Monday, June 24, 2013

Blood Tests For Runners


As distance runners we are diligent with our training routines and try and make sure we are doing all the little things we need to in order to make sure our body is fit and ready to train and race hard.  But it isn't always as simple as it sounds to make sure that you are adequately or optimally doing everything .  In blocks of hard training the things we need to keep up with and monitor go up, and the things we do in easier training may not be adequate any longer.   

Specifically in this blog I am referring to the level of hydration, electrolytes, vitamins, minerals, enzymes and hormones that our body needs in order to perform at its maximum.    In order to monitor and ensure these areas are at optimal (or at least sufficient) levels I am recommending that competitive runners, especially those running higher mileage levels, have some simple and relatively inexpensive blood tests performed on a periodic basis.   The benefits of doing so is 2 fold – first it helps us determine if there is any area of immediate concern that may be derailing or jeopardizing our current ability train and race optimally; and secondly by tracking our test results over time, we can see pick out any potential troubling trends and better learn our body and at what score in various areas do we usually perform our best.  These periodic tests can help us fine tune our ancillary (non-running) routines in order to help us perform at our best. 

OK so how often and what should I test?  Good questions and like most things on our sport the answer is “it depends”.   But I do have some basic recommendations that are a good start and something I think will be sufficient for the vast majority of serious runners.  Then as we follow these recommendations we can tweak what do to optimize it for our specific situation. 

What Tests To Have
Here is what I recommend that you get tested as part of your periodic testing program:

CBC – Complete Blood Count:  this will give you the white blood cell count, red blood cell count, hemoglobin levels, hematocrit levels, white blood cell types, red blood cell density and blood platelet counts.   Several important things in here to track and some that provide indications of infections, and other problems.

TSH Levels – This gives you a basic indication if your thyroid gland is working appropriately or at least indicate if a more thorough tests should be done in this area. Some runners have problems in this area.

Ferritin Levels – this is a good indicator of the iron stores available in your bone marrow to make new red blood cells.  Many runners, especially higher mileage runners, tend to be too low in this area if they don’t supplement iron intake.   Olympic Marathon Champ Joan Benoit Samuelson, a notoriously good eater, says that iron was the only thing she had to regularly supplement. 

Chemistry Panel – this is a test for many mineral levels in your blood, including key electrolytes such as sodium and potassium.  Also can give you a good indication if you are dehydrated and if you are high or low in any of these key minerals.   

Additional tests can be included such as glucose levels, iron and vitamin D, or others if desired or if you have reason to suspect something may be up or need to be tracked based on personal or family history. 

You can request these tests from your primary care physician or go to an independent lab testing facility, such as “Any Lab Test Now”, and have these tests run.   It is simple and the results are usually back within 48 hrs.   The cost will vary based on if you go through your doctor, what your insurance is,  or if you use an independent facility.  I know that I can get all of the above tests done through “Any Lab Test Now” for a total of $129 (their “Basic Check-up Panel” with Ferritin substituted in place of the Lipids test).

Reading The Test Results
All of these test results will come with a list of what is considered the “normal range” and what your score is.  But keep in mind that what is optimal for an athlete in serious training and what is “normal” may not coincide perfectly.  I recommend that you either find a reputable person in sports medicine who is use to working with athletes and reading blood tests results, to go over your results with you; or you take some time to do some research and reading and educate yourself on how to interpret the results yourself. 

Once you get your results start a spreadsheet and enter your results for each test and the date of the test.  Then when you get the test done again, note your new levels on the next column/row.  This way you will have an easy place to see any trends and possibly catch some potential problems before they fully manifest themselves.   In certain tests you will notice certain levels at which you feel best and what you need to do to get there (such as ferritin and what level of iron supplementation you need to achieve that ferritin level). 

How Often To Test
I recommend having the complete battery of tests done 2 to 3 times per year, with a follow-up test in-between on any area that is outside of the desired range.  For example, if I get the full run of tests done in January and everything looks good except for my ferritin levels, I may make some changes to my iron supplementation routine and then just have just my ferritin levels tested again in March to make sure my changes are working.  Then have the whole battery of tests done again in May or June.   Additionally if you run into a period of a few weeks in which we aren't feeling well and something seems off, by getting the full battery of tests it may help you isolate the problem. 

As serious runners, we want to leave no stone un-turned as we seek to achieve our goals, and these test can help us make sure we are doing what we need in terms of hydration, nutrition, vitamins and minerals, as well as point out any issues that may be lurking. 

Return on Investment
While following this recommendation can costs a few hundred dollars per year, it can also help make sure that you are getting the most out of the hundreds of hours you are putting into training and often the thousands of dollars you are investing in race entries and travel to races.  In all a very good return on your money in addition to the invaluable peace of mind it can bring.

Happy Running,


Coach Mark Hadley

Tuesday, June 4, 2013

Onward and Upward - Refinements In Philosophy




On the home page of the EliteMarathoning.com website I make the following statement:

“In early 2012, I decided to publish my training and racing philosophy for the marathon as a website rather than as a book.  This way it can be kept in a more dynamic setting and updated in real time when advancements are made, thus never letting the philosophy go static, but rather let it always be evolving and advancing. It is my sincere hope that this site can be a good reference tool to others (runners and coaches) and help them reach their full potential in marathon running.”
 - Coach Mark Hadley

I mean every word of that quote and in particular a couple of phrases in there: “dynamic setting”, “never letting the philosophy go static”, “evolving and advancing”, go deep to the heart of my coaching philosophy.  I never want to stop learning, to stop thinking, to stop exploring this sport.  Every experience should bring a deeper understanding, and every conversation spark a new way of looking at something.  I want my mind to churn for days on end with new ideas, tweaks to old ideas and to pour over all possible scenarios.  And through this, continue to advance and refine my training and racing philosophy for the longer distances so I can be even more effective at helping runners reach their potential in these races. I see it as an intellectual challenge, wrapped in a mission of service and stewardship.  Three things close to the core of my being. 

Advancements
For the past several months I have been working on some refinements and advancements to a few aspect of my training philosophy.  This is not a whole sale change of any aspect by any means, but rather further refining aspects to make it more effective at producing the desired results as efficiently as possible. 

Yesterday I rolled these advancements/refinements out on the EliteMarathoning.com website, and today I want to explain them on this blog and have included them on my Maximum Performance Running site as well.

Stress Workout Training Paces
As distance runners specializing on the longer races distances (Half Marathon to Marathon), our lactate threshold and aerobic threshold  (collectively - our stamina) are the areas of primary concern for us and much of our success will be based on how much we can improve these thresholds over time.  So we work regularly on these threshold paces, with 8 of the 16 stress workouts listed in the “Workout” page of the EliteMarathoning.com website dedicated to improving these thresholds.  But in order to support the improvement of these thresholds, we also need to regularly work paces moderately slower and faster than these threshold paces.  To this end I have refined my philosophy to include 3 stress workout training paces faster than these thresholds, and 3 slower than these thresholds, to uniformly support their continued improvement.
   
We want to select training paces that are sufficiently different enough from one another that they cause a change in blood chemistry (i.e. lactate levels, etc.) and/or energy usage characteristics so that we are working targeted physiological systems from significantly different angles, thereby maximizing the effectiveness of different work we do.  In taking a long look at this, I have decided that, for longer distance runners, that significant change in pace we are looking for is the difference between our lactate threshold (LT) and aerobic threshold (AT) paces or roughly a 4-5% change in pace.  So I utilize this change (between LT and AT) as my base unit for pace changes.

This gives me the following breakout for training paces by stress workout category:

Stamina Workouts

Lactate Threshold (LT):  the pace we can hold for 60 minutes in an all-out effort (i.e. race)

Aerobic Threshold (AT):  the pace we can hold for 120 minutes in an all-out effort (or roughly 4-5% slower than LT depending on predisposition). 

To these paces I add a 1% range (on the slower side) in order to allow for some small variations and progressions. 

This workout category did not change.  I still utilize the same paces and workouts in this category as I had previously used. 

Speed Workouts

If we define the change between LT and AT as 1∆  (AT pace – LT pace = 1∆) than our speed workout paces are as follows:

LT - 1∆:  This is speed used for Groove Repeats
LT - 2∆:  This is the speed used for VO2 Max Repeats
LT - 3∆:  This is the speed used for Fast Repeats

Note:  see the “Workout” page on the EliteMarathoning.com website or the "Training Paces" page on the MPR website for details on each workout type

Example:  If LT pace is 5:45 per mile and AT pace is 6:00 than :15 = 1∆, so our 3 speed workout paces would be:

LT - 1∆:   5:30  (5:45 - :15)
LT - 2∆:   5:15  (5:45 – (2 x :15))
LT - 3∆:   5:00  (5:45 – (3 x :15))

Similar to the stamina category, I add a 1% range (on the slower side) in order to allow for some small variations and progressions. 

LT - 1∆:   5:30-5:33
LT - 2∆:   5:15-5:18
LT - 3∆:   5:00-5:03

So how does this compare to what I used previously?   The Groove repeat pace is almost exactly the same but with a slightly smaller range, the VO2 Max Repeats are on the faster end of the range I used previously (and closer to true vVO2 Max), and the Fast Repeats are slightly faster than previously utilized.  I have tweaked the durations of some of these workouts in accordance these minor pace changes.  In most cases my current athletes will not notice any change to their Groove or VO2 Max workouts and a slight increase in speed with accompanying small reduction in volume in some of their Fast Repeat workouts. 

Endurance Workouts

If we define the change between LT and AT as 1∆  (AT pace – LT pace = 1∆) than our endurance workout paces are as follows:

AT + 1∆:   This is the pace used for Quick Pace Long Runs
AT + 2∆:  This is the pace used for Steady State Long Runs
AT + 3∆:  This is the pace used for Moderate Pace Long Runs

Note:  see the “Workout” page on the EliteMarathoning.com website or the "Training Paces" page on the MPR website for details on each workout type

Example:  If LT pace is 5:45 per mile and AT pace is 6:00 than :15 = 1∆, so our 3 endurance workout paces would be:

AT + 1∆:   6:15  (6:00 + :15)
AT + 2∆:   6:30  (6:00 + (2 x :15))
AT + 3∆:   6:45  (6:00 + (3 x :15))

Similar to the stamina category, I add a 1% range (on the slower side) in order to allow for some small variations and progressions. 

AT + 1∆:   6:15-6:19
AT + 2∆:   6:30-6:34
AT + 3∆:   6:45-6:49

So how does this compare to what I used previously?   This area includes some of the bigger refinements I am making, as I have added a completely new category of endurance workout, the Quick Pace Long Run, and I am very excited about it.  The more I see, experience, study, coach and talk with other coaches, the more I realize the importance of the quality aspect in our endurance work.  To that end, the pace I utilize for the standard “easy pace long run” as sped up just slightly and is now called Moderate Paced Long Runs.  Steady State Long Runs have been left virtually unchanged expect for a narrowing of the pace range, and we have added a Quick Pace Long Run to give additional work to energy systems usage closest to marathon pace.  The duration of each workout has been slightly adjusted accordingly.  Lower mileage runners will still mainly utilize the 2 slower paced versions of this category, but the inclusion of the new workout type should greatly enhance the preparations of the higher mileage runners. 

Calculations - No Worries
No worries on trying to figure out and calculate your LT and AT and other paces.  I have done the math for you, based on your recent race times and predisposition.  I have attached training pace charts and equivalent race time charts on both the EliteMarathoning.com and MPR websites.

Predispositions
Additionally I have refined my explanation and use of predispositions in determining training paces and race times.

Given equal preparation, how much an athlete slows down as the race distance gets longer depends on many individual variables ranging from muscle fiber make-up, to bone structure, to mental wiring and personality. Some people’s minds and bodies are better suited for longer races (HM and Marathon) and some for shorter races (5k and 10k).  I call this aptitude towards different distances their natural predisposition.

It only makes sense then that our natural predisposition will play a large part in what our potential is in the marathon and other races. If we have 2 people with the same 10k PR but one has a shorter distance predisposition (person A) and one has a longer distance predisposition (Person B), then Person B will have better potential in the marathon than Person A, and Person A will have greater potential at the 5k than Person B.  Different predispositions helps explain why Desi Davila and Shalane Flanagan were pretty evenly matched in the 2012 Olympic Trials Marathon, but Shalene has a 10k PR a minute faster than Desi.  This also helps explain why Dick Beardsley could run even with Alberto Salazar in the marathon when he might have been lapped by Alberto in a track 10k.  Desi and Dick may simply have greater long distance predispositions than Shalane and Alberto.  Similarly, people who could run with even with Paula Radcliffe over 5k and 10k (granted there were not many of them) generally had a short distance or neutral predisposition while Paula has a long distance predisposition, so she was able to beat them by multiple minutes in a marathon race. This doesn’t mean that a person with a longer distance predisposition can’t run very good at shorter races (Paula was exceptional at 5k and 10k), it just means that their potential is better at the races closer to their predisposition (Paula holds the WR in the marathon, as would make sense given her predisposition).

Doing some research and investigation on this subject over the last several years, I have made some general findings. The typical neutral predisposition distance runner will slow roughly 4.5% each time the distance is doubled (starting at 5k) if they are equally as well prepared for each race distance. Being "neutral" means they will fair roughly the same in equally competitive races at different distances from 5k to the marathon. 

With 4.5% representing neutral, I find the standard range to be roughly 4.0% (long distance predisposition) to 5.0% (short distance predisposition).  This range can make a big difference in the athlete’s potential at various distances. If we you use a 31:00 10k as our base time we see that a runner with a short distance predisposition may only have 2:24:54 marathon potential (slowing 5.0% each time the distance doubles), but a neutral predisposition may have 2:23:20 potential, and runner with a long distance predisposition may have 2:21:46 potential.  That is over 3 minutes difference in marathon potential for runners with the same 10k time.

While there may be a few individuals who fall outside of this 4.0% to 5.0% range (Paula actually is closer to 3.5%), I think the range captures 98% of all serious distance runners.  I break this range down into 3 sub-categories:

Long Distance Predisposition: slows roughly 4.0% - this runner fairs better against his/her peers in the longer races (half marathon and marathon)
Neutral Predisposition: slows roughly 4.5%- this runner fairs about the same against his/her peers in all distance races (5k - marathon)
Short Distance Predisposition: slows roughly 5.0% - this runners fairs better against his/her peers in the shorter races (5k and 10k)

My terminology is distance running specific so “short distance” is 5k-10k and “long distance” is the half marathon-marathon.

It is important to note that all of this assumes the runner is equally as well trained for each distance. This will not be the case for a lower mileage runner, as 60 miles a week will not allow you to be as well prepared for a marathon as it will for a 5k or 10k. For this reason it is hard for some recreational or even sub-elites to fully judge their predisposition based strictly on race times.

Our predispositions are not something that we can influence or change to a great degree, rather it just shows us what distances we are naturally best off focusing on for greatest potential success. This can be very valuable information for a runner and/or coach to have.

Understanding a runner's predisposition also helps a coach and athlete to understand the appropriate paces to use in training. For example, if I coach 2 runners with 31:00 10k PR's, but one has a long distance predisposition and the other a short distance predisposition, and I send them out to do a 10 mile aerobic threshold (AT) tempo run, the appropriate pace will be different for each of them because of their predispositions even though their 10k times are the same. The runner with the short distance predisposition will need to do this workout at about 5:30 pace while the runner with the long distance predisposition can probably handle about 5 seconds per mile faster on a similar effort.  Similarly if we are doing some VO2 Max repeats the runner with the shorter distance predisposition will probably be able to hit slightly better times than the longer distance predisposition runner. Knowing the runner's predisposition helps in setting expectations and to avoid over-training.

You will notice on both my websites that there are 3 versions of the training pace and equivalent race time charts, one for each main predisposition.  If you are not sure of your predisposition then I suggest using the neutral predisposition charts until see evidence to change from that

Workouts
One final refinement to my training philosophy is that I have added 2 workouts to the mix of workouts I regularly utilize in my training programs.  These two workouts are the addition of the Quick Pace Long Runs that I mentioned earlier, and the second workout is a hill repeat workout that I have used for some time, but never formalized as a specific workout on my websites.

Quick Pace - Long Run
Workout:  continuous long run done at a quick pace
Pace:  AT + 1x pace (AT plus the difference between AT and LT paces)
Duration:  Between 50% and 70% of your marathon race time (i.e. 1:30, etc.) up to a max of 120 minutes. 
Benefits:  Improves glycogen storage capacity, improves energy usage efficiency at a quicker pace, advances cardiovascular fitness and cellular adaptations
Use: Used sporadically in the fundamental phase and regularly in the specific phase of training for a marathon.
Example:  if AT pace is 6:00 and AT + 1 is 6:15, than 90 minutes at 6:15 pace

Hill Repeats
Workout:  Repeats of between 1:00 and 2:30 in duration, done up a hill, totaling between 15 and 21 minutes in total.
Hill:  hill of a moderate grade (3-5% slope) - roughly 6-10 seconds per 400 meters slower than flat.
Pace: roughly LT - 2x (VO2 Max Repeat pace) (LT minus 2 times the difference between AT and LT)
Recovery:  a slow jog back down the hill to the starting spot.
Benefits: Improves stride economy and power, stress aerpbic power (VO2 Max)
Use:  Used frequently early in a training cycle to build power and as a good way to breakthrough a plateau on fitness later in the cycle.
Example:  If LT pace is 5:30 and LT - 2x is 5:00, than 12 x 1:30 uphill at 5:00 pace with jog down recovery  

Additional Explanations
For further explanations I encourage you to read the “Workouts” and “Training Paces” pages of my EliteMarathoning.com website and "Training Paces" page of my MPR website.

Additionally training pace and equivalent race time charts are available on both of the follow locations:
For 10k times from up to 60 minutes:  MPR Pace Charts
For 10k times below 40 minutes:   EliteMarathoning Pace Charts

Onward and upwards my friends, and loving every minute of it!

Happy Running!

Coach Mark Hadley