, IF YOU CANNOT PERFORM A FUNCTIONAL DEEP SQUAT OR LUNGE, YOU SHOULD NOT BE RUNNING! PERIOD!!! These are progressive movement patterns that lead up to running. Babies learn to squat-ass-to-the-grass BEFORE they learn to walk and run.  You must do the same.  So do it.  And on top of training for functional lower body mobility, you will need to work on upper body mobility as well. When your thoracic spine, scapula, and neck are restricted, your hips will not function properly.

3. Stability: Now that you have improved Range-of-Motion (ROM), you will need to train your body for stabilization with this renewed ROM. This is the basic definition of posture. The ability of your body to stabilize throughout your entire ROM. For more on posture, read:

What is Posture

Here are some super basic corrective exercises to get you started.

The Foundation of your Posture – Injury Prevention Begins at your Foot

Corrective Exercises for the Hips

Corrective Exercises for the Scapula

4. Conditioning: Running is a very basic movement pattern. It is also a very small percentage of our overall functional movement pattern. If the only form of exercise you are doing is running… you are running directly into a potential injury. Your body needs to be conditioned throughout it’s entire movement ability. Full body functional movement is vital to overall health and vitality, as well as running ability. Another way to think about this is: How do you want to feel when you’re 70, 80, 90, or 100? Do you want to run comfortably in advanced age? Conditioning your body through full functional movement patterns, which includes running, is the key to both of these questions.

I encourage you to hire an expert team to help you through this process. The investment now will save you thousands in your long term pain and health. I suggest hiring a therapist to help with the pain; a movement coach to help improve your posture; and a running coach to teach you how to run (years and years of sitting on our butts means that we don’t know how to do this very basic movement pattern – even if we run frequently). Here is a link with tips on finding a quality therapist and coach:

Five Steps to Choosing a Professional Therapist

Here is an affiliate link to purchasing the foam roller that I recommend.

Good luck.

The Response:

Jesse, in a perfect world I would LOVE to be able to hire all of those folks to help me out. I have contacted an ART (Active Release Therapy) doctor in hopes they’ll be able to help me a little bit. As for the rest I’m going to have to go it alone or go through my HMO (which everyone knows could take years) to get to a physical therapist. My knees don’t actually hurt unless I’m running. I can do squats and everything w/o knee pain…it’s when my glutes get tight about mile 2 that everything goes to pot. So I’m sure some of it’s my form and some of it is that I’m just too tight. I will continue to work on it and stop running for the time being. Perhaps yoga is in my future…

My response:

I completely understand the issue of cost. At the bare minimum, I encourage you to invest in a foam roller, softball, lacrosse ball, and golf ball. This will allow you to do a great amount of the massage work on your own. The foam roller alone should make a huge difference with your pain during running. It may take a few weeks. Here is another article on foam roller therapy that has a bit more detail to it.

How to Treat and Prevent Injury and Become a Better Runner

Finding a good teacher, Part II

When looking into a PT, I recommend really vetting them out. You want the most educated, experienced, passionate, top of their game professional available. You are looking for a highly skilled therapist, preferably one who includes manual therapy; as well as multiple other modalities; and looks at the entire movement system, not just your knees. If they treat the knees in isolation, find another therapist! Hopefully, it won’t take too long, but you are better off taking your time searching for a therapist who is the best fit than to settle on someone who isn’t.

Can you really do a functional squat?

The majority of clients that I see, at the time they come in, say that they can do a squat. The fact is they cannot do a “functional” squat. This is what I consider a functional squat:

This Is A Functional Squat

http://nicktumminello.com

If you can’t do this from standing to sitting to standing keeping your shoulders down and back, without your heels coming up, your feet rolling out, or without pain then you can’t do a functional squat.

Here is a great little video from Barefoot AngieBee describing squatting

Understanding Pain: What to do about it in less than five minutes?

Do you have a story of pain you’d like to share? Please share in the comments.

You can read My Story of Pain here.

If you’re anything like me, the availability of ridiculous amounts of fatty and sugary treats has you reaching to loosen the belt notch. You may feel the need to burn off more than a few extra calories and redouble your focus on bringing in the new year feeling and looking great.

With that in mind I would like to take this opportunity to once again offer my top health and fitness related gifts for the holiday season. These are the items that I consistently recommend to my clients year round and that I personally cannot do without. Here are my top gift picks for health and fitness products for that special someone, including yourself.

In the interest of full disclosure, I am an affiliate for many of these products. This means that if you purchase one after clicking one of these links, I will get a small commission. That said, the only reason I am an affiliate for these products is because I believe in them 100%.

1. Foam Roller

If you read my blog regularly, then you already know that I am a huge advocate of foam roller therapy. Upon being introduced to foam roller therapy in 2003, I was an instant convert. Over the past 10 years, the foam roller has been an incredible tool for both me my clients. Including foam roller therapy into your daily or weekly health and wellness lifestyle will reduce the amount of chronic pain and injury in your life; improve mobility and joint range of motion; and help you feel and move better.  It has the potential to have enormous effects on both your short and long term health and well-being.

The Grid by Trigger Point Therapy

The Grid is currently my go-to roller. It is one of the firmest foam rollers on the market. I prefer a firm roller over a soft one. It is great for travel. It fits inside most carry-on luggage. The center is hollow allowing you to pack clothing or other items within it, making it a great space saver.

The Grid 2.0 is a longer version of the grid. The extra length is nice if you have the floor space to maneuver and it is useful for doing some of the corrective exercises I describe in the article, The Scapula: The Mast and Sails.

To learn more about foam roller therapy, benefits and use, check out Foam Roller Therapy For Beginners, How to Treat and Prevent Injury, and Foam Rolling the IT Band.

2. TRX Suspension Trainer

I love my TRX Suspension Trainer. There is no other piece of workout equipment that has as much versatility. With a pair of straps you can do full body flexibility and full body functional strength training.

Regardless of your current conditioning or ability, you can use the TRX Suspension Trainer. Suspension training utilizes your body weight to provide resistance. The beauty about the TRX is that adjusting the level of resistance is simple: all you have to do is move your feet back or forward. You can make exercises super easy, super hard, or somewhere in between. Every exercise engages your core from your fingers to your toes in ways that are unmatched by most traditional strength training equipment. The TRX Suspension Trainer is the number one piece of workout equipment that I recommend to every one of my clients.

A TRX Suspension Trainer weighs about a pound and fits in a small bag – also great for travel. They mount easily to a door, wall, ceiling, tree, or outdoor jungle gym. I have a few clients with very busy travel schedules. They struggle with making it to a gym while on the road. With a set of straps they can workout in their hotel room and are less likely to miss vital workout sessions. I took my straps on a five day trip and had a couple of great workouts.

3. The Ultimate Sandbag

I love throwing a sandbag into a workout… any workout. Whether I am focusing on core, strength, power, or a high intensity burnout, a sandbag is usually in the mix. It is just a great tool. The benefit isn’t always about how heavy the bag is, but how the sand shifts, forcing your body to dynamically stabilize through movement.  The Ultimate Sandbag is a great piece of equipment that would fit in well in any home or professional gym.

4. Rip Trainer

I had The Rip Trainer on my list last year as a new piece of equipment. Over the past year it has become one of my favorites. The Rip Trainer is great for adding multi-plane rotation and anti-rotation training into your workout. If you are creating the perfect home workout studio, I would suggest taking a good look at the Rip Trainer… right after you buy the TRX Suspension Trainer.

5. Barefoot/Minimalist Shoes

If you have been reading my blog for any length of time, you know by now that I am a huge advocate of a barefoot/minimalist lifestyle. As a deep tissue massage therapist, I  see a ton of chronic pain and injuries. I find that most injuries stem, in large part, from postural dysfunction. The majority of dysfunction that I treat is rooted at the  foundation of our posture… the feet. And shoes play a huge role in this dysfunction.

I made my transition into barefoot/minimalist footwear about five years ago when I came across the Vibram Five Finger shoes at Whole Earth Provision Company, a local outdoor living store in Austin, Texas. At the time there were only a handful of barefoot/minimalist shoes on the market. Today there are over 64 and growing. Here are my favorites:

Merrell Trail Glove

When it is time to hit the rugged trail, this is the shoe I reach for. They are stylish, light, fit snugly, have a ton of toe room and a nice protective plate underneath the forefoot that protects my feet from the sharp Texas trail rocks.

Luna Sandals

It’s December in Texas and still 80+ degrees. Which means I’m still wearing my summer time favorites. These are great shoes for minimalist running or casual wear. Each year, as the weather warms up, everyone pulls out their flip flops – one of the worst shoe choices you can make – and a rash of foot injuries come through my door. Luna Sandals provide all the comfort of a flip flop without the same foot and gait dysfunction.

Soft Star Shoes

Soft Star Shoes are simply some of the most comfortable shoes on the planet. They are warm and dry in the winter, and cool and dry in the summer. Plus they make great minimalist shoes for the kids.

These shoes are so comfortable, my son and I have matching pairs.

My son’s winter boots. He loves them!

In case you’re wondering, these are tops on my Christmas wish list.

To read more about the benefits of a barefoot/minimalist lifestyle you can read Free Your Feet, Not Just Any Movement, You Need Functional Movement and Heel Strike Compared to Forefoot Strike Gait Pattern and How it Relates to Pain.

Jesse James Retherford is a licensed massage therapist, certified personal trainer and barefoot movement coach. He specializes in the treatment and prevention of chronic pain and injury.

Jesse writes a blog with insights on the treatment and prevention of chronic pain and injury.  lt is also a great way to stay up to date with his availability and the best way to have access to occasional specials, offers, and announcements. You can sign up here.

What is Foam Roller Therapy?

Foam roller therapy is simply one of the best methods available to treat and prevent injury. If you don’t own or spend any time using a foam roller (the main tool used in foam roller therapy), then get one. Start.  A foam roller is, in my opinion, one the best investments of time and money you can make when it comes to your long term health and fitness.

Foam roller therapy is the use of a foam roller for self massage. There are many different kinds of self massage tools out on the market.  Finding the right one can be a confusing and expensive process. I prefer to keep my tools super simple, inexpensive, and effective.  The self massage tools that I most often recommend and use are a Trigger Point Grid foam roller, lacrosse ball, golf ball, and a softball.

Foam roller therapy helps break down dysfunctional tissue caused by poor movement patterns, i.e. poor form.  It increases joint function, mobility, and range of motion. It reduces acute pain, speeds up recovery and healing, and it reduces injury.

Click here to read more…

There are 26 bones in the human foot, 33 joints, more than 100 muscles, and roughly the same number of sensory nerves that you have on the palms of your hands.  By the way, that’s the same amount of nerves as the inside of your mouth, and coincidentally, your genitals.

It should be pretty obvious that the foot is designed to be incredibly dynamic.  It is fundamentally sensitive and responsive.

The foot is capable of an extremely wide range of functional movement and sensory feeling.  It offers the possibility of stability in almost any context.

Your feet are your first and primary connection to the earth.  It is no wonder that they are the foundation of your entire postural system, and of your spiritual and emotional health. Every joint and muscle in your body has a stake in how well your feet do their job.

When you change your foot, you affect what rests upon them.  When you alter the position, mobility, stabilization, and sensory feedback of your foot, you directly disturb its natural relationship with your knees, hips, back, shoulders, neck, and head.  Shoes change your feet and body.

Click here to read more…

By Carly Pollack, MS, Certified Holistic Lifestyle Coach

“Minds are useful when we need to conceptualize, plan and theorize; but when we depend on them to guide our inner lives, we’re lost” Geneen Roth

Maya Angelou is famous for saying, “when you know better, you do better”. After studying the mind and how it works, I don’t always believe this to be true. How many of you know exactly what you need to do to bring health and happiness into your life, but wonder why it is so hard to bridge that education into action? When clients come to see me, simply telling them what they should eat for optimal vitality is not enough.  If we don’t address the mind, how it works for and against you, you can never free yourself from emotional eating and self sabotage.

Your current health and weight are a direct reflection of how you live your life. This means your food behaviors can tell you much more than your current level of will power. They represent your personal order of priority, time management, how loving you are to yourself, how you choose to comfort in times of stress and most importantly, it can reveal the mind’s limiting beliefs.

We all have limiting beliefs or what I call the “stories we tell ourselves”. Let’s first make a few things clear. A fact is something that is true for everyone. A belief is just a thought that we think repetitively until we believe it to be “true”. Remember, it wasn’t THAT long ago when we thought the world was flat. How many times have you felt completely powerless when it came to food choices, telling yourself the story that you are not in control? This is an example of one of many stories we tell ourselves that prevent us from moving forward toward greater health. If we aren’t clear on what our stories are, we can’t actively begin to think, say, and function on more positive beliefs. I invite you to search yourself with compassion, to take a good look at the thoughts you have that aren’t helping you to live your dream. Who would you be and what could you achieve if you let go of these thoughts?

In order to control your mind, you must have a clear dream for yourself. Without fear or limiting beliefs, write down the dream you have for your life, health, family, career, etc…  Don’t know what your dream is? Then start by looking at what you DON’T want. People who don’t have a clear vision of their dream will need to thrive on a crisis (I’m too fat, not good enough, my pain will never go away, etc.). When you have a big enough dream, you don’t need a crisis! People actually begin to make life long changes when they have found something to love more than they love the pain of their problems. They begin to love and respect themselves. The stories of the mind begin to shift from a place of fear (I won’t be good enough, make enough money, find the right partner), to a place of love (everything comes to me at the right time, my body works for me, I feed my body with the intention of nourishment).

Remember, you pay attention to the things you love. They are the things you take care of.  If you are not taking care of yourself, counting calories or shaming yourself in front of the mirror are not going to get you there. I have never met one client that has attained his/her dream through fear. Most clients spin their wheels trying to work on the symptom (weight gain, insomnia, digestive stress) when their focus needs to be on the root cause (lack of love, lifestyle imbalances, unhealthy and fear based thoughts and stories).

The mind is like a television with many different channels. You get to choose what you watch, and for how long. If you have a repetitive thought that is no longer helping you, “change the channel” to a more positive, loving affirmation. Controlling your thoughts is the key to achieving your dreams because after all, your thoughts create your future. Think of your imagination as life’s preview of what’s to come.

What is Form?
When it comes to movement patterns, including – but certainly not limited to – squatting, lunging, running, jumping, throwing, etc, form is paramount. Break down in form is what breaks the body.

Poor form is one of, if not the primary cause of, chronic pain and injury.  This goes whether you are an elite level athlete, weekend warrior, or even a sedentary couch potato. The way you move has a direct and definite impact on how you feel.  It has everything to do with your form, good or bad.

Form is the applied combination of technique and skill. Form is a learned behavior.  It is built through repetition (aka practice), and is embedded in the nervous system. When you learn a new movement pattern, your nervous system creates a specific neural pathway for this new skill (the connection of one part of your nervous system with another).

At first this pathway is weak; the connection is poor. But the more often you repeat the movement pattern, the stronger the neural pathway becomes.  Sustained consistency goes farther than sheer force of effort.   It’s kind of like building a road.  Over time, as more and more traffic uses the road, it is expanded.  Over time, with enough use (i.e. traffic in this example), the road is slowly transformed into a highway.

Proper form takes the right movements and deeply hard wires them into a specialized skill through perfect repetition of movement patterns.

Poor form takes the wrong movements and deeply hard wires them into bad habits through the repetition of imperfect movement patterns.

Poor form
Is inefficient, leaks energy, and makes tasks harder and more exhausting to perform.
Wears down the soft tissue of joints, leading to inflammation and damage.
Creates dysfunctional pain patterns throughout the body.
Increases your short and long term medical costs, by way of…
-visits to doctors and physical therapy
-pain medications
-surgeries
-hospital stays
Poor form, in short, shortens your life!

Proper form
Increases efficiency – You move smoother and faster, jump higher, squat more weight, etc., all with less effort and strain.
Minimizes wear and tear on joints, ligaments, tendons, cartilage.
Allows you to do more with your body and your life.
Speeds recovery time.
Is preventative medicine.
Reduces short and long term health care costs.
Prevents living a life of pain and injury.
Increases productivity.
Proper form, in short, lengthens your life!

Form Must Come First
This is important. Proper form and poor form are both developed through repetition.  The difference lies in the quality of the movement being repeated.

Why does this matter?

Because you cannot train form and conditioning at the same time.

You cannot learn a new movement pattern (form), and – at the same time – use that movement pattern to train for endurance, strength, power, or speed (conditioning).

For example, say you are recovering from a running injury.  If you are training to improve your running gait (form), you cannot use running to improve your conditioning. The two – on a fundamental level – don’t work together!

Training to improve your form and training to improve conditioning are fundamentally incompatible.

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To improve form, you need practice… perfect practice. You need to practice your form perfectly in order for it to stick.  When you train for form you are allowing your neurological system to develop new bio-mechanical habits. Because it is so important to have flawless form, you must repeat the movement pattern flawlessly with every repetition.

At the beginning of form training, perfect form breaks down at the first sign of fatigue. Once fatigued, you will no longer be able to maintain perfect form.

Training with imperfect form reinforces the poor movement patterns that will ultimately lead to injury.

At the same time, you cannot improve your conditioning without fatigue.  Fatigue is a core component to training endurance, strength, power, and speed. You will not achieve significant improvements in your conditioning without training into some levels of fatigue.

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Case Study. An example from real life:
Susan had not had the time to run in over three months.  On Saturday she decided to try one mile for her first run.  One mile is a pretty short distance, and a perfect place to start to get back into good running condition, right? She ran at a 10 minute mile pace.

Here’s the problem: because of her level of conditioning, she is only able to run with proper form for about 1-2 minutes before fatigue sets in.  Once fatigued, it is impossible to maintain proper running form without rest. Each and every step she takes after her form breaks down is a step down the path of a poor neural pathway.  

If she decides to push through and complete the mile without rest, she will actually spend 80% of her running time practicing poor form. That is 80% of her training time building upon a highway system of dysfunction and future pain and injury!

Is that what she wants?  Is that what you want?

The same example can be used for all forms of movement.  Fatigue affects your form in all activities, like swimming, cycling, tennis, resistance training, etc.

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If you want to improve your form, if you want to reduce the recurrence of pain and injury, then you must train with patience.  You must limit how much you perform the desired movement until you have fully developed your new and improved form.

You need perfect practice until you have perfect form.

Then, and only then, can you use that movement to train conditioning.  It may take a few months or longer, depending on your age, conditioning level, injury history, and a few other factors.

It is very likely that you will be able to work on your conditioning in some way.  However, it must come from activities in which you already have a high level of skill and technique.

In any specific movement pattern, you cannot train form and conditioning at the same time.  Perfect form first.  Train conditioning later.

Interval Training
One of the best training methods for improving form is interval training.  Interval training maximizes the benefits of repetition and minimizes the instance of fatigue.   It involves a series of low to high intensity exercises followed by periods of rest or recovery. Interval training includes in the vital rest and recovery your body needs to maintain proper form.

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Case Study. An example from real life, Part 2:
Let’s take another look at Susan’s run.  Instead of running a mile nonstop, she can do a series of one minute runs followed by one minute recovery up to ten times, or really as long as she can maintain proper form, whichever comes first. Not only will she be able to get in the distance that she wanted to run, but she will do it using proper form during a much greater percentage of her workout.

Over the course of several weeks, she can slowly add more time to each running interval and decrease the time of each recovery interval. This helps improve form, increase mileage, and prevent injury. Within a couple months, she will be able to run nonstop for the desired distance while maintaining great form.

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Barefoot Running
If you have been thinking about making the switch to a barefoot lifestyle, this interval training is an ideal time to incorporate barefoot running into your training. By adding barefoot running into your training you get immediate feedback in your running form.  Basically, bad form will hurt immediately, allowing you to make immediate adjustments in your form.

It is also a great way to force yourself to limit the total amount of training time each day. Your feet will be far too sensitive to train beyond fatigue and poor form. A proper barefoot running transition needs to be done slowly.

It is important with barefoot running that you do not attempt to Push Through The Pain. (Here is more reading on how to make a smooth, safe, injury free transition into a barefoot lifestyle.)

12 Week Interval Running Program

This is the same interval training that I included in the article about Injury and the Grand Return.  It is an excellent interval training program and is a solid way to get back into proper running form.  Jump back over to the bottom of the “Injury” article to have a look or click here to download it as a PDF.

It’s not your fault. There is so much misinformation out there on the internet that is dangerous. There’s no way around it.

It concerns me to read advice – albeit from genuinely well meaning people – that I know, because I’ve seen it firsthand in the bodies of my clients, will only end up as pain and injury in the lives of those who go out and implement the techniques.

Right now I am working with a few clients who are just getting back in motion after long seasons of rest (aka: little or no exercise) due to pain and injury. Injuries are no joke. I have experienced them personally and see them in the lives of all my new clients and it is devastating.

There is hope.

A couple of my clients have have recently gotten past the Healing phase of TAO Fit.  They’re moving again.  But the goals we’re setting at this stage are very specific:

• reduce chronic pain,
• reduce incidences of chronic injury,
• improve overall health and fitness,
• lose body fat, and…
• get them into the best shape of their lives.

The last 4-6 weeks have been primarily focused on Healing.  It is the the first phase of the TAO Fit training program.  The Healing season specifically deals with nutrition (with nutritional counselor Carly Pollack Nutritional Wisdom), improving joint mobility and stability, and getting to the point where one can perform functional movement patterns without pain.

It is a really difficult season because the amount of exercise prescribed is extremely restricted.  More focus is put on deep tissue massage, self massage using a foam roller, corrective exercises, and light walking.  Remember: the primary goal of this phase is to reduce pain and recover from injury. It tends to feel excruciating and frustrating for my clients because they have a strong desire to exercise, the very reason they come to see me in the first place, and I purposely hold them back.

Phase 1 is about patience.  Move too fast too soon and it’s back to injury.  Most bad advice recommends doing too much too soon.  Lifelong health is about patience.

Click to tweet - “Lifelong health is about patience.”

The great thing is that Healing, in the grand scheme of things, is a short phase.  Soon enough it is time to move to phase two.

Phase 2 – Rebuild and Restore
With an adequate amount of Healing under our belts, it is time to kick things up a notch.  We kick into a higher gear with metabolic conditioning.

Your metabolism and your conditioning have a direct relationship with one another.

The more efficient and active your metabolism, the better your condition.  The more active with varying degrees of intensity your conditioning, the better your metabolism.

The inverse is true as well.  Terrible metabolism hampers your conditioning, while a lack of conditioning strangles your metabolism.

Metabolism
Metabolism is the mechanism your body uses to convert food into energy. Your metabolic rate (the energy you expend at rest and during exercise) can be an invaluable tool to help you gauge and best reach your overall health and fitness goals.

I often describe the body as an engine.  Regular exercise is great for your metabolism.  Even better if you exercise at every degree of intensity (low, medium, and high).  If you take it up another notch, and allow yourself adequate rest and recovery, and you eat high quality fuel, you will have a high efficiency engine that will burn a ton of energy (calories). This is the optimal place to be: great health, physically fit and conditioned, pain free, and ready to take on life’s challenges.

The flip side to this is: if you are physically inactive for a large period of time due to lifestyle choice or injury, your engine will drag, lag, and run inefficiently.  It won’t burn high amounts of energy. In that state, if you consume high calorie, low quality fuel, you will gain weight, have low energy, feel unproductive, and feel burdened by the daily challenges of living. If your goal is to embody the healthiest, fittest You… Then this is your time for change!

Metabolic Conditioning
Metabolic conditioning is a training program focused around improving the way your engine runs. It is designed to boost your metabolism.  We want to make your engine work more efficiently, burn more calories, run smoother, provide you with greater energy, increase your productivity, improve your health, and lengthen your lifespan.  Ultimately the goal is to allow you to lead a fulfilling and satisfying life. A well rounded training program with an emphasis on metabolic conditioning will improve cardiac capacity and function, increase your strength and muscle mass, and decrease fat.

All forms of exercise are metabolic. One form of metabolic conditioning is High Intensity Training. It is basically interval or circuit training. The goal is to get your heart rate up into the higher training zones. You will feel out of breath and you will feel your heart pounding a bit. These workouts are much shorter in duration. Generally lasting from 10-30 minutes (this does not including dynamic warm up or cool down).

The goal of this intro into high intensity metabolic training program is to “prime the pump” of your engine. Your body has been burning energy at a low, regular, and sustained rate for a long time. We want to get it engaged; fan the flames; turn the coals red; so that you can ignite the fire.

The great thing about high intensity metabolic training is that it can be added into just about any sport or activity that you love such as walking, running, cycling, swimming, strength training, rowing, etc. However, it is important, before you do any high intensity workouts, that you have a strong core, functional pain free range of motion, and great form.

Intro to High Intensity Training Program
This program is written specifically for my clients who have gone through, at minimum, four weeks of a healing phase, including: nutritional counseling (with nutritional counselor Carly Pollack of Nutritional Wisdom), deep tissue massage, foam roller therapy, corrective exercise, a regular pain free walking routine, and have solid functional movement.

If you experience pain with walking, squatting, lunging, or any other functional movement pattern, I do not recommend doing any higher intensity metabolic training until you have addressed these issues.

The Program
All workouts begin with a dynamic warm up. A good dynamic warm up is the most important phase of any workout. It prepares the body for your workout by increasing heart rate, body temperature, and joint mobility; while significantly preventing injury.  The dynamic warm up should last between 10-20 minutes and will feel like a workout in and of itself. I highly recommend doing the majority of these workouts completely barefoot.

Here are some great examples of dynamic warmup exercises by my buddy Doug Balzarini of DBStrength.com out in San Diego, Ca.

Weekly workout schedule
Day 1: 45-60 min brisk walk
Day 2: 30 min easy recovery walk
Day 3: hill workout*
Day 4: 60 min functional training, 45-60 min brisk walk
Day 5: 30 min easy recovery walk
Day 6: day off, you can foam roll and stretch
Day 7: 60 min functional training, hill workout*

*Hill or stairs workouts:
Find a nice big hill or several flights of stairs. They need to be long enough that it takes 2 minutes to climb them at your fastest pace.

Work = Walk uphill fast, pretty much as fast as you can, pumping your arms. You want to get your heart rate up high.

[Note: The body isn't ready to run at this stage.  Learn to love the power of a good, strong walk.  Never underestimate the value of walking. In later phases, as your body grows stronger and more capable of supporting itself through corrective and functional exercise, we will integrate running into the program.]

Rest = Walk as slow as you can walk while still moving.

If I give you a range of time or sets, then feel into your body and go with the time that feels best.

Pace yourself. You want to go fairly hard on each set, but I want you to go strongest on the last sets. Basically, don’t blow yourself up on the first couple of sets.

Week 1-3

hill day 1: Begin w/dynamic warm up. Then: [Work 45 sec / Rest 60-90 sec.] x10 sets

hill day 2: Begin w/dynamic warm up. Then: [Work 45 sec / rest 60-90 sec.] x12 sets

Week 4-6

hill day 1: Begin w/dynamic warm up. Then: [Work 60 sec / rest 90 sec.] x10 sets

hill day 2: Begin w/dynamic warm up. Then:[Work 60 sec / rest 90 sec.] x12 sets

Week 7-9

hill day 1: Begin w/dynamic warm up. Then: [Work 75 sec / rest 90-120 sec.] x8 sets

hill day 2: Begin w/dynamic warm up. Then: [Work 75 sec / rest 90-120 sec.] x10 sets

Week 10-12

hill day 1: Begin w/dynamic warm up. Then: [Work 90 sec / rest 120 sec.] x6 sets

hill day 2: Begin w/dynamic warm up. Then: [Work 90 sec / rest 120 sec.] x8 sets

Alternate Option: If the longest hill or flight of stairs you can find are too short and you find yourself getting to the top before your time is up, add body weight squats or lunges at the top until your time is up (as many as you can).

After a few weeks, this is how you will feel.

Does it hurt?
The first step in your recovery process is healing. It is important to give your body the adequate time it needs before attempting to return to full speed. This is where pain will provide you with the greatest input.

Before you can go out and start running again, It is important that you have pain free range of motion. Do you have a specific pain (can you point to it?) associated with joint movement? Yes? You are still injured! Your body has not fully healed. Now is not the time to begin your previous training program. Pain affects efficient movement, which creates inefficient habits (poor form). Poor form is one of the primary causes of injury and recurring injury, and it is incredibly hard to unroot from your body. If you do not have pain free joint range of motion, it is not worth the risks to push through it. You WILL be creating a cycle of chronic pain and injury for years to come.

Instead, I suggest taking extra time to allow your body to heal. This does not mean sitting on your rump and twiddling your thumbs. It is a very active process. There is much you can do to help facilitate the healing process including deep tissue fascial massage, self massage using a foam roller, lacrosse or soft ball, and corrective exercises. I suggest spending at least an hour each day devoted towards actively engaging in your healing process. Here are 10 steps to Recovery From Your Running Injury And Becoming A Better Runner.

Now That You’re Pain Free
This is a big step. What you do over the next 3-6 months will lay the foundation for how you move for the rest of your life. Now is the ideal time to work on improving how you move on a purely functional level.  Now is the time when you can develop healthy biomechanical habits, learn to move with efficiency, strength, balance, and postural awareness, and take the kinks out of your gait that may be the leading cause of your injury in the first place… i.e. now is the time to work on improving your form.

Every journey begins with a single step. The goal of this is to help you develop good running and movement habits and injury prevention so you can run pain free for the rest of your life. If you’re like me, that means another 40-50 years of running. Keep it in perspective. Three or Six months of training might seem like a long time, but if it means that you’ll significantly reduce the amount of time you are lame with chronic pain and injuries over the rest of your life, is it worth it?

Form, Not Conditioning
You cannot learn a new movement pattern (form), and – at the same time – use that movement pattern to train for endurance, strength, power, or speed (conditioning).

For example, if you are recovering from a running injury and are training to improve your running gait, you cannot use running to improve your conditioning. The two on a fundamental level don’t work together!

Training to improve your form and training to improve conditioning are not compatible trainings. To improve form, you need practice… perfect practice. You are training your neurological system to develop new bio-mechanical habits. To have flawless form, you must repeat the movement pattern flawlessly with every repetition. At this stage of training, form breaks down at the first sign of fatigue. Once fatigued, you will no longer be able to maintain perfect form. Training with imperfect form reinforces the very poor movement patterns that can ultimately lead to injury. Fatigue is a core component to training endurance, strength, power, and speed. You will not achieve significant improvements in your conditioning without training into some levels of fatigue.
What this means is that if you wish to improve your form to reduce the recurrence of injury, then you must limit how much you run until you have fully developed your new and improved running gait. This may take a few months or longer, depending on your age, conditioning level, injury history, and a few other factors.

You may be able to continue to work on conditioning.  However, it will come from activities which do not aggravate your injury (i.e. not running). Options may include: cycling, swimming,  climbing, walking, hiking, rowing, functional training, and metabolic conditioning.

Training Program
There is no training program that can guarantee for you a speedy pain and injury free recovery. Because of what I see in the lives and bodies of my clients doing the work I do, I tend to err on the conservative side. I would rather see them, and you, spend a few months developing a solid postural foundation and basic fundamental movement patterns.  We typically start with something like the ability to perform a functional squat or lunge prior to getting back on the trail. I feel that squats and lunges are a basic progression before running. If you cannot perform a functional deep squat, lunge, or lateral lunge, then running is not advisable.  Not until you can complete those movement patterns pain free. Spending a few months, right now, bomb-proofing your body with healthy and efficient movement patterns will pay off huge dividends in added years or decades to your active, pain and injury free running life.

I highly recommend performing foam roller therapy daily; corrective exercises to strengthen your feet, hips, and shoulders (click the links for exercises with descriptions); functional movement training, and transitioning to more of a barefoot/minimalist lifestyle. I also highly encourage you to find a highly qualified deep tissue fascial therapist with experience treating the specific injury you have and getting regular body work. Here are Five Steps to Choosing a Massage Professional.

Getting You Back To Speed
Be patient! For at least the first few months, I suggest limiting your total running time to no more than 2-3 days per week. With at least one day off between runs. For the first 12 weeks of getting back into running, I am a big fan of interval training. Running intervals builds recovery into your workout. This helps prevent fatigue and form collapse. Right now, running for 5-10 minutes straight is just too much. Your body is not conditioned for it. Within a minute or two, you will fatigue and your form will suffer.

Focus on form, not speed. Intervals are not about high intensity, unless you are specifically doing sprint intervals… which you should not be doing right now! Keep a nice quick cadence, around 180 steps per minute; and a quiet footfall.

Listen to your body
As I said in last week’s post,

“Pain is not good or bad. Pain is a vital piece of a complex communications system that tells you something is going on within your body. Pain is there for a reason, and it should be listened to, respected, and understood. Listening to, and participating in this conversation is incredibly important. If you listen to the ideas of “pushing through the pain” or “no pain, no gain,” you are  consciously disconnecting or ignoring the body’s natural warning signals.”

This period of time is ideal for reconnecting and listening to the communication of your body. Don’t push it. When something hurts, or doesn’t feel “right,” STOP! Your workout is over. Take a couple of days off.

An Example of a 12 Week Injury Recovery Running Program

All workouts begin with a dynamic warm up. A good dynamic warm up is the most important phase of any workout. It prepares the body for your workout by increasing heart rate, body temperature, and joint mobility; while significantly preventing injury.  The dynamic warm up should last between 10-20 minutes and will feel like a workout in and of itself. I highly recommend doing the majority of these workouts completely barefoot.

Here are some great examples of dynamic warmup exercises by my buddy Doug Balzarini of DBStrength.com out in San Diego, Ca.

Note:
It takes about eight weeks for your muscles to adapt to a new conditioning program. It takes years for your fascia to adapt. By incorporating self massage using a foam roller, deep tissue massage therapy, flexibility training, corrective exercises and functional movement into your training program, you can significantly speed up this process, while decreasing the amount of time dealing with chronic pain and injury.

Week 1
Day 1: Dynamic warm up: Run 1 minute: Walk 1 minute: Repeat 5 times.
Day 2: Dynamic warm up: 30-60 minutes functional exercise
Day 3: Dynamic warm up: Run 1 minute: Walk 1 minute: Repeat 5 times.
Day 4: Rest
Day 5: Dynamic warm up: Run 1 minute: Walk 1 minute: Repeat 6 times.
Day 6: Dynamic warm up: 30-60 minutes functional exercise
Day 7: Rest

Week 2
Day 1: Dynamic warm up:Run 90 seconds: Walk 1 minute: Repeat 4 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 90 seconds: Walk 1 minute: Repeat 5 times
Day 4: Rest
Day 5: Dynamic warm up: Run 90 seconds: Walk 1 minute: Repeat 5 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 3
Day 1: Dynamic warm up: Run 2 minutes: Walk 1 minute: Repeat 4 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 2 minutes: Walk 1 minute: Repeat 5 times
Day 4: Rest
Day 5: Dynamic warm up: Run 2 minutes: Walk 1 minute: Repeat 6 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 4
Day 1: Dynamic warm up: Run 2.5 minutes: Walk 1 minute: Repeat 4 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 2.5 minutes, Walk 1 minute: Repeat 5 times
Day 4: Rest
Day 5: Dynamic warm up: Run 2.5 minutes: Walk 1 minute: Repeat 6 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 5
Day 1: Dynamic warm up: Run 3 minutes: Walk 1 minute: Repeat 4 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 3 minutes: Walk 1 minute: Repeat 5 times
Day 4: Rest
Day 5: Dynamic warm up: Run 3 minutes: Walk 1 minute: Repeat 6 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 6
Day 1: Dynamic warm up: Run 3.5 minutes: Walk 1 minute: Repeat 5 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 3.5 minutes: Walk 1 minute: Repeat 6 times
Day 4: Rest
Day 5: Dynamic warm up: Run 3.5 minutes: Walk 1 minute: Repeat 7 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 7
Day 1: Dynamic warm up: Run 4 minutes: Walk 1 minute: Repeat 5 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 4 minutes: Walk 1 minute: Repeat 6 times
Day 4: Rest
Day 5: Dynamic warm up: Run 4 minutes: Walk 1 minute: Repeat 7 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 8
Day 1: Dynamic warm up: Run 4.5 minutes: Walk 1 minute: Repeat 5 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 4.5 minutes: Walk 1 minute: Repeat 6 times
Day 4: Rest
Day 5: Dynamic warm up: Run 4.5 minutes: Walk 1 minute: Repeat 7 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 9
Day 1: Dynamic warm up: Run 5 minutes: Walk 1 minute: Repeat 5 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 5 minutes: Walk 1 minute: Repeat 6 times
Day 4: Rest
Day 5: Dynamic warm up: Run 5 minutes: Walk 1 minute: Repeat 7 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 10
Day 1: Dynamic warm up: Run 5.5 minutes: Walk 1 minute: Repeat 5 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 5.5 minutes: Walk 1 minute: Repeat 6 times
Day 4: Rest
Day 5: Dynamic warm up: Run 5.5 minutes: Walk 1 minute: Repeat 7 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 11
Day 1: Dynamic warm up: Run 6 minutes: Walk 1 minute: Repeat 5 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 6 minutes: Walk 1 minute: Repeat 6 times
Day 4: Rest
Day 5: Dynamic warm up: Run 6 minutes: Walk 1 minute: Repeat 7 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Week 12
Day 1: Dynamic warm up: Run 6.5 minutes: Walk 1 minute: Repeat 5 times: 30 minutes functional exercise
Day 2: Dynamic warm up: 30-60 minute functional exercise
Day 3: Dynamic warm up: Run 6.5 minutes: Walk 1 minute: Repeat 6 times
Day 4: Rest
Day 5: Dynamic warm up: Run 6.5 minutes: Walk 1 minute: Repeat 7 times.
Day 6: Dynamic warm up: 30-60 minute functional exercise
Day 7: Rest

Go ahead and read it now, I don’t mind waiting…

Two Kinds of Pain
This is a topic that has been on my mind as well. In the runner’s groups and forums, I see the advice, “you have to push through the pain.” Usually it’s offered haphazardly by “experienced” barefoot runners to novice barefoot runners. This kind of thinking comes from a particular couple of ideas.  First, that when transitioning to barefoot/minimalist running you will experience pain, and second, that the only way to get beyond the pain is to push through it. “No pain, No gain.”

I consider this advice to be not only irresponsible, but dangerous for most people.  Doubly dangerous since the majority of those who offer the advice have very little experience in coaching. Triply dangerous because they’re often strangers on the internet, where trustworthiness and background info are superficial at best.

The Article
I agree with everything Jason says. But I think he is speaking to a very specific segment of the running population. For the most part, his audience is made up of people who are already in good to excellent physical condition and injury free. However, many of the people transitioning to a barefoot/minimalist lifestyle are doing so because they have been dealing with chronic issues of pain and injury. And they are searching for the cure to their woes.

I grew up as a competitive athlete and I am all too familiar with the sayings. “No Pain, No Gain!” and “You have to push through the pain.” One of my favorites comes from my best friend, an ex-Navy SEAL, “Pain is just weakness leaving the body.” My guess is that the last one would resonate well with Jason Robillard, being an ultra marathoner.

As a personal trainer and coach, I’ve even used these same phrases to motivate clients to push themselves just a little harder. But over the years my practice has deepened and grown, and I see more and more clients with issues of chronic pain and injury.  Many of my clients come to me over-trained and in pain because they spend the majority of their training time “pushing through the pain.” In light of this, the “idea” that I have makes me think of this in an entirely different way.

What is “good” vs “bad” pain?

“Good” pain….
… is general in feeling, meaning it does not have a specific origin (i.e. muscle soreness vs. “my knee hurts”).
… happens when you try a new exercise or workout after a long break.
… comes from pushing yourself to your limits of speed, strength, endurance, power.
… goes away once you slow down or stop exercising.
… in the case of Delayed Onset Muscle Soreness (DOMS), the soreness you get a couple days after intense exercise.  This pain should reduce within 72 hours, and be gone completely within 5-7 days.
… does not interrupt your sleep.

Most well-coached athletes spend less than 10% of their total training time pushing themselves into this level of pain. It is the extra kick at the end of a workout, or a planned high intensity day. The majority of their training volume is at a lower level of intensity. However, it is not uncommon for uncoached athletes to spend the majority of their training time at this level. Every workout is a hard workout. There are no rest days. They run as hard and fast as they can every run, lift as hard as they can every workout.  Their idea of a rest day is.. well, the only easy day was yesterday. Spend too much time training at this level of “good” pain and you will eventually feel the “bad” pain.

“Bad” pain…
… is when, in other words, you have done damage to your body.
… tends to be very specific (i.e. “my foot, heel, knee, hip, shoulder, elbow hurts right here.”)
… doesn’t necessarily go away once you stop exercising.
… lingers around for weeks or months.
… interrupts your sleep.
… affects performance.
… leaves you moody – frustrated, angry, or anxious.
… leaves you overly fatigued.
… makes your joints, bones, or limbs hurt.
… leads you to the point that your immune system is compromised.
… makes you question whether you should continue exercising.

Do you feel this? Well, if you do… You are injured. To continue pushing your body will make the injury worse, it will increase the amount of time needed to heal, and will prevent you from doing what you love to do so much. When you have this pain, you need to stop immediately and seek treatment from a professional involving aspects such as rest, sleep, deep tissue fascial massage, self massage using a foam roller, and pain free corrective exercises. It would be advisable to seek the advice of a health care professional.

What is Pain?
Pain is not good or bad. Pain is a vital piece of a complex communications system that tells you something is going on within your body. Pain is there for a reason, and it should be listened to, respected, and understood. Listening to, and participating in this conversation is incredibly important. If you listen to the ideas of “pushing through the pain” or “no pain, no gain,” you are  consciously disconnecting or ignoring the body’s natural warning signals.

Let’s get specific for a second.  If you are training for an ultramarathon (of 50 to 100 miles or more), then you will need be able to push through some pain if you are going to be successful. There is a level in which you have to disconnect and ignore pain to achieve
your goals. However, doing so is not necessarily in the best interest of your long term health and wellness. This, I believe, is the grey area in which Jason is addressing in his article. Most high level athletes understand that they may be sacrificing some level of health to achieve a specific goal.

However, if you are learning a new skill, perhaps you are learning how to barefoot run, now is precisely and absolutely the WRONG time to shut off or ignore the vital conversation that is taking place within your body. Keep in mind that you have spent the majority of your life cut off from the communication taking place at your feet at every step. To your body, the change from walking and running in a shoe with an arch support, cushion, and heel drop, to walking and running barefoot/minimalist is like training for the Kentucky Derby by riding a merry-go-round. It’s not the same thing. It’s not even in the same ballpark.

Now is the time for you to be extra vigilant and hypersensitive.  Listen carefully to every signal coming from your body. Right now pain is the best coach you could have on the planet. It will tell you when you have done enough, and when you have done too much. It will say when you need to rest and, ultimately, when you can push it a little harder.  Appreciate it, respect it, love it.  Listen to it, and don’t ignore it until you better understand exactly what it is telling you. Happy training.